Biomarkers for Acute Ischemic Stroke: a new Era with promise for Diagnostics

Author(s): Sun Y

Worldwide, stroke is regarded as the second leading cause of death and first cause of neurological dysfunction. The only chemical treatment for ischemic stroke that has been approved by the US Food and Drug Administration is recombinant tissue plasminogen activator. Until 2015, when multiple trials demonstrated the benefit of mechanical thromb ectomy during the first six hours and recent trials demonstrated that mechanical thrombectomy can be beneficial up to 24 hours if the patients meet certain criteria, including the presence of magnetic resonance imaging/computed tomography perfusion mismatch, which allows for better selectivity and higher recruitment of eligible stroke patients, it was the only standard of care with a very narrow therapeutic window. However, not all stroke centers offer computed tomography or magnetic resonance imaging perfusion. Thus, doctors need other simple and accessible demonstrative instruments to choose stroke patients qualified for mechanical thrombectomy. Additionally, stroke the executives is as yet trying for doctors, especially those managing patients with "awaken" stroke. Multiple molecular pathways influenced by inflammatory markers and post-transcriptional activity mediate ischemic stroke-related brain tissue damage and subsequent pathological processes. Inflammatory and cardiac brain-derived biomarkers (serum matrix metalloproteinase, thioredoxin, neuronal and glial markers, and troponin proteins) as well as various biomarkers, including the emerging roles of microRNAs, are suggested by a significant number of published works. In this review, we look at the growing body of evidence regarding the diagnostic biomarkers for acute ischemic stroke that could help doctor’s better treat stroke patients. The roles of the various emerging markers and micro-RNAs, which have the potential to be of high diagnostic value in stroke patients, may be revealed by our review. In fact, novel biomarkers that can stratify diagnosis, prognosis, and treatment are in great demand in the stroke and traumatic brain injury fields.