Kynurenic acid and kynurenine aminotransferase are potential biomarkers of early neurological improvement after thrombolytic therapy: A pilot study
| Autor: | Gabor Kecskemeti, József Toldi, Péter Klivényi, Ferenc Rárosi, Ferenc Tömösi, László Vécsei, László Sztriha, Ádám Annus, Tamás Janáky, Evelin Fehér |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Medicine (miscellaneous) Pilot Projects Kynurenic Acid Gastroenterology General Biochemistry Genetics and Molecular Biology Brain Ischemia chemistry.chemical_compound Kynurenic acid Internal medicine Internal Medicine medicine Humans Pharmacology (medical) Thrombolytic Therapy Genetics (clinical) Transaminases Receiver operating characteristic business.industry Kynurenine aminotransferase Thrombolysis United States Stroke chemistry Potential biomarkers Reviews and References (medical) Ischemic stroke Biomarker (medicine) business Kynurenine Biomarkers |
| Zdroj: | Advances in clinical and experimental medicine : official organ Wroclaw Medical University. 30(12) |
| ISSN: | 1899-5276 |
| Popis: | Background Biomarkers for predicting treatment response to thrombolysis in acute ischemic stroke are currently lacking. Both, animal models and clinical studies have provided evidence that the kynurenine (KYN) pathway is activated in ischemic stroke. Objectives In our pilot study, we aimed to investigate whether KYN pathway enzymes and metabolites could serve as potential biomarkers for treatment response in the hyperacute phase of ischemic stroke. Material and methods We included 48 acute ischemic stroke patients who received thrombolysis. Blood samples were taken both before and 12 h after treatment. Concentrations of 11 KYN metabolites were determined using ultra-high-performance liquid chromatography-mass spectrometry. To assess the treatment response, we used early neurological improvement (ENI), calculated as the difference between the admission and discharge National Institutes of Health Stroke Scale (NIHSS) scores. We performed receiver operating characteristic (ROC) analysis for KYN pathway metabolites and enzymes that showed a correlation with ENI. Results In the samples taken before thrombolysis, significantly lower concentrations of kynurenic acid (KYNA) and kynurenine aminotransferase (KAT) activity were found in patients who had ENI (p = 0.01 and p = 0.002, respectively). According to the ROC analysis, the optimal cut-off value to predict ENI for KYNA was 37.80 nM (sensitivity (SN) 69.2%, specificity (SP) 68.4%) and 0.0127 for KAT activity (SN 92.3%, SP 73.7%). Conclusions Our research is the first clinical pilot study to analyze changes in the KYN pathway in ischemic stroke patients who received thrombolytic treatment. Based on our results, baseline KYNA concentration and KAT activity could serve as potential biomarkers to predict early treatment response to thrombolysis. |
| Databáze: | OpenAIRE |
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