Relationship Between TH1/TH2 Cell Dysfunction And Post-stroke Depression

Background Post-stroke depression(PSD)refers to the depression secondary to stroke,which belongs to secondary depression.Stroke patients face unique challenges in identifying depression.At present,the pathogenesis of PSD is not clear,and the immune inflammatory response may play an important role in the pathophysiological process of post-stroke depression,especially the imbalance of CD4+T lymphocyte and its related cytokines.Therefore,this study is to explore the relationship between Th1/Th2 cell dysfunction and PSD,which may provide new clues for the recognition and diagnosis of PSD.Objective To study the relationship between the mechanism of Th1/Th2 cell dysfunction and PSD.Methods According to the admission criteria and exclusion criteria,the first hospitalized patients with acute ischemic stroke admitted to the neurology department of our hospital from March 2018 to July 2019 have completed imaging examination and related scale evaluation,and given routine neurology treatment.The patients were followed up 30 days after stroke,and the MRI,biochemical indexes and scale evaluation were reexamined.According to 17 items of Hamilton Depression Scale(HAMD-17),they were divided into PSD group(total score ? 7 points)and non-PSD group(total score < 7 points).The demographic data,past medical history(hypertension,diabetes,etc.)and various nervous system scores(National Institutes of Health Stroke Scale,Mini-mental State Examination Scale,Montreal Cognitive Assessment Scale,Barthel Index Assessment Scale)were collected.After 30 days of stroke,the fasting elbow vein blood of the patients was collected,and the CD4 + T lymphocytes were sorted by Dynabeads magnetic beads.After the purity of CD4 + T lymphocytes was detected by flow cytometry,the RNA was extracted,and the cytokines IFN-? and IL-4 secreted by Th1 and Th2 cells were detectedby quantitative real-time polymerase chain reaction(q-PCR)Expression level,hypersensitive C-reactive protein(hs-CRP)by immunoturbidimetry,homocysteine(Hcy)by circulating enzyme,and fasting blood glucose by glucose oxidase.Results(1)Among the 200 stroke patients,120 completed the follow-up,57 in PSD group,30 in male(52.63%),27 in female(47.37%);63 in non-PSD group,39 in male(61.90%),24 in female(38.10%);(2)Compared with the non-PSD group,there was no significant difference in gender,age,history of hypertension,history of diabetes,focus location,homocysteine,high-sensitivity C-reactive protein,fasting blood glucose,NHISS score,MMSE score,MOCA score,and Barthel score between the two groups(P > 0.05);there was significant difference in HAMD score between the two groups(P < 0.05);(3)The expression level of IFN-? and IL-4 in PSD group was significantly higher than that in non-PSD group(P < 0.05);(4)There was a positive correlation between IFN-? and depression score(r = 0.398,P= 0.011,95% CI: 0.68,4.90);there was a negative correlation between IL-4 and depression score(r = 0.324,P = 0.042,95% CI:-0.57,-0.11).Conclusions 1.In PSD patients,the expression of IFN-? increased,while the expression of IL-4decreased.The high expression of IFN-? was positively correlated with depression,while the low expression of IL-4 was negatively correlated with depression.2.The high expression of IFN-? and the low expression of IL-4 in Th1 cells indicate that the imbalance of Th1/ Th2 cells is involved in the development of PSD.