Gene expression in peripheral blood differs after cardioembolic compared with large-vessel atherosclerotic stroke: Biomarkers for the etiology of ischemic stroke

Huichun Xu, Yang Tang, Da Liu, Ruiqiong Ran, Bradley Ander, Michelle L Apperson, Xin She Liu, Jane C. Khoury, Jeffrey Gregg, Arthur Pancioli, Edward C. Jauch, Kenneth R. Wagner, Piero Verro, Joseph P. Broderick, Frank R Sharp

Research output: Contribution to journalArticle

69 Scopus citations

Abstract

There are no biomarkers that differentiate cardioembolic from large-vessel atherosclerotic stroke, although the treatments differ for each and ∼30% of strokes and transient ischemic attacks have undetermined etiologies using current clinical criteria. We aimed to define gene expression profiles in blood that differentiate cardioembolic from large-vessel atherosclerotic stroke. Peripheral blood samples were obtained from healthy controls and acute ischemic stroke patients (<3, 5, and 24 h). RNA was purified, labeled, and applied to Affymetrix Human U133 Plus 2.0 Arrays. Expression profiles in the blood of cardioembolic stroke patients are distinctive from those of large-vessel atherosclerotic stroke patients. Seventy-seven genes differ at least 1.5-fold between them, and a minimum number of 23 genes differentiate the two types of stroke with at least 95.2% specificity and 95.2% sensitivity for each. Genes regulated in large-vessel atherosclerotic stroke are expressed in platelets and monocytes and modulate hemostasis. Genes regulated in cardioembolic stroke are expressed in neutrophils and modulate immune responses to infectious stimuli. This new method can be used to predict whether a stroke of unknown etiology was because of cardioembolism or large-vessel atherosclerosis that would lead to different therapy. These results have wide ranging implications for similar disorders.

Original languageEnglish (US)
Pages (from-to)1320-1328
Number of pages9
JournalJournal of Cerebral Blood Flow and Metabolism
Volume28
Issue number7
DOIs
StatePublished - Jul 2008

Keywords

  • Atherosclerosis
  • Blood
  • Embolic stroke
  • Etiology
  • Gene expression profiling
  • Ischemic stroke

ASJC Scopus subject areas

  • Endocrinology
  • Neuroscience(all)
  • Endocrinology, Diabetes and Metabolism

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