Abstract
Stroke is one of the leading causes of mortality anddisability worldwide. Numerouspathophysiological mechanisms involving blood vessels, coagulation and inflammation contribute to the vascular occlusion. Perturbations in these pathways can be detected by numerous methods including changes in endoplasmic membrane remodeling and rearrangement leading to the shedding of microparticles (MPs) from various cellular origins in the blood. MPs are small membrane-derived vesicles that are shed from nearly all cells in the body in resting state or upon stimulation. MPs act as biological messengers to transfer information to adjacent and distant cells thus regulating various biological processes. MPs may be important biomarkers and tools for the identification of the risk and diagnosis of cerebrovascular diseases. Endothelial activation and dysfunction and altered thrombotic responses are two of the main features predisposing to stroke. Endothelial MPs (EMPs) have been recognized as both biomarkers and effectors of endothelial cell activation and injury while platelet-derived MPs (PMPs) carry a strong procoagulant potential and are activated in thrombotic states. Therefore, we reviewed here the role of EMPs and PMPs as biomarkers of stroke. Most studies reported high circulating levels of EMPs and PMPs in addition to other cell origins in stroke patients and have been linked to stroke severity, the size of infarction, and prognosis. The identification and quantification of EMPs and PMPs may thus be useful for the diagnosis and management of stroke.
Highlights
Stroke is one of the most devastating neurological disorders and is considered one of the leading causes of long-term acquired disability in adults (Katan & Luft, 2018)
Since endothelial dysfunction and thrombotic dysregulation are two major contributors to the pathophysiology of stroke, in this review we focused on the role of endothelial-derived MPs (EMPs), as key biomarkers of endothelial activation and dysfunction, and platelet-derived MPs (PMPs), as biomarkers of thrombotic state, in the development of stroke
We reviewed their value as biomarkers in the onset and progression of the disease
Summary
Stroke is one of the most devastating neurological disorders and is considered one of the leading causes of long-term acquired disability in adults (Katan & Luft, 2018). It is considered to be the second main cause of mortality in the world after ischemic heart disease (IHD) (Benjamin et al, 2018; Katan & Luft, 2018). According to the American Heart Association (AHA) latest statistical update, there were 6.3 million deaths due to cerebrovascular diseases around the world (Benjamin et al, 2018). In 2013, the AHA and the American Stroke Association (ASA) developed an expert consensus document for an updated definition of stroke, taking into account the remarkable advances in brain imaging and its clinical implications on the diagnosis of stroke and its subtypes (Coupland, Thapar, Qureshi, Jenkins, & Davies, 2017; Sacco et al, 2013). This document summarized different stroke etiologies and enlisted them in a table for a better definition of stroke
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