Abstract
Acute ischemic stroke (AIS) and intracerebral hemorrhage (ICH) are both cerebrovascular accidents where clinical management remains predominantly symptomatic, with few immunologically-targeted approaches. This cross-sectional study compared AIS (n = 73), ICH (n = 28), and controls (n = 31) in terms of demographic, clinical, laboratory, and immunological parameters, including regulatory T cells (Tregs), effector regulatory T cells (eTregs), CD4+ T cells, and cytokines. ICH patients showed lower total cholesterol (TCHO), low-density lipoprotein cholesterol (LDL-C), and non-high-density lipoprotein cholesterol (non-HDL-C) than both controls and AIS patients, whereas AIS patients had reduced high-density lipoprotein cholesterol (HDL-C) versus controls. Both stroke groups exhibited higher proportions of Tregs and eTregs versus controls. Correlation analyses revealed divergent immune networks: in AIS, the percentages of Tregs and eTregs positively correlated with interleukin-10 (IL-10), interleukin-1β (IL-1β), and interleukin-2 receptor (IL-2R), whereas in ICH, these percentages negatively correlated with tumor necrosis factor-α (TNF-α). We conclude that AIS features 'compensatory immune regulation', while ICH is characterized by 'uncontrolled innate immune inflammation', indicating two distinct immunological diseases with implications for subtype-specific therapy.