1
|
Eyiol A, Ertekin B. Association of red blood cell distribution width to albumin ratio with prognosis in stroke patients. Biomark Med 2024; 18:311-320. [PMID: 38648096 PMCID: PMC11218802 DOI: 10.2217/bmm-2023-0460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 03/05/2024] [Indexed: 04/25/2024] Open
Abstract
Aim: The authors investigated the association of red blood cell distribution width to albumin ratio (RAR) with prognosis and severity in acute ischemic stroke (AIS). Methods: One hundred twenty-seven patients with AIS were prospectively analyzed. The NIH Stroke Scale was used to determine stroke severity. RAR was compared between severe and nonsevere patients. Results: RAR was significantly higher in severe compared with nonsevere patients (p < 0.001). According to receiver operating characteristic analysis, RAR alone predicted mortality better than red blood cell distribution width and albumin (area under the curve: 0.933, 0.911, 0.870, respectively). Additionally, RAR was significantly correlated with NIH Stroke Scale score (p < 0.001). Conclusion: High RAR measured at presentation is a feasible index for prognosis and severity stratification in AIS.
Collapse
Affiliation(s)
- Azmi Eyiol
- Department of Cardiology, University of Health Sciences, Beyhekim Training & Research Hospital, Konya, Turkey
| | - Birsen Ertekin
- Department of Emergency, University of Health Sciences, Beyhekim Training & Research Hospital, Konya, Turkey
| |
Collapse
|
2
|
The Identification and Verification of Key Long Noncoding RNAs in Ischemic Stroke. BIOMED RESEARCH INTERNATIONAL 2021; 2020:2094320. [PMID: 33490236 PMCID: PMC7789472 DOI: 10.1155/2020/2094320] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 11/30/2020] [Accepted: 12/21/2020] [Indexed: 12/13/2022]
Abstract
Stroke is a neurological disease with high rates of mortality and disability. The pathogenesis of stroke is acute focal injury of the central nervous system, leading to impaired neural function. Ischemic stroke accounts for the majority of cases. At present, the exact molecular mechanism of ischemic stroke remains unclear. Studies have shown that long noncoding RNAs (lncRNAs) have an important regulatory role in biological processes, participating in the regulation of transcription and affecting the processing and splicing of mRNAs. Abnormal lncRNA expression is associated with various diseases, including diseases of the nervous system. To identify and verify the key lncRNAs in ischemic stroke, we downloaded gene expression data from the National Center for Biotechnology Information Gene Expression Omnibus (NCBI GEO) and obtain differentially expressed lncRNAs, miRNAs, and mRNAs by bioinformatics analysis. Cytoscape was used to reconstruct a lncRNA-miRNA-mRNA network on the basis of the competitive endogenous RNA theory. We performed Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses of the mRNAs regulated by lncRNAs in the lncRNA-miRNA-mRNA network. The resulting lncRNA-miRNA-mRNA network was composed of 91 lncRNA nodes, 70 mRNA nodes, 21 miRNA nodes, and 288 edges. GO analysis and KEGG pathway analysis have shown that 191 GO terms and 23 KEGG pathways were enriched. Finally, we found that four key lncRNAs were highly correlated with ischemic stroke and could be used as potential new targets for treatment.
Collapse
|
3
|
Li X, Xu L, Xu Z. The diagnostic and prognostic performance of Lp-PLA2 in acute ischemic stroke. Med Clin (Barc) 2021; 156:437-443. [PMID: 33483146 DOI: 10.1016/j.medcli.2020.11.034] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 11/15/2020] [Accepted: 11/20/2020] [Indexed: 01/04/2023]
Abstract
OBJECTIVE We aimed to investigate the correlation between serum lipoprotein-associated phospholipase A2 (Lp-PLA2) level and acute ischemic stroke (AIS) severity and recurrence, which could indicate the diagnostic and prognostic values of Lp-PLA2. METHODS Two hundred and fifty-one AIS patients who were diagnosed in the department of neurology, China-Japan Union Hospital, from April 2018 to June 2019 and 100 non-cerebrovascular disease patients were included in this study. Demographic data and clinical materials including age, sex, BMI, medical history, bad habits, imaging data, blood tests, etc., were collected. Stroke severity and risk were evaluated, respectively. AIS patients were followed up for 6 months for stroke recurrence monitoring. RESULTS The AIS group had significantly higher Lp-PLA2 level than the control group. High Lp-PLA2 level was the independent risk factor of AIS (OR 1.010; 95% CI 1.007-1.013, P<0.001). Admission NIHSS was compared between Lp-PLA2 categories dichotomized by median. Serum Lp-PLA2 level was positively correlated with NIHSS (r=0.268, P<0.001). Mild stroke group and severe stroke group were defined based on NIHSS. Compared with the mild stroke group, the severe stroke group had higher smoking ratio, posterior circulation stenosis incidence, LDL level, Lp-PLA2 level and admission Essen score. Logistic regression showed Lp-PLA2 levels per 50ng/mL (OR 1.381, 95% CI 1.212-1.573, P<0.001) and Lp-PLA2 category (OR 2.420, 95% CI 1.363-4.297, P=0.003) were both independently associated with severe stroke. During the 6-month follow-up of all 251 AIS patients, 31 stroke recurrence cases were observed. Both Lp-PLA2 levels per 50ng/mL (OR 1.420, 95% CI 1.212-1.664, P<0.001) and Lp-PLA2 category (OR 2.726, 95% CI 1.201-6.178, P=0.016) were significantly associated with the stroke recurrence. Under the receiver Operating Characteristic curve, Lp-PLA2 showed significant predicting ability for stroke recurrence (AUC 0.723; 95% CI 0.620-0.826, P<0.001). CONCLUSION High serum Lp-PLA2 level is correlated with AIS incidence, disease severity and recurrence, which could be utilized to guide clinical practice.
Collapse
Affiliation(s)
- Xiaoyan Li
- The Department of Neurology, China-Japan Union Hospital of Jilin University, PR China
| | - Lei Xu
- The Department of Neurology, China-Japan Union Hospital of Jilin University, PR China.
| | - Zhongxin Xu
- The Department of Neurology, China-Japan Union Hospital of Jilin University, PR China.
| |
Collapse
|
4
|
Qin Y, Qian X, Luo X, Li Y, Wang D, Jiang J, Zhang Q, Liu M, Xiao J, Zhang Y, Diao S, Zhao H. Association Between Plasma Lipoprotein-Associated Phospholipase A2 and Plaque Vulnerability in TIA Patients With Unilateral Middle Cerebral Artery Stenosis. Front Neurol 2020; 11:574036. [PMID: 33178116 PMCID: PMC7596647 DOI: 10.3389/fneur.2020.574036] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 09/02/2020] [Indexed: 12/16/2022] Open
Abstract
Background: Plasma lipoprotein-associated phospholipase A2 (Lp-PLA2) has emerged as a novel biomarker for coronary atherosclerosis. However, the association between Lp-PLA2 and plaque vulnerability in atherosclerosis of cervicocerebral arteries remains poorly defined, especially for intracranial atherosclerotic stenosis (ICAS). We aimed to investigate the association between Lp-PLA2 and plaque vulnerability in transient ischemic attack (TIA) patients with unilateral middle cerebral artery stenoses (MCAs). Methods: In this study, a total of 207 patients were enrolled from April 2017 to April 2020. Clinical data were collected, and MCA plaques were examined with high-resolution magnetic resonance imaging (HRMRI). Baseline characteristics of patients were collected during hospitalization. Statistical comparisons were performed using Pearson's chi-squared test, Mann–Whitney U test, and the Breslow–Day/Tarone's test for the determination of heterogeneity in different age strata. Multivariate binary logistic analysis was used to investigate the potential independent predictors that were highly correlated to plaque vulnerability. Results: The results showed that a high Lp-PLA2 level (>221 ng/ml) was associated with plaque vulnerability in TIA patients with unilateral MCAs. High Lp-PLA2 was independently associated with plaque vulnerability in patients ≤ 60 years old [multivariate adjusted odds ratio (OR) = 9.854; 95% CI, 2.458–39.501] but not in patients >60 years old (multivariate adjusted OR = 1.901; 95% CI, 0.640–5.650). Predictors of plaque vulnerability in different age strata were also different. Conclusion: Lp-PLA2 levels may be correlated to plaque vulnerability in TIA patients with unilateral MCAs and might be a diagnostic biomarker for plaque vulnerability in this kind of patients, especially for ones aged ≤ 60 years old.
Collapse
Affiliation(s)
- Yiren Qin
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xiaoyan Qian
- Department of Neurology, The First People's Hospital of Kunshan, Kunshan, China
| | - Xue Luo
- Department of Neurology, Shiqian County People's Hospital, Tongren, China
| | - Yuanfang Li
- Department of Neurology, Shiqian County People's Hospital, Tongren, China
| | - Dapeng Wang
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Jianhua Jiang
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Quanquan Zhang
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Meirong Liu
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Junhua Xiao
- Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yan Zhang
- Department of Neurology, The First People's Hospital of Kunshan, Kunshan, China
| | - Shanshan Diao
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Hongru Zhao
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
| |
Collapse
|
5
|
Zhang YJ, Liu WJ. Association between non-alcoholic fatty liver and acute cerebral infarction: a protocol of systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e20351. [PMID: 32541457 PMCID: PMC7302642 DOI: 10.1097/md.0000000000020351] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 04/21/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND This study will systematically synthesize the evidence on the potential association between non-alcoholic fatty liver (NAFL) and acute cerebral infarction (ACI). METHODS We will propose literature search in electronic databases (MEDLINE, EMBASE, Cochrane Library, Scopus, Web of Science, WANGFANG, and China National Knowledge Infrastructure) from the source to March 1, 2020. There are no restrictions related to the language and publication status. Two review authors will separately carry out records selection, data extraction and study quality assessment. Any divisions will be solved by discussion with consulting a third review author. We will use RevMan 5.3 software to perform data analysis. RESULTS The present study will afford additional insight into the investigation the association between NAFL and ACI. CONCLUSION The results of this study will provide helpful evidence to explore the association between NAFL and ACI.Study registration number: INPLASY202040102.
Collapse
|
6
|
Foroughinia F, Tabibi AA, Javanmardi H, Safari A, Borhani-Haghighi A. Association between high sensitivity C-reactive protein (hs-CRP) levels and the risk of major adverse cardiovascular events (MACE) and/or microembolic signals after carotid angioplasty and stenting. CASPIAN JOURNAL OF INTERNAL MEDICINE 2019; 10:388-395. [PMID: 31814936 PMCID: PMC6856919 DOI: 10.22088/cjim.10.4.388] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Background To evaluate the association between pre/post-procedural high sensitive C-reactive protein (hs-CRP) level and hs-CRP difference, and the risk of major adverse cardiovascular events (MACE) or new diffusion-weighted MRI lesions after carotid angioplasty and stenting (CAS). Methods In this study, conducted in 2016 in Shiraz (Iran), patients who underwent diagnostic angiography and CAS were recruited. CAS was performed with distal embolic protection device on patients with both standard and high risk of endarterectomy. Pre/post-procedural hs-CRP, and hs-CRP difference were determined by immunoenzymometric assay method. Results A total of 50 patients with diagnostic angiography and 60 patients with CAS were enrolled. No death, myocardial infarction, ischemic or hemorrhagic stroke, and need to revascularization occurred during the 30-days of the post-procedural period. Accordingly, the statistical evaluation in associating MACE and hs-CRP levels was impossible. Angioplasty was associated with higher frequency of elevated post-procedural hs-CRP in comparison to angiography (P=0.003). The higher age, symptomatic lesions, negative history of hypertension, and hs-CRP difference had significant association with the presence of new DWI lesions in univariate analysis (all P<0.05). Angioplasty of left carotid bulb and post-procedural hs-CRP levels was very close to the level of significance (P=0.06). But only left sided lesions had positive association (P=0.037) and hypertension had negative association (P=0.037) in multivariate regression analysis. There were significant association between post-procedural hs-CRP level (P=0.02) and hs-CRP difference (P=0.003), and the number of new lesions; and the hs-CRP difference and the accumulated lesion surface area (P=0.009). Conclusion Post-procedural hs-CRP and hs-CRP difference may predict embolic complications of CAS.
Collapse
Affiliation(s)
- Farzaneh Foroughinia
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Clinical Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amir Ashkan Tabibi
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Haniyeh Javanmardi
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Anahid Safari
- Stem Cells Technology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Afshin Borhani-Haghighi
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Neurology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
7
|
Tao L, ShiChuan W, DeTai Z, Lihua H. Evaluation of lipoprotein-associated phospholipase A2, serum amyloid A, and fibrinogen as diagnostic biomarkers for patients with acute cerebral infarction. J Clin Lab Anal 2019; 34:e23084. [PMID: 31713292 PMCID: PMC7083405 DOI: 10.1002/jcla.23084] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Revised: 09/30/2019] [Accepted: 10/09/2019] [Indexed: 12/12/2022] Open
Abstract
Objective The aim of this study was to explore the clinical values of combined detection of lipoprotein‐associated phospholipase A2 (Lp‐PLA2), serum amyloid A (SAA), and plasma fibrinogen (FIB) in the diagnosis of acute cerebral infarction (ACI). Methods A case‐control study including 100 hospitalized patients with ACI and 47 healthy controls was carried out. The level of Lp‐PLA2, SAA, and FIB was detected, respectively, and their clinical values were analyzed. Carotid lesions and neurological impairment were also analyzed in each patient. Results The level of Lp‐PLA2, SAA, and FIB in the ACI group was significantly higher than that of the controls, and the three biomarkers showed a significant positive correlation and were considered as risk factors for ACI. The area under the curve (AUC) for Lp‐PLA2, SAA, and FIB was 0.858, 0.743, and 0.672, respectively. When three biomarkers were used in combination, the AUC was 0.879. Compared with the other groups, the levels of three biomarkers in bilateral carotid plaque ACI group were all significantly higher. In addition, the level of Lp‐PLA2 and SAA in ACI patients with severe neurological impairment was also significantly higher than that of the mild‐to‐moderate group. Conclusion Lp‐PLA2 combined with SAA and FIB had a high clinical value for rapid diagnosis and prediction of ACI. These biomarkers were also significantly associated with the formation of bilateral carotid atherosclerotic plaques and the severe neurological impairment in ACI patients.
Collapse
Affiliation(s)
- Liang Tao
- Department of Clinical Laboratory, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wang ShiChuan
- Department of Clinical Laboratory, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhang DeTai
- Department of Clinical Laboratory, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hu Lihua
- Department of Clinical Laboratory, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| |
Collapse
|
8
|
Qiao J, Zhou K, Huang C, Fu S, Xing Y, Zhang B. Comparison of serum Lp-PLA2 levels in ischemic stroke patients with H-type hypertension or non-H-type hypertension. J Clin Lab Anal 2019; 34:e23068. [PMID: 31630457 PMCID: PMC7031582 DOI: 10.1002/jcla.23068] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 09/22/2019] [Accepted: 09/24/2019] [Indexed: 01/15/2023] Open
Abstract
Background Increased serum Lp‐PLA2 levels have been reported in patients who experienced an ischemic stroke; however, the relationship between Lp‐PLA2 and H‐type hypertension in patients with ischemic stroke remains unclear. Methods In the present study, we investigated the correlation between serum Lp‐PLA2 and H‐type hypertension in patients with ischemic stroke. A total of 135 patients who experienced acute ischemic stroke were enrolled in Tianjin Huanhu Hospital during October 2015 to May 2016. The demographic characteristics of the patients were collected, and biochemical parameters were detected. Results Among the 135 patients, 111 patients had essential hypertension, including 41 patients with H‐type hypertension and 70 with non‐H‐type hypertension. There were higher proportions of males and patients with diabetes mellitus in the H‐type hypertension group compared with the non‐H‐type hypertension group (P < .05). Lp‐PLA2, glucose, and LDL‐C levels were higher in the H‐type hypertension group than in the non‐H‐type hypertension group (P < .05). Multivariate logistic regression showed that Lp‐PLA2 levels >208.46 mg/L were independently associated with H‐type hypertension in patients with ischemic stroke (OR: 2.560, 95% CI: 1.085‐6.040, P = .032). The area under the ROC curve of Lp‐PAL2 levels in the H‐type hypertension group was 0.665 (95% CI: 0.561‐0.768, P = .004). Conclusion Synergetic effects of H‐type hypertension and Lp‐PLA2 levels were noted in the pathogenesis of ischemic stroke.
Collapse
Affiliation(s)
- Jie Qiao
- Tianjin Key Laboratory of Cerebral Vessels and Neural DegenerationTianjin Neurosurgical InstituteTianjin Huanhu HospitalTianjinChina
| | - KuiChen Zhou
- Department of Clinical LaboratoryThe First Affiliated Hospital of Jiamusi UniversityJiamusiChina
| | - Chao Huang
- Tianjin Key Laboratory of Cerebral Vessels and Neural DegenerationTianjin Neurosurgical InstituteTianjin Huanhu HospitalTianjinChina
| | - Siwen Fu
- Tianjin Key Laboratory of Cerebral Vessels and Neural DegenerationTianjin Neurosurgical InstituteTianjin Huanhu HospitalTianjinChina
| | - Yonghong Xing
- Tianjin Key Laboratory of Cerebral Vessels and Neural DegenerationTianjin Neurosurgical InstituteTianjin Huanhu HospitalTianjinChina
| | - Biao Zhang
- Tianjin Key Laboratory of Cerebral Vessels and Neural DegenerationTianjin Neurosurgical InstituteTianjin Huanhu HospitalTianjinChina
| |
Collapse
|
9
|
Wang Y, Hu S, Ren L, Lei Z, Lan T, Cai J, Li C. Lp-PLA 2 as a risk factor of early neurological deterioration in acute ischemic stroke with TOAST type of large arterial atherosclerosis. Neurol Res 2018; 41:1-8. [PMID: 30296199 DOI: 10.1080/01616412.2018.1493850] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Introduction: Lipoprotein-associated phospholipase A2 (Lp-PLA2) is a well-known risk factor of atherosclerotic vascular diseases. Nevertheless, its role in the acute phase of ischemic stroke is still unclear. The aim of this study is to identify the relationship between Lp-PLA2 levels and early neurological deterioration (END) in acute ischemic stroke patients with Trial of Org 10 172 in Acute Stroke Treatment (TOAST) subtype of large arterial atherosclerosis (LAA). Methods: We enrolled Chinese patients with first ever acute ischemic stroke admitted to Neurology Department of Shenzhen Second People's Hospital within 48 h from onset of symptoms during January - November 2015. Demographic and laboratory information were collected while END was defined as an increase in the National Institute of Health Stroke Scale score by ≥ 1 point in motor power, or ≥ 2 points in the total score within 10 days after admission. Results: Overall 181 patients were involved; END was diagnosed in 30 patients within 10 days after admission. The odds ratio for END increased with increasing levels of Lp-PLA2 (intermediate level, OR = 1.96, 95%CI 1.02-4.27, p = 0.041; high level, OR = 2.99, 95%CI 1.26-5.73, p = 0.023). Conclution: Intermediate and high level of Lp-PLA2 was identified as independent predictor of END in multivariate analysis. Lp-PLA2 could be valued as a risk factor of END in patients with acute ischemic stroke with TOAST subtype of LAA.
Collapse
Affiliation(s)
- Yang Wang
- a Department of Neurology , Shenzhen University 1st Affiliated Hospital , Guangdong , China
| | - Shiyu Hu
- a Department of Neurology , Shenzhen University 1st Affiliated Hospital , Guangdong , China
| | - Lijie Ren
- a Department of Neurology , Shenzhen University 1st Affiliated Hospital , Guangdong , China
| | - Zhihao Lei
- a Department of Neurology , Shenzhen University 1st Affiliated Hospital , Guangdong , China
| | - Tao Lan
- b Department of Orthopaedics , Shenzhen University 1st Affiliated Hospital , Guangdong , China
| | - Jingjing Cai
- a Department of Neurology , Shenzhen University 1st Affiliated Hospital , Guangdong , China
| | - Chao Li
- a Department of Neurology , Shenzhen University 1st Affiliated Hospital , Guangdong , China
| |
Collapse
|
10
|
Zhou F, Liu Y, Shi H, Huang Q, Zhou J. Relation between lipoprotein-associated phospholipase A 2 mass and incident ischemic stroke severity. Neurol Sci 2018; 39:1591-1596. [PMID: 29938341 DOI: 10.1007/s10072-018-3474-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 06/09/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND Manifestations of ischemic stroke vary widely, and serum biomarkers may be useful for stratification of risk of severe stroke. This study evaluated the association of lipoprotein-associated phospholipase A2 (Lp-PLA2) mass and initial severity. METHODS We employed a retrospective analysis on our hospital-based registry and recruited 488 first-onset ischemic stroke patients admitted within 24 h after onset and with Lp-PLA2 mass measured. Stroke severities evaluated by National Institutes of Health Stroke Scale (NIHSS) were compared between Lp-PLA2 categories dichotomized by median. Multivariate logistic regression was used to detect the independent risk factors of severe stroke (NIHSS ≥ 7) and receiver operator curve (ROC) was constructed to detect the value of addition of Lp-PLA2 to the model of other risk factors for predicting severe stroke. RESULTS Of the overall patients, the median admission NIHSS scores was 3 and 28.1% had severe manifestation. Admission NIHSS scores were different between patients of Lp-PLA2 above and under the median (median NIHSS 4 vs. 3, P < 0.001). Lp-PLA2 levels was correlated with admission NIHSS (r = 0.268, P < 0.001). Logistic regression showed Lp-PLA2 category (OR 2.37, 95%CI 1.44-3.90, P < 0.001) and levels per 100 ng/ml (OR 1.69, 95%CI 1.35-2.11, P < 0.001) were both independently associated with severe stroke. Addition of Lp-PLA2 category and levels to other independent risk factors both increased the area under curves (from 0.676 to 0.718 with category and 0.734 with levels). CONCLUSION Lp-PLA2 was independently related to admission severity in ischemic stroke patients, implying a potential predictive value of Lp-PLA2 for severe stroke in prevention.
Collapse
Affiliation(s)
- Feng Zhou
- Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Yukai Liu
- Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Hongchao Shi
- Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Qing Huang
- Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Junshan Zhou
- Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
| |
Collapse
|
11
|
Fang C, Lou B, Zhou J, Zhong R, Wang R, Zang X, Shen H, Li Y. Blood biomarkers in ischemic stroke: Role of biomarkers in differentiation of clinical phenotype. EUR J INFLAMM 2018. [DOI: 10.1177/2058739218780058] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Stroke is the major cause of death and disability worldwide and ischemic stroke contributes 80% among them. Although limited number of patients display hemorrhagic stroke (HS), the disability and death rate are higher in HS. Several studies have been reported on identification of suitable markers for diagnosis of stroke, but none of them holds true worldwide. These observations direct toward identification of population-specific biomarker of stroke. In this study, we screened various blood biomarkers in a large cohort of well-characterized Chinese stroke patients and healthy controls. A total of 308 stroke patients including 262 acute ischemic stroke (AIS) patients and 42 HS patients were enrolled in the study and blood samples were collected within 6–24 h of stroke onset. In addition, 46 stroke mimic subjects were included for comparison of blood markers with stroke patients. Furthermore, healthy controls (n = 200) and patient controls (n = 125) from similar ethnic group were enrolled in the study. Biomarkers (S100 calcium-binding protein B (S100B), C-reactive protein (CRP), interleukin 6 (IL-6), plasminogen activator inhibitor-1 (PAI-1), matrix metallopeptidase 9 (MMP-9), P-selectin, intercellular adhesion molecule 1 (ICAM-1), tumor necrosis factor α (TNF-α), low-density lipoprotein (LDL) cholesterol, interleukin 10 (IL-10), nitric oxide (NO), and glial fibrillary acidic protein (GFAP)) were quantified by ELISA. Blood levels of S100B, CRP, IL-6, PAI-1, MMP-9, P-selectin, ICAM-1, and TNF-α were significantly higher in AIS and HS patients compared to healthy controls, patient controls, and stroke mimic patients. Receiver operating characteristic (ROC) curve analysis revealed CRP, IL-6, PAI-1, P-selectin, and TNF-α as possible biomarkers for AIS patients, and HS patients can be diagnosed based on S100B, IL-6, PAI-1, MMP-9, and TNF-α. Interestingly, significant area under ROC curves were observed for plasma S100B and CRP for differentiating AIS from HS. The results of this study validated certain blood parameters used for diagnosis of AIS or HS in Chinese patients. Furthermore, S100B and CRP are promising biomarkers for differentiation of AIS from HS.
Collapse
Affiliation(s)
- Chunyan Fang
- Department of Neurology, Zhucheng People’s Hospital, Zhucheng, China
| | - Bin Lou
- Department of Neurology, Zhucheng People’s Hospital, Zhucheng, China
| | - Juanjuan Zhou
- Department of Neurology, Zhucheng People’s Hospital, Zhucheng, China
| | - Ren Zhong
- Department of Neurology, Zhucheng People’s Hospital, Zhucheng, China
| | - Rujie Wang
- Department of Neurology, Zhucheng People’s Hospital, Zhucheng, China
| | - Xiaopeng Zang
- Department of Neurology, Zhucheng People’s Hospital, Zhucheng, China
| | - Hongmei Shen
- Department of Neurology, Zhucheng People’s Hospital, Zhucheng, China
| | - Yonghong Li
- Department of Neurology, Zhucheng People’s Hospital, Zhucheng, China
| |
Collapse
|
12
|
Wang Y, Zhou B, Zhou P, Yao Y, Cui Q, Liu Y, Yang J, Wu S, Zhao X, Zhou Y. Association of lipoprotein-associated phospholipase A2 mass with asymptomatic cerebral artery stenosis. J Cell Mol Med 2018; 22:2329-2336. [PMID: 29424477 PMCID: PMC5867129 DOI: 10.1111/jcmm.13521] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 12/08/2017] [Indexed: 12/25/2022] Open
Abstract
Cerebral artery stenosis (CAS) is the most important causes of ischaemic stroke. Lipoprotein-associated phospholipase A2 (Lp-PLA2) plays 2 diverse roles in atherosclerosis (pro-inflammatory and anti-inflammatory), and the association between Lp-PLA2 mass and cardiovascular or cerebrovascular events is inconsistent among previous studies. A cross-sectional study including 2012 North Chinese adults aged ≥40 years was performed in 2010-2011 to investigate whether Lp-PLA2 mass is associated with asymptomatic cerebral artery stenosis (ACAS). Serum Lp-PLA2 mass was determined by enzyme-linked immunosorbent assay (ELISA). All participants underwent transcranial Doppler (TCD) and bilateral carotid duplex ultrasound to evaluate intracranial artery stenosis (ICAS) and extracranial arterial stenosis (ECAS). The median serum Lp-PLA2 mass of the participants was 140.74 ng/mL (interquartile range: 131.79-158.07 ng/mL). The adjusted odds ratio (OR) when comparing the 4th quartile to the 1st quartile of Lp-PLA2 was 1.98 (95% confidence interval (CI): 1.42-2.78), 1.79 (95% CI: 1.08-2.94) and 1.87 (95% CI: 1.28-2.73) for the occurrence of ACAS, asymptomatic ECAS and asymptomatic ICAS, respectively, after controlling for vascular risk factors. These independently significant associations remained statistically significant in the male or elderly subgroups, but not in females or middle-aged participants. Lp-PLA2 mass is positively correlated with subclinical atherosclerosis determined by ACAS, ICAS and ECAS in North Chinese, particularly in male and older participants, suggesting that serum Lp-PLA2 mass might be potential biomarker for the detection of ACAS in the adults.
Collapse
Affiliation(s)
- Youxin Wang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Bin Zhou
- Department of Neurosurgery, Baotou Eighth Hospital, Baotou, China
| | - Pingan Zhou
- Department of Ultrasound, Yan'an University Affiliated Hospital, Yan'an, China
| | - Yan Yao
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Qinghua Cui
- Department of Biomedical Informatics, Center for Noncoding RNA Medicine, MOE Key Laboratory of Cardiovascular Sciences, School of Basic Medical Sciences, Peking University, Beijing, China
| | - Yingping Liu
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Jichun Yang
- Pathophysiology, School of Basic Medical Sciences, Key Laboratory of Molecular Cardiovascular Science of the Ministry of Education Center for Non-coding RNA Medicine, Peking University Health Science Center, Beijing, China
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Xingquan Zhao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Municipal Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Yong Zhou
- Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
13
|
Kocak S, Ertekin B, Girisgin AS, Dundar ZD, Ergin M, Mehmetoglu I, Bodur S, Cander B. Lipoprotein-associated phospholipase-A 2 activity and its diagnostic potential in patients with acute coronary syndrome and acute ischemic stroke. Turk J Emerg Med 2017; 17:56-60. [PMID: 28616616 PMCID: PMC5459519 DOI: 10.1016/j.tjem.2016.10.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Revised: 10/09/2016] [Accepted: 10/11/2016] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The study examined the Lp-PLA2 activity at the patients presented to the emergency department with acute coronary syndrome (ACS) or acute ischemic stroke (AIS), as well as its diagnostic value. METHODS The prospective study included consecutive male and female patients aged >18 years that presented to the our emergency department with ACS or AIS between November 2009 and January 2010. Blood samples were obtained immediately following diagnosis in the ACS and AIS groups. The diagnostic value of Lp-PLA2 was determined based on receiver operating characteristic curves, sensitivity, specificity, predictive values, likelihood ratios and accuracy rates. RESULTS In all, 34 ACS and 32 AIS patients were included in the study, and the control group included 35 patients. Lp-PLA2 enzyme activity was significantly lower in the ACS and AIS groups than in the control group (26.7 ± 13.8, 31.4 ± 13.6, and 41.4 ± 8.1 nmol min-1·mL-1, respectively; p < 0.0001, p = 0.022). In the ACS group the area under the curve (AUC) was 0.825 (95%CI: 0.722-0.929), sensitivity was 71% for an optimal Lp-PLA2 cut-off value of 31.4 nmol min-1·mL-1, and specificity was 91%, whereas in the AIS group the AUC was 0.768 (95%CI: 0.652-0.884), sensitivity was 75% for an optimal Lp-PLA2 cut-off value of 38.1 nmol min-1·mL-1, and specificity was 74%. CONCLUSIONS Lp-PLA2 enzyme activity was significantly lower during the early stage of both ACS and AIS. The obtained statistic data suggest that low Lp-PLA2 enzyme activity can be used for diagnostic purposes.
Collapse
Affiliation(s)
- Sedat Kocak
- Emergency Department, Necmettin Erbakan University, Meram Faculty of Medicine, Konya, Turkey
| | - Birsen Ertekin
- Emergency Department, Beyhekim State Hospital, Konya, Turkey
| | - Abdullah Sadik Girisgin
- Emergency Department, Necmettin Erbakan University, Meram Faculty of Medicine, Konya, Turkey
| | - Zerrin Defne Dundar
- Emergency Department, Necmettin Erbakan University, Meram Faculty of Medicine, Konya, Turkey
| | - Mehmet Ergin
- Emergency Department, Necmettin Erbakan University, Meram Faculty of Medicine, Konya, Turkey
| | - Idris Mehmetoglu
- Biochemistry Department, Necmettin Erbakan University, Meram Faculty of Medicine, Konya, Turkey
| | - Said Bodur
- Public Health Department, Balıkesir University Faculty of Medicine, Balıkesir, Turkey
| | - Basar Cander
- Emergency Department, Necmettin Erbakan University, Meram Faculty of Medicine, Konya, Turkey
| |
Collapse
|
14
|
Monbailliu T, Goossens J, Hachimi-Idrissi S. Blood protein biomarkers as diagnostic tool for ischemic stroke: a systematic review. Biomark Med 2017; 11:503-512. [PMID: 28598212 DOI: 10.2217/bmm-2016-0232] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
AIM This systematic review provides a summary of the blood protein biomarkers that have been studied for the diagnosis of acute ischemic stroke. MATERIALS & METHODS An extensive MEDLINE (using PubMed) and Web of Knowledge search was performed. From the 354 articles found, 42 were eligible for further analysis and 25 protein biomarkers were examined. RESULTS Though many candidate blood-based protein biomarkers were examined, only two could significantly differentiate ischemic stroke patients from healthy controls, stroke mimics and hemorrhagic stroke patients. CONCLUSION The blood protein biomarkers, brain natriuretic peptide (BNP) and S100B, were promising biomarkers in diagnosing ischemic stroke. They could be used in cases of diagnostic uncertainty and/or when less experienced healthcare personnel are involved.
Collapse
Affiliation(s)
- Thomas Monbailliu
- Faculty of Medicine & Health Sciences, Ghent University, Ghent, Belgium
| | - Joline Goossens
- Department of Emergency Medicine, Ghent University Hospital, Ghent, Belgium
| | - Saϊd Hachimi-Idrissi
- Faculty of Medicine & Health Sciences, Ghent University, Ghent, Belgium.,Department of Emergency Medicine, Ghent University Hospital, Ghent, Belgium
| |
Collapse
|
15
|
Bakhshayesh-Eghbali B, Roudbary SA, Basir Jafari S, Nabizadeh SP, Naderi-Asrami N, Sohrabnejad R. Ability of serum C-reactive protein and white blood cell cout in predicting acute schemic stroke. A short -term follow-up study. CASPIAN JOURNAL OF INTERNAL MEDICINE 2016; 7:206-210. [PMID: 27757207 PMCID: PMC5062180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Stroke is one of the leading causes of mortality and long-term morbidity. The aim of the present study was to determine the ability of baseline serum C-reactive protein (CRP) and white blood cell count (WBC) values in predicting the outcome of acute ischemic stroke (AIS). METHODS This study consisted of patients with first AIS referred to Poursina Hospital, Rasht, Iran. Severity of stroke was determined according to the National Institute of Health (NIH) Stroke Scale at the time of admission. Serum CRP levels and WBC count were measured at the time of admission. All patients were followed-up for 90 days after discharge and the severity of stroke was assessed using modified Rankin Scale. Receiver operating characteristic curve analysis was used for calculating the most appropriate cutoff point of CRP and WBC count for differentiating patients with and without poor outcome at the end of the study period. RESULTS A total of 53 out of 102 patients (52%) had poor outcome. The most appropriate cutoff value for CRP in differentiating patients with and without poor outcome was 8.5mg/l (sensitivity: 73.1%, specificity: 69.4%) and for WBC the difference did not reach to a significant level. The cutoff points of CRP > 10.5 mg/ml yielded a predictive ability at sensitivity: 75%, specificity: 63.8% whereas predictive ability of WBC for mortality was at a borderline level. CONCLUSION These findings indicate that high levels of serum CRP in AIS at the time of admission is associated with poor prognosis. However, this study found no ability for WBC in predicting AIS outcome.
Collapse
Affiliation(s)
| | - Seyed-Ali Roudbary
- Department of Neurology, Guilan University of Medical Sciences, Rasht, Iran
| | | | | | | | - Reza Sohrabnejad
- Department of Neurology, Babol University of Medical Sciences, Babol, Iran.,Correspondence: Reza Sohranmejad, Department of Neurology, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran. E-mail: , Tel: 0098 11 32238284, Fax: 0098 11 32238284
| |
Collapse
|
16
|
Can S, Akdur O, Yildirim A, Adam G, Cakir DU, Karaman HIO. Myelin basic protein and ischemia modified albumin levels in acute ischemic stroke cases. Pak J Med Sci 2015; 31:1110-4. [PMID: 26648996 PMCID: PMC4641265 DOI: 10.12669/pjms.315.7702] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Objective: To investigate early diagnostic effects of serum myelin basic protein (MBP) and ischemic modified albumin (IMA) levels in patients with ischemic stroke. Methods: Fifty patients who presented to an emergency service with acute ischemic stroke between June 2013 to March 2014 were evaluated with the National Institute of Health Stroke Scale (NIHSS) and diffusion-weighted magnetic resonance imaging (MRI). Thirty four healthy cases were included as control group. All patients’ serum IMA and MBP level were assessed. Results: Mean IMA value was 0.52±0.25 cases with acute ischemic stroke and serum IMA levels were significantly higher than the control group (p<0.01). No statistical significance was observed between acute ischemic stroke group and control group related to the MBP serum levels (P>0.05). Statistically significant correlation was detected between the volumes of diffusion restriction on MRI and NIHSS score (P=0.002, r=0.43) and IMA (P=0.015, r=0.344) levels. Conclusions: We have found that serum IMA levels are elevated in acute ischemic stroke cases and these levels are correlated with the ischemic tissue volume. MBP levels do not increase in early period of stroke cases.
Collapse
Affiliation(s)
- Serdar Can
- Serdar Can, MD. Departments of Emergency Medicine, Canakkale Onsekiz Mart University Faculty of Medicine, Canakkale, Turkey
| | - Okhan Akdur
- Okhan Akdur, MD. Associate Professor, Departments of Emergency Medicine, Canakkale Onsekiz Mart University Faculty of Medicine, Canakkale, Turkey
| | - Ahmet Yildirim
- Ahmet Yildirim, MD. Assistant Professor, Departments of Emergency Medicine, Canakkale Onsekiz Mart University Faculty of Medicine, Canakkale, Turkey
| | - Gurhan Adam
- Gurhan Adam, MD. Assistant Professor, Departments of Radiology, Canakkale Onsekiz Mart University Faculty of Medicine, Canakkale, Turkey
| | - Dilek Ulker Cakir
- Dilek Ulker Cakir, MD. Associate Professor, Departments of Biochemistry, Canakkale Onsekiz Mart University Faculty of Medicine, Canakkale, Turkey
| | - Handan Isin Ozisik Karaman
- Handan Isin Ozisik Karaman, MD. Professor, Departments of Neurology, Canakkale Onsekiz Mart University Faculty of Medicine, Canakkale, Turkey
| |
Collapse
|
17
|
Serum pentraxin-3 levels in acute stroke: No association with stroke prognosis. Atherosclerosis 2015; 243:616-20. [PMID: 26546709 DOI: 10.1016/j.atherosclerosis.2015.10.089] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Revised: 10/10/2015] [Accepted: 10/20/2015] [Indexed: 11/23/2022]
Abstract
BACKGROUND Stroke is the leading cause of serious disability. Estimating severity of the disease and early risk assessment is crucial. Several studies have been carried on and several biomarkers have been proposed in the literature for risk assessment and to estimate the stroke prognosis. In this study we assessed the association of predictors such as patient age, gender, stroke volume and NIHS scores on prognosis of stroke event. We investigated whether the serum pentraxin-3 levels are linked with stroke prognosis. METHODS Forty-four stroke patients without cardiovascular risk factors were included in this study. Initial NIHS scores, stroke volumes, serum pentraxin-3 levels and the data regarding the risk factors were collected in the first and seventh days of event. Association of predictors with final NIHS scores were investigated using multivariate regression model. RESULTS Initial NIHS score, initial and final stroke volumes were independently associated with final NIHS score whereas serum pentraxin-3 levels, whether acquired at the first or seventh day of stroke, were not associated with final NIHS score. CONCLUSIONS In stroke patients without cardiovascular, cardiopulmonary and infectious diseases, serum pentraxin-3 levels are not associated with stroke prognosis.
Collapse
|
18
|
Simats A, García-Berrocoso T, Montaner J. Neuroinflammatory biomarkers: From stroke diagnosis and prognosis to therapy. Biochim Biophys Acta Mol Basis Dis 2015; 1862:411-24. [PMID: 26524637 DOI: 10.1016/j.bbadis.2015.10.025] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 10/19/2015] [Accepted: 10/28/2015] [Indexed: 12/29/2022]
Abstract
Stroke is the third leading cause of death in industrialized countries and one of the largest causes of permanent disability worldwide. Therapeutic options to fight stroke are still limited and the only approved drug is tissue-plasminogen activator (tPA) and/or mechanical thrombectomy. Post-stroke inflammation is well known to contribute to the expansion of the ischemic lesion, whereas its resolution stimulates tissue repair and neuroregeneration processes. As inflammation highly influences susceptibility of stroke patients to overcome the disease, there is an increasing need to develop new diagnostic, prognostic and therapeutic strategies for post-stroke inflammation. This review provides a brief overview of the contribution of the inflammatory mechanisms to the pathophysiology of stroke. It specially focuses on the role of inflammatory biomarkers to help predicting stroke patients' outcome since some of those biomarkers might turn out to be targets to be therapeutically altered overcoming the urgent need for the identification of potent drugs to modulate stroke-associated inflammation. This article is part of a Special Issue entitled: Neuro Inflammation edited by Helga E. de Vries and Markus Schwaninger.
Collapse
Affiliation(s)
- Alba Simats
- Neurovascular Research Laboratory, Vall d'Hebron Institute of Research, Universitat Autònoma de Barcelona, Spain.
| | - Teresa García-Berrocoso
- Neurovascular Research Laboratory, Vall d'Hebron Institute of Research, Universitat Autònoma de Barcelona, Spain.
| | - Joan Montaner
- Neurovascular Research Laboratory, Vall d'Hebron Institute of Research, Universitat Autònoma de Barcelona, Spain; Neurology Department, Hospital Vall d'Hebron, Barcelona, Spain.
| |
Collapse
|
19
|
Alawieh A, Sabra Z, Sabra M, Tomlinson S, Zaraket FA. A Rich-Club Organization in Brain Ischemia Protein Interaction Network. Sci Rep 2015; 5:13513. [PMID: 26310627 PMCID: PMC4550934 DOI: 10.1038/srep13513] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2015] [Accepted: 07/24/2015] [Indexed: 12/23/2022] Open
Abstract
Ischemic stroke involves multiple pathophysiological mechanisms with complex interactions. Efforts to decipher those mechanisms and understand the evolution of cerebral injury is key for developing successful interventions. In an innovative approach, we use literature mining, natural language processing and systems biology tools to construct, annotate and curate a brain ischemia interactome. The curated interactome includes proteins that are deregulated after cerebral ischemia in human and experimental stroke. Network analysis of the interactome revealed a rich-club organization indicating the presence of a densely interconnected hub structure of prominent contributors to disease pathogenesis. Functional annotation of the interactome uncovered prominent pathways and highlighted the critical role of the complement and coagulation cascade in the initiation and amplification of injury starting by activation of the rich-club. We performed an in-silico screen for putative interventions that have pleiotropic effects on rich-club components and we identified estrogen as a prominent candidate. Our findings show that complex network analysis of disease related interactomes may lead to a better understanding of pathogenic mechanisms and provide cost-effective and mechanism-based discovery of candidate therapeutics.
Collapse
Affiliation(s)
- Ali Alawieh
- Department of Neurosciences, Medical University of South Carolina, Charleston, SC 29425.,Department of Electrical and Computer Engineering, American University of Beirut, Beirut, Lebanon
| | - Zahraa Sabra
- Department of Neurosciences, Medical University of South Carolina, Charleston, SC 29425.,Department of Electrical and Computer Engineering, American University of Beirut, Beirut, Lebanon
| | - Mohammed Sabra
- Department of Electrical and Computer Engineering, American University of Beirut, Beirut, Lebanon
| | - Stephen Tomlinson
- Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC 29425
| | - Fadi A Zaraket
- Department of Electrical and Computer Engineering, American University of Beirut, Beirut, Lebanon
| |
Collapse
|
20
|
Jia L, Hao F, Wang W, Qu Y. Circulating miR-145 is associated with plasma high-sensitivity C-reactive protein in acute ischemic stroke patients. Cell Biochem Funct 2015; 33:314-9. [PMID: 26096228 DOI: 10.1002/cbf.3116] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 04/17/2015] [Accepted: 04/20/2015] [Indexed: 11/09/2022]
Abstract
Stroke is a major cerebrovascular disease threatening human health and life with high morbidity, disability and mortality. We aimed to find effective biomarkers for the early diagnosis on stroke. Nine previously reported stroke-associated miRNAs (miR-21, miR-23a, miR-29b, miR-124, miR-145, miR-210, miR-221, miR-223 and miR-483-5p) were measured by quantitative real time-PCR, and plasma high-sensitivity C-reactive protein (hs-CRP) and serum interleukin 6 (IL-6), the pro-inflammation markers in brain injury, were examined by enzyme-linked immunosorbent assay in 146 acute ischemic stroke patients and 96 healthy blood donors. We found that serum miR-145 was significantly increased within 24 h after stroke onset and serum miR-23a and miR-221 were decreased in patients. Moreover, serum miR-145 was strong positively correlated with plasma hs-CRP and moderate positively correlated with serum IL-6. Meanwhile, serum miR-23a and miR-221 were moderate negatively correlated with plasma hs-CRP but not serum IL-6. Importantly, the combination of hs-CRP and serum miR-145 gained a better sensitivity/spectivity for prediction of acute ischemia stroke (area under receiver operating characteristic curve from 0.794 to 0.896). Conclusively, our preliminary findings indicate that serum miR-145 upregulated in acute ischemic stroke might be a new biomarker for acute ischemia stroke evaluation.
Collapse
Affiliation(s)
- Lihua Jia
- Department of Neurology, Liaocheng People's Hospital, Medical School of Liaocheng, Taishan Medical University, Liaocheng, Shandong Province, China
| | - Fang Hao
- Department of Neurology, Liaocheng People's Hospital, Medical School of Liaocheng, Taishan Medical University, Liaocheng, Shandong Province, China
| | - Weihua Wang
- Central Laboratory, Liaocheng People's Hospital, Medical School of Liaocheng, Taishan Medical University, Liaocheng, Shandong Province, China
| | - Yang Qu
- Department of Neurology, Liaocheng People's Hospital, Medical School of Liaocheng, Taishan Medical University, Liaocheng, Shandong Province, China
| |
Collapse
|
21
|
Liu LB, Li M, Zhuo WY, Zhang YS, Xu AD. The role of hs-CRP, D-dimer and fibrinogen in differentiating etiological subtypes of ischemic stroke. PLoS One 2015; 10:e0118301. [PMID: 25680111 PMCID: PMC4332510 DOI: 10.1371/journal.pone.0118301] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2014] [Accepted: 01/13/2015] [Indexed: 02/03/2023] Open
Abstract
The aim of this study was to evaluate the diagnostic value of the serum biochemical markers high-sensitivity C-reactive protein (hs-CRP), D-dimer (DD) and fibrinogen (Fg) in differentiating etiological subtypes of ischemic stroke. This study was a retrospective case-only study, consecutively including patients with acute ischemic stroke. All patients were classified into subtypes using the TOAST classification system. A total of 317 patients were evaluated. Hs-CRP and DD levels were significantly different among the subtypes and were the highest in CE, followed by LAA and SAA; no significant difference between the subtypes was found for Fg. Hs-CRP > 6.96 mg/L was classified as the CE subtype, with a sensitivity of 41% and a specificity of 74%; DD > 791.30 ng/mL was classified as CE, with a sensitivity of 58% and a specificity of 78%. The combination of hs-CRP and DD classification as CE yielded a sensitivity of 65% and a specificity of 91%. DD > 791.30 ng/mL was considered an independent predictive factor of CE. Hs-CRP and DD could be useful for identifying the etiological subtypes of acute ischemic stroke, especially for predicting CE. The diagnostic value of DD was higher than that of hs-CRP.
Collapse
Affiliation(s)
- Li-Bin Liu
- Department of Neurology, the First Affiliated Hospital of Jinan University, Guangzhou, China; Department of Neurology, Zhuhai Hospital of Jinan University, Zhuhai, China
| | - Mu Li
- Department of Neurology, the First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Wen-Yan Zhuo
- Department of Neurology, Zhuhai Hospital of Jinan University, Zhuhai, China
| | - Yu-Sheng Zhang
- Department of Neurology, the First Affiliated Hospital of Jinan University, Guangzhou, China
| | - An-Ding Xu
- Department of Neurology, the First Affiliated Hospital of Jinan University, Guangzhou, China
| |
Collapse
|