Rapid point of care diagnosis of stroke: development of GFAP biomarkers
- Research Opportunity
- PhD, Masters by Research, Honours
- Project Status
- Medicine and Radiology
- Royal Melbourne Hospital
|A/Professor Bernard Yanemail@example.com||Personal web page|
|Prof. Patrick Kwanfirstname.lastname@example.org||Personal web page|
Stroke is the leading cause of disability and the third leading cause of death in the industrial world. In the United States alone each year some 600,000 patients suffer from an ishcaemic stroke each year, and about 25% die within the first month.
GFAP is a cytoskeletal filament found almost exclusively in astrocytic cells within the central nervous system. Under physiological conditions GFAP is typically not at detectable levels in the blood . When astrocytes are damaged they undergo astrogliosis, during which GFAP production markedly increases. When this damage becomes terminal, astrocytes undergo necrosis and cytolysis, spilling their contents into the extracellular milieu. In ICH, shear stress and mechanical forces during haematoma expansion result in instant astrocyte necrosis and destruction of the blood-brain barrier, with subsequent translocation of GFAP into the blood.
The release of GFAP occurs much more slowly in AIS, with serum GFAP levels peaking between 48 and 96 hours after onset15. These distinct patterns have allowed several studies to investigate GFAP biomarkers to differentiate AIS and ICH. Some of these studies have also correlated GFAP concentrations with stroke severity, haematoma volume, or outcome in ICH, indicating that GFAP may also be of prognostic value An accurate, rapid, and portable diagnostic GFAP biomarker assay is of great potential value in pre-hospital stroke care. First, it would differentiate between AIS and ICH, allowing for expedited triage assessment and subsequent diversion to the most appropriate stroke centre. Second, it would allow ambulance personnel to initiate potentially lifesaving treatment that would have otherwise been delayed until a radiological diagnosis is confirmed.
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