[Cellular microparticles, potential useful biomarkers in the identification of cerebrovascular accidents].
The clinical utility of biomarkers depends on their ability to identify high-risk individuals in order to establish preventive, diagnostic or therapeutic measures. Currently, no practical, rapid and sensitive test is available for the diagnosis of acute ischemic stroke. A number of soluble molecules have been identified that are merely associated to these cerebrovascular accidents. Despite this association not a single molecule has the characteristics of a true biomarker directly involved in the pathophysiology of ischemic stroke-none of them is organ-specific and may therefore be elevated in the context of medical comorbidities. When explored as a combination of biomarkers, e.g. matrix metalloproteinase 9, brain natriuretic protein, D-dimer, protein S100B, the question still remains whether serial biomarker analysis provides additional prognostic information. Even S100B, a glial activation protein, has a low specificity for acute ischemic stroke because it may originate from extracranial sources. Current knowledge from the field of cell-derived microparticles suggests that these membrane fragments may represent reliable biomarkers as they are cell-specific and are released early in the pathophysiological cascade of a disease. These microparticles can be found not only in the cerebrospinal fluid but also in tears and circulating blood in case of blood-brain barrier dysfunction. They represent a new challenge in stroke diagnosis and management.
Anglés-Cano
Eduardo
E
Inserm U919, Sérine protéases et physiopathologie de l'unité neurovasculaire, UMR-CNRS 6232 CINAPS, Cyceron, Caen, F-14074 France. Angles-Cano@inserm.fr
Vivien
Denis
D
D015415:Biomarkers / Q000097:blood; D001777:Blood Coagulation; D055252:Cell-Derived Microparticles / Q000378:metabolism; D005342:Fibrinolysis; D006801:Humans; D045726:Metalloproteases / Q000097:blood; D020521:Stroke / Q000097:blood* / Q000175:diagnosis / Q000201:enzymology
D015415:Biomarkers; D045726:Metalloproteases