RT Journal Article SR Electronic T1 Harmful neutrophil subsets in patients with ischemic stroke JF Neurology - Neuroimmunology Neuroinflammation JO Neurol Neuroimmunol Neuroinflamm FD Lippincott Williams & Wilkins SP e571 DO 10.1212/NXI.0000000000000571 VO 6 IS 4 A1 Weisenburger-Lile, David A1 Dong, Yuan A1 Yger, Marion A1 Weisenburger, Gaƫlle A1 Polara, Giulia Frasca A1 Chaigneau, Thomas A1 Ochoa, Riccardo Zapata A1 Marro, Beatrice A1 Lapergue, Bertrand A1 Alamowitch, Sonia A1 Elbim, Carole YR 2019 UL http://nn.neurology.org/content/6/4/e571.abstract AB Objective To better understand the functional state of circulating neutrophils in patients with ischemic stroke (IS) for planning future clinical trials.Methods We analyzed by flow cytometry activation state of circulating neutrophils and the distribution of neutrophil peripheral subsets in 41 patients with acute IS less than 6 hours before admission and compared them with 22 age-matched healthy controls.Results Our results demonstrated continuous basal hyperactivation of circulating neutrophils during acute IS, characterized by lower l-selectin expression and higher CD11b expression at the cell surface, increased ROS production by neutrophils, and greater circulating levels of neutrophil elastase. Neutrophil hyperactivation was associated with deregulation of the equilibrium between apoptotic and necrotic. Patients also had higher percentages than controls of the overactive senescent (CXCR4bright/CD62Ldim) neutrophil subset and increased percentage of neutrophils with a reverse transendothelial migration (CD54highCXCR1low) phenotype. Importantly, neutrophil alterations were associated with the clinical severity of the stroke, evaluated by its NIH Stroke Scale score.Conclusion Altogether, our results indicate that during acute IS, the inflammatory properties of circulating neutrophils rise, associated with the expansion of harmful neutrophil subsets. These changes in neutrophil homeostasis, associated with disease severity, may play an instrumental role by contributing to systemic inflammation and to the blood-brain barrier breakdown. Our findings highlight new potential therapeutic approaches of stroke by rebalancing the ratio of senescent to immunosuppressive neutrophils or decreasing reverse neutrophil transmigration or both.AAD=amino-actinomycin D; ANOVA=analysis of variance; APC=allophycocyanine; BBB=blood-brain barrier; DAMP=danger-associated molecular pattern; fMLP=N-formylmethionyl-leucyl-phenylalanine; HC=healthy control; HE=hydroethidine; HMGB=high-mobility group box; IS=ischemic stroke; LPS=lipopolysaccharide; MMP=matrix metalloproteinase; MPO=myeloperoxidase; NET=neutrophil extracellular trap; NIHSS=NIH Stroke Scale; NLR=Nod-like receptor; PBS=phosphate buffered saline; PMN=polymorphonuclear neutrophil; ROS=reactive oxygen species; rTEM=reverse transendothelial migration; sJAM-C=soluble JAM-C; TNF=tumor necrosis factor; TLR=Toll-like receptor