Chiu Nina L, Kaiser Brian, Nguyen Y Vien, Welbourne Susan, Lall Chandana, Cramer Steven C
Department of Neurology, University of California, Irvine, California.
Department of Radiological Sciences, University of California, Irvine, California.
J Stroke Cerebrovasc Dis. 2016 Dec;25(12):2958-2961. doi: 10.1016/j.jstrokecerebrovasdis.2016.08.012. Epub 2016 Sep 5.
Animal studies describe changes in the spleen following a stroke, with an immediate reduction in volume associated with changes in the counts of specific blood white blood cell (WBCs). This brain-spleen cell cycling after stroke affects systemic inflammation and the brain inflammatory milieu and may be a target for emerging therapeutic studies. This study aimed to evaluate features of this brain-spleen model in human patients admitted for acute stroke.
Medical and imaging records were retrospectively reviewed for 82 consecutive patients admitted for acute stroke in whom an abdominal computed tomography scan was performed.
Mean ± SD splenic volume was 224.5 ± 135.5 cc. Splenic volume varied according to gender (P = .014) but not stroke subtype (ischemic versus hemorrhagic, P = .76). The change in splenic volume over time was biphasic (P = .04), with splenic volumes initially decreasing over time, reaching a nadir 48 hours after stroke onset, then increasing thereafter. Splenic volume was related inversely to percent blood lymphocytes (r = -.36, P = .001) and positively to percent blood neutrophils (r = .30, P = .006).
Current results support that several features of brain-spleen cell cycling after stroke described in preclinical studies extend to human subjects, including the immediate contraction of splenic volume associated with proportionate changes in blood WBC counts. Splenic volume may be useful as a biomarker of systemic inflammatory events in clinical trials of interventions targeting the immune system after stroke.
动物研究描述了中风后脾脏的变化，脾脏体积立即减小，同时特定血液白细胞（WBC）计数发生变化。中风后的这种脑-脾细胞循环会影响全身炎症和脑内炎症环境，可能是新兴治疗研究的一个靶点。本研究旨在评估急性中风住院患者的这种脑-脾模型的特征。
对连续82例因急性中风住院且进行了腹部计算机断层扫描的患者的医学和影像记录进行回顾性分析。
脾脏平均体积±标准差为224.5±135.5立方厘米。脾脏体积因性别而异（P = 0.014），但与中风亚型无关（缺血性与出血性，P = 0.76）。脾脏体积随时间的变化呈双相性（P = 0.04），最初随时间减小，在中风发作后48小时达到最低点，然后增加。脾脏体积与血液淋巴细胞百分比呈负相关（r = -0.36，P = 0.001），与血液中性粒细胞百分比呈正相关（r = 0.30，P = 0.006）。
目前的结果支持临床前研究中描述的中风后脑-脾细胞循环的几个特征在人类受试者中也存在，包括脾脏体积的立即收缩与血液白细胞计数的相应变化相关。在针对中风后免疫系统的干预临床试验中，脾脏体积可能作为全身炎症事件的生物标志物。
