Biomarkers of cerebral microembolic signals

Clin Chim Acta. 2017 Dec:475:164-168. doi: 10.1016/j.cca.2017.10.028. Epub 2017 Oct 27.

Abstract

Stroke is a major cause of mortality and morbidity around the world. Microembolic signals (MES), as the markers of unstable atherosclerotic plaque, can predict the occurrence and prognosis of ischemic stroke (IS). MES can also assess the efficacy of antithrombotic agents and predict the recurrence probability of IS. Unstable plaques are the main source of MES; thus, numerous biomarkers of atherosclerotic plaque instability are highly likely to predict the presence of MES. This study aims to review recent biomarker candidates for MES or microembolism. Current research indicates that the following are independent markers for positive MES: high level of serum soluble P-selectin, chemokine (C-X-C motif) ligand 16 (CXCL16) and fibrinogen, high neutrophil count, reduced ratio of CD4+CD25high regulatory T cells (Tregs) and the C allele of tumor necrosis factor receptor superfamily member 11B (TNFRSF11B) rs3102735. However, a more integrated profile of biomarkers for MES is needed to improve the stratification of patients with carotid stenosis and enhance the effectiveness of therapeutic interventions and prevention for IS.

Keywords: Biomarker; Ischemic stroke; Microembolic signals; Plaque.

Publication types

  • Review

MeSH terms

  • Biomarkers / blood
  • Brain Ischemia / blood
  • Brain Ischemia / diagnosis*
  • Brain Ischemia / drug therapy
  • Brain Ischemia / pathology
  • Chemokine CXCL16 / blood*
  • Chemokine CXCL16 / genetics
  • Fibrinogen / metabolism
  • Fibrinolytic Agents / therapeutic use
  • Humans
  • Intracranial Embolism / blood
  • Intracranial Embolism / diagnosis*
  • Intracranial Embolism / drug therapy
  • Intracranial Embolism / pathology
  • Neutrophils / immunology
  • Neutrophils / pathology
  • Osteoprotegerin / blood
  • Osteoprotegerin / genetics
  • P-Selectin / blood*
  • P-Selectin / genetics
  • Plaque, Atherosclerotic / blood
  • Plaque, Atherosclerotic / diagnosis*
  • Plaque, Atherosclerotic / drug therapy
  • Plaque, Atherosclerotic / pathology
  • Prognosis
  • Recurrence
  • Stroke / blood
  • Stroke / diagnosis*
  • Stroke / drug therapy
  • Stroke / pathology
  • T-Lymphocytes, Regulatory / immunology
  • T-Lymphocytes, Regulatory / pathology

Substances

  • Biomarkers
  • CXCL16 protein, human
  • Chemokine CXCL16
  • Fibrinolytic Agents
  • Osteoprotegerin
  • P-Selectin
  • TNFRSF11B protein, human
  • Fibrinogen