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Peripheral blood monocytes are polarized to specific subtypes and express distinct activation states after aneurysmal subarachnoid hemorrhage (SAH)
EANS Academy. Muhammad S. Sep 27, 2019; 275931; EP01082
Assoc. Prof. Sajjad Muhammad
Assoc. Prof. Sajjad Muhammad

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Abstract
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Background: State of the art research reveal critical role of inflammation during the phase of early and delayed brain injury after aSAH. Monocytes/macrophages being fundamental part of the innate immunity are the most important players to drive or inhibit inflammation that in turn depends on their polarization status either towards M1 type (pro-inflammatory) or M2-type (anti-inflammatory) monocytes. Monocytes polarization and their activation states after SAH have not been investigated in detail.
Methods: Peripheral venous blood from 15 SAH patients on day 1 and day 7, and once from 10 healthy controls was used for multicolour flow cytometry. Cells were stained with specific anti-human mouse monoclonal antibodies for 20 mins and were then acquired on BD LSR FortessaTM. Monocytes were gated based on their intermediate side scatter and CD45 expression. Monocyte subsets were characterized based on differential CD14 and CD16 expression and for expression of activation markers (CCR2, CX3CR1 and HLA-DR).
Results: Analysis of monocyte sub-types revealed that non-classical monocytes were significantly decreased compared to healthy controls on day 1. Moreover, intermediate monocytes were significantly higher on post-SAH day 1 compared to day 7. The CX3CR1+ intermediate and non-classical monocytes showed similar significant differences. Intriguingly, classical CCR2+ monocytes significantly increased on post-SAH day 1 as compared to controls and intermediate CCR2+ monocytes compared to post-SAH day 7. Finally, HLA-DR+ classical monocytes were significantly decreased after SAH on both day 1 and day 7 compared to controls, while intermediate and non-classical HLA-DR+ monocytes showed significant differences as that of their parent populations.
Conclusion: Different monocyte subsets were altered after SAH with distinct profiles of their activation markers. Further studies are needed to find out how the monocytes polarization influence the outcome after SAH.
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