Faculty of Health Sciences, Pomeranian University of Slupsk, 64 Bohaterów Westerplatte St., 76-200, Slupsk, Poland.
Department of Anatomy and Neurobiology, Medical University of Gdansk, 1 Debinki St., 80-211, Gdansk, Poland.
Transl Stroke Res. 2020 Aug;11(4):553-579. doi: 10.1007/s12975-019-00744-5. Epub 2019 Nov 7.
Cerebral stroke, which is one of the most frequent causes of mortality and leading cause of disability in developed countries, often leads to devastating and irreversible brain damage. Neurological and neuroradiological diagnosis of stroke, especially in its acute phase, is frequently uncertain or inconclusive. This results in difficulties in identification of patients with poor prognosis or being at high risk for complications. It also makes difficult identification of these stroke patients who could benefit from more aggressive therapies. In contrary to the cardiovascular disease, no single biomarker is available for the ischemic stroke, addressing the abovementioned issues. This justifies the need for identifying of effective diagnostic measures characterized by high specificity and sensitivity. One of the promising avenues in this area is studies on the panels of biomarkers characteristic for processes which occur in different types and phases of ischemic stroke and represent all morphological constituents of the brains' neurovascular unit (NVU). In this review, we present the current state of knowledge concerning already-used or potentially applicable biomarkers of the ischemic stroke. We also discuss the perspectives for identification of biomarkers representative for different types and phases of the ischemic stroke, as well as for different constituents of NVU, which concentration levels correlate with extent of brain damage and patients' neurological status. Finally, a critical analysis of perspectives on further improvement of the ischemic stroke diagnosis is presented.
脑卒中是发达国家最常见的死亡原因之一，也是导致残疾的主要原因，常导致毁灭性和不可逆转的脑损伤。脑卒中的神经和神经放射学诊断，尤其是在其急性期，往往不确定或不确定。这导致难以识别预后不良或有并发症高风险的患者。也难以识别那些可能受益于更积极治疗的脑卒中患者。与心血管疾病不同，缺血性脑卒中没有单一的生物标志物可以解决上述问题。这证明需要确定具有高特异性和敏感性的有效诊断措施。在这方面有希望的途径之一是研究在不同类型和阶段的缺血性脑卒中发生的过程中具有特征的生物标志物，代表大脑神经血管单元 (NVU) 的所有形态成分。在这篇综述中，我们介绍了目前关于已经使用或潜在适用的缺血性脑卒中生物标志物的知识状况。我们还讨论了鉴定代表缺血性脑卒中不同类型和阶段以及 NVU 不同成分的生物标志物的前景，这些标志物的浓度水平与脑损伤程度和患者的神经状态相关。最后，对进一步改善缺血性脑卒中诊断的前景进行了批判性分析。
