Biomarkers for acute diagnosis and management of stroke in neurointensive care units
The effectiveness of current management of critically ill stroke patients depends on rapid assessment of the type of stroke, ischemic or hemorrhagic, and on a patient′s general clinical status. Thrombolytic therapy with recombinant tissue plasminogen activator (r-tPA) is the only effective treatment...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2016-01-01
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| Series: | Brain Circulation |
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| Online Access: | http://www.braincirculation.org/article.asp?issn=2394-8108;year=2016;volume=2;issue=1;spage=28;epage=47;aulast=Glushakova |
| _version_ | 1818248729927352320 |
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| author | Olena Y Glushakova Alexander V Glushakov Emmy R Miller Alex B Valadka Ronald L Hayes |
| author_facet | Olena Y Glushakova Alexander V Glushakov Emmy R Miller Alex B Valadka Ronald L Hayes |
| author_sort | Olena Y Glushakova |
| collection | DOAJ |
| description | The effectiveness of current management of critically ill stroke patients depends on rapid assessment of the type of stroke, ischemic or hemorrhagic, and on a patient′s general clinical status. Thrombolytic therapy with recombinant tissue plasminogen activator (r-tPA) is the only effective treatment for ischemic stroke approved by the Food and Drug Administration (FDA), whereas no treatment has been shown to be effective for hemorrhagic stroke. Furthermore, a narrow therapeutic window and fear of precipitating intracranial hemorrhage by administering r-tPA cause many clinicians to avoid using this treatment. Thus, rapid and objective assessments of stroke type at admission would increase the number of patients with ischemic stroke receiving r-tPA treatment and thereby, improve outcome for many additional stroke patients. Considerable literature suggests that brain-specific protein biomarkers of glial [i.e. S100 calcium-binding protein B (S100B), glial fibrillary acidic protein (GFAP)] and neuronal cells [e.g., ubiquitin C-terminal hydrolase-L1 (UCH-L1), neuron-specific enolase (NSE), αII-spectrin breakdown products SBDP120, SBDP145, and SBDP150, myelin basic protein (MBP), neurofilament light chain (NF-L), tau protein, visinin-like protein-1 (VLP 1), NR2 peptide] injury that could be detected in the cerebrospinal fluid (CSF) and peripheral blood might provide valuable and timely diagnostic information for stroke necessary to make prompt management and decisions, especially when the time of stroke onset cannot be determined. This information could include injury severity, prognosis of short-term and long-term outcomes, and discrimination of ischemic or hemorrhagic stroke. This chapter reviews the current status of the development of biomarker-based diagnosis of stroke and its potential application to improve stroke care. |
| first_indexed | 2024-12-12T15:25:14Z |
| format | Article |
| id | doaj.art-2057f60468834a6faaf56658a8c9e1eb |
| institution | Directory Open Access Journal |
| issn | 2455-4626 |
| language | English |
| last_indexed | 2024-12-12T15:25:14Z |
| publishDate | 2016-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Brain Circulation |
| spelling | doaj.art-2057f60468834a6faaf56658a8c9e1eb2022-12-22T00:20:16ZengWolters Kluwer Medknow PublicationsBrain Circulation2455-46262016-01-0121284710.4103/2394-8108.178546Biomarkers for acute diagnosis and management of stroke in neurointensive care unitsOlena Y GlushakovaAlexander V GlushakovEmmy R MillerAlex B ValadkaRonald L HayesThe effectiveness of current management of critically ill stroke patients depends on rapid assessment of the type of stroke, ischemic or hemorrhagic, and on a patient′s general clinical status. Thrombolytic therapy with recombinant tissue plasminogen activator (r-tPA) is the only effective treatment for ischemic stroke approved by the Food and Drug Administration (FDA), whereas no treatment has been shown to be effective for hemorrhagic stroke. Furthermore, a narrow therapeutic window and fear of precipitating intracranial hemorrhage by administering r-tPA cause many clinicians to avoid using this treatment. Thus, rapid and objective assessments of stroke type at admission would increase the number of patients with ischemic stroke receiving r-tPA treatment and thereby, improve outcome for many additional stroke patients. Considerable literature suggests that brain-specific protein biomarkers of glial [i.e. S100 calcium-binding protein B (S100B), glial fibrillary acidic protein (GFAP)] and neuronal cells [e.g., ubiquitin C-terminal hydrolase-L1 (UCH-L1), neuron-specific enolase (NSE), αII-spectrin breakdown products SBDP120, SBDP145, and SBDP150, myelin basic protein (MBP), neurofilament light chain (NF-L), tau protein, visinin-like protein-1 (VLP 1), NR2 peptide] injury that could be detected in the cerebrospinal fluid (CSF) and peripheral blood might provide valuable and timely diagnostic information for stroke necessary to make prompt management and decisions, especially when the time of stroke onset cannot be determined. This information could include injury severity, prognosis of short-term and long-term outcomes, and discrimination of ischemic or hemorrhagic stroke. This chapter reviews the current status of the development of biomarker-based diagnosis of stroke and its potential application to improve stroke care.http://www.braincirculation.org/article.asp?issn=2394-8108;year=2016;volume=2;issue=1;spage=28;epage=47;aulast=GlushakovaBiomarkerbloodcerebrospinal fluid (CSF)bloodclinical trialintracerebral hemorrhage (ICH)ischemic strokeserumtransient ischemic attacks (TIAs) |
| spellingShingle | Olena Y Glushakova Alexander V Glushakov Emmy R Miller Alex B Valadka Ronald L Hayes Biomarkers for acute diagnosis and management of stroke in neurointensive care units Brain Circulation Biomarker blood cerebrospinal fluid (CSF) blood clinical trial intracerebral hemorrhage (ICH) ischemic stroke serum transient ischemic attacks (TIAs) |
| title | Biomarkers for acute diagnosis and management of stroke in neurointensive care units |
| title_full | Biomarkers for acute diagnosis and management of stroke in neurointensive care units |
| title_fullStr | Biomarkers for acute diagnosis and management of stroke in neurointensive care units |
| title_full_unstemmed | Biomarkers for acute diagnosis and management of stroke in neurointensive care units |
| title_short | Biomarkers for acute diagnosis and management of stroke in neurointensive care units |
| title_sort | biomarkers for acute diagnosis and management of stroke in neurointensive care units |
| topic | Biomarker blood cerebrospinal fluid (CSF) blood clinical trial intracerebral hemorrhage (ICH) ischemic stroke serum transient ischemic attacks (TIAs) |
| url | http://www.braincirculation.org/article.asp?issn=2394-8108;year=2016;volume=2;issue=1;spage=28;epage=47;aulast=Glushakova |
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