Expression of Acidic Fibrillar Protein and Neuroglobin in Thrombolytic Patients in Ischemic Stroke

Hanna Pawluk,1 Renata Ko&lstrok;odziejska,1 Grzegorz Grze&sacute;k,2 Mariusz Kozakiewicz,3 Agnieszka Kosinska,4 Mateusz Pawluk,1 El&zdot;bieta Grzechowiak,5 Jakub Wojtasik,6 Grzegorz Kozera7 1Department of Medical Biology and Biochemistry, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toru&nacute;, Bydgoszcz, Poland; 2Department of Cardiology and Clinical Pharmacology, Faculty of Health Sciences, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toru&nacute;, Bydgoszcz, Poland; 3Faculty of Health Science, The Masovian Academy in P&lstrok;ock, P&lstrok;ock, Poland; 4Centre for Languages & International Education, University College London, London, UK; 5Department of Neurology, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toru&nacute;, Bydgoszcz, Poland; 6Statistical Analysis Centre, Nicolaus Copernicus University in Toru&nacute;, Toru&nacute;, Poland; 7Centre of Medical Simulations, Faculty of Medicine, Medical University of Gda&nacute;sk, Gda&nacute;sk, PolandCorrespondence: Hanna Pawluk; Renata Ko&lstrok;odziejska, Department of Medical Biology and Biochemistry, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toru&nacute;, Kar&lstrok;owicza 24, 85– 092, Bydgoszcz, Poland, Tel +48 52 585 37 37, Fax +48 52 585 37 42, Email [email protected]; [email protected]: Glial fibrillary acidic protein (GFAP) and neuroglobin (NGB) are important biomarkers of cerebral hypoxia. For this reason, an attempt was made to assess their concentrations in various time intervals and their impact on the severity of neurological symptoms and functional prognosis of thrombolytic ischemic stroke patients.Patients and Methods: The study involved 94 patients reporting to the emergency department of the Collegium Medicum University Hospital in Bydgoszcz within < 4.5 hours of the onset of stroke symptoms. GFAP and neuroglobin levels were measured in plasma at indicated times using a commercial ELISA kit.Results: Based on the data gathered, statistically significant differences were found between the concentration of biomarkers in stroke patients and the control group. The concentrations of both biomarkers, GFAP and NGB, were elevated in patients after ischemic stroke and the changes in their concentrations in the subsequent stages of stroke may suggest their prognostic value strictly dependent on time. NGB was determined on the 7th day, and mRS - after a year (0.35). GFAP measured after 24 h and on day 7 could be a promising biomarker of functional outcome after one year (cut-off point ≤ 0.231 ng/mL, sensitivity 75.0%, specificity 61.2%, cut off point ≤ 0.235 ng/mL, sensitivity 75.0%, specificity 73.9%, respectively) and the severity of the patient’s neurological condition. At GFAP concentrations above 0.25 ng/mL, measured within 24 hours, a sharp increase in mortality was observed in stroke patients. In the case of NGB, at the time of stroke occurrence (14 ng/mL) and after 24 hours (10– 60 ng/mL). Differences in the concentrations of these biomarkers have been demonstrated in different stroke subtypes.Conclusion: NGB and GFAP are important biomarkers of ischemic brain injury and may also participate in predicting neurological outcomes.Keywords: GFAP, NGB, stroke, oxidative stress, inflammation, thrombolysis