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Brain & Heart

REVIEW ARTICLE
Cerebral ischemia biomarkers: Their roles in early

diagnosis and prognosis with potential clinical
applications

Lidija Radenovic*

Center for Laser Microscopy, Faculty of Biology, University of Belgrade, Belgrade, Serbia

Abstract

Cerebral ischemia, caused by a disruption in blood supply to the brain, remains
a significant cause of morbidity and mortality worldwide. Identifying reliable
biomarkers for the early diagnosis and prognosis of cerebral ischemia is crucial for
timely intervention and improved patient outcomes. This review aims to provide a
comprehensive overview of the current knowledge on cerebral ischemia biomarkers,
focusing on their potential role in early detection and prediction of clinical outcomes.
Specifically, we discuss the current advances in the field of cerebral ischemia
biomarkers, which serve as essential tools for early diagnosis and monitoring of
ischemic stroke. We examine several promising biomarkers, including omics data,
genetic (FOXF2 and ATP5H), physiological and neuroinflammatory biomarkers,
neuroimaging markers, blood-based biomarkers (proteins, microRNAs, and
metabolites), and newer modalities such as exosomes, microvesicles, and cell-free
deoxyribonucleic acid (cfDNA). In addition, we highlight the challenges and future
directions in translating these biomarkers into clinical practice. Standardization and
*Corresponding author: reproducibility, methodological limitations, and cost and accessibility are critical
Lidija Radenovic challenges in the translation of biomarkers into clinical practice. Addressing these
(lidijar@bio.bg.ac.rs) challenges requires multi-stakeholder collaborations and coordinated efforts to
Citation: Radenovic L. Cerebral establish standardized protocols, improve analytical methods, and develop cost-
ischemia biomarkers: Their roles in effective biomarker assays. The use of point-of-care testing devices or miniaturized
early diagnosis and prognosis with lab-on-a-chip technologies can reduce costs and improve accessibility, particularly
potential clinical applications.
Brain & Heart. 2024;2(3):2750. in low-resource settings. Furthermore, collaborations between academia, industry,
doi: 10.36922/bh.2750 and regulatory agencies can facilitate the translation of biomarkers by addressing
Received: January 15, 2024 regulatory and reimbursement hurdles that affect the affordability and availability
of these tests.
Accepted: July 12, 2024
Published Online: August 5, 2024
Keywords: Cerebral ischemia; Biomarkers; Neuroimaging; Blood-based markers; Early
Copyright: © 2024 Author(s). diagnosis; Prognosis; Monitoring
This is an Open-Access article
distributed under the terms of the
Creative Commons Attribution
License, permitting distribution,
and reproduction in any medium, 1. Introduction
provided the original work is
properly cited. Cerebral ischemia is a complex, heterogeneous condition characterized by insufficient
Publisher’s Note: AccScience blood supply to the brain. This lack of blood flow, primarily caused by reduced cerebral
Publishing remains neutral with blood flow or occlusion of cerebral arteries, results in an inadequate supply of oxygen
regard to jurisdictional claims in
published maps and institutional and nutrients to brain tissue, triggering a cascade of cellular events that ultimately lead
1
affiliations. to brain damage. The pathophysiology of cerebral ischemia involves a complex interplay
Volume 2 Issue 3 (2024) 1 doi: 10.36922/bh.2750