Ji Xiaotan, Tian Long, Yao Shumei, Han Fengyue, Niu Shenna, Qu Chuanqiang
Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, China.
Department of Neurology, Jining No. 1 People's Hospital, Jining, China.
Front Aging Neurosci. 2022 May 30;14:918473. doi: 10.3389/fnagi.2022.918473. eCollection 2022.
Biomarkers are objectively measured biological properties of normal and pathological processes. Early neurological deterioration (END) refers to the deterioration of neurological function in a short time after the onset of acute ischemic stroke (AIS) and is associated with adverse outcomes. Although multiple biomarkers have been found to predict END, there are currently no suitable biomarkers to be applied in routine stroke care. According to the Preferred Reporting Items for Systematic Review standards, we present a systematic review, concentrating on body fluids biomarkers that have shown potential to be transferred into clinical practice. We also describe newly reported body fluids biomarkers that can supply different insights into the mechanism of END. In our review, 40 scientific papers were included. Depending on the various mechanisms, sources or physicochemical characteristics of body fluids biomarkers, we classified related biomarkers as inflammation, protease, coagulation, metabolism, oxidative stress, and excitatory neurotoxicity. The body fluids biomarkers whose related articles are limited or mechanisms are unknown are categorized as other biomarkers. The inflammation-related biomarkers, such as neutrophil-to-lymphocyte ratio and hypersensitive C-reactive protein, play a crucial role among the mentioned biomarkers. Considering the vast heterogeneity of stroke progression, using a single body fluids biomarker may not accurately predict the risk of stroke progression, and it is necessary to combine multiple biomarkers (panels, scores, or indices) to improve their capacity to estimate END.
生物标志物是对正常和病理过程进行客观测量的生物学特性。早期神经功能恶化（END）是指急性缺血性卒中（AIS）发病后短时间内神经功能的恶化，且与不良预后相关。尽管已发现多种生物标志物可预测END，但目前尚无适用于常规卒中护理的生物标志物。根据系统评价的首选报告项目标准，我们进行了一项系统评价，重点关注已显示出具有转化为临床实践潜力的体液生物标志物。我们还描述了新报道的体液生物标志物，它们可为END的机制提供不同见解。在我们的综述中，纳入了40篇科学论文。根据体液生物标志物的各种机制、来源或物理化学特征，我们将相关生物标志物分为炎症、蛋白酶、凝血、代谢、氧化应激和兴奋性神经毒性。相关文章有限或机制不明的体液生物标志物归类为其他生物标志物。在上述生物标志物中，炎症相关生物标志物，如中性粒细胞与淋巴细胞比值和超敏C反应蛋白，起着关键作用。考虑到卒中进展的巨大异质性，使用单一的体液生物标志物可能无法准确预测卒中进展风险，有必要结合多种生物标志物（组合、评分或指数）以提高其评估END的能力。
