Abstract WP212: Rapid Point-of-care Nr2 Peptide Test for Acute Stroke Detection

Abstract

Background and Objectives: Time delay is a challenge in using biomarkers in guiding acute ischemic stroke (IS) therapy. Therapeutic decisions must be made quickly and standard blood draws with transport to a laboratory results in delay of results and possible degradation of biomarkers. We report the initial experience with rapid nanoparticle lateral flow (nLF) tests on fingerstick blood samples for the NR2 peptide (NP), a fragment of the NMDA receptor. This extends our prior research (PLoS ONE, 2012, 7, e42362). Methods: Capillary blood (20 microliter) withdrawn less than 15 hours after IS onset was developed within 5 min yielding test (T) and control ( C ) bands in a nLF assay (DRD/CIS Biotech, Inc, Atlanta, GA). An Epson V700 scanner and ImageJ software (Rasband, W.S., ImageJ, U. S. NIH, Bethesda, Maryland) were used to quantify the LF bands. Plasma measurements of NP using MP-ELISA were carried out as well. Patient Selection: Patients (n=13) with thrombotic and embolic stroke and controls (n=16) with non-vascular disease of the CNS and healthy volunteers were enrolled. Diagnosis of ischemic stroke was confirmed by clinical evaluation and neuroimaging (CT, MRI and transcranial doppler). Increased NR2 peptide was detected in plasma of 9/13 patients with IS, i.e., the rapid test showed 2 lines (control and test). In some patients both lines are visualized equally others the T-line is stained less intensively. In the control group there is only one band (16/16) Elevated NP correlated with new lesion areas on DWI/MRI with a slope of ~ 1ng per 5 ml stroke volume. Conclusions: NR2 peptide is elevated with IS and may be detected by rapid fingerstick tests. Plasma NR2 peptide levels correlate with stroke volume.