Stroke: extracellular vesicle related indicators, which can assist in the diagnosis of transient ischemic attack

The traditional definition of transient ischemic attack (TIA): sudden focal neurological dysfunction caused by blood vessels , duration <24 hours
.

Blood vessel

Patients with transient symptoms and evidence of infarction can be classified as cerebral infarction with transient neurological symptoms
.

Regardless of the definition, the diagnosis of TIA is challenging because of the lack of a gold standard

diagnosis

In order to overcome these difficulties, Precise Diagnostic Score (PREDISC) is a well-structured scoring tool composed of standardized clinical and neuroimaging elements, which can more objectively distinguish patients with suspicious symptoms of TIA, and has a good score.
Consistency between participants
.

In order to improve the diagnostic process, reliable biomarkers are a prerequisite

Extracellular vesicles (EVs) are new promising biomarker candidates
.

EVs are secreted nano-sized particles that play an important role in the communication between cells and participate in many biological mechanisms related to cerebrovascular diseases, such as immune response, inflammation and blood coagulation processes

They found that compared with the control group, the EV concentration of TIA patients with very likely or possible-probable TIA increased (P<0.

05)

Compared with the control group, the EV concentration of TIA patients with very likely or possible-probable TIA increased (P<0.
05)

ROC curve analysis confirmed that each of these markers used alone, and the composite marker obtained from their linear combination has reliable diagnostic performance (area under the curve is 0.

851)

Finally, in the training and external validation cohorts, the random forest model combined with the expression levels of the selected markers can distinguish between 96% and 78.
9% of patients who are most likely to have TIA
.

The important significance of this study lies in the discovery: Compared with patients whose symptoms are unlikely to be caused by cerebral ischemia, the EV-surface antigen profile of patients who are judged to be very likely to be caused by cerebral ischemia seems to be different
.

This proposed algorithm based on the specific characteristics of EV-surface antigen may help TIA identification

Compared with patients whose symptoms are unlikely to be caused by cerebral ischemia, the EV-surface antigen profile of patients judged to be very likely to be caused by cerebral ischemia appears to be different

Burrello J, Bianco G, Burrello A, et al.
Extracellular Vesicle Surface Markers as a Diagnostic Tool in Transient Ischemic Attacks.
Stroke.
Published online August 4, 2021.
doi:10.
1161/STROKEAHA.
120.
033170

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