Increased systemic T-lymphocyte reactivity in patients with established stroke.
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Резюме
We have analyzed the impact of stroke with subsequent hemiparesis and sensory loss on systemic in vivo and in vitro mediated immune functions. Delayed-type hypersensitivity (DTH) reaction to purified protein derivate (PPD, tuberculin), evaluated on the non-paretic side, was used as an in vivo measure of systemic antigen specific T-cell reactivity. Subcutaneous immunization with influenza vaccine was employed to analyse T-cell dependent B-cell function. The influence of stroke on T-cell function in vitro was studied by proliferative responses to PPD and Concanavalin A. Twenty five out of 54 (46%) stroke patients tested displayed positive DTH reaction to PPD. In contrast, only 24% of age matched controls displayed positive DTH reaction (p < 0.05). There was a good correlation between in vivo and in vitro reactivity to PPD. Consequently, peripheral blood mononuclear cells in 50% of stroke patients but only in 20% of matched controls showed proliferative response in vitro to PPD. Immunization of stroke patients and controls with influenza vaccine, a T-cell dependent B-cell antigen, raised equal antigen-specific serum IgG, IgA and IgM antibody responses in both study groups. We conclude that (a) stroke enhances systemic antigen-specific T-cell reactivity in vivo and in vitro, and (b) stroke has no significant effect on antigen-specific B-cell responses.