transmedТрансляционная медицинаTranslational Medicine2311-44952410-5155Almazov National Medical Research Centre, Saint Petersburg, Russia10.18705/2311-4495-2021-8-5-5-20transmed-639Research ArticleНЕВРОЛОГИЯNEUROLOGYРоль нейрон-специфической енолазы, глиального фибриллярного кислого белка и NR2-антител в ранней диагностике ишемического инсультаRole of neuron-specific enolase, glial fibrillar acidic protein and NR2-antibodies in early diagnostic of ischemic strokehttps://orcid.org/0000-0003-1140-8039ЧайковскаяА. Д.ChaykovskayaA. D.

Чайковская Александра Дмитриевна, аспирант кафедры неврологии и психиатрии 

ул. Аккуратова, д. 2, Санкт-Петербург, 197341

Chaykovskaya Alexandra D., postgraduate student of the Department of Neurology and Psychiatry

Akkuratova str. 2, Saint Petersburg, 197341

mumu6394@gmail.comhttps://orcid.org/0000-0002-0175-3085ТопузоваМ. П.TopuzovaM. P.

Топузова Мария Петровна, кандидат медицинских наук, доцент кафедры неврологии и психиатрии, старший научный сотрудник НИЛ цереброваскулярной патологии НИО неврологии и нейрореабилитации 

Санкт-Петербург

Topuzova Mariya P., MD, PhD, Senior Scientist, Associate Professor of the Department of Neurology and Psychiatry, Senior Researcher of the Research Laboratory of Cerebrovascular Pathology of the Research Department of Neurology and Neurorehabilitation

Saint Petersburg

topuzova_mp@almazovcentre.ruМахановаА. М.MakhanovaA. M.

Маханова Альбина Мансуровна, аспирант кафедры неврологии и психиатрии

Санкт-Петербург

Makhanova Albina M., postgraduate student of the Department of Neurology and Psychiatry

Saint Petersburg

a.mahanova.a@mail.ruМихееваА. Г.MikheevaA. G.

Михеева Анна Геннадьевна, ординатор кафедры неврологии и психиатрии

Санкт-Петербург

Mikheeva Anna G., graduate student of the Department of Neurology and Psychiatry

Saint Petersburg

amikheevag@mail.ruКоротковаД. С.KorotkovaD. S.

Короткова Дарья Сергеевна, ординатор кафедры неврологии и психиатрии

Санкт-Петербург

Korotkova Daria S., graduate student of the Department of Neurology and Psychiatry

Saint Petersburg

11kenny@mail.ruhttps://orcid.org/0000-0003-3553-6537ПоспеловаМ. Л.PospelovaM. L.

Поспелова Мария Львовна, доктор медицинских наук, ведущий научный сотрудник НИЛ цереброваскулярной патологии НИО неврологии и нейрореабилитации, доцент кафедры неврологии и психиатрии ИМО

Санкт-Петербург

Pospelova Maria L., MD, DrSci, Leading Researcher of the Laboratory of Cerebrovascular Pathology of the Research and Development Department of Neurology and Neurorehabilitation, Associate Professor of the Department of Neurology and Psychiatry

Saint Petersburg

pospelova_ml@almazovcentre.ruhttps://orcid.org/0000-0003-3637-5405ПанинаЕ. Б.PaninaE. B.

Панина Елена Борисовна, кандидат медицинских наук, доцент кафедры неврологии и психиатрии 

Санкт-Петербург

Panina Elena B., MD, PhD, Associate Professor of the Department of Neurology and Psychiatry

Saint Petersburg

panina_eb@almazovcentre.ruhttps://orcid.org/0000-0001-8537-3639ВавиловаТ. В.VavilovaT. V.

Вавилова Татьяна Владимировна, доктор медицинских наук, профессор, заведующий кафедрой лабораторной медицины и генетики

Санкт-Петербург

Vavilova Tat’yana V., MD, DrSci, Professor, Head of the Department of Laboratory Medicine and Genetics

Saint Petersburg

vavilova_tv@almazovcentre.ruhttps://orcid.org/0000-0002-2115-8873ВасильеваЕ. Ю.VasilievaE. Yu.

Васильева Елена Юрьевна, заведующий ЦКДЛ, ассистент кафедры лабораторной медицины и генетики

Санкт-Петербург

Vasilieva Elena Yu., MD, Head of Central Clinical Diagnostics Laboratory, Assistant of the Department of Laboratory Medicine and Genetics

Saint Petersburg

 

vasilieva_eyu@almazovcentre.ruhttps://orcid.org/0000-0002-0708-2219СимаковК. В.SimakovK. V.

Симаков Каюм Владимирович, руководитель Регионального сосудистого центра, заведующий неврологическим отделением для лечения больных с острыми нарушениями мозгового кровообращения

Санкт-Петербург

Simakov Kayum V., MD, Head of the Regional Vascular Center, head of the neurological department for the treatment of patients with acute cerebrovascular accident

Saint Petersburg

simakov_kv@almazovcentre.ruhttps://orcid.org/0000-0003-2949-6268СергееваТ. В.SergeevaT. V.

Сергеева Татьяна Васильевна, кандидат медицинских наук, заместитель главного врача по неврологии (руководитель Регионального сосудистого центра) СПбГБУЗ «Елизаветинская больница», доцент кафедры медицинской реабилитации и спортивной медицины ФГБУ «Санкт-Петербургский государственный педиатрический медицинский университет» Минздрава России, ассистент кафедры нейрохирургии и неврологии ФГБУ «Санкт-Петербургский государственный университет»

Санкт-Петербург

Sergeeva Tat’yana V., MD, PhD, Deputy Chief Physician for Neurology (Head of the Regional Vascular Center) SPb State Budget Healthcare Institution; Municipal Hospital of the Saint Martyr Elizabeth, Associate Professor of Medical Rehabilitation and Sports Medicine of St. Petersburg State Pediatric Medical University of the Ministry of Health of Russia, Assistant of the Department of Neurosurgery and Neurology of Federal State Budget Educational Institution of Higher Education, Saint-Petersburg State University

Saint Petersburg

tatyana_serg@mail.ruhttps://orcid.org/0000-0002-4441-1165АлексееваТ. М.AlekseevaT. M.

Алексеева Татьяна Михайловна, доктор медицинских наук, доцент, заведующая кафедрой неврологии и психиатрии, ведущий научный сотрудник НИЛ цереброваскулярной патологии НИО неврологии и нейрореабилитации 

Санкт-Петербург

Alekseeva Tat’yana M., MD, DrSci, Associate Professor, Head of the Department of Neurology and Psychiatry, Leading Researcher of the Laboratory of Cerebrovascular Pathology of the Research and Development Department of Neurology and Neurorehabilitation

Saint Petersburg

alekseeva_tm@almazovcentre.ruФедеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр имени В. А. Алмазова» Министерства здравоохранения Российской ФедерацииРоссияAlmazov National Medical Research CentreRussian FederationСанкт-Петербургское государственное бюджетное учреждение здравоохранения «Городская больница Святой̆ преподобномученицы Елизаветы»РоссияSaint Martyr Elizabeth Sity HospitalRussian Federation20211812202185520Copyright © Чайковская А.Д., Топузова М.П., Маханова А.М., Михеева А.Г., Короткова Д.С., Поспелова М.Л., Панина Е.Б., Вавилова Т.В., Васильева Е.Ю., Симаков К.В., Сергеева Т.В., Алексеева Т.М., 20222022Чайковская А.Д., Топузова М.П., Маханова А.М., Михеева А.Г., Короткова Д.С., Поспелова М.Л., Панина Е.Б., Вавилова Т.В., Васильева Е.Ю., Симаков К.В., Сергеева Т.В., Алексеева Т.М.Chaykovskaya A.D., Topuzova M.P., Makhanova A.M., Mikheeva A.G., Korotkova D.S., Pospelova M.L., Panina E.B., Vavilova T.V., Vasilieva E.Y., Simakov K.V., Sergeeva T.V., Alekseeva T.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://transmed.almazovcentre.ru/jour/article/view/639Актуальность

Актуальность. Применение панели биомаркеров ишемического инсульта (ИИ) может способствовать более точной и быстрой диагностике и определению оптимального подхода к ведению пациентов.

Цель

Цель. Уточнить значения нейрон-специфической енолазы (НСЕ), глиального фибриллярного кислого белка (ГФКБ) и антител к NR2-субъединице NMDA-рецептора (NR2-антитела) в остром периоде ИИ в динамике, сравнить с показателями пациентов без ИИ, оценить взаимосвязь с тяжестью неврологических нарушений и краткосрочным исходом, установить чувствительность и специфичность панели биомаркеров.

Материалы и методы

Материалы и методы. Обследованы 63 пациента с ИИ и 31 человек (11 с хронической ишемией мозга (ХИМ) и 20 здоровых добровольцев) в качестве группы сравнения. Результаты. Значения НСЕ и ГФКБ у группы ИИ в начале заболевания превышали пороговые значения и значимо снижались к 10-14 дню, а значения NR2-антител в начале заболевания были ниже, чем в группах сравнения и повышались к 10-14 дню заболевания. У пациентов с неблагоприятным краткосрочным исходом ИИ был отмечен более высокий уровень НСЕ, ГФКБ и NR2-антител. Панель данных биомаркеров обладает более высокой чувствительностью и специфичностью по сравнению с использованием их по отдельности.

Заключение

Заключение. Исследованные вещества могут применяться в качестве панели биомаркеров при ИИ для диагностики, контроля степени повреждения мозга, оценки состояния пациента в динамике и прогнозирования краткосрочного исхода заболевания.

 

 

Background

Background. Application of a biomarker panel during the acute period of the ischemic stroke (IS) can contribute to a more accurate and prompter diagnostics and verification of the optimal approach to a patients’ management.

Objective

Objective. We aimed to clarify values of neuron-specific enolase (NSE), glial fibrillar acidic protein (GFAP) and antibodies for NMDA receptor’s NR2-subunit (NR2-antibodies) in the acute period of IS, to compare with such values in patients without IS, to assess their relationship with severity of neurological deficit and short-term outcome and also to establish sensitivity and specificity of the biomarker panel.

Design and methods

Design and methods. 63 patients with IS and 31 people (11 with chronic brain ischemia and 20 healthy individuals) as controls were included. Results. NSE and GFAP values in IS group exceeded reference values at the onset of disease, lowering significally by 10-14 day, while NR2-antibodies’ values were lower at the onset of the disease compared with controls, rising by 10-14 day. In patients with unfavourable short-term outcome higher levels of NSE, GFAP and NR2-antibodies were found. A panel of such biomarkers has higher sensitivity and specificity than each of them individually.

Conclusion

Conclusion. Researched substances can be used in a biomarker panel for IS diagnostics, brain damage monitoring, patient’s condition evaluation and short outcome prognosing.

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The authors declare that there are no conflicts of interest present.