Response to Letter by Urra et al Regarding Article, “Autoimmune Responses to the Brain After Stroke Are Associated With Worse Outcome”

Abstract

Response: We appreciate the interest in our work and concede that we have generated more questions than we have answered. We are, however, able to address some of the questions raised by Urra and colleagues.1 In our study cohort, we did find that infection was an independent predictor of poor outcome at 90 days; this finding was published in an earlier article focusing on the potential role of interleukin-1 receptor antagonist in predisposing patients to poststroke infection.2 The issue regarding the relative importance of infection versus stroke severity for determining the likelihood for developing TH1 responses to brain antigens after stroke is an important one deserving of further discussion. In our study cohort, all patients who developed pneumonia had a National Institutes of Health Stroke Scale score of at least 20. Outcome data at 90 days were available for 18 patients with an initial National Institutes of Health Stroke …