• Hanna RyderChenCBrain and Behavior Research Institute, Western Galilee Academic College, Acre, Israel, Department of Neurology, Ziv Medical Center, Safed, Israel., Yori Gidron, Darian Ryder, Yair Shmidt, Naomi Dovrat, Ziv Sarusi, Noam Welder-Segalovich, Matan Segalovich, Daniel Marmor, and Radi Shahien.
• Brain and Behavior Research Institute, Western Galilee Academic College, Acre, Israel, Department of Neurology, Ziv Medical Center, Safed, Israel.
• Isr Med Assoc J. 2023 Apr 1; 25 (4): 298302298-302.

BackgroundThe two cerebral hemispheres influence the immune response differently. While the left hemisphere enhances cellular immunity, the right hemisphere inhibits it.ObjectivesTo determine whether immune and inflammatory markers correlated with stroke severity and hospitalization duration as a function of stroke side.MethodsThe study included 137 patients with unilateral ischemic stroke. The medical records were reviewed for demographic and clinical laboratory data, including C-reactive protein (CRP), white blood cell (WBC) count, its differential stroke side and stroke severity according to the National Institute of Health Stroke Scale (NIHSS), and length of hospital stay (LOS). We examined differences between right side (RS) and left side (LS) stroke on immune and inflammatory markers and compared correlations between these markers and NIHSS and LOS as a function of stroke side.ResultsRS stroke patients had higher CRP and monocytes than LS stroke patients. In RS stroke patients, CRP, total WBC, and lymphocyte levels positively correlated with both NIHSS and LOS, whereas levels of neutrophils were positively correlated with NIHSS alone. No correlations were found for LS stroke patients.ConclusionsImmune-inflammatory markers correlated with stroke severity and LOS only in patients with RS stroke. Neuroimmunological processes influence short-term clinical outcomes after stroke, especially considering the differential effects of the hemispheres on immunity. Prospective studies that evaluate long-term clinical outcomes are needed. Testing the effects of anti-inflammatory treatments on prognosis of RS stroke patients should be considered.

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