Abstract TP225: A New Chemokine (CCL23) Is Useful As A Brain Damage Marker And Reflects The Time After Stroke Onset Serving As A Biological Clock.
Cardiologists use several blood biomarkers to assess acute myocardial infarction diagnosis and onset, which would be also of great value in the stroke field; specially in the case of patients that show brain damage due to an ischemic stroke and who reach the hospital unconscious or with inability to communicate, or wake-up strokes in which we may not determine precisely when symptoms began.
Methods: To identify such markers a first screening step  was performed exploring around 200 candidate proteins (multiplex Searchlight technology) among a small number of stroke patients that identified a protein, chemokine CCL23, significantly elevated in blood with respect to healthy individuals. Next step  included a large replication study among patients with stroke suspicion who came to the ED with acute neurological symptoms initiated <24h before admission. Following step  evaluated time profiles and kinetics of CCL23 level in strokes who received t-PA. Serum CCL23 was determined in duplicate by two ELISA-type commercial immunoassays (Aushon Biosystems and RayBiotech).
Results: Healthy controls had CCL23 blood levels lower (p<0.001) than patients with ischemic stroke (n=146), and lower than patients with other stroke mimics (n=58). CCL23 was found higher in patients with brain damage caused by a structural injury (TBI or brain tumors) than in those with the same neurological symptoms but without structural brain injuries (simulators, primary headaches, etc). CCL23 increased progressively in the acute stage of ischemic stroke as shown in the Figure (dashed-line=healthy control′s range). Lower CCL23 levels, between 2-3.5 hours were observed in patients who improved at 48h.
Conclusion: Chemokine CCL23 level is useful as a diagnostic marker of pathologies associated with neurological damage. This allows rapid diagnosis of stroke patients and determining stroke onset regarding CCL23 blood level, that might allow starting safely and sooner reperfusion therapies.
- © 2012 by American Heart Association, Inc.