Immunotherapy in CVA

Abstract Introduction: Immune inflammation mediated by T cells that interact with microglia leads to brain damage after ischemic stroke (IS). CD4+CD25+ T (Treg) cells and Th17 cells play important roles in immunopathogenesis of IS. Method and material: Thirty patients with IS and 30 individuals as healthy control group were enrolled in this study. In the present study, the frequency of Th17 and Treg cells, the expressionlevels of related transcription factors, and the secretion levels of associated cytokines were assessed by Flow cytometry, Real-time PCR, and ELISA, respectively, at 1, 5, and 10 days after stroke as compared with healthy control subjects. Results: A significant reduction infrequency of Treg cells was observed in patients with IS at 1 day (p<0.0001) and 5 days (p=0.016) after stroke, but not 10 days. The expression levels of FOXP3 were decreased significantly at 1 day (p=0.0005) and 5 days (p=0.007) after stroke in compared with the control group. Also TGF-β secretion levels were decreased at 1 day (p=0.001), 5 days (p=0.002), after stroke in patients with IS in compared with the control group. We showed that the number of Th17 cells and expression levels of RORγt were significantly increased in patients with IS at1 day and 5 days after stroke (p<0.0001), but not in 10 days after stroke. IL-17 secretion levels were increased significantly at 1 day (p=0.0003), 5 days (p=0.005), and 10 days (p=0.005) after stroke in compared with the healthy control group. Conclusion: Our resultsrecommend that a numeral and functional imbalance between Th17 and Treg cells occurs in patients with ischemic stroke. Manipulating the balance between the anti- and pro-inflammatory properties of T cells may offer a hopeful therapeutic approach to speed up therecovery from IS.