Basic research on prevention of aspiration pneumonia in acute stroke patients

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Acute stroke patients have a high risk of aspiration pneumonia. The purpose of this study was to examine the relationship among complication of aspiration pneumonia and salivary secretory immunoglobulin A (sIgA), interleukin 6 (IL-6), epidermal growth factor (EGF), and oral bacteria. Fourteen stroke patients (Age : mean±SD ; 79.5±9.0) were classified into a non-pneumonia group (6 people) or a pneumonia group (8 people). Saliva samples were collected three times (10am, 14am, and 18 pm) on days 5, 7, 9, 11 and 13 in the hospital. Samples were measured by enzyme-linked immunosorbent assay (ELISA) and real-time polymerase chain reaction (real-time PCR), then compared between the two groups. As a result, there was a significant increase in the salivary sIgA (concentration of sIgA × saliva volume) in the pneumonia group (ANOVA ; p<0.01). The IL-6 and EGF concentrations did not significantly differ between groups, whereas the concentration of EGF correlated with the sIgA level (rs=0.574～0.900). Two people in the non-pneumonia group evidenced in Streptococcus pneumoniae. The pneumonia group people were given antibiotics. Six people showed less Streptococcus pneumoniae and Streptococcus mitis, and 4 people demonstrated increased Pseudomonas aeruginosa.