The Early Changes And Related Influencing Factors Of CD19⁺CD24^hiCD38^hi Regulatory B Cells In Peripheral Blood Of Acute Ischemic Stroke

ObjectiveTo investigate the changes and influencing factors of CD19⁺CD24^hiCD38^hii regulatory B cell in early peripheral blood of patients with acute ischemic stroke.Methods1.From May to October 2018,total 61 patients with acute ischemic stroke within 96hours of stroke onset,hospitalized in Department of Neurology in Subei People’s Hospital of Jiangsu province,and 24 individuals as control group were enrolled in this study,whose clinical baselines data and blood sample were collected.The proportion of peripheral CD19⁺CD24^hiCD38^hiregulatory B cell（Breg）and the serum level of interleukin-10（IL-10）were assessed by flow cytometry and ELISA,respectively.2.Patients with AIS were divided into two groups,including within 48 hour and 48-96hour of stroke onset.The changes of CD19⁺CD24^hiCD38^hiBreg proportion and the serum level of IL-10 in different groups were compared by one-way ANOVA.3.AIS patients,within 48 hour of stroke onset,were classified into several groups according to TOAST criteria.The one-way ANOVA were used to compare the differences of CD19⁺CD24^hiCD38^hiBreg proportion and IL-10 level among groups.4.According to the quartiles of peripheral CD19⁺CD24^hiCD38^hiBreg proportion,AIS patients within 48hours of onset were classified into four subgroups.The differences of NIHSS score,infarct volume and IL-10 level across quartiles were compared,and regression analysis was used to examine the association of peripheral CD19⁺CD24^hiCD38^hiBreg proportions with admission NIHSS score,infarct volume,and serum IL-10level,respectively.5.To observe the infection of AIS patients within 48 hours of stroke onset during hospitalization,and to analyze the differences of peripheral proportion of CD19⁺CD24^hiCD38^hiBreg and serum IL-10 level between infected patients and non-infected patients.Regression analysis were used to analyze risk factors for infection of patients during hospitalization.Results1.The peripheral proportion of CD19⁺CD24^hiCD38^hiBreg in AIS patients within 48hours of stroke oneset（0.064±0.057%）was significantly lower than that of control group（0.121±0.101%）（P<0.05）,and there was no statistical difference among the other groups（P>0.05）.There was no significant difference in serum IL-10 levels across the groups（P>0.05）.2.AIS patients within 48 hours of stroke onset were grouped according to TOAST criteria,including large vessel atherothromboembolic,cardioembolic,small vessel occlusion,other etiology/undetermined etiology.Among groups there was no significant difference in the peripheral proportion of CD19⁺CD24^hiCD38^hiBreg（P>0.05）.Serum IL-10 level of AIS patients with cardioembolic etiology was significantly different from those in other groups（P<0.01）;and there was no statistical difference in serum IL-10level across the other groups（P>0.05）.3.According to the quartiles of peripheral CD19⁺CD24^hiCD38^hiBreg proportion,AIS patients within 48 hours of stroke onset were classified into four subgroups.The differences of admission NIHSS score infarct volume and IL-10 level across quartiles were no statistical difference（P>0.05）.Univariate regression analysis showed that the peripheral proportion of CD19⁺CD24^hiCD38^hiBreg of AIS patients was negatively correlated with admission NIHSS score（χ²=4.953,P=0.026）.Multivariate regression analysis indicated the proportion of peripheral proportion of CD19⁺CD24^hiCD38^hiBreg in AIS patients was negatively correlated with admission NIHSS score（χ²=6.568,P=0.01）.There was no correlation between the peripheral proportion of CD19⁺CD24^hii CD38^hiBreg and infarct volume,and no correlation between the peripheral proportion of CD19⁺CD24^hiCD38^hiBreg and serum IL-10 level（P>0.05）.4.In the AIS patients within 48 hours of onset,regression analysis found that the higher admission NIHSS score of patients with acute ischemic stroke,the higher risk of infection during hospitalization.（OR=1.244,95%CI:1.055-1.466）,and the proportion of peripheral CD19⁺CD24^hiCD38^hiBreg and serum IL-10 level within 48 hours of onset were not associated with infection during hospitalization.Conclusions1.The peripheral proportion of CD19⁺CD24^hiCD38^hiBreg of patients with acute ischemic stroke decreased within 48 hour and 48-96 hours after onset,and significantly within 48 hour of onset.2.The serum IL-10 level of AIS patients with cardioembolic etiology was significantly increased compared with large vessel atherothromboembolic,small vessel occlusion,other etiology/undetermined etiology types.3.Among AIS patients within 48 hours of oneset,the proportion of peripheral CD19⁺CD24^hiCD38^hiBreg was negatively correlated with admission NIHSS score.We speculate that the more severe of neurological deficit,the lower proportion of peripheral CD19⁺CD24^hiCD38^hiBreg within 48 hours of stroke onset.4.The higher admission NIHSS score of patients with acute ischemic stroke,the higher risk of infection during hospitalization.