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Differentiating ischemic from hemorrhagic stroke using plasma biomarkers: the S100B/RAGE pathway
Joan Montaner1, Maite Mendioroz, Pilar Delgado
1Neurovascular Research Laboratory, Vall d'Hebron University Hospital, Research Institut, Universitat Autònoma de Barcelona, Barcelona, Spain. 31862jmv@comb.cat
Journal of Proteomics
|February 21, 2012
Summary
A rapid blood test using biomarkers like S100B and sRAGE shows promise in quickly distinguishing between ischemic and hemorrhagic stroke, aiding pre-hospital care.
Area of Science:
- Biochemistry
- Neurology
- Clinical Diagnostics
Background:
- Neuroimaging is standard for stroke differentiation, but a rapid biochemical test is needed for pre-hospital settings.
- Early diagnosis of stroke type (ischemic vs. hemorrhagic) is crucial for timely and appropriate patient management.
Purpose of the Study:
- To evaluate the predictive value of blood-borne biomarkers for differentiating ischemic stroke (IS) from hemorrhagic stroke (ICH).
- To identify a panel of biomarkers for rapid biochemical diagnosis of stroke type.
Main Methods:
- Analyzed admission blood samples from 915 stroke patients (776 IS, 139 ICH) using ELISA.
- Measured levels of CRP, D-dimer, sRAGE, MMP9, S100B, BNP, NT-3, caspase-3, chimerin-II, secretagogin, cerebellin, and NPY.
- Utilized regression tree analysis (CART method) to assess classification ability.
Main Results:
- Within 6 hours of symptom onset, S100B levels were higher in ICH, while sRAGE levels were lower compared to IS.
- S100B and sRAGE were independently associated with ICH in early-presenting patients.
- A regression tree model demonstrated good classification ability (AUC=0.762) for differentiating stroke types.
Conclusions:
- A combination of biomarkers, particularly those in the S100B/RAGE pathway, shows potential for rapid biochemical diagnosis of IS versus ICH.
- This biomarker panel could significantly improve pre-hospital triage and management of stroke patients.
- Further research into these biomarkers may lead to a widely available, rapid diagnostic tool for stroke.
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