TY  - JOUR
A1  - Strinitz, Marc
A1  - Pham, Mirko
A1  - März, Alexander G.
A1  - Feick, Jörn
A1  - Weidner, Franziska
A1  - Vogt, Marius L.
A1  - Essig, Fabian
A1  - Neugebauer, Hermann
A1  - Stoll, Guido
A1  - Schuhmann, Michael K.
A1  - Kollikowski, Alexander M.
T1  - Immune cells invade the collateral circulation during human stroke: prospective replication and extension
JF  - International Journal of Molecular Sciences
N2  - It remains unclear if principal components of the local cerebral stroke immune response can be reliably and reproducibly observed in patients with acute large-vessel-occlusion (LVO) stroke. We prospectively studied a large independent cohort of n = 318 consecutive LVO stroke patients undergoing mechanical thrombectomy during which cerebral blood samples from within the occluded anterior circulation and systemic control samples from the ipsilateral cervical internal carotid artery were obtained. An extensive protocol was applied to homogenize the patient cohort and to standardize the procedural steps of endovascular sample collection, sample processing, and laboratory analyses. N = 58 patients met all inclusion criteria. (1) Mean total leukocyte counts were significantly higher within the occluded ischemic cerebral vasculature (I) vs. intraindividual systemic controls (S): +9.6%, I: 8114/µL ± 529 vs. S: 7406/µL ± 468, p = 0.0125. (2) This increase was driven by neutrophils: +12.1%, I: 7197/µL ± 510 vs. S: 6420/µL ± 438, p = 0.0022. Leukocyte influx was associated with (3) reduced retrograde collateral flow (R\(^2\) = 0.09696, p = 0.0373) and (4) greater infarct extent (R\(^2\) = 0.08382, p = 0.032). Despite LVO, leukocytes invade the occluded territory via retrograde collateral pathways early during ischemia, likely compromising cerebral hemodynamics and tissue integrity. This inflammatory response can be reliably observed in human stroke by harvesting immune cells from the occluded cerebral vascular compartment.
KW  - ischemic stroke
KW  - cerebral ischemia
KW  - mechanical thrombectomy
KW  - large vessel occlusion
KW  - leukocytes
KW  - neutrophils
KW  - collateral circulation
Y1  - 2021
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-284281
SN  - 1422-0067
VL  - 22
IS  - 17
ER  -