Journal d'immunologie clinique et cellulaire
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Possible Protective Effect of Regulatory T cells on White Matter Microstructural Abnormalities in Stroke Patients

Fumihiko Yasuno, Akihiko Taguchi, Akie Kikuchi-Taura, Akihide Yamamoto, Hiroaki Kazui, Takashi Kudo, Atsuo Sekiyama, Katsufumi Kajimoto, Toshihiro Soma, Toshifumi Kishimoto, Hidehiro Iida and Kazuyuki Nagatsuka

Background: Despite advances in the understanding of stroke, therapeutic options for stroke are limited. Inflammatory mechanisms activated after brain ischemia are a key target of translational cerebrovascular research. The purpose of the present study was to investigate the existence of microstructure abnormalities in the white matter of stroke patients and their relationship to lymphocyte subsets.

Methods: The study included 18 patients with acute ischemic stroke and 22 healthy subjects. Diffusion tensor scans with magnetic resonance imaging were performed. Whole brain voxel-based analysis was used to compare fractional anisotropy (FA) in the stroke and healthy control groups. Blood samples were obtained from all subjects at the initial examination. The lymphocyte subsets in peripheral blood were evaluated with flow cytometric analysis. Helper T cells (CD3+ and CD4+), cytotoxic T cells (CD3+ and CD8+), B cells (CD19+), natural killer cells (CD16+ or CD56+), and regulatory T cells (Tregs) (CD4+, CD25+, and FOXP3+) were identified.

Results: In the voxel-based analysis, FA in the bilateral anterior limbs of the internal capsule was lower in stroke patients than in healthy subjects. These regions exhibited decreased axial diffusivity. The frequency of Tregs was lower in patients than in healthy controls. In patients, we found a significant positive relationship between the level of circulating Tregs and the FA value in the anterior limb of the internal capsule.

Conclusions: Patients exhibited a decreased frequency of circulating Tregs and the degree of reduction correlated with the decrease in the FA value in the internal capsule. Tregs might attenuate post-stroke white matter tissue damage by limiting the immune response. Our findings demonstrate the need for further study of the role of Tregs in the prevention of post-stroke cerebral damage.