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Nouri-Vaskeh M, Khalili N, Sadighi A, Yazdani Y, Zand R. Biomarkers for Transient Ischemic Attack: A Brief Perspective of Current Reports and Future Horizons. J Clin Med 2022; 11:jcm11041046. [PMID: 35207321 PMCID: PMC8877275 DOI: 10.3390/jcm11041046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 02/09/2022] [Accepted: 02/16/2022] [Indexed: 02/05/2023] Open
Abstract
Cerebrovascular disease is the leading cause of long-term disability in the world and the third-leading cause of death in the United States. The early diagnosis of transient ischemic attack (TIA) is of great importance for reducing the mortality and morbidity of cerebrovascular diseases. Patients with TIA have a high risk of early subsequent ischemic stroke and the development of permanent nervous system lesions. The diagnosis of TIA remains a clinical diagnosis that highly relies on the patient's medical history assessment. There is a growing list of biomarkers associated with different components of the ischemic cascade in the brain. In this review, we take a closer look at the biomarkers of TIA and their validity with a focus on the more clinically important ones using recent evidence of their reliability for practical usage.
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Affiliation(s)
- Masoud Nouri-Vaskeh
- Tropical and Communicable Diseases Research Centre, Iranshahr University of Medical Sciences, Iranshahr 7618815676, Iran;
- Network of Immunity in Infection, Malignancy and Autoimmunity, Universal Scientific Education and Research Network, Tehran 1419733151, Iran
| | - Neda Khalili
- School of Medicine, Tehran University of Medical Sciences, Tehran 1449614535, Iran;
- Cancer Immunology Project (CIP), Universal Scientific Education and Research Network (USERN), Tehran 1419733151, Iran
| | - Alireza Sadighi
- Neuroscience Institute, Geisinger Health System, Danville, PA 17822, USA;
| | - Yalda Yazdani
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz 5165665931, Iran;
| | - Ramin Zand
- Neuroscience Institute, Geisinger Health System, Danville, PA 17822, USA;
- Neuroscience Institute, Pennsylvania State University, State College, PA 16801, USA
- Correspondence: or ; Tel.: +1-570-808-7330; Fax: +1-570-808-3209
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Kovács-Ábrahám Z, Aczél T, Jancsó G, Horváth-Szalai Z, Nagy L, Tóth I, Nagy B, Molnár T, Szabó P. Cerebral and Systemic Stress Parameters in Correlation with Jugulo-Arterial CO 2 Gap as a Marker of Cerebral Perfusion during Carotid Endarterectomy. J Clin Med 2021; 10:jcm10235479. [PMID: 34884182 PMCID: PMC8658406 DOI: 10.3390/jcm10235479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 10/30/2021] [Accepted: 11/21/2021] [Indexed: 11/16/2022] Open
Abstract
Intraoperative stress is common to patients undergoing carotid endarterectomy (CEA); thus, impaired oxygen and metabolic balance may appear. In this study, we aimed to identify new markers of intraoperative cerebral ischemia, with predictive value on postoperative complications during CEA, performed in regional anesthesia. A total of 54 patients with significant carotid stenosis were recruited and submitted to CEA. Jugular and arterial blood samples were taken four times during operation, to measure the jugulo-arterial carbon dioxide partial pressure difference (P(j-a)CO2), and cortisol, S100B, L-arginine, and lactate levels. A positive correlation was found between preoperative cortisol levels and all S100B concentrations. In addition, they are positively correlated with P(j-a)CO2 values. Conversely, postoperative cortisol inversely correlates with P(j-a)CO2 and postoperative S100B values. A negative correlation was observed between maximum systolic and pulse pressures and P(j-a)CO2 after carotid clamp and before the release of clamp. Our data suggest that preoperative cortisol, S100B, L-arginine reflect patients' frailty, while these parameters postoperatively are influenced by intraoperative stress and injury. As a novelty, P(j-a)CO2 might be an emerging indicator of cerebral blood flow during CEA.
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Affiliation(s)
- Zoltán Kovács-Ábrahám
- Department of Anesthesiology and Intensive Care, Medical School, University of Pécs, H-7624 Pécs, Hungary; (Z.K.-Á.); (I.T.); (B.N.); (T.M.)
| | - Timea Aczél
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, H-7624 Pécs, Hungary;
- Molecular Pharmacology Research Group & Centre for Neuroscience, János Szentágothai Research Centre, University of Pécs, H-7624 Pécs, Hungary
| | - Gábor Jancsó
- Department of Vascular Surgery, Medical School, University of Pécs, H-7624 Pécs, Hungary;
| | - Zoltán Horváth-Szalai
- Department of Laboratory Medicine, Medical School, University of Pécs, H-7624 Pécs, Hungary;
| | - Lajos Nagy
- Department of Applied Chemistry, Institute of Chemistry, Faculty of Science and Technology, University of Debrecen, H-4032 Debrecen, Hungary;
| | - Ildikó Tóth
- Department of Anesthesiology and Intensive Care, Medical School, University of Pécs, H-7624 Pécs, Hungary; (Z.K.-Á.); (I.T.); (B.N.); (T.M.)
| | - Bálint Nagy
- Department of Anesthesiology and Intensive Care, Medical School, University of Pécs, H-7624 Pécs, Hungary; (Z.K.-Á.); (I.T.); (B.N.); (T.M.)
| | - Tihamér Molnár
- Department of Anesthesiology and Intensive Care, Medical School, University of Pécs, H-7624 Pécs, Hungary; (Z.K.-Á.); (I.T.); (B.N.); (T.M.)
| | - Péter Szabó
- Department of Anesthesiology and Intensive Care, Medical School, University of Pécs, H-7624 Pécs, Hungary; (Z.K.-Á.); (I.T.); (B.N.); (T.M.)
- Correspondence:
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Yuan X, Wang J, Wang D, Yang S, Yu N, Guo F. NSE, S100B and MMP9 Expression Following Reperfusion after Carotid Artery Stenting. Curr Neurovasc Res 2019; 16:129-134. [PMID: 30907315 DOI: 10.2174/1567202616666190321123515] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 03/07/2019] [Accepted: 03/09/2019] [Indexed: 12/22/2022]
Abstract
Objective:
Previous studies have shown that the neuron-specific- enolase (NSE), S100B protein (S100B) and matrix metalloproteinase-9 (MMP9) are specific markers for studying cerebral injury. This study was aimed to demonstrate these biomarkers for their correlation with reperfusion after carotid artery stenting (CAS).
Methods:
In this study, a total of 44 patients who were diagnosed unilateral carotid artery stenosis by digital subtraction angiography (DSA) and underwent CAS, were selected as the operation groups. The patients' blood samples were collected at three different time points: T1, prior to operation; T2, next morning after operation (24 hours); T3, three days after operation (72 hours); All of the patients with the operation received computed tomography perfusion (CTP) at T1 and T3. The second group of 12 patients, who were excluded for carotid artery stenosis by DSA, were assigned to be the control group; Blood samples of these patients were collected at T1. The concentrations of NSE, S100B and MMP9 in serum from patients of both groups were detected by ELISA.
Results:
All of the operations were implanted in stents successfully without complications. (1) After CAS, rCBF increased while rMTT and rTTP decreased. (2) The concentrations of NSE, S100B and MMP9 in the serum decreased gradually (T1>T2>T3). There was no significant difference between the control group and the operation group at T1 (P>0.05) on their concentrations of NSE, S100B and MMP9 in the serum. When compared among the operation groups, the concentrations of NSE, S100B and MMP9 in the serum at T1 and T3 showed significant difference (P < 0.05). (3) Correlation analysis among the operation groups indicated that NSE, S100B, MMP9 and rCBF were positively correlated before operation (r = 0.69, 0.58 and 0.72, respectively, P < 0.05), as well as after operation (r = 0.75, 0.65 and 0.60, respectively, P < 0.05).
Conclusion:
We concluded that the concentrations of NSE, S100B and MMP9 in serum decreased with the improvement of cerebral reperfusion after CAS. NSE, S100B and MMP9 can be used as laboratory biochemical markers to evaluate the improvement of reperfusion after CAS. The results very well complement the imaging methods, such as CTP.
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Affiliation(s)
- Xiaofan Yuan
- Department of Neurology, School of Clinical Medical, Southwest Medical University, Luzhou, China
| | - Jianhong Wang
- Department of Neurology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China
| | - Duozi Wang
- Department of Neurology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China
| | - Shu Yang
- Department of Neurology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China
| | - Nengwei Yu
- Department of Neurology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China
| | - Fuqiang Guo
- Department of Neurology, School of Clinical Medical, Southwest Medical University, Luzhou, China
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Alserr AH, Elwan H, Antonopoulos CN, Abdelreheem A, Elmahdy H, Sayed A, Taha A, Maratou E, Brountzos E, Khairy H, Liapis CD. Using serum s100-β protein as a biomarker for comparing silent brain injury in carotid endarterectomy and carotid artery stenting. INT ANGIOL 2019; 38:136-142. [PMID: 30650951 DOI: 10.23736/s0392-9590.19.04079-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND S100-β protein has been introduced as a sensitive biomarker of silent cerebral injury. This study compares its serum levels before, during, and 24 hours after carotid artery stenting (CAS) and carotid endarterectomy (CEA). METHODS We measured serum level of S100-β in arterial blood before (S100Ba), during (S100Bb), and 24 hours after (S100Bc) CAS and CEA. We assessed differences in S100-β levels using non-parametric tests. We analyzed the relationship between carotid plaque type (echolucency) and S100-β protein level. We also examined its relation to the oximetry results in the CEA group (ipsilateral and contralateral). RESULTS Thirty patients were enrolled, including 15 CAS and 15 CEA patients, with no significant differences in baseline atherosclerotic characteristics. There was no significant difference in S100Ba or S100Bb levels between CAS and CEA patients. However, a significant difference was found in S100Bc: 331.3 pg/mL (IQ range 56.4-583.5) for CAS vs. 76.3 pg/mL (IQ range 29.7-117.4) for CEA (P=0.01). Type I and II plaques were associated with the higher S100Bc levels in CAS (P=0.048). S100Bc was higher in CEA patients when the contralateral cerebral hemisphere had oximetry values less than 60% (P=0.043). CONCLUSIONS Our study suggests that CAS might produce silent brain injury. Moreover, vulnerable plaques might be associated with higher levels of S100-β protein, especially in CAS. This pilot study demonstrates that S100-β is a useful biomarker for silent brain injury in carotid revascularization. Large scale studies are still needed to confirm these findings.
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Affiliation(s)
- Ayman H Alserr
- Department of Vascular Surgery, Attikon University Hospital, Athens, Greece - .,Division of Vascular Surgery, Department of General Surgery, Cairo University Hospital, Cairo, Egypt -
| | - Hussein Elwan
- Division of Vascular Surgery, Department of General Surgery, Cairo University Hospital, Cairo, Egypt
| | | | - Amr Abdelreheem
- Division of Vascular Surgery, Department of General Surgery, Cairo University Hospital, Cairo, Egypt
| | - Hossam Elmahdy
- Division of Vascular Surgery, Department of General Surgery, Cairo University Hospital, Cairo, Egypt
| | - Ahmed Sayed
- Division of Vascular Surgery, Department of General Surgery, Cairo University Hospital, Cairo, Egypt
| | - Ahmed Taha
- Division of Vascular Surgery, Department of General Surgery, Cairo University Hospital, Cairo, Egypt
| | - Eirini Maratou
- Hellenic National Center for Research, Prevention and Treatment of Diabetes Mellitus and its Complications (HNCDC), Athens, Greece
| | - Elias Brountzos
- Department of Interventional Radiology, Attikon University Hospital, Athens, Greece
| | - Hussein Khairy
- Division of Vascular Surgery, Department of General Surgery, Cairo University Hospital, Cairo, Egypt
| | - Christos D Liapis
- Department of Vascular Surgery, Attikon University Hospital, Athens, Greece
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Branco JP, Oliveira S, Sargento-Freitas J, Santos Costa J, Cordeiro G, Cunha L, Freire Gonçalves A, Pinheiro J. S100β Protein as a Predictor of Poststroke Functional Outcome: A Prospective Study. J Stroke Cerebrovasc Dis 2018; 27:1890-1896. [PMID: 29571758 DOI: 10.1016/j.jstrokecerebrovasdis.2018.02.046] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 01/26/2018] [Accepted: 02/15/2018] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Stroke is one of the leading causes of disability worldwide. Early prediction of poststroke disability using clinical models is of great interest, especially in the rehabilitation field. Although some biomarkers and neuroimaging techniques have shown potential predictive value, there are still insufficient data to support their clinical utility in predicting poststroke functional recovery. We aimed to assess the value of serum biomarkers (C-reactive protein [CRP], D-dimer, fibrinogen, and S100β protein) in predicting medium-term (12 weeks) functional outcome in patients with acute ischemic stroke. METHODS This is an observational, prospective study in a sample of patients hospitalized for ischemic stroke (N = 131). Peripheral blood levels of biomarkers of interest were determined at admission (CRP, D-dimer, and fibrinogen) or at 48 hours poststroke (S100β protein). Functional status was accessed at 48 hours and 12 weeks poststroke using the modified Rankin Scale (mRS). RESULTS S100β protein levels measured at 48 hours were significantly associated with mRS scores at 12 weeks (odds ratio = 1.005, 95% confidence interval [CI] [1.005-1.007]; P <.001). This association was not seen for the remaining biomarkers of interest. The S100β cutoff for poor functionality at 12 weeks was 140.5 ng/L or more (sensibility 83.8%; specificity 71.4%; area under the curve = .80, 95% CI [.722, .879]). CONCLUSIONS S100β levels in peripheral blood at 48 hours poststroke reflect acute stroke severity and predict functional outcome at 12 weeks with a cutoff value of 140.5 ng/dL. The value of S100β as predictor of functional recovery after stroke should be emphasized in further clinical research and clinical practice.
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Affiliation(s)
- João Paulo Branco
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Physical and Rehabilitation Medicine Department, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal; Physical and Rehabilitation Medicine Department, Centro de Medicina de Reabilitação da Região Centro-Rovisco Pais, Tocha, Portugal.
| | - Sandra Oliveira
- Physical and Rehabilitation Medicine Department, Centro de Medicina de Reabilitação da Região Centro-Rovisco Pais, Tocha, Portugal
| | - João Sargento-Freitas
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Neurology Department, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal
| | - Joana Santos Costa
- Physical and Rehabilitation Medicine Department, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal
| | - Gustavo Cordeiro
- Neurology Department, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal
| | - Luís Cunha
- Neurology Department, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal
| | - António Freire Gonçalves
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Neurology Department, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal
| | - João Pinheiro
- Physical and Rehabilitation Medicine Department, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal; Neurology Department, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal
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Wang L, Li X, Song J, Jiang T, Wu X, Zhou S. Comparisons of cognitive function and serum S-100B level between diabetic and non-diabetic patients after the implantation of carotid artery stent (CAS). Neurosci Lett 2014; 570:58-62. [PMID: 24746932 DOI: 10.1016/j.neulet.2014.04.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Revised: 02/22/2014] [Accepted: 04/07/2014] [Indexed: 10/25/2022]
Abstract
To investigate cognitive function improvement in diabetic and non-diabetic patients after the implantation of Carotid Artery Stent (CAS), 128 patients suffering severe carotid stenosis were successfully enrolled in this study. Tests including, the Mini Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Alzheimer's Disease Assessment Scale-Cognitive subscale (ADAS-Cog), Clock Drawing Test (CDT), Hasegawa's Dementia Scale-Revised (HDS-R) and the serum levels of S-100B, were all measured at baseline for 3 months after the implantation of CAS. The baseline characteristics were similar between the patients with and without diabetes. 3 months after the implantation, significant improvements in MMSE (24.8 ± 2.2 vs. 25.2 ± 2.1, p=0.003), MoCA (25.6 ± 2.0 vs. 26.1 ± 1.9, p=0.000), ADAS-Cog (6.5 ± 1.3 vs. 6.1 ± 1.3, p=0.000), and CDT (3.3 ± 0.7 vs. 3.5 ± 0.7, p=0.034) were observed in the non-diabetic group. In contrast, there was no significant improvement in any of the cognitive test for the diabetic group. Another interesting discovery was the CAS procedure significantly decreased the S-100B level in the non-diabetic group (0.11 ± 0.04 ng/mL vs. 0.10 ± 0.04 ng/mL, p=0.000), but similar phenomena were not discovered in the diabetic group. In this light, the change of the S-100B level was negatively correlated with the results in the MMSE (p<0.01) and the MoCA (p<0.01) tests, and positively correlated with the result in ADAS-Cog (p<0.05) test. Our findings suggest that the CAS-induced beneficial effects on cognitive function might have a correlation relationship with the serum level of S-100B.
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Affiliation(s)
- Lizhou Wang
- Department of Radiology, Affiliated Hospital of Guiyang Medical College, Guiyang 550004, China
| | - Xing Li
- Department of Radiology, Affiliated Hospital of Guiyang Medical College, Guiyang 550004, China
| | - Jie Song
- Department of Radiology, Affiliated Hospital of Guiyang Medical College, Guiyang 550004, China
| | - Tianpeng Jiang
- Department of Radiology, Affiliated Hospital of Guiyang Medical College, Guiyang 550004, China
| | - Xiaoping Wu
- Department of Radiology, Affiliated Hospital of Guiyang Medical College, Guiyang 550004, China
| | - Shi Zhou
- Department of Radiology, Affiliated Hospital of Guiyang Medical College, Guiyang 550004, China.
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Surgical resection of carotid body paragangliomas: 10 years of experience. Am J Surg 2014; 207:293-8. [DOI: 10.1016/j.amjsurg.2013.06.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Revised: 06/18/2013] [Accepted: 06/20/2013] [Indexed: 11/29/2022]
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Wang Y, Zhang H, Wang Z, Geng Z, Liu H, Yang H, Song P, Liu Q. Therapeutic effect of nerve growth factor on cerebral infarction in dogs using the hemisphere anomalous volume ratio of diffusion-weighted magnetic resonance imaging. Neural Regen Res 2012; 7:1873-80. [PMID: 25624813 PMCID: PMC4298901 DOI: 10.3969/j.issn.1673-5374.2012.24.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2012] [Accepted: 06/19/2012] [Indexed: 11/18/2022] Open
Abstract
A model of focal cerebral ischemic infarction was established in dogs through middle cerebral artery occlusion of the right side. Thirty minutes after occlusion, models were injected with nerve growth factor adjacent to the infarct locus. The therapeutic effect of nerve growth factor against cerebral infarction was assessed using the hemisphere anomalous volume ratio, a quantitative index of diffusion-weighted MRI. At 6 hours, 24 hours, 7 days and 3 months after modeling, the hemisphere anomalous volume ratio was significantly reduced after treatment with nerve growth factor. Hematoxylin-eosin staining, immunohistochemistry, electron microscopy and neurological function scores showed that infarct defects were slightly reduced and neurological function significantly improved after nerve growth factor treatment. This result was consistent with diffusion-weighted MRI measurements. Experimental findings indicate that nerve growth factor can protect against cerebral infarction, and that the hemisphere anomalous volume ratio of diffusion-weighted MRI can be used to evaluate the therapeutic effect.
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Affiliation(s)
- Yong Wang
- Department of Radiology, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
| | - Hui Zhang
- Department of Radiology, Hebei General Hospital, Shijiazhuang 050051, Hebei Province, China
| | - Zhe Wang
- Department of Computer Science, Institute of Basic Medicine, Hebei Medical University, Shijiazhuang 050031, Hebei Province, China
| | - Zuojun Geng
- Department of Radiology, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
| | - Huaijun Liu
- Department of Radiology, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
| | - Haiqing Yang
- Department of Radiology, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
| | - Peng Song
- Department of Radiology, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
| | - Qing Liu
- Department of Radiology, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
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