Liaptsi Eirini, Merkouris Ermis, Polatidou Efthymia, Tsiptsios Dimitrios, Gkantzios Aimilios, Kokkotis Christos, Petridis Foivos, Christidi Foteini, Karatzetzou Stella, Karaoglanis Christos, Tsagkalidi Anna-Maria, Chouliaras Nikolaos, Tsamakis Konstantinos, Protopapa Maria, Pantazis-Pergaminelis Dimitrios, Skendros Panagiotis, Aggelousis Nikolaos, Vadikolias Konstantinos
Neurology Department, Democritus University of Thrace, 68100 Alexandroupolis, Greece.
Department of Physical Education and Sport Science, Democritus University of Thrace, 69100 Komotini, Greece.
Neurol Int. 2023 Sep 28;15(4):1212-1226. doi: 10.3390/neurolint15040076.
Stroke has become the first cause of functional disability and one of the leading causes of mortality worldwide. Therefore, it is of crucial importance to develop accurate biomarkers to assess stroke risk and prognosis. Emerging evidence suggests that neutrophil extracellular trap (NET) levels may serve as a valuable biomarker to predict stroke occurrence and functional outcome. NETs are known to create a procoagulant state by serving as a scaffold for tissue factor (TF) and platelets inducing thrombosis by activating coagulation pathways and endothelium. A literature search was conducted in two databases (MEDLINE and Scopus) to trace all relevant studies published between 1 January 2016 and 31 December 2022, addressing the potential utility of NETs as a stroke biomarker. Only full-text articles in English were included. The current review includes thirty-three papers. Elevated NET levels in plasma and thrombi seem to be associated with increased mortality and worse functional outcomes in stroke, with all acute ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage included. Additionally, higher NET levels seem to correlate with worse outcomes after recanalization therapies and are more frequently found in strokes of cardioembolic or cryptogenic origin. Additionally, total neutrophil count in plasma seems also to correlate with stroke severity. Overall, NETs may be a promising predictive tool to assess stroke severity, functional outcome, and response to recanalization therapies.
中风已成为全球功能残疾的首要原因和主要死因之一。因此，开发准确的生物标志物以评估中风风险和预后至关重要。新出现的证据表明，中性粒细胞胞外陷阱（NET）水平可能是预测中风发生和功能结局的有价值的生物标志物。已知NETs通过作为组织因子（TF）和血小板的支架，通过激活凝血途径和内皮诱导血栓形成，从而形成促凝状态。在两个数据库（MEDLINE和Scopus）中进行了文献检索，以追踪2016年1月1日至2022年12月31日期间发表的所有相关研究，探讨NETs作为中风生物标志物的潜在用途。仅纳入英文全文文章。本综述包括33篇论文。血浆和血栓中NET水平升高似乎与中风患者死亡率增加和功能结局较差相关，涵盖所有急性缺血性中风、脑出血和蛛网膜下腔出血。此外，较高的NET水平似乎与再通治疗后的较差结局相关，并且在心源性或隐源性中风中更常见。此外，血浆中的总中性粒细胞计数似乎也与中风严重程度相关。总体而言，NETs可能是评估中风严重程度、功能结局和再通治疗反应的有前景的预测工具。
