AUTHOR=Liu Jia , Sugimoto Kazuo , Cao Yuanbo , Mori Masahiro , Guo Li , Tan Guojun 

TITLE=Serum Sphingosine 1-Phosphate (S1P): A Novel Diagnostic Biomarker in Early Acute Ischemic Stroke

JOURNAL=Frontiers in Neurology

VOLUME=11

YEAR=2020

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2020.00985

DOI=10.3389/fneur.2020.00985

ISSN=1664-2295

ABSTRACT=<p><bold>Background:</bold> Sphingosine 1-phosphate (S1P) is a lipid metabolite that mediates various physiological processes, including vascular endothelial cell function, inflammation, coagulation/thrombosis, and angiogenesis. As a result, S1P may contribute to the pathogenesis of stroke.</p><p><bold>Objective:</bold> This study aimed to evaluate the diagnostic value of serum S1P in acute stroke.</p><p><bold>Method:</bold> A total of 72 patients with ischemic stroke, 36 patients with hemorrhagic stroke, and 65 controls were enrolled. Serum S1P was detected by enzyme-linked immunosorbent assay (ELISA).</p><p><bold>Results:</bold> Receiver operating characteristic curve analysis demonstrated that serum S1P could discriminate ischemic stroke from hemorrhagic stroke in both total population and subgroup analyses of samples obtained within 24 h of symptom onset (subgroup<sub> &lt; 24h</sub>) (area under curve, AUC<sub>Total</sub> = 0.64, <italic>P</italic> = 0.017; AUC<sub>Subgroup &lt; 24h</sub> = 0.91, <italic>P</italic> &lt; 0.001) and controls (AUC<sub>Total</sub> = 0.62, <italic>P</italic> = 0.013; AUC<sub>Subgroup &lt;24h</sub> = 0.83, <italic>P</italic> &lt; 0.001). Furthermore, S1P showed higher efficacy than high-density lipoprotein cholesterol (HDL-C) in discriminating ischemic stroke from controls in the total population (<italic>P</italic><sub>S1P</sub> = 0.013, <italic>P</italic><sub>HDL−C</sub> = 0.366) and in the subgroup analysis (i.e., &lt;24 h; <italic>P</italic><sub>S1P</sub> &lt; 0.001, <italic>P</italic><sub>HDL−C</sub> = 0.081). Additionally, lower serum S1P was associated with cervical artery plaques (<italic>P</italic> = 0.021) in controls and with dyslipidemia (<italic>P</italic> = 0.036) and milder neurological impairment evaluated by the National Institute of Health Stroke Scale (NIHSS, <italic>P</italic> = 0.047) in the ischemic stroke group.</p><p><bold>Conclusions:</bold> The present study preliminarily investigated the diagnostic value of serum S1P in acute stroke. Decreased serum S1P may become a potential biomarker for early acute ischemic stroke and can indicate disease severity.</p>