Myelin basic protein and ischemia modified albumin levels in acute ischemic stroke cases

Serdar Can, Okhan Akdur, Ahmet Yildirim, Gurhan Adam, Dilek Ulker Cakir, Handan Isin Ozisik Karaman, Serdar Can, Okhan Akdur, Ahmet Yildirim, Gurhan Adam, Dilek Ulker Cakir, Handan Isin Ozisik Karaman

Abstract

Objective: To investigate early diagnostic effects of serum myelin basic protein (MBP) and ischemic modified albumin (IMA) levels in patients with ischemic stroke.

Methods: Fifty patients who presented to an emergency service with acute ischemic stroke between June 2013 to March 2014 were evaluated with the National Institute of Health Stroke Scale (NIHSS) and diffusion-weighted magnetic resonance imaging (MRI). Thirty four healthy cases were included as control group. All patients' serum IMA and MBP level were assessed.

Results: Mean IMA value was 0.52±0.25 cases with acute ischemic stroke and serum IMA levels were significantly higher than the control group (p<0.01). No statistical significance was observed between acute ischemic stroke group and control group related to the MBP serum levels (P>0.05). Statistically significant correlation was detected between the volumes of diffusion restriction on MRI and NIHSS score (P=0.002, r=0.43) and IMA (P=0.015, r=0.344) levels.

Conclusions: We have found that serum IMA levels are elevated in acute ischemic stroke cases and these levels are correlated with the ischemic tissue volume. MBP levels do not increase in early period of stroke cases.

Keywords: Acute stroke; Cerebral Ischemia; Ischemia-modified serum albumin.

Figures

Fig.1
Fig.1
Correlation between the plasma IMA levels and the infarct volume.

References

    1. Kara H, Akinci M, Degirmenci S, Bayir A, Ak A, Nayman A, Unlu A, et al. High-sensitivity C-reactive protein, lipoprotein-related phospholipase A2, and acute ischemic stroke. Neuropsychiatr Dis. Treat. 2014;10:1451–1457. doi:10.2147/NDT.S67665.
    1. Fiebach JB, Schellinger PD, Jansen O, Meyer M, Wilde P, Bender J, et al. CT and diffusion-weighted MR imaging in randomized order: diffusion-weighted imaging results in higher accuracy and lower interrater variability in the diagnosis of hyper acute ischemic stroke. Stroke. 2002;33:2206–2210. doi:10.1161/01.STR.0000026864.20339.CB.
    1. Kruetzelmann A, Köhrmann M, Sobesky J, Cheng B, Rosenkranz M, Röther J, et al. Pretreatment diffusion-weighted imaging lesion volume predicts favorable outcome after intravenous thrombolysis with tissue-type plasminogen activator in acute ischemic stroke. Stroke. 2011;42:1251–1254. doi:10.1161/STROKEAHA.110.600148.
    1. Katzan IL, Hammer MD, Hixson ED, Furlan AJ, Abou-Chebi A, Nadzam DM. Utilization of intravenous tissue plasminogen activator for acute ischemic stroke. Arch Neurol. 2004;61(3):346–350.
    1. Vos PE, van Gils M, Beems T, Zimmerman C, Verbeek MM. Increased GFAP and S100 beta but not NSE serum levels after subarachnoid haemorrhage are associated with clinical severity. Eur J Neurol. 2006;13:632–638. doi:10.1111/j.1468-1331.2006.01332.x.
    1. Petzold A, Keir G, Lim D, Smith M, Thompson EJ. Cerebrospinal fluid (CSF) and serum S100B: release and wash-out pattern. Brain Res Bull. 2003;61:281–285. doi:10.1016/S0361-9230(03)00091-1.
    1. Herrmann M, Vos P, Wunderlich MT, de Bruijn CH, Lamers KJ. Release of glial tissue–specific proteins after acute stroke: A comparative analysis of serum concentration of protein S-100B and glial fibrillary acidic protein. Stroke. 2000;31:2670–2677. doi:10.1161/01.STR.31.11.2670.
    1. Martini R, Mohajeri MH, Kasper S, Giese KP, Schachner M. Mice doubly deficient in the genes for P0 and myelin basic protein show that both proteins contribute to the formation of the major dense line in peripheral nerve myelin. J Neurosci. 1995;15:4488–4495.
    1. Lamers KJ, Vos P, Verbeek MM, Rosmalen F, van Geel WJ, van Engelen BG. Protein S-100B, neuron-specific enolase (NSE), myelin basic protein (MBP) and glial fibrillary acidic protein (GFAP) in cerebrospinal fluid (CSF) and blood of neurological patients. Brain Res Bull. 2003;61:261–264. doi:10.1016/S0361-9230(03)00089-3.
    1. Marx G, Chevinon M. Site-specific modification of albumin by free radicals. Reaction with copper(II) and ascorbate. Biochem J. 1985;236:397–400.
    1. Talwalkar SS, Bon Homme M, Miller JJ, Elin RJ. Ischemia modified albumin, a marker of acute ischemic events: a pilot study. Ann Clin Lab Sci. 2008;38:132–137.
    1. Hatano S. Variability of the diagnosis of stroke by clinical judgment and by a scoring method. Bull World Health Organ. 1976;54:533–540.
    1. Briggs DE, Felberg RA, Malkoff MD, Bratina P, Grotta JC. Should mild or moderate stroke patients be admitted to an intensive care unit? Stroke. 2001;32:871–876. doi:10.1161/01.STR.32.4.871.
    1. Bar-Or D, Lau E, Winkler JV. A novel assay for cobalt-albumin binding and its potential as a marker for myocardial ischemia-a preliminary report. J Emerg Med. 2000;19:311–315. doi:10.1016/S0736-4679(00)00255-9.
    1. National Institutes of Health Stroke Scale. Available at .
    1. Gunduz A, Turedi S, Mentese A, Altunayoglu V, Turan I, Karahan SC, et al. Ischemia-modified albumin levels in cerebrovascular accidents. Am J Emerg Med. 2008;26:874–878. doi:10.1016/j.ajem.2007.11.023.
    1. Zini I, Tomasi A, Grimaldi R, Vannini V, Agnati LF. Detection of free radicals during brain ischemia and reperfusion by spin trapping and microdialysis. Neurosci Lett. 1992;138:279–282. doi:10.1016/0304-3940(92)90933-X.
    1. Ertekin B, Kocak S, Defne Dundar Z, Girisgin S, Cander B, Gul M, et al. Diagnostic value of ischemia-modified albumin in acute coronary syndrome and acute ischemic stroke. Pak J Med Sci. 2013;29:1003–1007. doi: .
    1. Abboud H, Labreuche J, Meseguer E, Lavallee PC, Simon O, Olivot JM, et al. Ischemia-modified albumin in acute stroke. Cerebrovasc Dis. 2007;23:216–220. doi:10.1159/000097644.
    1. Hjalmarsson C, Bjerke M, Andersson B, Blennow K, Zetterberg H, Aberg ND, et al. Neuronal and glia-related biomarkers in cerebrospinal fluid of patients with acute ischemic stroke. J Cent Nerv Syst Dis. 2014;19:51–58. doi:10.4137/JCNSD.S13821.
    1. Wardlaw JM. Surrogate outcomes: a cautionary note. Stroke. 2009;40:1029–1031. doi:10.1161/STROKEAHA.108.540641.

Source: PubMed

Подписаться