Molecular markers of hemorrhagic stroke

Stroke is the second most common cause of death after coronary heart disease (CHD) globally and the third most common cause of disability worldwide. Aim: to identify patterns of serum levels of candidate molecular markers in various stages of hemorrhagic stroke. Material and methods. The number of enrolled patients with hemorrhagic stroke was 33, 15 of them were men and 18 women. The age of the patients was 31–65 years. The serum levels of molecular markers of the central nervous system (CNS) were measured in the hyperacute phase of stroke (during 1–3 hours after the onset), and on Days 7, 14 and 30 after the onset of the disease. The serum levels of candidate molecular markers of CNS in patients with hemorrhagic stroke were measured by immunoenzyme analysis during the hyperacute phase (first 1–3 hours), then on Days 7, 14 and 30 after the onset of disease. The levels of neurotrophic brain derived factor, neuron-specific enolase, total S-100 protein, glial cell line-derived neurotrophic factor, vascular endothelial growth factor, sialylated carbohydrate antigen, and superoxide dismutase were determined. The molecular markers of CNS were measured using the Immunomat (TM) automatic microplate immunoenzyme analyzer. The control group included 20 volunteers aged 24–58 years. Statistical analysis of the obtained data was performed using the Statistica 7.0 software. Parametric methods of statistical analysis were used, data were presented as medians and 25th and 75th percentiles (25–75 IQR). The difference at P<0.05 was considered statistically significant. Results. Changes in the serum levels of the studied candidate molecular markers were found in the patients with hemorrhagic stroke compared with the control group. During the hyperacute phase of hemorrhagic stroke (first 1–3 hours), significant increases of S100 protein, glial cell line-derived neurotrophic factor, vascular endothelial growth factor, superoxide dismutase, sialylated carbohydrate antigen levels, as well as decrease of brain derived neurotrophic factor and increase of neuron-specific enolase levels were revealed. In the acute phase of hemorrhagic stroke (Days 7–14), statistically significant decrease in brain-derived neurotrophic factor level (Day 14) and increase in vascular endothelial growth factor, superoxide dismutase, sialylated carbohydrate antigen levels were observed. In the subacute phase of disease (Day 30), a statistically significant increases in the vascular endothelial growth factor, superoxide dismutase and sialylated carbohydrate antigen levels were observed. Conclusion. Serial changes of serum levels of candidate molecular markers in patients with hemorrhagic stroke were found, which presumably represent alteration and regeneration corresponding to the disease phases. The use of these candidate molecular biomarkers, after appropriate validation, is a promising tool for comprehensive diagnosis, treatment monitoring and rehabilitation in this category of patients. © 2020, V.A. Negovsky Research Institute of General Reanimatology. All rights reserved.