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Interleukin 10, monocytes and increased risk of early infection in ischaemic stroke
  1. Á Chamorro1,
  2. S Amaro1,
  3. M Vargas1,
  4. V Obach1,
  5. Á Cervera1,
  6. F Torres2,
  7. A M Planas3
  1. 1Stroke Unit, Hospital Clínic and Institut d’ Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
  2. 2Clinical Pharmacology Unit–Unitat d’Avaluació i Suport de Proyectes, Hospital Clínic, Barcelona
  3. 3Pharmacology and Toxicology Department, Consejo Superior de Investigaciones Científicas (IIBB-CSIC) and IDIBAPS, Barcelona
  1. Correspondence to:
 Á Chamorro
 Stroke Unit, Hospital Clínic and Institut d’ Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Hospital Clínic, 08036 Barcelona, Spain; achamorro{at}ub.edu

Abstract

Background and purpose: : The pathophysiology of stroke-associated infection (SAI) is uncertain. The cytokine profile and peripheral white cell response were assessed in patients with or without SAI.

Methods: The incidence of SAI was assessed in 110 patients with ischaemic stroke allocated antibiotic prophylaxis or placebo within 24 h of clinical onset. Peripheral white cell counts, interleukin (IL)6, tumour necrosis factor (TNF)α and IL10 were measured in plasma.

Results: 17 (15%) patients developed infection and showed time-dependent increases of total white cell count, neutrophils, monocytes, lymphocytes, IL6 and IL10, whereas TNFα and the TNFα/IL10 ratio decreased. In logistic regression, IL10 (odds ratio (OR) 1.08, 95% confidence interval (CI) 1.01 to 1.16), monocyte count (OR 1.42, 95% CI 1.08 to 1.87) and National Institute for Health Stroke Survey score on admission (OR 1.17, 95% CI 1.05 to 1.31) were independent predictors of systemic infection.

Conclusions: SAI is associated with stroke severity, excessive IL10-mediated response and an increased number of circulating monocytes. These results support the finding that acute ischaemic brain injury triggers a blood-borne anti-inflammatory response that decreases the antimicrobial drive of the immune system.

  • IFN, interferon
  • SAI, stroke-associated infection
  • TNF, tumour necrosis factor

https://doi.org/10.1136/jnnp.2006.100800

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    Footnotes

    • Competing interests: None.