To summarize and evaluate the diagnostic biomarkers for ischemic stroke found in blood, urine, and saliva, with a focus on their molecular pathways and clinical utility in differentiating ischemic stroke from other conditions.
Approach:
Key Findings:
Blood-based biomarkers are the most advanced, with glial fibrillary acidic protein providing high specificity for early stroke subtyping, making it a key focus for clinical application.
Many biomarkers for neuronal injury have slow kinetics or poor specificity, limiting their immediate utility in acute settings.
Emerging research indicates that brain-specific proteins can be detected in urine and saliva, but these methods lack validation in larger acute patient groups, highlighting the need for further studies.
No single biomarker or biofluid is currently sufficient for early ischemic stroke diagnosis, underscoring the complexity of stroke identification.
Interpretation:
Future progress in ischemic stroke diagnosis will likely depend on multi-marker strategies that integrate various biomarkers, standardized methods for testing, and early-timepoint sampling to improve diagnostic accuracy.
Limitations:
Current biomarkers lack endorsement in clinical guidelines for routine stroke diagnosis, which limits their application in clinical practice.
The literature on urinary and salivary biomarkers is limited compared to blood biomarkers, indicating a need for more comprehensive studies in these areas.
Conclusion:
The review highlights the promise and limitations of current research on biomarkers for ischemic stroke diagnosis, suggesting that future research should focus on validating multi-marker approaches and expanding the evidence base for urine and saliva biomarkers.
