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Biomarkers of cerebral microembolic signals
Ruihua Yin1, Aijun Ma1, Xudong Pan1
1Department of Neurology, The Affiliated Hospital of Qingdao University, Medical School of Qingdao University, Qingdao, Shandong Province 266100, China.
Abstract:
Stroke is a major cause of mortality and morbidity around the world. Microembolic signals (MES), as the markers of unstable atherosclerotic plaque, can predict the occurrence and prognosis of ischemic stroke (IS). MES can also assess the efficacy of antithrombotic agents and predict the recurrence probability of IS. Unstable plaques are the main source of MES; thus, numerous biomarkers of atherosclerotic plaque instability are highly likely to predict the presence of MES. This study aims to review recent biomarker candidates for MES or microembolism. Current research indicates that the following are independent markers for positive MES: high level of serum soluble P-selectin, chemokine (C-X-C motif) ligand 16 (CXCL16) and fibrinogen, high neutrophil count, reduced ratio of CD4+CD25high regulatory T cells (Tregs) and the C allele of tumor necrosis factor receptor superfamily member 11B (TNFRSF11B) rs3102735. However, a more integrated profile of biomarkers for MES is needed to improve the stratification of patients with carotid stenosis and enhance the effectiveness of therapeutic interventions and prevention for IS.
Insights
Microembolic signals (MES) indicate unstable plaques and predict stroke risk. Biomarkers like soluble P-selectin, CXCL16, fibrinogen, neutrophil count, Tregs, and TNFRSF11B genotypes can identify MES, aiding stroke prevention.
Area of Science:
- Neurology
- Cardiovascular Medicine
- Biomarker Research
Background:
- Stroke is a leading cause of death and disability globally.
- Microembolic signals (MES) are crucial indicators of unstable atherosclerotic plaques, predicting ischemic stroke (IS) occurrence, prognosis, and recurrence.
- MES also help evaluate antithrombotic therapy effectiveness.
Purpose of the Study:
- To review emerging biomarker candidates for detecting MES or microembolism.
- To identify specific biomarkers associated with atherosclerotic plaque instability and MES presence.
Main Methods:
- Literature review of recent studies on MES and associated biomarkers.
- Analysis of identified independent markers for positive MES.
Main Results:
- High serum levels of soluble P-selectin, chemokine (C-X-C motif) ligand 16 (CXCL16), and fibrinogen are linked to positive MES.
- Elevated neutrophil counts and a reduced ratio of CD4+CD25high regulatory T cells (Tregs) are also associated with MES.
- The C allele of tumor necrosis factor receptor superfamily member 11B (TNFRSF11B) rs3102735 is identified as an independent marker for positive MES.
Conclusions:
- Several biomarkers, including specific proteins, cell counts, and genetic variants, show potential for identifying MES.
- An integrated biomarker profile is necessary for improved patient stratification in carotid stenosis and enhanced IS prevention strategies.
