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Abstract

Introduction

To delineate the distinct immunoregulatory and mitochondrial characteristics in patients with acute ischemic stroke (AIS) and intracerebral hemorrhage (ICH).

Methods

We conducted a cross-sectional study (34 AIS, 27 ICH, 30 controls) and a dynamic tracking study (1 AIS, 1 ICH). T-cell subpopulations, mitochondrial mass (MM), low mitochondrial membrane potential (MMPlow, %), and cytokine profiles were analyzed. Limitations include the small dynamic cohort and potential treatment-related confounding.

Results

The percentages of T regulatory lymphocytes (Treg%) and effector T regulatory

lymphocytes (eTreg%) were significantly higher in AIS patients than in ICH patients ( = 0.029, = 0.017) and correlated with disease severity in AIS patients ( = 0.024, = 0.014). The

IL-10/IL-6 ratio was significantly higher in AIS than in ICH patients ( = 0.004). AIS patients exhibited predominant changes in CD4+ (T4) lymphocyte subsets, whereas ICH patients showed more pronounced alterations in CD8+ (T8) subsets, with corresponding mitochondrial damage observed in T-cells in both groups.

Discussion

Despite limitations from the small dynamic cohort and inherent clinical confounders, this study demonstrates that AIS and ICH are characterized by distinct and evolving immune-inflammatory-mitochondrial axes. These preliminary findings highlight the role of Treg cells in AIS and suggest divergent T-cell subset involvement, providing a rationale for developing subtype-specific therapeutic strategies targeting the immune–mitochondrial axis.

Conclusion

Our study delineates a distinct immune–inflammatory–mitochondrial axis in stroke, characterized by predominant CD4+ involvement in AIS CD8+ T-cell alterations in ICH. These findings underscore the potential for immunomodulatory and mitochondrial-protective strategies tailored to specific stroke subtypes.

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2025-12-30
2026-01-26

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New Perspectives on Stroke: The Immune-inflammatory-mitochondrial Axis
Bentham Science Publishers ; https://doi.org/10.2174/0115672026420631251201053456
/content/journals/cnr/10.2174/0115672026420631251201053456
/content/journals/cnr/10.2174/0115672026420631251201053456
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  • Article Type:     Research Article
Keywords: cytokines ; T regulatory lymphocytes ; mitochondrial membrane potential ; mitochondrial mass ; Acute ischemic stroke ; intracerebral hemorrhage ; T-cell subpopulations

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