{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:48:33Z","timestamp":1787071713312,"version":"build-2736575974"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T00:00:00Z","timestamp":1759190400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract:<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Post-stroke immunosuppression elevates the risk of stroke-associated pneumonia (SAP). Our earlier research indicated that perihematomal neuron-derived PD-L1 may play a role in peripheral immunosuppression following intracerebral hemorrhage (ICH); however, the specific carriers of PD-L1 and its potential as a predictor for SAP risk are yet to be determined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>MATERIALS AND METHODS:<\/jats:title>\n                    <jats:p>We hypothesize that elevated levels of exosomal PD-L1 in peripheral blood after ICH mediate immune suppression and increase the risk of SAP. This observational study aimed to investigate the levels of exosomal PD-L1 post-ICH and their relationship with SAP. In an exploratory cohort of 39 patients with ICH and 24 healthy controls and a validation cohort of 144 patients with ICH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>At admission, patients with ICH exhibited significantly increased exosome numbers in their peripheral blood, with these exosomes showing high expression of the neuronal marker neural cell adhesion molecule L1, suggesting a brain origin. Exosomal PD-L1 levels were elevated in patients with ICH compared to healthy controls and were higher in patients with SAP than those without. After adjusting for confounders, exosomal PD-L1 was confirmed to be independently associated with SAP in both the exploratory cohort and validation cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Brain-derived exosomes with high expression of PD-L1 are substantially released into the periphery after ICH. Elevated exosomal PD-L1 levels correlate with an increased risk of SAP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/bc.bc_187_24","type":"journal-article","created":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T10:00:13Z","timestamp":1759312813000},"page":"270-278","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Exosomal programmed death-ligand 1 is associated with post-intracerebral hemorrhage pneumonia"],"prefix":"10.4103","volume":"12","author":[{"given":"Bin","family":"Gao","sequence":"first","affiliation":[{"name":"Department of Neurology, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China"},{"name":"Chinese Institutes for Medical Research, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurology, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China"},{"name":"Chinese Institutes for Medical Research, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuo","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunnan","family":"Ge","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tangdu Hospital, Airforce Medical University, Xi\u2019an, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhichao","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Nantong University Affiliated Hospital, Nantong, 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