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Heindl, S.; Ricci, A.; Carofiglio, O.; Zhou, Q.; Arzberger, T.; Lenart, N.; Franzmeier, N.; Hortobagyi, T.; Nelson, P. T.; Stowe, A. M.; Denes, A.; Edbauer, D.; Liesz, Arthur (26. May 2021): Chronic T cell proliferation in brains after stroke could interfere with the efficacy of immunotherapies. In: Journal of Experimental Medicine, Vol. 218, No. 8, e20202411


Neuroinflammation is an emerging focus of translational stroke research. Preclinical studies have demonstrated a critical role for brain-invading lymphocytes in post-stroke pathophysiology. Reducing cerebral lymphocyte invasion by anti-CD49d antibodies consistently improves outcome in the acute phase after experimental stroke models. However, clinical trials testing this approach failed to show efficacy in stroke patients for the chronic outcome 3 mo after stroke. Here, we identify a potential mechanistic reason for this phenomenon by detecting chronic T cell accumulation—evading the systemic therapy—in the post-ischemic brain. We observed a persistent accumulation of T cells in mice and human autopsy samples for more than 1 mo after stroke. Cerebral T cell accumulation in the post-ischemic brain was driven by increased local T cell proliferation rather than by T cell invasion. This observation urges re-evaluation of current immunotherapeutic approaches, which target circulating lymphocytes for promoting recovery after stroke.