Pathophysiology and Biomarkers in Acute Ischemic Stroke – A Review

Abstract

Stroke is one of the major causes of death and disability, including ischemic stroke, which accounts for 85 -87 % of cases. Currently, there are few treatment options available for minimizing tissue death following a stroke. Emerging data suggest that biomarkers may help improve current clinical outcome of stroke. As such, there is a pressing need to understand the pathophysiology and to explore effective biomarkers following an ischemic brain event. The pathophysiology of ischemic stroke is complex, and majorly involves excitotoxicity, oxidative stress, inflammation, blood-brain barrier dysfunction, apoptosis, etc. Several of the biomarkers are related to these pathophysiologic mechanisms and they may have applications in stroke prediction, diagnosis, assessment, prognosis or treatment. In this review, we summarized the pathophysiology of ischemic stroke and some related biomarkers are examined.

The interplay of microRNAs and post-ischemic glutamate excitotoxicity: an emergent research field in stroke medicine

“…It involves a complex series of biological and molecular mechanisms such as excitotoxicity, oxidative stress, inflammation, ionic imbalance, blood-brain barrier disruption and apoptosis [7,8]. Among these mechanisms, excitotoxicity is notable.…”

“…It is mainly a glutamate-mediated specific type of neurotoxicity and is the overlooked link between ischemic stroke and neuronal damage and cell death [9]. It stems from excessive accumulation of excitatory amino acids such as glutamate and leads to toxic increases in intracellular calcium [7,10] which mediates neuronal damage in stroke [11]. miRNAs are small (*19 to 23 nucleotides) noncoding endogenous molecules that bind messenger RNAs (mRNA) and promote their degradation or repression of translation [12].…”

Role of Rauwolfia serpentina in stroke induced experimental dementia

“…Stroke is the second leading cause of death and disability [1,2] worldwide after heart disease and cancer and is the major cause of morbidity, particularly in the middle aged and elderly population [3,4]. Stroke is a serious neurological disease [1,2].…”

“…Stroke is the second leading cause of death and disability [1,2] worldwide after heart disease and cancer and is the major cause of morbidity, particularly in the middle aged and elderly population [3,4]. Stroke is a serious neurological disease [1,2]. Stroke, according to the American Heart Association (AHA) definition, is a sudden loss of brain function due to disturbance in the cerebral blood supply with symptoms lasting at least 24 hours or leading to death with vascular background as its only cause.…”

“…Ischemic stroke occurs when the blood supply to a part of the brain is suddenly interrupted by occlusion [7][8][9]. Ischemic cerebrovascular disease is mainly caused by thrombosis, embolism and focal hypoperfusion, all of which can lead to a reduction or an interruption in cerebral blood flow (CBF) that affect neurological function due to deprivation of the glucose and oxygen [1,5,10,11]. Within seconds to minutes after the loss of blood flow to a region of the brain, the ischemic cascade is rapidly initiated [12].…”