PLoS ONE (Jan 2016)

High CD3+ Cells in Intracranial Thrombi Represent a Biomarker of Atherothrombotic Stroke.

  • Cyril Dargazanli,
  • Valérie Rigau,
  • Omer Eker,
  • Carlos Riquelme Bareiro,
  • Paolo Machi,
  • Grégory Gascou,
  • Caroline Arquizan,
  • Xavier Ayrignac,
  • Isabelle Mourand,
  • Astrid Corlobé,
  • Kyriakos Lobotesis,
  • Nicolas Molinari,
  • Valérie Costes,
  • Alain Bonafé,
  • Vincent Costalat

DOI
https://doi.org/10.1371/journal.pone.0154945
Journal volume & issue
Vol. 11, no. 5
p. e0154945

Abstract

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BACKGROUND AND PURPOSE:Approximately 30% of strokes are cryptogenic despite an exhaustive in-hospital work-up. Analysis of clot composition following endovascular treatment could provide insight into stroke etiology. T-cells already have been shown to be a major component of vulnerable atherosclerotic carotid lesions. We therefore hypothesize that T-cell content in intracranial thrombi may also be a biomarker of atherothrombotic origin. MATERIALS AND METHODS:We histopathologically investigated 54 consecutive thrombi retrieved after mechanical thrombectomy in acute stroke patients. First, thrombi were classified as fibrin-dominant, erythrocyte-dominant or mixed pattern. We then performed quantitative analysis of CD3+ cells on immunohistochemically-stained thrombi and compared T-cell content between "atherothrombotic", "cardioembolism" and "other causes" stroke subtypes. RESULTS:Fourteen (26%) thrombi were defined as fibrin-dominant, 15 (28%) as erythrocyte-dominant, 25 (46%) as mixed. The stroke cause was defined as "atherothrombotic" in 10 (18.5%), "cardioembolism" in 25 (46.3%), and "other causes" in 19 (35.2%). Number of T-cells was significantly higher in thrombi from the "atherothrombotic" group (53.60 ± 28.78) than in the other causes (21.77 ± 18.31; p<0.0005) or the "cardioembolism" group (20.08 ± 15.66; p<0.0003). CONCLUSIONS:The CD3+ T-cell count in intracranial thrombi was significantly higher in "atherothrombotic" origin strokes compared to all other causes. Thrombi with high content of CD3+ cells are more likely to originate from an atherosclerotic plaque.