This anti-inflammatory state leads to immunodepression that could be considered a protective adaptative reaction to suppress the aggressive Th1 response against presented endogenous brain antigens. Therefore, in spite of being OSI906 beneficial, the enhanced Th2 response might increase the risk of detrimental secondary infections [21,22]. In that context, the modulation of the immune system

by the use of monoclonal antibodies could be of interest in stroke as well as in other diseases with an inflammatory background [reviewed in 23]. Our results showed a very faint power for CCL17 and CCL22 to discriminate those patients who will improve within the first 24–48 h after stroke. Thus, none of these chemokines seem a reliable prognostic biomarker in the hyperacute phase of stroke, when quick decision-making is needed to start a more exhaustive management in order to avoid secondary complications. However, the results of our study might inspire
s of investigation focused on the modulation of CCL17 and/or CCL22 or even CCR4. Our study stands with some limitations. We cannot dismiss the possible presence of some astrocyte end-feet in our vessel samples, since in brain tissue these cell types are tightly interrelated to form the blood–brain-barrier. We cannot dismiss out of hand the fact that the concentration EPZ015666 research buy of chemokines in systemic circulation

could contribute to their quantification in LMD-vessels since necropsies might contain traces of blood in vessel lumens. Nevertheless, the undetectable concentration of some of these chemokines in LMD-vessels may suggest a minimal contribution of the circulating levels of each chemokine to its amount in the LMD samples. On the other hand, human brain samples from stroke patients are scarce and thus the small sample size used in this part of the study might affect the results on chemokine levels. Regarding blood samples, we were not able to study the relation between chemokines and neurological outcome in the MISTIC cohort due to the limited number of worsening/improvement

cases. Moreover, the sample size used for the study in the hyperacute phase is relatively small, but the sample size calculations 3-oxoacyl-(acyl-carrier-protein) reductase showed a very large number of samples needed to get significant results for most of the studied chemokines. Further studies are necessary to answer if CCL17 or CCL22 could have a role as outcome biomarkers at a later point in time after hyperacute phase. Other chemokines not included in SearchLight® array might be of interest in stroke field, especially some of them that have not been studied in human stroke (CCL7, CCL9, CXCL2). Novel multiplexed immunoassays based on fluorescently encoded microspheres might increase the screening of circulating inflammatory molecules in stroke patients while using very few amount of sample [24].