Diagnostic and Prognostic Biomarker for Acute Stroke in Serum Translocator Protein (Tspo) and the Related Association with Neuro-Inflammation

Background: Translocator protein (TSPO) expression have been noted to associate in neuroinflammatory conditions such as Alzheimer disease and Parkinson disease. This increase in TSPO expression has been reported to coincide with the process of microglial activation. Stroke is a nuroinflammation, and also activated the glial cell. However, few study focus in the association between peripheral TSPO and central nervous system (CNS) diseases. Unlike the use of diagnostic serum biomarkers such as creatinine kinase and troponin to evaluate acute coronary syndrome, the current diagnosis of stroke relies solely on a neurological examination and neuroimaging studies. The search for serum biomarkers for differential diagnoses, assessment of stroke severity, and predication of prognoses is increasingly needed. Aims: (1) We aim to plot the trend of TSPO expression from 2 hours, 12 hours, 24hours, 36hours, 48hours, 72hours, 96hours, 120hours, and 144hours after stroke onset in those stroke patients who reached to emerge department. (2) We also express the comparison of diagnostic ability of plasma TSPO levels between stroke patients and healthy controls, between new stroke patients and old stroke patients, and between ischemic stroke and hemorrhage stroke. (3) We also aim to understand the predictive ability of plasma TSPO level within 24 hours to the progression after stroke at 14days and 30 days. Method: First, we expect to include 30 persons with acute stroke onset within 2 hours, and follow up for 7 days with 10 measurements. In addition, we expect to include 450 persons with first-ever stroke as patient cohort, and, finally, include 150 healthy persons and 150 old stroke patients as comparison groups. Stroke patient will be recruited at 24hr and followed at around 10 days and 30 days. Demography data, body mass index, fasting plasma glucose and lipid profiles will be examined. Concentrations of TSPO, TNFα, IL-1β and IL-6 will be measured by ELISA. The indices of function progression included NIH stroke scale, Barthel index and modified Rankin scale. Expected impact: The establishment of serum TSPO in the differential diagnosis of stroke application, like serum creatinine kinase as a diagnostic marker of acute coronary heart disease, will be shorten the duration window of the diagnosis in acute stroke patients.