The Role of Biomarkers in Stroke from Pathophysiology to Prognosis

We read the article “Prognostic Value of Blood Parameters in Patients Diagnosed with Ischemic and Hemorrhagic Cerebrovascular Events” by Ayten (2024) with great interest. The study highlights the correlation between neutrophil-lymphocyte ratio (NLR) at admission and hospital stay duration in stroke patients. While this is valuable, we would like to expand the discussion by considering additional prognostic biomarkers. Cerebrovascular events remain a major cause of morbidity and mortality, with outcome prediction posing a challenge despite advances in treatment. Emerging biomarkers provide insights into disease severity, treatment guidance, and recovery prognosis. Glial fibrillary acidic protein (GFAP) and S100B indicate astrocytic injury, while neurofilament light chain (NFL) and tau protein reflect neuronal damage. Inflammatory cytokines (IL-6, TNF-α) contribute to stroke-related neuroinflammation, and oxidative stress markers (8-isoprostanes) reveal vascular integrity. Additionally, circulating microRNAs (miRNAs) have shown promise as molecular regulators of post-stroke recovery. This review underscores the prognostic value of these biomarkers in ischemic and hemorrhagic stroke, emphasizing their clinical relevance, limitations, and future applications in personalized stroke management.