## 4 Discussion
Data from the biomolecular scientific literature further highlight the essential role of biomarkers in diagnosis, evaluating the neurological prognosis, understanding pathogenesis, and promoting recovery in pediatric IS. Inflammatory markers, such as pro-inflammatorycytokines IL-6 and IL-1\(\upbeta\), as well as other biological factors like VEGF, ciliary neurotrophic factor (CNTF), the S100B protein, ENG (CD105), and antiphospholipid antibodies, have been identified as critical contributors. Among these, the S100B protein is the most extensively studied biomarker in IS. It has intracellular and extracellular functions, including regulating calcium homeostasis and signaling as a secondary messenger. In experimental settings, S100B promotes cell differentiation, cell cycle progression, and the inhibition of apoptosis. Extracellular, it supports neurogenesis and neuronal plasticity and enhances learning and memory processes in both normal and traumatic conditions. The role of VEGF in promoting angiogenesis, the role of S100B in neurogenesis, and the findings on ENG deficiency's impact on recovery processes emphasize the importance of further exploring these biomarkers. Collectively, these insights offer critical avenues for understanding and improving interventions in pediatric ischemic stroke. This study highlights the role of interleukin-6 (IL-6) in promoting and sustaining neuroinflammation in pediatric ischemic stroke (IS), with an emphasis on evaluating the extent of brain lesions and subsequent sequelae [18]. The findings suggest that IL-6 serves as a neuroinflammatory biomarker in IS. Based on the confirmed inflammatory role of IL-6 in stroke progression, this study suggests incorporating anti-inflammatory therapies to complement standard treatments, offering a novel approach for enhancing recovery following ischemic stroke. [PERSON] et al. have identified vascular endothelial growth factor (VEGF) and ciliary neurotrophic factor (CNTF) as key biomarkers in stroke. In animal models, CNTF, which is endogenously upregulated during IS onset, mediates neurogenesis and exerts anti-inflammatory effects. The present study corroborated these findings, emphasizing the importance of CNTF as a biomarker. Specifically, CNTF is involved in increased neurotoxicity during the early stages of IS and the progression of neuroinflammation and neurodegenerative processes and has a protective role in brain tissue during disease progression. CNTF appears to limit the pathological spread in ischemic areas and prevent neuronal death, particularly safeguarding motor and sensory neurons. VEGF is implicated in processes such as atherosclerosis, arteriogenesis, cerebral edema, neuroprotection, neurogenesis, angiogenesis, and post-ischemic brain repair [18]. Additionally, VEGF contributes to the effects of transplanted stem cells in experimental IS research. Research by [PERSON] et al. demonstrated that vascular growth factors, including VEGF-A, VEGF-B, and placental growth factor (PIGF), play pivotal roles in the development and function of the circulatory and nervous systems, further supporting their involvement in stroke through the interaction of these systems [19]. Both the literature and the current findings indicate that VEGF is a potent peripheral biomarker in acute pediatric IS. The strong correlation between VEGF levels and the functional outcomes six months post-stroke reinforces its role as a marker for long-term neurological sequelae. VEGF is thus considered a clinical marker for assessing distress, the infarct volume, and the prognosis in pediatric IS. VEGF exhibits direct trophic and protective effects on neurons, making its vascular and neuronal roles highly relevant to IS. Several studies [20; 21] highlight the effects of cerebral ischemia on VEGF expression and its receptors, particularly in the ischemic penumbra (the transitional zone between the infarct core and the surrounding region). This penumbra remains partially perfused, and its fate significantly influences the clinical outcomes. [PERSON] et al.