Glutamate biomarkers in comprehensive diagnostics of acute and chronic brain ischemia

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Abstract

The development and implementation of biomarkers of ischaemic brain damage at the pre-hospital and hospital stages, as well as during screening and regular medical examinations, are a priority in neurology. This review describes the role of NR2 peptide, a subunit of the NMDA ionotropic glutamate receptors, in the pathogenesis of cerebral ischemia. Experimental data are presented, showing that NR2 peptide expression increases in brain ischemia, its fragments passing through the blood-brain barrier and entering the bloodstream, thus stimulating the immune response and autoantibody production. Key studies are reviewed that have demonstrated the possibility of using glutamate receptors and their antibodies as potential biomarkers of acute and chronic cerebral ischemia. The sensitivity and specificity of NR2 peptide and NR2 antibodies in these studies averaged >90%. It has been shown that NR2A/B is the only marker with high negative and positive predictive value in people with suspected ischaemic stroke. Monitoring treatment effectiveness is another promising area of application for glutamate biomarkers.

Previous studies have shown that the NR2 peptide and its antibodies are potential biomarkers of cerebral infarction, transient ischaemic attack, and chronic cerebral ischemia and may become important components in a successful and comprehensive approach to treatment, screening, and monitoring of disease outcomes.

About the authors

Grigory V. Ponomarev

Pavlov First Saint Petersburg State Medical University

Author for correspondence.
Email: grigoryponomarev@yandex.ru
Russian Federation, St. Petersburg

Igor A. Vozniuk

Saint Petersburg I.I. Dzhanelidze Research Institute оf Emergency Medicine; Military Medical Academy named after S.M. Kirov

Email: grigoryponomarev@yandex.ru
Russian Federation, St. Petersburg

Marina A. Izumi

Pavlov First Saint Petersburg State Medical University

Email: grigoryponomarev@yandex.ru
Russian Federation, St. Petersburg

Alexander A. Skoromets

Pavlov First Saint Petersburg State Medical University

Email: grigoryponomarev@yandex.ru
Russian Federation, St. Petersburg

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