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Isolation and Flow Cytometric Assessment of Neuroimmune Interactions in a Mini-Stroke Murine Model
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Circulating Metabolites Differentiate Acute Ischemic Stroke from Stroke Mimics.

Steffen Tiedt1,2, Stefan Brandmaier3,4, Hanna Kollmeier1

  • 1Institute for Stroke and Dementia Research, University Hospital, LMU Munich, Munich, Germany.

Annals of Neurology
|August 5, 2020
PubMed
Summary

Early detection of ischemic stroke (IS) is improved by analyzing four key metabolites in blood. These biomarkers, including dimethylarginine and adenosine, accurately distinguish IS from stroke mimics, aiding rapid diagnosis.

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Area of Science:

  • Biochemistry
  • Neurology
  • Medical Diagnostics

Background:

  • Distinguishing ischemic stroke (IS) from stroke mimics (SMs) presents a diagnostic challenge.
  • The circulating metabolome may offer insights into acute IS pathophysiology.
  • Early identification of IS is crucial for timely and effective treatment.

Purpose of the Study:

  • To investigate the utility of early metabolic changes in differentiating IS from SMs.
  • To identify specific metabolites that can serve as biomarkers for acute IS.
  • To compare the diagnostic accuracy of metabolites with existing imaging techniques.

Main Methods:

  • Untargeted metabolomics on serum samples from IS patients (N=508), SMs (N=349), and controls (N=112).
  • Analysis within 24 hours of symptom onset using multivariable regression, machine learning, and propensity score matching.
  • Validation through comparison with published metabolite sets and cranial CT imaging.

Main Results:

  • 41 metabolites were significantly associated with IS compared to controls.
  • Asymmetrical/symmetrical dimethylarginine, pregnenolone sulfate, and adenosine differentiated IS from SMs with an AUC of 0.90.
  • This metabolite panel outperformed cranial CT (AUC=0.80) and previously identified metabolite sets.

Conclusions:

  • A panel of four key metabolites demonstrates high utility in identifying IS patients upon hospital arrival.
  • These metabolites, with known roles in stroke pathophysiology, offer a promising diagnostic approach.
  • Further multicenter studies are warranted to validate these findings for clinical application.