What question did this study set out to answer?

The aim is to analyze immune activation and molecular signatures of myeloid cells in different blood compartments during acute ischemic stroke.

February 16, 2026Open Access

Comprehensive immunological profiling of acute ischemic stroke during mechanical thrombectomy: myeloid cell activation and molecular signatures in blood and thrombus

Key Points

The aim is to analyze immune activation and molecular signatures of myeloid cells in different blood compartments during acute ischemic stroke.
Conducted a prospective, single-center study on AIS patients undergoing mechanical thrombectomy.
Collected matched samples from arterial blood, peripheral blood, and thrombus.
Utilized techniques such as spectral flow cytometry, cytokine profiling, and RNA sequencing.
Correlated immune and molecular data with clinical scores and imaging markers.
Identified distinct immune activation patterns in myeloid cells across different blood compartments.
Found correlations between immune signatures and clinical outcomes such as NIHSS and mRS scores.
Established associations with imaging markers indicative of acute ischemic events.

Abstract

Background Acute ischemic stroke (AIS) induces a complex local and systemic inflammatory response; however, most studies rely solely on peripheral blood, providing an incomplete view of immune activity at the occlusion site and within the thrombus. Objective To characterize immune activation and transcriptomic signatures of myeloid cells across three compartments—arterial blood at the occlusion site, peripheral blood, and thrombus—and to evaluate their associations with radiological and clinical outcomes following mechanical thrombectomy. Methods This prospective, single-center study will include AIS patients treated with mechanical thrombectomy. Matched arterial, peripheral, and thrombus samples will undergo spectral flow cytometry, cytokine profiling, cell-free DNA (cfDNA) quantification, microscopy, and RNA sequencing. Immune and molecular readouts will be correlated with clinical scores (NIHSS, mRS), imaging markers (e.g., hyperdense middle cerebral artery sign HMCAS), and procedural outcomes (TICI score, number of passes). Significance Integrating local and systemic immune profiles with clinical and radiological parameters may identify biomarkers predictive of thrombectomy efficacy and functional recovery, thereby supporting precision-medicine approaches in AIS. Clinical trial registration www.ClinicalTrials.gov

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