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Brain & Heart Cerebral ischemia biomarkers

pathophysiology of cerebral ischemia and identifying A comprehensive proteomic analysis of plasma samples
potential biomarkers for early detection and prognosis. from ischemic stroke patients and healthy controls
Genomics has revolutionized our understanding of the identified nine significantly dysregulated proteins in the
genetic component of cerebral ischemia and has enabled ischemic stroke group, including vasoactive intestinal
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the identification of several genetic variants associated peptide, complement C3, and haptoglobin. These
with an increased risk of stroke. One notable example is the proteins are implicated in biological processes related to
locus 9p21, which is associated with large vessel ischemic inflammation, oxidation, and coagulation, highlighting
stroke and other cardiovascular diseases. In addition, the their potential as blood-based biomarkers of cerebral
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identification of single nucleotide polymorphisms (SNPs) ischemia.
in candidate genes involved in endothelial dysfunction, Proteomics aims to identify and quantify protein
platelet aggregation, and lipid metabolism has contributed expression patterns, providing valuable insights into the
to the discovery of new therapeutic targets. 9 functional consequences of changes in gene expression.

3.1. Transcriptomics biomarkers in cerebral ischemia Proteomic studies have identified numerous differentially
expressed proteins associated with cerebral ischemia,
Transcriptomics enables the study of gene expression including matrix metalloproteinases (MMPs), heat shock
patterns in cerebral ischemia and provides insights into the proteins, and neuroinflammatory markers. For example,
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molecular mechanisms involved in ischemic injury. For elevated levels of MMP-9 are associated with blood-
instance, microarray analyses have revealed differentially brain barrier (BBB) dysfunction and an increased risk of
expressed genes involved in inflammation, neuronal hemorrhagic transformation in ischemic stroke patients.
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apoptosis, and oxidative stress following cerebral ischemia. Proteomic analysis has also revealed the potential of plasma
Researchers have identified potential biomarkers such as biomarkers such as copeptin and miR-134 as predictors of
pituitary adenylate cyclase-activating polypeptide and stroke severity and patient outcomes. 15
S100 calcium-binding protein B (S100B) as early indicators
of ischemic brain injury. 10 Proteomic biomarkers have shown great potential
for improving the detection, diagnosis, and monitoring
A potential biomarker for cerebral ischemia is hypoxia- of cerebral ischemia. Several proteomic studies have
inducible factor 1 (HIF1). HIF1 is a transcription factor identified dysregulated proteins associated with
that plays a crucial role in the cellular response to low inflammation, oxidative stress, neuronal cell death, and
oxygen levels—hypoxia. During cerebral ischemia, the other biological processes involved in cerebral ischemia.
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brain is exposed to hypoxia, leading to the activation of These biomarkers provide valuable insights into the
HIF1. Studies have shown that serum HIF-1α is closely pathophysiology of cerebral ischemia, aid early diagnosis,
correlated with hemorrhagic severity and poor outcomes and may guide targeted therapeutic approaches. However,
and may serve as a potential prognostic biomarker for further research is needed to validate these proteomic
this condition. In addition, HIF1 is involved in the biomarkers and translate them into routine clinical practice
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regulation of genes related to cell survival, angiogenesis, for treating patients with cerebral ischemia.
and metabolism, all of which are important processes in
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the pathophysiology of cerebral ischemia. 3.3. Metabolomic biomarkers in cerebral ischemia
In addition, transcriptomic profiling has facilitated the Conventional diagnostic imaging techniques such as CT
discovery of genes associated with post-stroke recovery, or MRI provide valuable information about the extent
offering potential targets for neurorestorative therapies. 8 and location of ischemic lesions. However, they lack the
ability to assess the underlying metabolic changes that
3.2. Proteomic biomarkers in cerebral ischemia occur during the ischemic event. Metabolomic profiling
Proteomic biomarkers are molecules measurable in offers a promising approach to identifying and quantifying
various body fluids or tissues that have shown promise in different metabolites that may serve as biomarkers for
elucidating the biological processes involved in cerebral ischemic stroke.
ischemia. A frequently used approach for discovering Metabolomics is a comprehensive analysis of small
proteomic biomarkers is mass spectrometry. This molecule metabolites (e.g., amino acids, lipids, and sugars)
technique identifies and quantifies proteins in a sample present in biological samples. By analyzing changes in
based on their mass-to-charge ratio. By comparing protein the metabolome, metabolomic studies aim to unravel
profiles between healthy individuals and those with stroke, the complex metabolic pathways altered during cerebral
researchers can identify potential biomarkers for further ischemia. This approach has the potential to identify
validation and clinical use. new biomarkers that can aid in the early diagnosis, risk

Volume 2 Issue 3 (2024) 4 doi: 10.36922/bh.2750