T-lymphocyte subsets as a predictive biomarker for stroke-associated pneumonia

Area of Science:

• Immunology
• Neurology
• Clinical Medicine

Background:

• Stroke-associated pneumonia (SAP) complicates stroke recovery, impacting patient prognosis.
• Understanding immune system alterations, particularly T-lymphocyte subsets, is crucial for managing SAP.
• Existing research has not fully elucidated the role of T-lymphocyte dynamics in SAP development.

Purpose of the Study:

• To investigate the association between T-lymphocyte subset alterations and the occurrence of SAP.
• To identify potential biomarkers for predicting SAP risk in acute ischemic stroke patients.
• To enhance clinical treatment and prognosis strategies for SAP.

Main Methods:

• Retrospective analysis of stroke patients admitted between 2014-2016.
• Classification of patients into pneumonia and non-pneumonia groups.
• Collection of demographic and clinical data, including risk factors, NIH stroke scale (NIHSS) scores, and T-lymphocyte subset levels (CD3, CD4, CD8).

Main Results:

• SAP patients were older, more often dysphagic, and had higher NIHSS scores and neutrophil:lymphocyte ratios.
• SAP was associated with elevated leukocyte, neutrophil, and CD8+ T-cell levels, alongside decreased CD3+, CD4+ T-cells, and lymphocytes.
• A lower CD4:CD8 ratio and higher NIHSS scores were significant predictors of SAP, with combined models showing strong predictive power (AUC up to 0.867).

Conclusions:

• Specific T-lymphocyte subset changes, particularly a lower CD4:CD8 ratio, are associated with an increased risk of SAP after acute ischemic stroke.
• Factors like smoking, dysphagia, and NIHSS score also contribute to SAP risk.
• Monitoring T-lymphocyte subsets may offer a valuable tool for early SAP risk assessment and personalized patient management.