title: Plasma thrombin-cleaved osteopontin elevation after carotid artery stenting in symptomatic ischemic stroke patients.
abstract: Atherothrombosis is the primary pathophysiology that underlies ischemic cerebral infarction. Osteopontin (OPN) is produced in atherosclerotic lesions and is cleaved by activated thrombin. We hypothesized that the rupture or damage of an unstable atherosclerotic plaque increases plasma levels of thrombin-cleaved OPN (trOPN). This study included 90 patients who received carotid angioplasty with stenting (CAS), 23 patients with essential hypertension (EHT) and 10 patients who were treated with carotid endarterectomy (CEA). The CAS patient group included 36 patients that had pre- and post-operative blood tests, diffusion-weighted imaging (DWI) using cerebral MRIs and estimated thrombus debris within the protection device. Immunohistochemistry of CEA specimens revealed that trOPN was detected around intra-plaque vessels. The highest tertile of plasma trOPN levels in CAS patients was higher than trOPN levels in EHT patients. Post-operative trOPN levels were significantly higher in symptomatic compared with asymptomatic patients (P=0.003). New ipsilateral DWI-positive patients revealed higher post-operative trOPN levels (P=0.003) and a higher grade of thrombi (P<0.001) than DWI-negative patients. TrOPN may be a novel biomarker that reflects the atherothrombotic status in ischemic stroke.
authors: Department of Pathology, Division of Pathogenomics, Ehime University Graduate School of Medicine, Toon City, Japan.
authors: Mie
authors: M
authors: Kurata
authors: Takafumi
authors: T
authors: Okura
authors: Yoshiaki
authors: Y
authors: Kumon
authors: Masahiko
authors: M
authors: Tagawa
authors: Hideaki
authors: H
authors: Watanabe
authors: Toshinori
authors: T
authors: Nakahara
authors: Tatsuhiko
authors: T
authors: Miyazaki
authors: Jitsuo
authors: J
authors: Higaki
authors: Masato
authors: M
authors: Nose
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000097:blood* / Q000150:complications / Q000473:pathology; D016893:Carotid Stenosis / Q000097:blood* / Q000473:pathology / Q000601:surgery*; D002533:Cerebral Angiography; D038524:Diffusion Magnetic Resonance Imaging; D016894:Endarterectomy, Carotid; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D053495:Osteopontin / Q000097:blood*; D058226:Plaque, Atherosclerotic / Q000473:pathology; D011446:Prospective Studies; D015607:Stents; D020521:Stroke / Q000097:blood* / Q000209:etiology; D013917:Thrombin / Q000378:metabolism*; D014057:Tomography, X-Ray Computed
chemical_list: D053495:Osteopontin; D013917:Thrombin