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Review
Stroke-induced immunosuppression and poststroke infection
  1. Kaibin Shi1,2,
  2. Kristofer Wood2,
  3. Fu-Dong Shi1,2,
  4. Xiaoying Wang3,
  5. Qiang Liu1,2
  1. 1 Departments of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
  2. 2 Departments of Neurology, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, Arizona, USA
  3. 3 Departments of Neurology and Radiology, Neuroprotection Research Laboratory, Massachusetts General Hospital, Neuroscience Program, Harvard Medical School, Boston, Massachusetts, USA
  1. Correspondence to Dr Qiang Liu, Departments of Neurology Tianjin Neurological Institute, Tianjin Medical University General Hospital Tianjin China; qliu.asu{at}gmail.com

Abstract

Infections occur commonly after stroke and are strongly associated with an unfavourable functional outcome of these patients. Approaches for effective management of poststroke infection remain scarce, presenting an urgent need for preventive anti-infection strategies for patients who have suffered a stroke. Emerging evidence indicates that stroke impairs systemic immune responses and increases the susceptibility to infections, suggesting that the modification of impaired immune defence could be beneficial. In this review, we summarised previous attempts to prevent poststroke infections using prophylactic antibiotics and the current understanding of stroke-induced immunosuppression. Further elucidation of the immune mechanisms of stroke will pave the way to tailored design of new treatment to combat poststroke infection via modifying the immune system.

  • stroke
  • infection
  • post-stroke immunosuppression

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/svn-2017-000123

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    Footnotes

    • Contributors QL, F-DS and XW formulated the concept, KS reviewed the articles and drafted the manuscript, KW contributed to discussion and editing the manuscript.

    • Funding This study was supported in part by the National Basic Research Program of China, grant 2013CB966900; National Science Foundation of China, grant 81230028, 81301044, 81471535; American Heart Association, grant 16SDG27250236; National Institutes of Health, grant R01NS092713; National Multiple Sclerosis Society, grant RG-1507-05318.

    • Competing interests None declared.

    • Provenance and peer review Commissioned; externally peer reviewed.

    • Data sharing statement No additional data are available.