Open AccessGFAP and antibodies against NMDA receptor subunit NR 2 as biomarkers for acute cerebrovascular diseases
Author(s) -
Stanca Delia Maria,
Mărginean Ioan Constantin,
Sorițău Olga,
Dragoș Cristian,
Mărginean Mariana,
Mureșanu Dafin Fior,
Vester Johannes C.,
Rafila Alexandru
Publication year - 2015
Publication title -
journal of cellular and molecular medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.44
H-Index - 130
eISSN - 1582-4934
pISSN - 1582-1838
DOI - 10.1111/jcmm.12614
Subject(s) - glial fibrillary acidic protein , stroke (engine) , medicine , antibody , biomarker , lesion , gastroenterology , ischaemic stroke , nmda receptor , pathology , receptor , immunology , immunohistochemistry , ischemia , biology , biochemistry , mechanical engineering , engineering
We studied whether the serum levels of glial fibrillary acidic protein ( GFAP ) and of antibodies against the N ‐methyl‐ d ‐aspartate receptor subunit NR 2 ( NR 2 R NMDA ) can discriminate between intracerebral haemorrhage ( ICH ) and ischaemic stroke ( IS ) in stroke patients. We prospectively recruited patients with suspected stroke (72 confirmed) and 52 healthy controls. The type of brain lesion ( ICH or IS ) was established using brain imaging. The levels of GFAP and of antibodies against NR 2 R NMDA were measured in blood samples obtained within 12 hrs after stroke onset and 24, 48 and 72 hrs and 1 and 2 weeks later using ELISA immunoassay. Improvement in diagnostic performance was assessed in logistic regression models designed to predict the diagnosis and the type of stroke. GFAP peaks early during haemorrhagic brain lesions (at significantly higher levels), and late in ischaemic events, whereas antibodies against NR 2 R NMDA have significantly higher levels during IS at all time‐points. Neither of the two biomarkers used on its own could sufficiently discriminate patients, but when they are used in combination they can differentiate at 12 hrs after stroke, between ischaemic and haemorrhagic stroke with a sensitivity and specificity of 94% and 91%, respectively.