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

2019年，世界卫生组织将脑血管疾病列为全球第二大死亡原因和长期严重残疾的首要原因。因此，为了避免严重的后遗症，在短时间内诊断急性缺血性中风(AIS)是至关重要的。然而，在超急性期，急性脑成像(CT、MRI)检测AIS的敏感性从57%到83%不等。生物标记物或许能够缩小这一诊断差距。到目前为止，还没有合适的生物标志物来检测AIS。然而，新的miRNAPC-5P-12969代表了一个非常有前途的生物标记物。在Vijayan等人的miRNA测序分析中，与健康对照组相比，AIS患者中总共检测了4656个miRNAs。其中4个miRNAs适合进一步研究。特别是，新的miRNAPC-5P-12969表现出明显的上调，一旦从组织释放到血液中似乎是稳定的，检测可以进行高可靠性。这种生物标志物可以在日常临床实践中使用，而不会使患者面临任何风险。鉴于动脉高血压是卒中最重要的危险因素，而且已有证据表明高血压会影响miRNA的表达，因此将匹配的对照与包括动脉高血压在内的现有心血管危险因素与患有AIS的患者进行比较是很重要的。因此，这项前瞻性实验研究的详细研究问题是“定量逆转录聚合酶链式反应检测入院时基于血液的miRNAPC-5p-12969的表达水平在经CT/MRI证实的急性缺血性中风患者和匹配的对照组之间是否存在差异？”临床研究的主要目的是检测入院的急性缺血性中风患者及其亲属或合适的参与者(风险特征匹配)血浆中miRNAPC-5p-12969的表达水平。进一步的目标是：i)比较观察到的功能结果(用改进的兰金标准衡量)在症状出现后90天+/-14天与测量的miRNAPC-5p-12969的表达水平。Ii)比较以下两组患者的miRNAPC-5p-12969表达水平：再发卒中组、症状起病后90+/-14天无再发卒中组。Iii)将入院时miRNAPC-5p-12969的表达水平与其他变量，如检测到的卒中大小、从症状出现到采血的时间、肾功能、肌酐、收缩压关联起来。Iiii)研究可能的影响/相互作用变量对miRNAPC-5P-12969表达水平的影响。可能的影响变量：房颤、慢性心力衰竭、血脂异常、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