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ORIGINAL RESEARCH article

Front. Neurol.
Sec. Stroke
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1470718
This article is part of the Research Topic Blood-Based Cellular and Molecular Biomarkers in Acute Ischemic Stroke and Hemorrhagic Stroke - Volume II View all 10 articles

Serum Glial Fibrillary Acidic Protein in Acute Stroke: Feasibility to Determine Stroke-type, Timeline and Tissue-Impact

Provisionally accepted
Julien F Paul Julien F Paul Célina Ducroux Célina Ducroux Pamela Correia Pamela Correia Audrey Daigneault Audrey Daigneault Catherine Larochelle Catherine Larochelle Christian Stapf Christian Stapf Laura C. Gioia Laura C. Gioia *
  • University of Montreal Hospital Centre (CRCHUM), Montreal, Canada

The final, formatted version of the article will be published soon.

    Background: Interest is emerging regarding the role of blood biomarkers in acute stroke. The aim of this pilot study was to determine the feasibility of biomarker acquisition in suspected acute stroke, using modern ultrasensitive immunoassay techniques, and explore their potential usefulness for stroke diagnosis and management. Methods: In 62 patients with suspected acute stroke, blood samples were prospectively obtained upon arrival and prior to neuroimaging. Serum levels of glial fibrillary acidic protein (sGFAP) and neurofilament light chain (sNfL) were analyzed using a single molecule array (SIMOA®) method, according to time of symptom onset, neuroimaging, and final diagnosis. Results: Acute ischemic stroke (AIS) was diagnosed in 35 patients, 10 with large-vessel occlusion (LVO). The remaining were diagnosed with intracerebral hemorrhage (ICH) (n=12), transient ischemic attack (n=4), and stroke mimics (n=11). Median (IQR) sGFAP levels were significantly higher in ICH (2,877.8 [1,002.1-10,402.5] pg/mL) compared to others diagnoses. In AIS, GFAP levels appear to increase with longer delays since symptom onset and were higher in patients with more extensive ischemic changes on baseline CT (ASPECTS ≤ 7) than those without, particularly in LVO stroke. NfL values were similar across groups. Conclusions: In acute stroke, serum GFAP levels show potential as an adjunct tool for the distinction between ICH and AIS. Specific to AIS, GFAP may also offer insight into time from onset, and extent of ischemic tissue injury on neuroimaging, particularly in LVO stroke. These preliminary findings merit further study.

    Keywords: ischemic stroke, intracerebral hemorrhage, biomarkers, GFAP, Large-vessel occlusion Total Word Count: 3, 976 Figures/ Tables: 4 Supplementary Tables: 1 No. References: 23

    Received: 26 Jul 2024; Accepted: 25 Nov 2024.

    Copyright: © 2024 Paul, Ducroux, Correia, Daigneault, Larochelle, Stapf and Gioia. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Laura C. Gioia, University of Montreal Hospital Centre (CRCHUM), Montreal, Canada

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.