title: GFAP and antibodies against NMDA receptor subunit NR2 as biomarkers for acute cerebrovascular diseases.
abstract: We studied whether the serum levels of glial fibrillary acidic protein (GFAP) and of antibodies against the N-methyl-d-aspartate receptor subunit NR2 (NR2 RNMDA ) can discriminate between intracerebral haemorrhage (ICH) and ischaemic stroke (IS) in stroke patients. We prospectively recruited patients with suspected stroke (72 confirmed) and 52 healthy controls. The type of brain lesion (ICH or IS) was established using brain imaging. The levels of GFAP and of antibodies against NR2 RNMDA were measured in blood samples obtained within 12 hrs after stroke onset and 24, 48 and 72 hrs and 1 and 2 weeks later using ELISA immunoassay. Improvement in diagnostic performance was assessed in logistic regression models designed to predict the diagnosis and the type of stroke. GFAP peaks early during haemorrhagic brain lesions (at significantly higher levels), and late in ischaemic events, whereas antibodies against NR2 RNMDA have significantly higher levels during IS at all time-points. Neither of the two biomarkers used on its own could sufficiently discriminate patients, but when they are used in combination they can differentiate at 12 hrs after stroke, between ischaemic and haemorrhagic stroke with a sensitivity and specificity of 94% and 91%, respectively.
authors.affiliation: Department of Neurosciences, "Iuliu Hatieganu" University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania.
authors.forename: Delia Maria
authors.initials: DM
authors.lastname: Stanca
authors.affiliation: Department of Neurosciences, "Iuliu Hatieganu" University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania.
authors.forename: Ioan Constantin
authors.initials: IC
authors.lastname: Mărginean
authors.affiliation: Department of Cancer Immunology of "Prof. dr. Ion Chiricuță" Oncologic Institute Cluj-Napoca, Cluj-Napoca, Romania.
authors.forename: Olga
authors.initials: O
authors.lastname: Sorițău
authors.affiliation: Department of Statistics, Babes-Bolyai University Cluj-Napoca, Cluj-Napoca, Romania.
authors.forename: Cristian
authors.initials: C
authors.lastname: Dragoș
authors.affiliation: Department of Histology, "Iuliu Hatieganu" University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania.
authors.forename: Mariana
authors.initials: M
authors.lastname: Mărginean
authors.affiliation: Department of Neurosciences, "Iuliu Hatieganu" University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania.|"RoNeuro" Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania.
authors.forename: Dafin Fior
authors.initials: DF
authors.lastname: Mureșanu
authors.affiliation: Department of Biometry and Clinical Research, IDV Data Analysis and Study Planning, Krailling, Germany.
authors.forename: Johannes C
authors.initials: JC
authors.lastname: Vester
authors.affiliation: Department of Microbiology and Epidemiology, University of Medicine and Pharmacy "Carol Davila", Bucharest, Romania.
authors.forename: Alexandru
authors.initials: A
authors.lastname: Rafila
mesh_terms: D000208:Acute Disease; D000368:Aged; D000906:Antibodies / Q000378:metabolism*; D015415:Biomarkers / Q000378:metabolism; D002561:Cerebrovascular Disorders / Q000378:metabolism*; D005260:Female; D005904:Glial Fibrillary Acidic Protein / Q000378:metabolism*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D021122:Protein Subunits / Q000378:metabolism*; D012372:ROC Curve; D016194:Receptors, N-Methyl-D-Aspartate / Q000276:immunology*; D020521:Stroke / Q000378:metabolism
chemical_list: D000906:Antibodies; D015415:Biomarkers; D005904:Glial Fibrillary Acidic Protein; C120997:NR2A NMDA receptor; D021122:Protein Subunits; D016194:Receptors, N-Methyl-D-Aspartate
keywords: GFAP; NMDA; intracerebral haemorrhage; ischaemic stroke; neuronal biomarkers