Prediction of cardioembolic, arterial, and lacunar causes of cryptogenic stroke by gene expression and infarct location.
Prediction of cardioembolic, arterial, and lacunar causes of cryptogenic stroke by gene expression and infarct location.
复制标题
通过基因表达和梗塞位置预测隐源性中风的心脏栓塞、动脉和腔隙原因。
DOI：
10.1161/strokeaha.111.648725
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发表时间：
2012-08
期刊：
影响因子：
8.3
通讯作者：
Sharp FR
中科院分区：
文献类型：
--
作者：
Jickling GC;Stamova B;Ander BP;Zhan X;Liu D;Sison SM;Verro P;Sharp FR
在多达35%的中风患者中，缺血性中风的原因仍不清楚或原因不明。不知道中风的原因限制了预防治疗的最佳实施，并限制了中风研究。我们展示了血液中的基因表达谱如何与神经影像学上梗死位置的测量结合使用，以预测隐源性卒中的可能原因。隐源性卒中的病因是利用先前描述的心源性、动脉性和腔隙性卒中患者的差异表达基因特征来预测的。从131例隐源性中风患者的外周血中分离RNA，并与149例已知原因中风患者的RNA谱进行比较。每个样品都在Affytron U133 Plus2.0微阵列上运行。隐源性卒中的病因可通过血液中的基因表达和梗死部位来预测。隐源性卒中预计为58%心源性栓塞、18%动脉栓塞、12%腔隙性和12%病因不明。与预测动脉病因的卒中相比，预测心源性栓塞病因的隐源性卒中有更多的既往心肌梗死和更高的CHA 2DS 2-VASc评分。与预测的动脉和心源性卒中相比，预测的腔隙性卒中具有较高的收缩压和舒张压以及较低的NIHSS。病因不明的隐源性卒中不太可能有TIA或缺血性卒中病史。基因表达结合梗死部位的测量可以预测隐源性卒中的可能原因。预测组需要进一步评估，以确定各组是否存在相关的临床、影像学或治疗差异。
The cause of ischemic stroke remains unclear, or cryptogenic, in as many as 35% of stroke patients. Not knowing the cause of stroke restricts optimal implementation of prevention therapy and limits stroke research. We demonstrate how gene expression profiles in blood can be used in conjunction with a measure of infarct location on neuroimaging to predict a probable cause in cryptogenic stroke. The cause of cryptogenic stroke was predicted using previously described profiles of differentially expressed genes characteristic of patients with cardioembolic, arterial and lacunar stroke. RNA was isolated from peripheral blood of 131 cryptogenic strokes and compared to profiles derived from 149 strokes of known cause. Each sample was run on Affymetrix U133 Plus2.0 microarrays. Cause of cryptogenic stroke was predicted using gene expression in blood and infarct location. Cryptogenic strokes were predicted to be 58% cardioembolic, 18% arterial, 12% lacunar and 12% unclear etiology. Cryptogenic stroke of predicted cardioembolic etiology had more prior myocardial infarction and higher CHA2DS2-VASc scores compared to stroke of predicted arterial etiology. Predicted lacunar strokes had higher systolic and diastolic blood pressures and lower NIHSS compared to predicted arterial and cardioembolic strokes. Cryptogenic strokes of unclear predicted etiology were less likely to have a prior TIA or ischemic stroke. Gene expression in conjunction with a measure of infarct location can predict a probable cause in cryptogenic strokes. Predicted groups require further evaluation to determine whether relevant clinical, imaging, or therapeutic differences exist for each group.