Cited by 858Neuroinflammation and Neurodegeneration MechanismsAcute Ischemic Stroke ManagementIntracerebral and Subarachnoid Hemorrhage Research

Immune responses to stroke: mechanisms, modulation, and therapeutic potential.

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Iadecola, Costantino, Buckwalter, Marion S., Anrather, Josef·2020·Journal of Clinical Investigation

Abstract

Stroke is the second leading cause of death worldwide and a leading cause of disability. Most strokes are caused by occlusion of a major cerebral artery, and substantial advances have been made in elucidating how ischemia damages the brain. In particular, increasing evidence points to a double-edged role of the immune system in stroke pathophysiology. In the acute phase, innate immune cells invade brain and meninges and contribute to ischemic damage, but may also be protective. At the same time, danger signals released into the circulation by damaged brain cells lead to activation of systemic immunity, followed by profound immunodepression that promotes life-threatening infections. In the chronic phase, antigen presentation initiates an adaptive immune response targeted to the brain, which may underlie neuropsychiatric sequelae, a considerable cause of poststroke morbidity. Here, we briefly review these pathogenic processes and assess the potential therapeutic value of targeting immunity in human stroke.

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  1. Abbas AK, Lichtman AH, Pillai S. Cellular and Molecular Immunology. 7th ed. Philadelphia, Pennsylvania, USA: Elsevier; 2012.

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Authors
Iadecola, C., Buckwalter, M. S., & Anrather, J.
Affiliations
  • Weill Cornell Medicine (US)
  • Stanford Medicine (US)
Corresponding author
Iadecola, Costantino
Venue
Journal of Clinical Investigation
Published
2020-05-11
Volume
130
Issue
6
Pages
2777-2788
ISSN
  • 0021-9738 (ISSN-L)
  • 1558-8238
OpenAlex
W3022448963
Cited by
853
References
203
Citations by year
2026: 151 · 2025: 171 · 2024: 175 · 2023: 167 · 2022: 128 · 2021: 49 · 2020: 10 · 2019: 1
FWCI
8.84
Type
journal article
Language
en
Open access
Locations
  • Journal of Clinical Investigation (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • American Heart Association (19PABHI34580007)
  • National Institutes of Health (NS34179, R01-NS34179)
  • College of Veterinary Medicine, Cornell University
  • National Institute of Neurological Disorders and Stroke (R01NS034179, R01NS081179, R01NS094507)
Topics
  • Life Sciences › Neuroscience › Neurology › Neuroinflammation and Neurodegeneration Mechanisms
  • Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
  • Health Sciences › Medicine › Neurology › Intracerebral and Subarachnoid Hemorrhage Research
Keywords
stroke, immune response, ischemic stroke, innate immunity, adaptive immunity, neuroinflammation, secondary infection, antigen presentation, neuropsychiatric sequelae, immunomodulatory therapy, cerebral ischemia
MeSH terms
Animals, Brain Ischemia, Humans, Inflammation, Stroke, Adaptive Immunity

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