Frequenza periferica delle cellule CD28null e tipizzazione degli aplotipi KIR e degli alleli HLA e in soggetti con ictus ischemico acuto

Introduction: Inflammation and T cell activation have been also described as involved in pathophysiology of some complication of atherosclerosis, nevertheless no study has yet evaluated the relationship between KIR aplotypes and HLA alleles and acute cerebrovascular disease. Material and methods : Between November 2013 and February 2016, all consecutive patients with acute ischemic stroke were recruited. As healthy controls we enrolled consecutive subjects without acute ischemic stroke. KIR aplotype and HLA allele phenotyping has been performed. Results : Subjects with acute ischemic stroke in comparison to subjects without acute ischemic stroke showed a significantly a higher frequency of 2DL3, 2DL5B, 2DS2 and 2DS4 KIR aplotypes and a significantly lower frequency of HLA-B-Bw4I allele. With regard of interaction of HLA and KIR aplotype, subjects with acute ischemic stroke showed no significant difference with regard of frequency of co-expression of any considered HLA and KIR aplotype, whereas subjects without acute ischemic stroke showed a higher frequency of 2DS2 -HLAC2 co-expression. The multiple logistic regression analysis considering variables predictive of the occurrence of acute ischemic stroke showed a protective effect of HLA-B.Bw4I and of 2DL2HLAC1, 2DS2HLAC2 and a detrimental effect of 2DL2HLAC1_A HLA-KIR interactions. We also observed an higher frequency of 2DL3 and 2 DL4 KIR aplotype in subjects with LAAS subtype . Discussion: Our findings of a higher frequency of both activating KIR haplotypes seem to be consistent with findings previously reported patients with coronary syndrome acute and unstable atherosclerotic plaques. this higher frequency of "proinflammatory"genotype in subjects with ischemic stroke