title: Genomic biomarkers and cellular pathways of ischemic stroke by RNA gene expression profiling.
abstract: OBJECTIVE
  The objective of this study was to provide insight into the molecular mechanisms of acute ischemic cerebrovascular syndrome (AICS) through gene expression profiling and pathway analysis.
  
  
  METHODS
  Peripheral whole blood samples were collected from 39 MRI-diagnosed patients with AICS and 25 nonstroke control subjects ≥ 18 years of age. Total RNA was extracted from whole blood stabilized in Paxgene RNA tubes, amplified, and hybridized to Illumina HumanRef-8v2 bead chips. Gene expression was compared in a univariate manner between stroke patients and control subjects using t test in GeneSpring. The significant genes were tested in a logistic regression model controlling for age, hypertension, and dyslipidemia. Inflation of type 1 error was corrected by Bonferroni and Ingenuity Systems Pathway analysis was performed. Validation was performed by QRT-PCR using Taqman gene expression assays.
  
  
  RESULTS
  A 9-gene profile was identified in the whole blood of ischemic stroke patients using gene expression profiling. Five of these 9 genes were identified in a previously published expression profiling study of stroke and are therefore likely biomarkers of stroke. Pathway analysis revealed toll-like receptor signaling as a highly significant canonical pathway present in the peripheral whole blood of patients with AICS.
  
  
  CONCLUSIONS
  Our study highlights the relevance of the innate immune system through toll-like receptor signaling as a mediator of response to ischemic stroke and supports the claim that gene expression profiling can be used to identify biomarkers of ischemic stroke. Further studies are needed to validate and refine these biomarkers for their diagnostic potential.
authors.affiliation: National Institute of Nursing Research, Tissue Injury Unit Building, Bethesda, MD 20812, USA. barrt@mail.nih.gov
authors.forename: T L
authors.initials: TL
authors.lastname: Barr
authors.forename: Y
authors.initials: Y
authors.lastname: Conley
authors.forename: J
authors.initials: J
authors.lastname: Ding
authors.forename: A
authors.initials: A
authors.lastname: Dillman
authors.forename: S
authors.initials: S
authors.lastname: Warach
authors.forename: A
authors.initials: A
authors.lastname: Singleton
authors.forename: M
authors.initials: M
authors.lastname: Matarin
mesh_terms: D000368:Aged; D015415:Biomarkers; D002545:Brain Ischemia / Q000235:genetics* / Q000473:pathology*; D016022:Case-Control Studies; D015331:Cohort Studies; D015342:DNA Probes; D005260:Female; D020869:Gene Expression Profiling; D005819:Genetic Markers; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009961:Orosomucoid / Q000235:genetics / Q000502:physiology; D011446:Prospective Studies; D040081:Protein Array Analysis; D012313:RNA / Q000235:genetics* / Q000302:isolation & purification; D054400:Receptors, CCR7 / Q000235:genetics / Q000502:physiology; D012015:Reference Standards; D012189:Retrospective Studies; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012307:Risk Factors; D018401:Sample Size; D015398:Signal Transduction / Q000235:genetics; D020521:Stroke / Q000235:genetics* / Q000473:pathology*; D020703:ras GTPase-Activating Proteins / Q000235:genetics / Q000502:physiology
chemical_list: D015415:Biomarkers; D015342:DNA Probes; D005819:Genetic Markers; C101203:IQ motif containing GTPase activating protein 1; D009961:Orosomucoid; D054400:Receptors, CCR7; D020703:ras GTPase-Activating Proteins; D012313:RNA