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Comparison of plasma beta-globin DNA and S-100 protein concentrations in acute stroke
Timothy H Rainer1, Ka Sing Wong, Wynnie Lam
1Accident and Emergency Medicine Academic Unit, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China.
Insights
Plasma DNA and serum S100 protein show promise in diagnosing stroke and predicting patient outcomes. While S100 protein is better for general stroke diagnosis, plasma DNA is a stronger indicator of hemorrhagic stroke.
Area of Science:
- Biochemistry
- Neurology
- Molecular Diagnostics
Background:
- Stroke diagnosis and prognosis remain critical challenges in emergency medicine.
- Biomarkers for rapid and accurate stroke assessment are highly sought after.
- Current diagnostic methods may have limitations in differentiating stroke types and predicting outcomes.
Purpose of the Study:
- To compare plasma beta-globin DNA and serum S100 protein for stroke diagnosis.
- To evaluate these biomarkers in predicting stroke-related mortality and morbidity.
- To assess the combined diagnostic and prognostic utility of these markers.
Main Methods:
- Recruitment of patients with stroke-like symptoms in an emergency department setting.
- Analysis of plasma DNA for the beta-globin gene using fluorescent-based PCR.
- Quantification of serum S100 protein concentrations via ELISA.
- Primary outcome assessment included stroke diagnosis, mortality, and modified Rankin Score (mRS) at 6 months.
Main Results:
- Serum S100 and plasma DNA levels were elevated in stroke patients compared to controls.
- Plasma DNA showed significantly higher levels in hemorrhagic stroke and was associated with poorer outcomes (higher mRS, mortality).
- Combined analysis of S100 and DNA demonstrated a superior odds ratio for diagnosing hemorrhagic stroke.
Conclusions:
- Serum S100 protein is a more effective biomarker for general stroke diagnosis than plasma DNA.
- Plasma DNA serves as a valuable marker for identifying hemorrhagic stroke.
- The combination of serum S100 and plasma DNA offers enhanced diagnostic accuracy for hemorrhagic stroke and predicts patient morbidity and mortality.
Background:
This study aimed to compare changes in plasma beta-globin DNA and serum S100 protein to diagnose stroke and for predicting mortality and morbidity.
Methods:
Patients with stroke-like symptoms presenting to the emergency department of a Hong Kong hospital were recruited. Plasma DNA was analyzed for the beta-globin gene with fluorescent-based PCR. S100 concentrations were determined using ELISA. Primary outcomes were diagnosis of stroke, mortality, and modified Rankin Score (mRS) after 6 months.
Results:
One hundred ninety-seven consecutive patients recruited, 118 (60%) ischemic stroke, 35 (18%) hemorrhage and 44 (22%) with no acute neuroimaging changes. Serum S100 and plasma DNA were increased in 126 (p<0.0010) and 36 (p=0.21) stroke patients respectively vs. controls. Median plasma DNA was higher in hemorrhagic stroke than those without (1725 vs. 1050 kilogenome-equivalents/l, p=0.0104). Median plasma DNA was higher in mRS>2 vs. mRS
Conclusion:
For stroke diagnosis, S100 performs better than DNA; DNA is a better marker for hemorrhage. For diagnosis of hemorrhagic stroke, combined S100 and DNA performs better than either alone. Plasma DNA and serum S100 predict morbidity and mortality in stroke.
