Transient increase in CSF GAP-43 concentration after ischemic stroke.

Abstract

BACKGROUND:

Cerebrospinal fluid (CSF) biomarkers reflect ongoing processes in the brain. Growth-associated protein 43 (GAP-43) is highly upregulated in brain tissue shortly after experimental ischemia suggesting the CSF GAP-43 concentration may be altered in ischemic brain disorders. CSF GAP-43 concentration is elevated in Alzheimer's disease patients; however, patients suffering from stroke have not been studied previously.

METHODS:

The concentration of GAP-43 was measured in longitudinal CSF samples from 28 stroke patients prospectively collected on days 0-1, 2-4, 7-9, 3 weeks, and 3-5 months after ischemia and cross-sectionally in 19 controls. The stroke patients were clinically evaluated using a stroke severity score system. The extent of the brain lesion, including injury size and degrees of white matter lesions and atrophy were evaluated by CT and magnetic resonance imaging.

RESULTS:

Increased GAP-43 concentration was detected from day 7-9 to 3 weeks after stroke, compared to day 1-4 and to levels in the control group (P = 0.02 and P = 0.007). At 3-5 months after stroke GAP-43 returned to admission levels. The initial increase in GAP-43 during the nine first days was associated to stroke severity, the degree of white matter lesions and atrophy and correlated positively with infarct size (rs = 0.65, P = 0.001).

CONCLUSIONS:

The transient increase of CSF GAP-43 is important to take into account when used as a biomarker for other neurodegenerative diseases such as Alzheimer's disease. Furthermore, GAP-43 may be a marker of neuronal responses after stroke and additional studies confirming the potential of CSF GAP-43 to reflect severity and outcome of stroke in larger cohorts are warranted.

• Authors: Åsa Sandelius, Nicholas C Cullen, Åsa Källén, Lars Rosengren, Crister Jensen, Vesna Kostanjevecki, Manu Vandijck, Henrik Zetterberg, Kaj Blennow
• Journal: BMC neurology (BMC Neurol) Vol. 18 Issue 1 Pg. 202 (Dec 07 2018) ISSN: 1471-2377 [Electronic] England
• PMID: 30526557 (Publication Type: Journal Article)

Chemical References

• Biomarkers
• GAP-43 Protein

Topics

• Aged
• Alzheimer Disease (cerebrospinal fluid)
• Atrophy (pathology)
• Biomarkers (cerebrospinal fluid)
• Brain (pathology)
• Brain Ischemia (pathology)
• Female
• GAP-43 Protein (cerebrospinal fluid)
• Humans
• Longitudinal Studies
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Prospective Studies
• Stroke (pathology)