Gene expression profiling of blood for the prediction of ischemic stroke.
Gene expression profiling of blood for the prediction of ischemic stroke.
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DOI：
10.1161/strokeaha.110.588335
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发表时间：
2010-10
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：
Stamova B;Xu H;Jickling G;Bushnell C;Tian Y;Ander BP;Zhan X;Liu D;Turner R;Adamczyk P;Khoury JC;Pancioli A;Jauch E;Broderick JP;Sharp FR
基于血液的急性缺血性脑卒中的生物标志物将在临床实践中具有重要价值。这项研究的目的是：1）在更大的队列中复制我们之前使用基因表达谱预测缺血性中风的研究; 2）通过纳入与缺血性中风相关的对照组来完善缺血性中风的预测。将缺血性卒中患者（n=70，199个样本）与健康对照组（n=38）、有血管危险因素的对照组（n=52）和心肌梗死对照组（n=17）进行比较。在卒中发作后≤ 3 h、5 h和24 h以及对照组中抽取全血。在全基因组微阵列上处理RNA。缺血性卒中中差异表达的基因被鉴定并分析用于区分卒中与对照的预测能力。先前报道的29个探针组预测了一组新的缺血性卒中，灵敏度为93.5%，特异性为89.5%。60-46个探针组分别将对照组与3 h和24 h缺血性卒中样品区分开。97个探头组正确分类了86%的缺血性卒中（3 h +24 h）、84%的健康受试者、96%的血管危险因素受试者和75%的心肌梗死。这项研究在一个更大的队列中复制了我们先前报道的基因表达谱，并确定了区分缺血性卒中与相关对照组的其他基因。这种多基因方法显示了在急性缺血性卒中中进行即时检测的潜力。
A blood based biomarker of acute ischemic stroke would be of significant value in clinical practice. This study aimed to 1) replicate in a larger cohort our previous study using gene expression profiling to predict ischemic stroke and 2) refine prediction of ischemic stroke by including control groups relevant to ischemic stroke. Ischemic stroke patients (n=70, 199 samples) were compared to controls who were healthy (n=38), had vascular risk factors (n=52), and who had myocardial infarction (n=17). Whole blood was drawn ≤3h, 5h and 24h after stroke onset and from controls. RNA was processed on whole genome microarrays. Genes differentially expressed in ischemic stroke were identified and analyzed for predictive ability to discriminate stroke from controls. The 29 probe sets previously reported predicted a new set of ischemic strokes with 93.5% sensitivity and 89.5% specificity. 60- and 46-probe sets differentiated control groups from 3h and 24h ischemic stroke samples, respectively. A 97-probe set correctly classified 86% of ischemic strokes (3h + 24h), 84% of healthy subjects, 96% of vascular risk factor subjects and 75% with myocardial infarction. This study replicated our previously reported gene expression profile in a larger cohort and identified additional genes that discriminate ischemic stroke from relevant control groups. This multi-gene approach shows potential for a point-of-care test in acute ischemic stroke.