Department of Biotechnology Engineering, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel.
School of Material Science & Engineering, Nanyang Technology University, 50 Nanyang Avenue, Singapore 639798, Singapore.
Biosensors (Basel). 2017 Aug 3;7(3):30. doi: 10.3390/bios7030030.
Stroke, the second highest leading cause of death, is caused by an abrupt interruption of blood to the brain. Supply of blood needs to be promptly restored to salvage brain tissues from irreversible neuronal death. Existing assessment of stroke patients is based largely on detailed clinical evaluation that is complemented by neuroimaging methods. However, emerging data point to the potential use of blood-derived biomarkers in aiding clinical decision-making especially in the diagnosis of ischemic stroke, triaging patients for acute reperfusion therapies, and in informing stroke mechanisms and prognosis. The demand for newer techniques to deliver individualized information on-site for incorporation into a time-sensitive work-flow has become greater. In this review, we examine the roles of a portable and easy to use point-of-care-test (POCT) in shortening the time-to-treatment, classifying stroke subtypes and improving patient's outcome. We first examine the conventional stroke management workflow, then highlight situations where a bedside biomarker assessment might aid clinical decision-making. A novel stroke POCT approach is presented, which combines the use of quantitative and multiplex POCT platforms for the detection of specific stroke biomarkers, as well as data-mining tools to drive analytical processes. Further work is needed in the development of POCTs to fulfill an unmet need in acute stroke management.
中风是导致死亡的第二大主要原因，是由于大脑血液供应突然中断引起的。需要迅速恢复血液供应，以避免神经元不可逆转的死亡。目前对中风患者的评估主要基于详细的临床评估，并辅以神经影像学方法。然而，新出现的数据表明，血液来源的生物标志物在辅助临床决策方面具有潜在的应用价值，特别是在缺血性中风的诊断、对急性再灌注治疗的患者进行分类，以及告知中风机制和预后方面。对能够提供现场个体化信息并纳入到时间敏感工作流程的新技术的需求变得更加迫切。在这篇综述中，我们研究了一种便携式、易于使用的即时检测（POCT）技术在缩短治疗时间、分类中风亚型和改善患者预后方面的作用。我们首先检查了传统的中风管理工作流程，然后强调了床边生物标志物评估可能有助于临床决策的情况。提出了一种新型中风 POCT 方法，该方法结合了定量和多重 POCT 平台用于检测特定的中风生物标志物，以及数据挖掘工具来驱动分析过程。在开发即时检测技术以满足急性中风管理中的未满足需求方面，还需要进一步的工作。
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