Table 1.
Brain-specific inflammatory biomarkers potentially useful in stroke diagnosis, response to treatment, and outcome.
| Author | Year | Study Design | Biomarker | Outcome | Results |
|---|---|---|---|---|---|
| Astroglial activation | |||||
| Dassan et al. [146] | 2009 | Systematic review (13 longitudinal studies) | S100B | IS diagnosis HT mRS | S100B may be useful in predicting clot lysis (p = 0.001) and HT after thrombolysis (p = 0.017) with sensitivity and specificity of 46% and 82%, respectively. S100B also predict final infarct volume and eventually functional outcome (sensitivity 87%, specificity 78%). |
| Ye et al. [147] | 2015 | Meta-analysis (10 pooled case-control studies enrolling 773 patients with IS and 438 healthy controls) | S100B | IS diagnosis | Serum levels of S100B were higher in IS patients as compared to controls (SMD = 1.71 [95% CI 0.62–2.79]; p = 0.002). Subgroup analysis based on ethnicity revealed that S100B predict IS progression in Asians but not in Caucasians. However, no statistical significance was observed in large samples. |
| Kazmierski et al. [148] | 2015 | Prospective observational (458 IS patients) | S100B | HT | HT was associated with higher serum concentrations of S100B (AUC = 0.746; sensitivity 92.9%, specificity 48.1%). |
| Tsai et al. [149] | 2014 | Case-control (100 IS patients and 80 healthy subject) | TBARS thiol | 3-month NIHSS | As compared to controls, IS patients had higher TBARS and low free thiol. Furthermore, serum levels of thiol were lower in large- than small-vessel disease. TBARS at day 7 was identified as independent predictor of poor neurological outcome (OR 1.37 [95% CI 1.14–1.65]; p = 0.001). |
| Lorente et al. [150] | 2015 | Case-control (50 IS patients and 100 healthy controls) | MDA | 30-day mortality | MDA levels were significantly higher in IS patients as compared to healthy controls, as well as in non-surviving IS patients than in survivors (p < 0.001 for both). Furthermore, MDA predicted 30-day mortality (OR 7.23 [95% CI 1.84–28.73]; p = 0.005) with a sensitivity of 65% and a specificity of 75% (AUC of 0.77). |
| Neuronal cell injury | |||||
| Bharosay et al. [151] | 2012 | Case-control (150 IS patients and 101 controls) | NSE | NIHSS at days 1–7 | NSE was higher in IS patients (p < 0.001), also correlating with stroke severity at admission (r = 0.919; p < 0.001) and after 7 days (r = 0.706; p < 0.001). |
| Singh et al. [152] | 2013 | Case-control (100 IS patients and 101 controls) | NSE | NIHSS at admission | Serum NSE was higher in IS group, also correlating with IS severity (r = 0.800; p < 0.001). |
| Zaheer et al. [153] | 2013 | Prospective observational (75 IS patients) | NSE | 30-day mRS | A positive correlation was found between NSE infarct size (r = 0.955, p < 0.001), whereas a negative relationship with GCS was demonstrated (r = −0.806, p < 0.001). Finally, there was a positive correlation between NSE and neurological outcome (r = 0.744, p < 0.001). |
| Kim et al. [155] | 2014 | Prospective observational (83 IS patients) | NSE | HT | In patients with HT, NSE time course was characterized by two peak levels. This specific pattern was significantly associated with the occurrence of HT (OR 6.84 [95% CI 1.12–41.70]; p = 0.04). |
| Lu et al. [156] | 2015 | Prospective observational (74 IS patients) | NSE | 3-month mRS | NSE sowed predictive accuracy toward poor neurological outcome (77.1% sensitivity and 59.4% specificity). However, the adjusted RR for NSE was not effective in predicting poor neurological outcome. |
| Haupt et al. [157] | 2016 | Prospective observational (31 IS patients) | NSE | mRS days 7 and 10 | NSE peak at day 4 in the good outcome patients, whereas a continuous increase was observed in those with poor outcome. Sensitivity of NSE analysis showing an increase over time to >90% at day 4. |
| Park et al. [154] | 2013 | Case-control (111 IS patients and 127 controls) | H-FABP | Stroke diagnosis | H-FABP was significantly higher in the IS group (OR 1.08 [95% CI 1.02–1.13]; p < 0.001). However, H-FABP was not sensitive enough to discriminate stroke from control group or IS subtype. |
HT: hemorrhagic transformation; IS: ischemic stroke; SMD: standardized mean differences; CI: confidence interval; AUC: area under the curve; TBARS: thiobarbituric acid-reactive substances; OR: odds ratio; MDA: malonildyaldeide; NSE: neuron-specific enolase; NIHSS: National Institute of Health Stroke Scale; mRS: modified Rankin Scale; H-FABP: heart-type fatty acid binding protein.