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Immune discovery points to stroke therapy

University of Edinburgh College of Medicine News Apr 22, 2017

Having a stroke damages immune cells as well as affecting the brain, research has found.

The findings help explain why patients have a greater risk of catching life–threatening infections, such as pneumonia, after having a stroke.

Therapies that boost survival of the affected immune cells or compensate for their damage could help improve the recovery of stroke patients, the researchers say.

The study found that patients have reduced levels of protective antibodies in their blood after having a stroke, which might explain why they are more susceptible to infections.

Tests with mice revealed those which experienced a stroke had fewer numbers of specialised immune cells called marginal zone B cells, which produce antibodies.

Affected mice were more susceptible to bacterial lung infections, the researchers found.

Loss of the B cells was caused by a chemical called noradrenaline produced by nerves activated during stroke.

Researchers, led by the University of Edinburgh’s Roslin Institute, found they could protect the mice from infections using a therapy to block the effects of noradrenaline. "We now plan to build on our findings by developing and testing new treatments that can block or bypass these immune deficits with B cells a particular target," said Dr Barry McColl from The Roslin Institute at the University of Edinburgh.

Noradrenaline is part of the body’s fight or flight response. It helps to prepare the body for action and has a range of effects, such as raising heart rate, boosting blood supply and triggering the release of energy from stores.

Blocking noradrenaline would probably be too dangerous in stroke patients, the researchers caution.

They say development of other therapies that block or bypass the damage to the immune system could offer new approaches to help cut the risk of infection after stroke.

The study could also lead to new tests to identify which stroke patients have the highest chances of developing an infection, so that they can be monitored more closely. "Infections are a major complication of stroke and lead to a worse outcome for patients. This is an important study which provides new insights about how stroke affects the immune system, which we hope will lead to new approaches to preventing infections after stroke," said Professor Craig Smith, Salford Royal NHS Foundation Trust.

Around one–third of stroke patients are stricken by infections, which can lessen their chances of making a good recovery.

Treatment with antibiotics does not protect patients from developing infections and new therapies are urgently needed.

The research was published in the journal Nature Communications.
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