Immunological and autonomic profile of ischemic stroke in lowlands
Introduction: Ischemic stroke (IS) accounts for 80–92% of all stroke cases and is primarily associated with cardiovascular diseases and chronic cerebral ischemia. Stroke severity is influenced not only by the localization and volume of the ischemic focus but also by the degree of autonomic-vascular...
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Center for Scientific Research and Development of Education.
2025-01-01
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| Series: | Heart Vessels and Transplantation |
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| Online Access: | https://hvt-journal.com/articles/art539 |
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| author | Nargiza T. Chekeeva Svetalana G. Shleifer Bolot B. Kulov Begimai B. Kadyrova Asel T. Jusupova Elena V. Andrianova |
| author_facet | Nargiza T. Chekeeva Svetalana G. Shleifer Bolot B. Kulov Begimai B. Kadyrova Asel T. Jusupova Elena V. Andrianova |
| author_sort | Nargiza T. Chekeeva |
| collection | DOAJ |
| description | Introduction: Ischemic stroke (IS) accounts for 80–92% of all stroke cases and is primarily associated with cardiovascular diseases and chronic cerebral ischemia. Stroke severity is influenced not only by the localization and volume of the ischemic focus but also by the degree of autonomic-vascular and neuroinflammatory changes. Investigating the relationship between immune and autonomic system parameters in IS, particularly concerning disease severity, remains a crucial area of research.
Research objective was to study immunological and autonomic parameters in patients with primary IS of varying severity in low-mountain conditions and clarify the pathogenesis and mechanisms underlying stroke severity.
Methods: An observational cohort study was conducted involving 52 patients with primary IS divided into three groups: mild stroke (n = 12), moderate stroke (n = 28), and severe stroke (n = 12). In the acute phase, 44 survivors were observed, of whom 2 (4.5%) had severe neurological deficits, 26 (59%)- moderate deficits, and 16 (36.4%) - mild deficits. Additionally, 8 deceased patients were analyzed separately. Stroke severity was assessed using the Gusev and Skvortsova scale and the NIH Stroke Scale (NIHSS). Heart rate variability (HRV) and immunological parameters, including lymphocyte subpopulations and cytokine profiles, were evaluated on the 1st and 10th days of illness.
Results: In the acutest period, mild stroke was characterized by balanced autonomic activity, with neurohumoral activity at 30.1 (8.0)%, decreasing slightly in the acute period to 27.7 (8.6)%. Moderate stroke showed increased sympathetic activation, with neurohumoral activity reaching 61.6 (11.0)% and 83.7(8.0)% in the acute period (p< 0.05). Severe stroke demonstrated parasympathetic predominance and reduced immune activity, with levels of complement (CD) CD3+, CD16+, CD19+, and interleukin 1β being 1.4–2 times lower than in moderate stroke and 1.5–3 times lower than in mild stroke (p<0.05). Correlation analysis revealed that in mild stroke, 24% of studied parameters showed significant correlations, which was 5 times higher than in moderate and severe stroke. Among the 8 patients with fatal stroke, the number of significant correlations doubled compared to mild stroke, reaching 59.2%.
Conclusion: The interaction between the immune and autonomic systems in IS depends on disease severity. Severe stroke is associated with diminished sympathetic regulation and reduced immune activation, while mild stroke demonstrates greater reciprocity between autonomic and immune parameters. These findings contribute to understanding the pathogenesis of ischemic stroke and offer insights for tailored therapeutic strategies.
The study provides new insights into the interplay between immune and autonomic systems in IS, enriching knowledge of disease pathogenesis and progression. The results of this study can enhance the treatment of IS patients by incorporating HRV and immunological assessments into clinical practice. These methodologies are already implemented at the Angioneurology Department, City Clinical Hospital No. 1, Bishkek. |
| format | Article |
| id | doaj-art-be3f33d04963479793ee0d5839e23f45 |
| institution | Kabale University |
| issn | 1694-7886 1694-7894 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Center for Scientific Research and Development of Education. |
| record_format | Article |
| series | Heart Vessels and Transplantation |
| spelling | doaj-art-be3f33d04963479793ee0d5839e23f452025-01-14T17:18:45ZengCenter for Scientific Research and Development of Education.Heart Vessels and Transplantation1694-78861694-78942025-01-019110.24969/hvt.2024.539Immunological and autonomic profile of ischemic stroke in lowlandsNargiza T. Chekeeva0https://orcid.org/0000-0002-2285-7705Svetalana G. Shleifer1https://orcid.org/0000-0003-1437-7696Bolot B. Kulov2https://orcid.org/0000-0003-2484-8906Begimai B. Kadyrova3https://orcid.org/0000-0003-3208-5689Asel T. Jusupova4https://orcid.org/0000-0001-8430-9504Elena V. Andrianova5https://orcid.org/0000-0002-7565-9892National Hospital under the Ministry of Health of the Kyrgyz RepublicDepartment of Neurology, Neurosurgery and Clinical Genetics, Kyrgyz-Russian Slavic University named after B.N. YeltsinDepartment of Neurology, Neurosurgery and Clinical Genetics, Kyrgyz-Russian Slavic University named after B.N. YeltsinDepartment of Special Clinical Disciplines, International School of Medicine of International University of Kyrgyzstan, Bishkek, Kyrgyz RepublicDepartment of Special Clinical Disciplines, International School of Medicine of International University of Kyrgyzstan, Bishkek, Kyrgyz RepublicDepartment of Neurology, Neurosurgery and Clinical Genetics, Kyrgyz-Russian Slavic University named after B.N. YeltsinIntroduction: Ischemic stroke (IS) accounts for 80–92% of all stroke cases and is primarily associated with cardiovascular diseases and chronic cerebral ischemia. Stroke severity is influenced not only by the localization and volume of the ischemic focus but also by the degree of autonomic-vascular and neuroinflammatory changes. Investigating the relationship between immune and autonomic system parameters in IS, particularly concerning disease severity, remains a crucial area of research. Research objective was to study immunological and autonomic parameters in patients with primary IS of varying severity in low-mountain conditions and clarify the pathogenesis and mechanisms underlying stroke severity. Methods: An observational cohort study was conducted involving 52 patients with primary IS divided into three groups: mild stroke (n = 12), moderate stroke (n = 28), and severe stroke (n = 12). In the acute phase, 44 survivors were observed, of whom 2 (4.5%) had severe neurological deficits, 26 (59%)- moderate deficits, and 16 (36.4%) - mild deficits. Additionally, 8 deceased patients were analyzed separately. Stroke severity was assessed using the Gusev and Skvortsova scale and the NIH Stroke Scale (NIHSS). Heart rate variability (HRV) and immunological parameters, including lymphocyte subpopulations and cytokine profiles, were evaluated on the 1st and 10th days of illness. Results: In the acutest period, mild stroke was characterized by balanced autonomic activity, with neurohumoral activity at 30.1 (8.0)%, decreasing slightly in the acute period to 27.7 (8.6)%. Moderate stroke showed increased sympathetic activation, with neurohumoral activity reaching 61.6 (11.0)% and 83.7(8.0)% in the acute period (p< 0.05). Severe stroke demonstrated parasympathetic predominance and reduced immune activity, with levels of complement (CD) CD3+, CD16+, CD19+, and interleukin 1β being 1.4–2 times lower than in moderate stroke and 1.5–3 times lower than in mild stroke (p<0.05). Correlation analysis revealed that in mild stroke, 24% of studied parameters showed significant correlations, which was 5 times higher than in moderate and severe stroke. Among the 8 patients with fatal stroke, the number of significant correlations doubled compared to mild stroke, reaching 59.2%. Conclusion: The interaction between the immune and autonomic systems in IS depends on disease severity. Severe stroke is associated with diminished sympathetic regulation and reduced immune activation, while mild stroke demonstrates greater reciprocity between autonomic and immune parameters. These findings contribute to understanding the pathogenesis of ischemic stroke and offer insights for tailored therapeutic strategies. The study provides new insights into the interplay between immune and autonomic systems in IS, enriching knowledge of disease pathogenesis and progression. The results of this study can enhance the treatment of IS patients by incorporating HRV and immunological assessments into clinical practice. These methodologies are already implemented at the Angioneurology Department, City Clinical Hospital No. 1, Bishkek.https://hvt-journal.com/articles/art539ischemic strokeseverityimmunologicalautonomic changescorrelation |
| spellingShingle | Nargiza T. Chekeeva Svetalana G. Shleifer Bolot B. Kulov Begimai B. Kadyrova Asel T. Jusupova Elena V. Andrianova Immunological and autonomic profile of ischemic stroke in lowlands Heart Vessels and Transplantation ischemic stroke severity immunological autonomic changes correlation |
| title | Immunological and autonomic profile of ischemic stroke in lowlands |
| title_full | Immunological and autonomic profile of ischemic stroke in lowlands |
| title_fullStr | Immunological and autonomic profile of ischemic stroke in lowlands |
| title_full_unstemmed | Immunological and autonomic profile of ischemic stroke in lowlands |
| title_short | Immunological and autonomic profile of ischemic stroke in lowlands |
| title_sort | immunological and autonomic profile of ischemic stroke in lowlands |
| topic | ischemic stroke severity immunological autonomic changes correlation |
| url | https://hvt-journal.com/articles/art539 |
| work_keys_str_mv | AT nargizatchekeeva immunologicalandautonomicprofileofischemicstrokeinlowlands AT svetalanagshleifer immunologicalandautonomicprofileofischemicstrokeinlowlands AT bolotbkulov immunologicalandautonomicprofileofischemicstrokeinlowlands AT begimaibkadyrova immunologicalandautonomicprofileofischemicstrokeinlowlands AT aseltjusupova immunologicalandautonomicprofileofischemicstrokeinlowlands AT elenavandrianova immunologicalandautonomicprofileofischemicstrokeinlowlands |