Abstract 120: Leveraging a Range of Blood Biomarkers in Acute Ischemic Stroke
Authors: OBEROI V. , Ishfaq M. F. , Pandhi A. 
Published: January 2025

Introduction
Ischemic stroke is characterized by an abrupt onset of cerebral deficits due to a disruption in blood supply to the brain. Early and accurate diagnosis, along with prompt treatment, is critical in stroke management. This exclusive review seeks to holistically examine the diagnostic, prognostic, and therapeutic potential of blood biomarkers in ischemic stroke. Because ‘time is brain’ development of blood biomarkers in acute ischemic stroke can revolutionize the stroke management particularly via early diagnosis.

Methods
A systematic search of literature was conducted using databases such as Google Scholar and PUBMED for the past decade, identifying 112 relevant articles. Keywords related to ischemic stroke and blood biomarkers were employed. After applying rigorous exclusion criteria, 52 articles were selected, including narrative/systematic reviews, meta‐analyses, and animal studies.

Results
Among the 52 studies reviewed, 40% concentrated on diagnostic biomarkers, 13 studies addressed therapeutic biomarkers, and 25% focused on prognostic biomarkers. Additionally, three animal studies investigated therapeutic biomarkers in mice. Evaluation by two independent authors revealed consistent results across the studies. Protein biomarkers like GFAP, BNP, and S100B, as well as emerging microRNAs and circRNAs, showed promise for early diagnosis and prognosis. Exosomal microRNAs and circRNAs also offered targeted therapeutic opportunities. A common limitation noted across studies was small sample sizes.

Conclusion
This review highlights the diverse roles of blood biomarkers in ischemic stroke, including their potential for diagnosis, prognosis, and therapy. Currently, stroke diagnosis primarily relies on imaging techniques such as CT scans and MRI. Advancing these biomarkers from research to clinical practice could significantly impact ischemic stroke management. Further research is necessary to define their exact roles and enable their integration into routine clinical use.

References

1. Dagonnier M, Donnan GA, Davis SM, Dewey HM, Howells DW. Acute Stroke Biomarkers: Are We There Yet? Front Neurol. 2021 Feb 5;12:619721. doi: 10.3389/fneur.2021.619721. PMID: 33633673; PMCID: PMC7902038. 2. Katan M, Elkind MS. The Potential Role of Blood Biomarkers in Patients with Ischemic Stroke: An Expert Opinion. Clinical and Translational Neuroscience. 2018; 2(1):13.
https://doi.org/10.1177/2514183×18768050
. 3. Florijn BW, Leontien van der Bent M, Nguyen TMT, Quax PHA, Wermer MJH, Yaël Nossent A, Kruyt ND. Non‐coding RNAs versus protein biomarkers to diagnose and differentiate acute stroke: Systematic review and meta‐analysis. J Stroke Cerebrovasc Dis. 2023 Nov;32(11):107388. doi: 10.1016/j.jstrokecerebrovasdis.2023.107388. Epub 2023 Sep 29. PMID: 37778160. 4. Jadav RK, Mortazavi R, Yee KC. Blood Biomarkers for Triaging Patients for Suspected Stroke: Every Minute Counts. J Clin Med. 2022 Jul 21;11(14):4243. doi: 10.3390/jcm11144243. PMID: 35888011; PMCID: PMC9323101. 5. Ciaccio AM, Tuttolomondo A. Exosomal miRNAs as Biomarkers of Ischemic Stroke. Brain Sci. 2023 Nov 27;13(12):1647. doi: 10.3390/brainsci13121647. PMID: 38137095; PMCID: PMC10741776. 6. Wang Y, Su X, Leung GHD, Ren B, Zhang Q, Xiong Z, Zhou J, Yang L, Lu G, Chan WY, Ren L. Circulating microRNAs as diagnostic biomarkers for ischemic stroke: evidence from comprehensive analysis and real‐world validation. Int J Med Sci. 2023 Jun 4;20(8):1009‐1023. doi: 10.7150/ijms.83963. PMID: 37484808; PMCID: PMC10357437.