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Liquid biopsy markers for stroke diagnosis.
Expert Review of Molecular Diagnostics ( IF 5.1 ) Pub Date : 2020-07-05 , DOI: 10.1080/14737159.2020.1777859
Harshani Wijerathne 1, 2 , Malgorzata A Witek 1, 2, 3 , Alison E Baird 4 , Steven A Soper 1, 2, 3, 5, 6, 7
Affiliation  

Introduction

There is a short time window (4.5 h) for the effective treatment of acute ischemic stroke (AIS), which uses recombinant tissue plasminogen activator (rt-PA). Unfortunately, this short therapeutic timeframe is a contributing factor to the relatively small number of patients (~7%) that receive rt-PA. While neuroimaging is the major diagnostic for AIS, more timely decisions could be made using a molecular diagnostic.

Areas covered

In this review, we survey neuroimaging techniques used to diagnose stroke and their limitations. We also highlight the potential of various molecular/cellular biomarkers, especially peripheral blood-based (i.e. liquid biopsy) biomarkers, for diagnosing stroke to allow for precision decisions on managing stroke in a timely manner. Both protein and nucleic acid molecular biomarkers are reviewed. In particular, mRNA markers are discussed for AIS and hemorrhagic stroke diagnosis sourced from both cells and extracellular vesicles.

Expert opinion

While there are a plethora of molecular markers for stroke diagnosis that have been reported, they have yet to be FDA-cleared. Possible reasons include the inability for these markers to appear in sufficient quantities for highly sensitive clinical decisions within the rt-PA therapeutic time



中文翻译:

用于中风诊断的液体活检标志物。

介绍

使用重组组织纤溶酶原激活剂 (rt-PA) 有效治疗急性缺血性中风 (AIS) 的时间窗口很短 (4.5 小时)。不幸的是,这种较短的治疗时间是导致接受 rt-PA 的患者数量相对较少(约 7%)的一个因素。虽然神经影像学是 AIS 的主要诊断方法,但使用分子诊断可以做出更及时的决定。

覆盖区域

在这篇综述中,我们调查了用于诊断中风的神经影像技术及其局限性。我们还强调了各种分子/细胞生物标志物,尤其是基于外周血(液体活检)生物标志物的潜力,用于诊断中风,以便及时做出中风管理的精确决策。回顾了蛋白质和核酸分子生物标志物。特别是,讨论了来自细胞和细胞外囊泡的 AIS 和出血性中风诊断的 mRNA 标记物。

专家意见

虽然已经报道了大量用于中风诊断的分子标记物,但它们尚未得到 FDA 的批准。可能的原因包括这些标志物无法在 rt-PA 治疗时间内以足够的数量出现以用于高度敏感的临床决策

更新日期:2020-09-03
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