Targeting T cell metabolism and polarization to modulate post-stroke immune responses and improve outcomes

T cells drive post-stroke secondary brain injury, with the Th17/Treg balance shaping post-stroke inflammation. Soraphen A (SorA) inhibits Th17 polarization while preserving Tregs. We examined SorA's effects on post-stroke T cell activation - distinguishing antigen-specific from bystander activation - including inflammatory conditions induced by LPS.

Male Nur77^GFP mice (12-14 weeks) underwent tMCAO. At reperfusion, mice received intraperitoneal LPS or vehicle; SorA or vehicle was given 2 h later and daily thereafter. MRI at 16 h and 7 d confirmed infarcts and measured lesion volumes. Functional outcomes were assessed by daily scoring and behavioral tests before surgery and at 2 and 6 d. T cell activation and polarization were analyzed by flow cytometry in brain, lungs, spleen, blood, and lymph nodes at 16 h, 2, 3, and 7 d, with GFP indicating antigen-specific activation.

LPS worsened functional outcomes and increased peripheral T cell activation post-stroke. SorA improved functional recovery, reduced peripheral T cell activation and enhanced antigen-specific T cell activation. SorA increased Treg in LPS-treated mice and reversed LPS-induced alterations in both T cell activation and behavior.

Soraphen A modulates systemic and organ-specific T cell responses in experimental ischemic stroke and improves outcomes. SorA increases regulatory T cells, reverses LPS-associated T cell activation (CD25, CD69, PD-1) and behavioral deficits, and shifts responses toward antigen-specific T cell receptor-mediated activation. These results support SorA as a promising immunomodulatory strategy to refine post-stroke immunity, extend the therapeutic window, and improve outcomes with potential benefits in the context of post-stroke infections.