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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Normal pregnancy changes include physiologic anemia, leukocytosis, and thrombocytopenia. Cardiac rate and stroke volume increase, vascular resistance falls, and creatinine clearance markedly rises. Thyroid binding globulin and cortisol binding globulin both increase, as do complement proteins and fibrinogen, the latter resulting in a normally high erythrocyte sedimentation rate. Estrogen and progesterone rise dramatically. Low back pain, hip and sacroiliac complaints are common. The cytolytic activity of natural killer (NK) cells is decreased, as are adhesion and chemotaxis of phagocytic cells. Antibody responses are normal. CD4 cells proportionately decrease. A large number of circulating proteins suppression lymphocyte proliferation, and T-cell interleukin-2 (IL-2) production may be suppressed. In studies of pregnant patients, controls must include normal pregnant women.
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PMID:Physiologic adaptations of pregnancy. 128 59

Arterial and pulmonary artery catheters were used to monitor the cardiopulmonary effects of recombinant interleukin-2 (rIL-2) given iv at a dose of 100,000 U/kg every 8 hours on days 1-5 to 10 patients with metastatic solid tumors. As anticipated, a severe capillary leak syndrome developed in all patients. Myocardial infarction (MI) occurred unexpectedly in three patients, as evidenced by a focal injury pattern on ECG and elevations of creatinine phosphokinase myocardial band fractions. All patients receiving rIL-2 exhibited major reductions in their left ventricular stroke work index (47 +/- 11 g.m/m2 to 29 +/- g.m/m2), an index of cardiac contractility. It remains uncertain whether the MIs were a byproduct of the capillary leak syndrome in patients with underlying coronary artery disease or whether rIL-2 directly or indirectly damages cardiac muscle.
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PMID:Myocardial toxic effects during recombinant interleukin-2 therapy. 278 57

Immunoregulatory cytokines have been implicated in the pathophysiology of graft dysfunction after heart transplantation (HTx). In 15 consecutive patients undergoing HTx we prospectively determined levels of interleukin-6 (IL-6), tumor-necrosis-factor-alpha (TNF-alpha), interleukin-2 (IL-2), and soluble-interleukin-2-receptor (sIL-2-R) at eight points in time during biopsy and right heart catheterization and within 12 hr of echocardiography during the first three months after HTx. Blood was taken from the pulmonary arterial line. IL-6-levels correlated positively with hemodynamic and echocardiographic parameters of pump dysfunction--namely, pulmonary capillary wedge pressure, pulmonary arterial pressure, right atrial pressure, heart rate--and negatively with isovolumic relaxation time and stroke volume independent of the degree of cellular rejection as classified by the ISHLT criteria. A similar pattern was found for TNF-alpha- and sIL-2-R, while IL-2 correlated negatively with left and right heart filling pressures and positively with fractional shortening. In the three patients who died of sepsis or multiorgan failure within the study period IL-6-, TNF-alpha, and sIL-2-R-levels were elevated and IL-2-levels were suppressed compared with the 12 patients with a stable clinical course. IL-6 and sIL-2-R correlated positively while IL-6 and IL-2 correlated negatively. In this pilot study, a cytokine pattern with elevated levels of IL-6, TNF-alpha, and sIL-2-R as well as suppressed levels of IL-2 in the early period after HTx corresponds to impaired hemodynamics independent of cellular rejection and may indicate an unfavorable prognosis. These cytokines may therefore be useful for monitoring and warrant further study.
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PMID:The relation of interleukin-6, tumor necrosis factor-alpha, IL-2, and IL-2 receptor levels to cellular rejection, allograft dysfunction, and clinical events early after cardiac transplantation. 748 19

The two sides of the brain may be differently involved in the modulation of immune responses as demonstrated by lesional and behavioral approaches in rodents. Lesions of right or left neocortex induced opposite effects on various immune parameters including mitogen-induced lymphoproliferation, interleukin-2 production, macrophage activation or natural killer cell activity. This animal model, useful to elucidate whereby the brain and the immune system can communicate, appears to be suitable for studying the immune perturbations observed during stroke in humans. Brain asymmetry in modulation of immune reactivity may also be demonstrated in intact animal using a behavioral paradigm. The direction of a lateralized motor behavior ie paw preference in a food reaching task, correlated with an asymmetrical brain organization, was shown to be associated with lymphocyte reactivity, natural killer cell activity and auto-antibody production. The association between paw preference and immune reactivity in mice varies according to the immune parameters tested and is a sex-dependent phenomenon in which genetic background may be involved. The experimental models for investigating asymmetrical brain modulation of the immune system should be useful for studying several physiological, pathological and genetic aspects of neuroimmunomodulation.
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PMID:Brain lateralization and immunomodulation. 808 21

Nitric oxide (NO), previously identified with endothelium derived relaxing factor (EDRF), is thought to play a role in central neurotransmission: it is characterized by high lipid solubility and short half life, and NO-synthase, the enzyme which generates NO from L-arginine, has been found in the central nervous system (CNS), both in neuronal and glial cells. NO is believed to be involved in many neural events, such as neurotoxicity from N-methyl-D-aspartate (NMDA) receptor overstimulation, brain damage from vascular stroke, fever, nociception, memory and appetite control. Recent evidence implicates NO as a modulator of endocrine secretions, with inhibition of insulin, growth hormone (GH) and oxytocin release and stimulation of vasopressin (AVP), adrenocorticotropin (ACTH) and corticotropin releasing hormone (CRH) release. NO and prostaglandins could mediate neuroendocrine activities of cytokines such as interleukin-1 (IL-1) and interleukin-2 (IL-2), particularly in the CNS.
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PMID:Nitric oxide: a gas as a modulator of neuroendocrine secretions. 818 Dec 9

The effects of physical therapy on immunological parameters were evaluated in 22 patients (14 males, aged 68.1 +/- 9.9 years) with cerebrovascular diseases in a stable situation 3 to 6 months after the onset of stroke who were entered into a rehabilitation program in our hospital between 1990 and 1993. The proportion of CD4+ cells was significantly increased but that of CD8+ cells was decreased throughout the rehabilitation program, resulting in an increase in the ratio of CD4+/CD8+ cells. The lymphocyte response to phytohemagglutinin and concanavalin A was increased, while no significant differences were observed in CD3+ cells, natural killer cell activity, and serum levels of immunoglobulins, interleukin-1 beta, interleukin-2 and interleukin-6. These findings suggest that repeated physical exercise may activate the immune system, especially T-cell function, for possible prevention of infectious diseases that are often complicated in patients with cerebrovascular diseases.
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PMID:Effects of physical therapy on immunological parameters in patients with cerebrovascular diseases. 898 64

Cerebrospinal fluid (CSF) and serum samples of 20 young adults (mean age 41 +/- 3.4 yr) with a first episode of stroke were tested for interleukin-2 (IL-2), soluble interleukin-2 receptor (SIL-2R), tumour necrosis factor-alpha (TNF-alpha) and interleukin-1-beta (IL-1 beta) levels. The results were compared to 20 patients who had neurological symptoms without evidence of a neurological disease. Three subgroups were formed according to the aetiological source of the stroke, determined by the neurological examination and evaluation. In 13 patients, the presence of atheromatous carotid plaque or cardiac disease was found. In five of the patients, stroke was the presenting symptom of systemic lupus erythematosus (SLE), which developed during the follow-up period. In two patients, no obvious aetiology could be demonstrated. The SIL-2R level was significantly higher in the CSF of patients who later developed definite SLE (P = 0.001). Other CSF interleukins and all serum interleukin levels were not significantly different in any of the groups. No correlation between albumin quotient and CSF SIL-2R was found. The SIL-2R level in the CSF may be used as a diagnostic tool to differentiate immunologically mediated vascular processes in the CNS from stroke of other origin.
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PMID:Cerebrospinal fluid soluble interleukin-2 receptor in cerebral lupus. 913 27

This review summarizes the present knowledge on melatonin in several areas on physiology and discusses various prospects of its clinical utilization. Ever increasing evidence indicates that melatonin has an immuno-hematopoietic role. In animal studies, melatonin provided protection against gram-negative septic shock, prevented stress-induced immunodepression, and restored immune function after a hemorrhagic shock. In human studies, melatonin amplified the antitumoral activity of interleukin-2. Melatonin has been proven as a powerful cytostatic drug in vitro as well as in vivo. In the human clinical field, melatonin appears to be a promising agent either as a diagnostic or prognostic marker of neoplastic diseases or as a compound used either alone or in combination with the standard cancer treatment. Utilization of melatonin for treatment of rhythm disorders, such as those manifested in jet lag, shift work or blindness, is one of the oldest and the most successful clinical application of this chemical. Low doses of melatonin applied in controlled-release preparation were very effective in improving the sleep latency, increasing the sleep efficiency and rising sleep quality scores in elderly, melatonin-deficient insomniacs. In the cardiovascular system, melatonin seems to regulate the tone of cerebral arteries; melatonin receptors in vascular beds appear to participate in the regulation of body temperature. Heat loss may be the principal mechanism in the initiation of sleepiness caused by melatonin. The role of melatonin in the development of migraine headaches is at present uncertain but more research could result in new ways of treatment. Melatonin is the major messenger of light-dependent periodicity, implicated in the seasonal reproduction of animals and pubertal development in humans. Multiple receptor sites detected in brain and gonadal tissues of birds and mammals of both sexes indicate that melatonin exerts a direct effect on the vertebrate reproductive organs. In a clinical study, melatonin has been used successfully as an effective female contraceptive with little side effects. Melatonin is one of the most powerful scavengers of free radicals. Because it easily penetrates the blood-brain barrier, this antioxidant may, in the future, be used for the treatment of Alzheimer's and Parkinson's diseases, stroke, nitric oxide, neurotoxicity and hyperbaric oxygen exposure. In the digestive tract, melatonin reduced the incidence and severity of gastric ulcers and prevented severe symptoms of colitis, such as mucosal lesions and diarrhea.
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PMID:Prospects of the clinical utilization of melatonin. 973 May 80

The possibility that brain damage results in a sustained dysregulation of lymphocyte responsiveness to the lymphokine, interleukin-2 (IL-2), was investigated in individuals who had experienced a unilateral stroke in adulthood or who presented with spastic hemiparesis since childhood. Following verification of unilateral brain damage via neuromotor assessment, and determination of their health status, blood samples were obtained to evaluate a panel of immune measures. Soluble interleukin-2 receptor (sIL-2R) and lymphocyte proliferative and cytolytic responses in the subjects with stroke or cerebral palsy were compared to age- and gender-matched controls. In addition, lymphocyte populations were enumerated via flow cytometry, and lymphocyte cyclic AMP (cAMP) levels were determined. Circulating blood levels of sIL-2R were significantly elevated in all individuals that had experienced unilateral brain damage. Cytolytic activity also failed to be stimulated to the normal level by in vitro treatment of lymphocytes with IL-2. Further, lymphocytes from the stroke subjects proliferated significantly less after mitogen and IL-2 stimulation. These functional differences were not accounted for by an abnormal leukocyte profile, although phenotypic analyses revealed subtle differences in the natural killer cell subsets. Overall, the findings indicate that individuals with brain damage may not respond appropriately when immune activation is required. These immune differences appear to be a stable trait given that they were manifested after both perinatal and adult brain insult in otherwise healthy, independently living individuals.
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PMID:Immune consequences of stroke and cerebral palsy in adults. 984 27

The plasticity of endothelin ETB receptor activity and the influence of pro-inflammatory cytokines was examined in cerebral artery. In fresh rat basilar artery, the selective ETB receptor agonist, sarafotoxin S6c, induced negligible contractions. However, after 1 day of organ culture, fully defined concentration-response curves were obtained in artery segments exposed to sarafotoxin S6c. Organ culture in the presence of either interleukin-1 beta or tumour necrosis factor-alpha, but not interleukin-2 or interleukin-6, further amplified the maximal contraction to sarafotoxin S6c. The plasticity of ETB receptor expression in cerebral arteries and sensitivity for pro-inflammatory cytokines, suggest a role in inflammatory cerebral diseases such as stroke.
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PMID:Cytokines increase endothelin ETB receptor contractile activity in rat cerebral artery. 1043 63


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