Relevance of Post-Stroke Circulating BDNF Levels as a Prognostic Biomarker of Stroke Outcome. Impact of rt-PA Treatment

PLoS One. 2015 Oct 15;10(10):e0140668. doi: 10.1371/journal.pone.0140668. eCollection 2015.

Abstract

The recombinant form of tissue plasminogen activator (rt-PA) is the only curative treatment for ischemic stroke. Recently, t-PA has been linked to the metabolism of brain-derived neurotrophic factor (BDNF), a major neurotrophin involved in post-stroke neuroplasticity. Thus, the objective of our study was to investigate the impact of rt-PA treatment on post-stroke circulating BDNF levels in humans and in animals. Serum BDNF levels and t-PA/plasmin activity were measured at hospital admission and at up to 90 days in stroke patients receiving (n = 24) or not (n = 14) rt-PA perfusion. We investigated the relationships between serum BDNF with concurrent t-PA/plasmin activity, neurological outcomes and cardiovascular scores at admission. In parallel, serum BDNF levels and t-PA/plasmin activity were assessed before and after (1, 4 and 24h) the induction of ischemic stroke in rats. Our study revealed higher serum BDNF levels and better neurological outcome in rt-PA-treated than non-treated patients. However, serum BDNF levels did not predict stroke outcome when the whole cohort of stroke patients was analyzed. By contrast, serum BDNF levels when measured at admission and at day 90 correlated with cardiovascular scores, and those at day 1 correlated with serum t-PA/plasmin activity in the whole cohort of patients whereas no association could be found in the rt-PA-treated group. In rats devoid of cardiovascular risk, no difference in post-stroke serum BDNF levels was detected between rt-PA- and vehicle-treated animals and no correlation was found between serum BDNF levels and t-PA/plasmin activity. Overall, the data suggest that serum BDNF levels may not be useful as a prognostic biomarker of stroke outcome and that endothelial dysfunction could be a confounding factor when serum BDNF levels after stroke are used to reflect of brain BDNF levels.

MeSH terms

  • Aged
  • Animals
  • Biomarkers / blood
  • Brain Ischemia / blood
  • Brain Ischemia / drug therapy*
  • Brain-Derived Neurotrophic Factor / blood*
  • Female
  • Fibrinolytic Agents / administration & dosage*
  • Fibrinolytic Agents / blood
  • Fibrinolytic Agents / therapeutic use
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Perfusion
  • Prognosis
  • Rats
  • Stroke / blood
  • Stroke / drug therapy*
  • Tissue Plasminogen Activator / administration & dosage*
  • Tissue Plasminogen Activator / blood
  • Tissue Plasminogen Activator / therapeutic use
  • Treatment Outcome

Substances

  • Biomarkers
  • Brain-Derived Neurotrophic Factor
  • Fibrinolytic Agents
  • BDNF protein, human
  • Tissue Plasminogen Activator

Grants and funding

The authors have no support or funding to report.