Towards blood biomarkers for stroke patients

Rust, Ruslan

doi:10.1177/0271678x21992664

Cited by 5 publications

(6 citation statements)

References 10 publications

(12 reference statements)

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“…Apart from that, the fact that the neurological outcome poststroke appears to fluctuate considerably between a mild nondisabling type and a more severe type characterized by permanent disability or even death should be considered. Consequently, the utilization of blood biomarkers has emerged as a promising novel tool aimed at reliably forecasting functional outcomes poststroke [ 7 , 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Stroke and Emerging Blood Biomarkers: A Clinical Prospective

Gkantzios

Tsiptsios

Karatzetzou

et al. 2022

Neurology International

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Stroke constitutes the primary source of adult functional disability, exhibiting a paramount socioeconomic burden. Thus, it is of great importance that the prediction of stroke outcome be both prompt and accurate. Although modern neuroimaging and neurophysiological techniques are accessible, easily available blood biomarkers reflecting underlying stroke-related pathophysiological processes, including glial and/or neuronal death, neuroendocrine responses, inflammation, increased oxidative stress, blood–brain barrier disruption, endothelial dysfunction, and hemostasis, are required in order to facilitate stroke prognosis. A literature search of two databases (MEDLINE and Science Direct) was conducted in order to trace all relevant studies published between 1 January 2010 and 31 December 2021 that focused on the clinical utility of brain natriuretic peptide, glial fibrillary acidic protein, the red cell distribution width, the neutrophil-to-lymphocyte ratio, matrix metalloproteinase-9, and aquaporin-4 as prognostic tools in stroke survivors. Only full-text articles published in English were included. Twenty-eight articles were identified and are included in this review. All studied blood-derived biomarkers proved to be valuable prognostic tools poststroke, the clinical implementation of which may accurately predict the survivors’ functional outcomes, thus significantly enhancing the rehabilitation efficiency of stroke patients. Along with already utilized clinical, neurophysiological, and neuroimaging biomarkers, a blood-derived multi-biomarker panel is proposed as a reasonable approach to enhance the predictive power of stroke prognostic models.

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Section: Introductionmentioning

confidence: 99%

Stroke and Emerging Blood Biomarkers: A Clinical Prospective

Gkantzios

Tsiptsios

Karatzetzou

et al. 2022

Neurology International

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“…As pointed out by Rust, 46 the additional pieces of information given by biomarkers like NfL and GFAP, could be useful also to refer patients to more intensive rehabilitation units, and to monitor the efficacy of pharmacological and rehabilitative treatments. These future perspectives could be furtherly boosted combining these biomarkers with others under study, to envisage a multi-biomarker panel for monitoring brain injury/repair.…”

Section: Discussionmentioning

confidence: 99%

Quantification and prospective evaluation of serum NfL and GFAP as blood-derived biomarkers of outcome in acute ischemic stroke patients

Ferrari

Rossi

Ricciardi

et al. 2023

J Cereb Blood Flow Metab

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Identification of reliable and accessible biomarkers to characterize ischemic stroke patients’ prognosis remains a clinical challenge. Neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) are markers of brain injury, detectable in blood by high-sensitive technologies. Our aim was to measure serum NfL and GFAP after stroke, and to evaluate their correlation with functional outcome and the scores in rehabilitation scales at 3-month follow-up. Stroke patients were prospectively enrolled in a longitudinal observational study within 24 hours from symptom onset (D1) and monitored after 7 (D7), 30 ± 3 (M1) and 90 ± 5 (M3) days. At each time-point serum NfL and GFAP levels were measured by Single Molecule Array and correlated with National Institute of Health Stroke Scale (NIHSS), modified Rankin scale (mRS), Trunk Control Test (TCT), Functional Ambulation Classification (FAC) and Functional Independence Measure (FIM) scores. Serum NfL and GFAP showed different temporal profiles: NfL increased after stroke with a peak value at D7; GFAP showed an earlier peak at D1. NfL and GFAP concentrations correlated with clinical/rehabilitation outcomes both longitudinally and prospectively. Multivariate analysis revealed that NfL-D7 and GFAP-D1 were independent predictors of 3-month NIHSS, TCT, FAC and FIM scores, with NfL being the biomarker with the best predictive performance.

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“… 1 , 2 , 47 Recently, with the continuous progress of gene‐level research, the differences in the transcriptional process of monocytes after ischemic stroke may be another potential reason for the different tendencies of different subtypes of stroke. 48 In addition, recent studies reported some novel prognostic biomarkers for predicting stroke outcomes, such as circulating immunoregulatory lymphocytes, 49 neurofilament light chain protein, 50 and circulating microRNA. 51 However, we could not adjust them due to the lack of data.…”

Section: Discussionmentioning

confidence: 99%

Monocyte to high‐density lipoprotein ratio predicts clinical outcomes after acute ischemic stroke or transient ischemic attack

Chen

et al. 2023

CNS Neurosci Ther

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Aims The monocyte to high‐density lipoprotein cholesterol ratio (MHR) has emerged as a novel inflammatory biomarker of atherosclerotic cardiovascular disease. However, it has not yet been identified whether MHR can predict the long‐term prognosis of ischemic stroke. We aimed to investigate the associations of MHR levels with clinical outcomes in patients with ischemic stroke or transient ischemic attack (TIA) at 3 months and 1 year. Methods We derived data from the Third China National Stroke Registry (CNSR‐III). Enrolled patients were divided into four groups by quartiles of MHR. Multivariable Cox regression for all‐cause death and stroke recurrence and logistic regression for the poor functional outcome (modified Rankin Scale score 3–6) were used. Results Among 13,865 enrolled patients, the median MHR was 0.39 (interquartile range, 0.27–0.53). After adjustment for conventional confounding factors, the MHR level in quartile 4 was associated with an increased risk of all‐cause death (hazard ratio [HR], 1.45; 95% confidence interval [CI], 1.10–1.90), and poor functional outcome (odd ratio [OR], 1.47; 95% CI, 1.22–1.76), but not with stroke recurrence (HR, 1.02; 95% CI, 0.85–1.21) at 1 year follow‐up, compared with MHR level in quartile 1. Similar results were observed for outcomes at 3 months. The addition of MHR to a basic model including conventional factors improved predictive ability for all‐cause death and poor functional outcome validated by the C‐statistic and net reclassification index (all p < 0.05). Conclusions Elevated MHR can independently predict all‐cause death and poor functional outcome in patients with ischemic stroke or TIA.

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Towards blood biomarkers for stroke patients

Cited by 5 publications

References 10 publications

Stroke and Emerging Blood Biomarkers: A Clinical Prospective

Stroke and Emerging Blood Biomarkers: A Clinical Prospective

Quantification and prospective evaluation of serum NfL and GFAP as blood-derived biomarkers of outcome in acute ischemic stroke patients

Monocyte to high‐density lipoprotein ratio predicts clinical outcomes after acute ischemic stroke or transient ischemic attack

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