miRNA PC-5P-12969 expression levels in patients with acute ischemic stroke confirmed by intracranial imaging and a matched control group.

2019年，世界卫生组织认为脑血管疾病是全球第二大死亡原因，也是导致严重长期残疾的主要原因。因此，在短时间内诊断出急性缺血性脑卒中（AIS），以避免严重的后遗症是至关重要的。然而，急性期脑成像（CT、MRI）检测AIS的灵敏度在超急性期从57%到83%不等。生物标记物或许能够弥补这一诊断差距。迄今为止，还没有发现适合检测AIS的生物标志物。然而，新的miRNA PC-5P-12969代表了一个非常有前途的生物标志物。在Vijayan等人的miRNA测序分析中，与健康对照组相比，AIS患者共检测了4656个miRNA。其中，4个mirna显示适合进一步研究。特别是，新的miRNA PC-5p-12969表现出明显的上调，并且一旦从组织释放到血液中似乎是稳定的，并且可以高可靠性地进行检测。这种生物标志物可以在日常临床实践中使用，而不会给患者带来任何风险。鉴于动脉高血压是脑卒中最重要的危险因素，且已有证据表明高血压会影响miRNA的表达，因此对AIS患者动脉高血压等现有心血管危险因素进行对照比较具有重要意义。因此，本前瞻性实验研究的详细研究问题是“qRT-PCR检测的基于血液的miRNA PC-5P-12969在入院时的表达水平在颅内成像确诊（CT/MRI）急性缺血性脑卒中患者与匹配对照组之间是否存在差异？”临床的主要目的是测量入院时急性缺血性卒中患者及其亲属或合适参与者（风险特征匹配）血浆中miRNA PC-5P-12969的表达水平。进一步的目标是：I)比较症状出现后90天+/- 14天观察到的功能结果（通过改进的Rankin量表测量）与miRNA PC-5P-12969的表达水平。II)比较以下组的miRNA PC-5P-12969表达水平：卒中复发组和卒中无复发组在症状出现后90 +/- 14天。III)将入院时miRNA PC-5P-12969表达水平与其他变量（如检测到的脑卒中大小、从症状出现到采血的时间、肾功能、肌酐、收缩压）相关联。iii)探讨可能影响/相互作用miRNA PC-5P-12969表达水平的变量。可能的影响变量：心房颤动、慢性心力衰竭、脂蛋白异常血症、I型或II型糖尿病、高血压、酒精和尼古丁滥用

In 2019, the World Health Organization considered cerebrovascular disease the second leading cause of death worldwide and the leading cause of serious long-term disability. Therefore, it is of utmost importance to diagnose an acute ischemic stroke (AIS) in a short manner of time in order to avoid severe sequelae. However, the sensitivity for detecting AIS by acute brain imaging (CT, MRI) varies from 57% to 83% in the hyperacute phase. Biomarkers might be able to close this diagnostic gap. To date, no suitable biomarker for the detection of AIS is known. However, the novel miRNA PC-5P-12969 represents a very promising biomarker. In a miRNA sequencing analysis by Vijayan et al., a total of 4656 miRNAs were examined in AIS patients compared with healthy controls. Of those, 4 miRNAs showed to be suitable for further investigation. Especially, the novel miRNA PC-5p-12969 showed a pronounced up-regulation and seems to be stable once released to the blood from tissues and detection can be performed with high reliability. This biomarker can be used in daily clinical practice without exposing patients to any risks. Given that arterial hypertension constitutes the most important risk factor for stroke and existing evidence that hypertension impacts miRNA expression, it is important to compare matched controls with existing cardiovascular risk factors including arterial hypertension with patients suffering from AIS. Therefore, the elaborated research question of this prospective experimental study is "Are qRT-PCR measured blood-based miRNA PC-5P-12969 expression levels on admission different between in intracranial imaging-confirmed (CT/MRI) acute ischemic stroke patients and matched controls?" The primary objective of the clinical is to measure miRNA PC-5P-12969 expression levels in the plasma of patients with acute ischemic stroke on hospital admission and their relatives or suitable participants (matched for risk profile). Further aims are: I) to compare observed functional outcomes (measured by the modified Rankin Scale) 90 days +/- 14 days after symptom onset with measured expression levels of miRNA PC-5P-12969. II) To compare measured miRNA PC-5P-12969 expression levels between the following groups: recurrent stroke, no recurrent stroke 90 +/- 14 days after symptom onset. III) To correlate miRNA PC-5P-12969 expression levels on admission and other variables, such as size of detected stroke, time from symptom onset to blood sampling, renal function, creatinine, systolic blood pressure. IIII) To investigate possible influencing/interacting variables on the expression levels of miRNA PC-5P-12969. Possible influencing variables: atrial fibrillation, chronic heart failure, dyslipoproteinemia, diabetes mellitus type I or II, hypertension, alcohol and nicotine abuse