Admission Lymphocytopenia is Associated with Urinary Tract Infection and Nosocomial Infections in Hemorrhagic Stroke

Carneiro, Thiago; Spears, William; LeClair, Jessica; Mahoney, Taylor F.; Takahashi, Courtney; Cervantes‐Arslanian, Anna M.

doi:10.1016/j.jstrokecerebrovasdis.2021.106079

Cited by 4 publications

(3 citation statements)

References 19 publications

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“… 28 These data suggest that brain injury-induced immunosuppression and, consequently, susceptibility to infection, plays a major role in post-stroke outcomes. 29 In line with these findings, of all CNS pathologies, systemic immune derangements have been most thoroughly characterized in stroke patients 30–38 and mouse models thereof. 38–40 …”

Section: Intracranial Pathologiesmentioning

confidence: 79%

“…Two independent retrospective studies showed that approximately one quarter of stroke patients presented with lymphopenia on admission. 30 , 33 Lymphopenia on admission is independently associated with both an increased risk of infection 30 , 33 and mortality at 90-days post-stroke. 33 Interestingly, infarct volume is the factor that is most highly correlated with the development of lymphopenia in the first several days post-stroke.…”

Section: Intracranial Pathologiesmentioning

confidence: 99%

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Systemic immune derangements are shared across various CNS pathologies and reflect novel mechanisms of immune privilege

Lorrey

Polania

Wachsmuth

et al. 2023

Neuro-Oncology Advances

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The nervous and immune systems interact in a reciprocal manner, both under physiologic and pathologic conditions. Literature spanning various CNS pathologies including brain tumors, stroke, traumatic brain injury and de-myelinating diseases describes a number of associated systemic immunologic changes, particularly in the T-cell compartment. These immunologic changes include severe T-cell lymphopenia, lymphoid organ contraction, and T-cell sequestration within the bone marrow. In this review, we propose that the same immunologic changes in the T-cell compartment, hereafter termed ‘systemic immune derangements’, are present across CNS pathologies and may represent a novel, systemic mechanism of immune privilege for the CNS. We further demonstrate that systemic immune derangements are transient when associated with isolated insults such as stroke and TBI but persist in the setting of chronic CNS insults such as brain tumors. Systemic immune derangements have vast implications for informed treatment modalities and outcomes of various neurologic pathologies.

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Section: Intracranial Pathologiesmentioning

confidence: 79%

Section: Intracranial Pathologiesmentioning

confidence: 99%

Systemic immune derangements are shared across various CNS pathologies and reflect novel mechanisms of immune privilege

Lorrey

Polania

Wachsmuth

et al. 2023

Neuro-Oncology Advances

View full text Add to dashboard Cite

show abstract

“…Noteworthy, a consensus on the definition of SII—and of the precise NLR cut-off for defining it—is still lacking. Possible markers of SII are represented by absolute lymphocytopenia, lymphocyte-to-monocyte ratio (LMR), reduction of monocytes HLA-DR expression, platelet-to-lymphocyte ratio (PLR) 7 , 8 , 13 , 18 , 21 – 23 . Park et al showed that a low LMR was a negative predictor of good clinical outcomes (mRS 0–1 at 3 months), and it was associated to a higher predisposition to infectious complications 21 .…”

Section: Discussionmentioning

confidence: 99%

The role of stroke-induced immunosuppression as a predictor of functional outcome in the neurorehabilitation setting

Vaghi,

Morotti,

Piella

et al. 2024

Sci Rep

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Stroke affects the interconnection between the nervous and immune systems, leading to a down-regulation of immunity called stroke-induced immunosuppression (SII). The primary aim of this study is to investigate SII role as a predictor of functional, neurological, and motor outcomes in the neurorehabilitation setting (NRB). We conducted a prospective observational study enrolling post-acute stroke patients hospitalized for neurorehabilitation. At NRB admission (T0) and discharge (T1), we assessed presence of SII (defined by a neutrophil-to-lymphocyte ratio ≥ 5) and we evaluated functional independence (Functional Independence Measure-FIM, Barthel Index-BI), motor performances (Tinetti Score, Hauser Ambulation Index) and neurological impairment (NIHSS). We enrolled 96 patients (45.8% females, 70.6 ± 13.9 years, 88.5% ischemic stroke). At T0, 15.6% of patients (15/96) had SII. When compared to immunocompetent patients (IC), the SII group was characterized by worse baseline functional independence, motor performances and neurological disability. The same was confirmed at T1 (FIM p = 0.012, BI p = 0.007, Tinetti p = 0.034, NIHSS p = 0.001). Neurological disability demonstrated a less pronounced improvement in SII (ΔNIHSS: SII: − 2.1 ± 2.3 vs. IC: − 3.1 ± 2.5, p = 0.035). SII group presented a higher percentage of infectious complications during the neurorehabilitation period (SII 80% vs. IC 25.9%; p = 0.001). SII may represent a negative prognostic factor in the neurorehabilitation setting. SII patients were characterized by poorer functional, motor, neurological performances and higher risk of infectious complications. ClinicaTrial registration: NCT05889169.

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Early mean absolute lymphocyte count in acute necrotizing pancreatitis is associated with infected pancreatic necrosis

Cai

Mao

Liu

et al. 2023

International Immunopharmacology

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Admission Lymphocytopenia is Associated with Urinary Tract Infection and Nosocomial Infections in Hemorrhagic Stroke

Cited by 4 publications

References 19 publications

Systemic immune derangements are shared across various CNS pathologies and reflect novel mechanisms of immune privilege

Systemic immune derangements are shared across various CNS pathologies and reflect novel mechanisms of immune privilege

The role of stroke-induced immunosuppression as a predictor of functional outcome in the neurorehabilitation setting

Early mean absolute lymphocyte count in acute necrotizing pancreatitis is associated with infected pancreatic necrosis

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