New diagnostic and prognostic biomarkers of the ischemic brain damage

Abstract

Background . To determine the optimal approach to managing patients in the acute period of stroke, the search for biomarkers that can increase value of existing diagnostic methods continues. Objective : to clarify the significance of the levels of neuron-specific enolase (NSE), glial fibrillar acid protein (GFAP), NR2-antibodies in the blood serum (BS) of patients in the acute period of ischemic stroke (IS) in dynamics, determine their relationship with the severity of neurological disturbances and short-term outcome. Design and methods . 40 patients were examined in the acute period of IS, mean age 72.6 ± 1.9 years. The levels of biomarkers were determined in the BS in the first 72 hours of IS and on days 10–14. Results . The concentration of NSE and GFAP in patients with IS in the first 72 hours exceeded the reference values and significantly decreased by 10–14 days (34.9 ± 5.9 → 17.7 ± 1.1; p = 0.007 and 0.4 ± 0, 1 → 0.2 ± 0.005, p = 0.22 respectively). The level of NR2 antibodies did not exceed of the reference values (1.01 ± 0.3), and in dynamics, by 10–14 days, an increase in the indicator was noted (1.1 ± 0.3), p = 0.007. In patients with more severe symptoms, the concentration of NSE, GFAP and NR2 antibodies was higher by 10–14 days. Patients who had an unfavorable short-term outcome by 10–14 days had a higher level of NSE, GFKB and NR2 antibodies. Conclusion . The investigated substances can be used as biomarkers in IS to control the degree of damage to the brain tissue, monitor the worsening of the pathological process, as well as for prognostic purposes.