Characterization of the Protein Profile in Thrombi of Patients With Ischemic Stroke and Identification of Potential Biomarkers as Predictors of Negative Clinical Evolution

Ischemic stroke is a heterogeneous multifactorial disorder recognized by the sudden onset of neurologic signs related directly to the sites of injury in the brain where the morbid process occurs. After the diagnosis of embolic stroke, patients undergo long diagnostic cascades to determine underlying risk factors and potential pathogenesis to provide the best possible therapy and minimize the risk of recurrent stroke events. Unfortunately, in ~40% of patients, the origin of the stroke is unclear. Additional tests, such as histological clot analysis, have shown promise to improve diagnostic accuracy and simplify diagnostic cascades. Chary Lopez-Pedrera, Ph.D., of Reina Sofia Hospital in Cordoba, Spain, reported specifically on this phenomenon. Her mission through this project was to analyze the proteomic profile of thrombi obtained by thrombectomy in ischemic stroke patients, its association with the presence of specific cardiovascular risk factors, and the clinical evolution of the thrombi after thrombectomy, per her presentation on Monday during the Virtual Diagnostics and OMICs session.

Based on the results of the proteomic analysis of 50 thrombi of stroke patients, 585 proteins were identified and quantified. Comparative analyses identified four protein signatures based on predisposing factors such as hypertension, dyslipidemia, obesity, and diabetes. Fifteen proteins, related to immune response or cellular metabolism and involved in vascular diseases, correlated with the NIHSS and ASPECTS scales. Ten altered proteins in patients with negative evolution at 3 months (mRS > 2) were identified and were associated with the development of stroke or brain damage, platelet aggregation, mortality, and arterial thrombosis. As Lopez-Pedrera commented, the technique used in this study allowed the identification of numerous proteins in the thrombi and the characterization of protein signatures as potential biomarkers to determine their origin and define a therapeutic strategy after ischemic stroke. This aspect depends on the protein evaluated. There are also distinctive median values that differentiate among patients with different thrombotic risk factors or among patients that have negative or positive evolution 90 days after stroke.

Read the full abstract here.