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

2020/05/10 by Costantino Iadecola, Marion S. Buckwalter, Josef Anrather · 2 citations
Neuroscience · Medicine · #Neuroinflammation and Neurodegeneration Mechanisms #Neurological Disease Mechanisms and Treatments #Acute Ischemic Stroke Management

paper · pdf · doi:10.1172/jci135530

openalex publication_date 2020/05/10 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/31

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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