RNA expression studies in stroke: what can they tell us about stroke mechanism?
RNA expression studies in stroke: what can they tell us about stroke mechanism?
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DOI：
10.1097/wco.0000000000000786
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发表时间：
2020-02
影响因子：
4.8
通讯作者：
Jickling GC
中科院分区：
文献类型：
--
作者：
Falcione S;Kamtchum-Tatuene J;Sykes G;Jickling GC
对中风的诊断和对中风发病机制的了解是实施最佳治疗的关键。在外周血细胞中表达的RNA正在成为一种精确的生物标志物，有助于中风的诊断和中风原因的预测。在这篇综述中，我们总结了关于RNA在预测卒中中的作用、这些变化的理论基础以及对新的机制洞察力和临床应用的讨论的现有数据。卒中患者血液中RNA基因表达的差异已被发现，包括区分缺血性卒中和出血性卒中的差异，以及心栓性、大血管动脉粥样硬化和小血管腔隙卒中病因的差异。基因表达差异有望成为预测病因不明的卒中(隐源性卒中)的新的卒中生物标志物。RNA表达的差异为研究卒中机制，包括免疫反应和血栓形成在人类卒中中的作用提供了新的视角。对卒中基因表达调控及其原因的重要见解正在获得，包括选择性剪接、非编码RNA和微RNA。改善对中风的诊断和中风病因的确定将改善中风的治疗和预防。RNA生物标记物有望帮助卒中的诊断和病因学的确定，并为卒中的发病机制提供新的见解。虽然还需要进一步的研究，但总有一天，RNA图谱可能会成为卒中医疗机构的一部分，用于指导急性卒中的治疗和预防策略，并改进卒中的表型。
Diagnosis of stroke and understanding the mechanism of stroke is critical to implement optimal treatment. RNA expressed in peripheral blood cells is emerging as a precision biomarker to aid in stroke diagnosis and prediction of stroke cause. In this review we summarize available data regarding the role of RNA to predict stroke, the rationale for these changes, and a discussion of novel mechanistic insight and clinical applications. Differences in RNA gene expression in blood have been identified in patients with stroke, including differences to distinguish ischemic from hemorrhagic stroke, and differences between cardioembolic, large vessel atherosclerotic, and small vessel lacunar stroke etiology. Gene expression differences show promise as novel stroke biomarkers to predict stroke of unclear etiology (cryptogenic stroke). The differences in RNA expression provide novel insight to stroke mechanism, including the role of immune response and thrombosis in human stroke. Important insight to regulation of gene expression in stroke and its causes are being acquired, including alternative splicing, non-coding RNA, and microRNA. Improved diagnosis of stroke and determination of stroke cause will improve stroke treatment and prevention. RNA biomarkers show promise to aid in the diagnosis of stroke and etiology determination, as well as providing novel insight to mechanism of stroke in patients. While further study is required, an RNA profile may one day be part of the stroke armamentarium with utility to guide acute stroke therapy and prevention strategies and refine stroke phenotype.