The Role Of T Lymphocytes In Acute Cerebral Infarction Patients And The Immune Mechanism Of Remote Ischemic Postconditioning

Objective:To investigate the changes and the role of T lymphocytes in acute cerebral infarction patients and the immune mechanism of remote ischemic postconditioning which would protect against focal ischemia and preserve neurological functions.Methods:Accordingto the inclusion criteria and exclusion criteria,46 cases of acute cerebral infarction who were admitted to hospital within 72 hours in Department of Neurology,the First Hospital of Jilin University during April 2017 to December 2017,were taken part in this research.And 25 cases whose basic information marched with those patients were also involved.The patients were set into 2 groups: 20 cases as remote ischemic postconditioning(RIPost C)group and 26 cases as conventional treatment group.The two groups were both treated with regular treatment(aspirin and statins),but the RIPost C group were also treated with RIPost C that put pressure on bilateral arms five episodes which is 5-minute ischemia plus 5-minute reperfusion,twice a day,for 7 days.The peripheral blood of patients in RIPost C group were collected before RIPost C,1 day and 7 days after RIPost C.The patients in conventional treatment group acted the same.The blood of patients in control group were collected at the physical examination day.Before and after treatment,all patients underwent NIHSS and ADL to observe the recovery degree of neurological functions.We collected the basic information,and the population of subpopulations of T lymphocyte were calculated by flow cytometry analyses and flowjo software.Results:1,NIHSS and ADL: Before RIPost C,the score of NIHSS and ADL in RIPost C group and conventional treatment group was with no significant difference(P>0.05);after RIPost C,the score of NIHSS and ADL in two groups both reduced significantly(P<0.005)and the changes of NIHSS and ADL in RIPost C group were more obvious(P<0.05).2,Compared with the control group,the conventional treatment group showed the proportion of Th2 increased dramatically(P=0.049)and the proportion of Treg and Treg/Th17 decreased(P<0.001,P=0.03)at the first time.As time goes on,the conventional treatment group showed that the population of Th1,Th17 and Th1/Th2 was in decline(P=0.510,0.119,0.172),but the population of Treg and Treg/Th17 was on the rise(P =0.553,0.157)and the population of Th2 decreased at first and then rised(P=0.165).However,there is no significant difference.3,Compared with the conventionaltreatment group,the changes of population of T lymphocytes in RIPost C group were obvious,especially Treg,Treg/Th17 and Th1/Th2 at 7 days after RIPost C(P=0.004,0.039,0.048).Conclusion:1,For patients of acute ischemic stroke,Th2 and Treg cell may be helpful,but Th1 and Th17 cell may be harmful.2,RIPost C could protect against focal ischemia and preserve neurological functions.3,RIPost C performs a beneficial role on neuroprotection by changing the population of subpopulations of T lymphocytes,such as Th1,Th2,Th17 and Treg cell.