van Gemmeren Till, Schuppner Ramona, Grosse Gerrit M, Fering Jessica, Gabriel Maria M, Huber René, Worthmann Hans, Lichtinghagen Ralf, Weissenborn Karin
Department of Neurology, Hannover Medical School, 30625 Hannover, Germany.
Institute of Clinical Chemistry, Hannover Medical School, 30625 Hannover, Germany.
J Clin Med. 2020 Mar 23;9(3):872. doi: 10.3390/jcm9030872.
To investigate whether neutrophil granulocytes' function relates to post-stroke infections and clinical outcome after stroke, we prospectively recruited 95 patients after ischemic stroke and tested them for their microbiocidal neutrophil functions in this exploratory study. Additionally, 24 age-adjusted controls were examined regarding neutrophil function. Phagocytic capacity and the ability of the neutrophil granulocytes to produce reactive oxygen species (ROS) as well as CD11b and CD16 receptor expression profile were measured by flow cytometry at days 1, 3, 7, and 90 after symptom onset. Primary outcome was the development of an infection within the first week after stroke. Results of neutrophil functional measurements were compared between patients with and without infection as well as between all stroke patients and controls. Further risk factors for the development of infections were summarized in an infection-risk score for the purpose of multivariate statistical analysis. The ROS production in neutrophils after stimulation with formyl-methionyl-leucyl-phenylalanine (fMLP) was reduced at baseline in patients with post-stroke infections compared to those without ( = 0.013). This difference proved to be independent from the infection-risk score in the binary logistic regression ( = 0.011). Phagocytosis and oxidative bursts were not significantly reduced in the whole stroke patient group compared to controls. Dysfunction of neutrophil granulocytes seems to play a significant role in the development of post-stroke infections. Further studies are warranted to investigate neutrophil granulocytes´ function as a potential biomarker of post-stroke infections.
为了研究中性粒细胞的功能是否与中风后感染及中风后的临床结局相关，在这项探索性研究中，我们前瞻性招募了95例缺血性中风患者，并检测了他们中性粒细胞的杀菌功能。此外，还对24名年龄匹配的对照者进行了中性粒细胞功能检测。在症状发作后的第1、3、7和90天，通过流式细胞术测量吞噬能力、中性粒细胞产生活性氧（ROS）的能力以及CD11b和CD16受体表达谱。主要结局是中风后第一周内是否发生感染。比较了有感染和无感染患者之间以及所有中风患者与对照者之间中性粒细胞功能测量结果。为了进行多变量统计分析，将感染发生的其他危险因素汇总为一个感染风险评分。与未发生中风后感染的患者相比，中风后感染患者在基线时用甲酰甲硫氨酰亮氨酰苯丙氨酸（fMLP）刺激后中性粒细胞中的ROS生成减少（P = 0.013）。在二元逻辑回归中，这一差异被证明独立于感染风险评分（P = 0.011）。与对照相比，整个中风患者组的吞噬作用和氧化爆发没有显著降低。中性粒细胞功能障碍似乎在中风后感染的发生中起重要作用。有必要进一步研究中性粒细胞功能作为中风后感染潜在生物标志物的作用。
