title: Thrombolytic treatment decreases glutamate/GABA ratio in serum during acute ischaemic stroke: a pilot study.
abstract: There is no information about possible effect of recombinant tissue plasminogen activator (rtPA) therapy on excitotoxic/neuroprotective amino acids during acute phase of ischaemic stroke (IS). Our purpose was to evaluate iv thrombolytic treatment on glutamate (Glu) and gamma-aminobutyric acid (GABA) serum levels during acute IS. Eleven thrombolytic (rtPA group) and 12 non-thrombolytic (non-rtPA group) patients with acute IS were enrolled. The serum samples were obtained at three time points for rtPA group (time point 0: first to fourth hour of stroke; time point 1: immediately after rtPA administration; time point 2: on days 5-7 from stroke onset). The remaining patients had blood collection at two time points: time point 1: 5(th)-10(th) hour of stroke and time point 2: on days 5-7 of stroke. Glutamate and GABA were determined by the automated ion-exchange chromatography using Amino Acids Analyser (AAA 400) by INGOS Corp., Praha, Czech Republic. The statistically significant elevation of GABA serum level was noticed directly after thrombolysis (time point 1) in comparison to the corresponding time point in non-rtPA group [0.016 (0.002-0.032) μM/ml vs 0.001 (0.001-0.004) μM/ml for rtPA vs non-rtPA groups, respectively, median (first to third quartile), P < 0.05]. At the same time point, the Glu/GABA ratio was significantly decreased in rtPA group (P < 0.05) suggesting the decrease of excitotoxicity biomarkers in the blood after thrombolysis. Considering the beneficial effect of GABA receptor agonists, the elevation of GABA by rtPA should bring an additional positive features of thrombolytic treatment.
authors.forename: Jacek
authors.initials: J
authors.lastname: Kurzepa
authors.forename: Maria
authors.initials: M
authors.lastname: Szpetnar
authors.forename: Anna
authors.initials: A
authors.lastname: Hordyjewska
authors.forename: Sławomir
authors.initials: S
authors.lastname: Wątroba
authors.forename: Piotr
authors.initials: P
authors.lastname: Gołąb
authors.forename: Anna
authors.initials: A
authors.lastname: Boguszewska-Czubara
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000097:blood* / Q000188:drug therapy*; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D005971:Glutamates / Q000097:blood; D006801:Humans; D008297:Male; D010865:Pilot Projects; D020521:Stroke / Q000097:blood* / Q000188:drug therapy*; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D016896:Treatment Outcome; D005680:gamma-Aminobutyric Acid / Q000097:blood
chemical_list: D005343:Fibrinolytic Agents; D005971:Glutamates; D005680:gamma-Aminobutyric Acid; D010959:Tissue Plasminogen Activator
keywords: GABA,; Glutamate,; rtPA,; stroke