Blood biomarkers for stroke: the role of thioredoxin in diagnosis and prognosis of acute ischemic stroke

Abstract

Abstract Background Oxidative stress plays a crucial role in the pathophysiology of acute ischemic stroke. Thioredoxin exists and released from cells during inflammation and oxidative stress and was recognized as an oxidative-stress marker. Objective The objective of this study was to assess the role of thioredoxin as an oxidative stress biomarker in diagnosis and prognosis of acute ischemic stroke in a sample of patients recruited from Beni-Suef Governorate, north Upper Egypt. Methods A case control study included 100 subjects; 50 patients with first-ever acute ischemic stroke presented within 24 h from the onset and 50 healthy volunteers as a control. Clinical, functional, and radiological evaluation was done for the patients, and all patients and control were subjected to routine laboratory tests and assessment of serum level of thioredoxin by solid-phase sandwich enzyme-linked immunosorbent assay. Results Thioredoxin was significantly higher in acute stroke patients compared to control group (p value = 0.001). Thioredoxin level was significantly higher in hypertensive patients (p value = 0.007), patients who had carotid stenosis ≥50% (p value = 0.001), patients with poor outcome (p value = 0.009), and in patients with cardio-embolic stroke (p value = 0.001). Significant positive correlation was found between thioredoxin level and volume of infarction (r = 0.501 and p = 0.001), stroke severity at presentation (r = 0.503 and p = 0.021) and clinical outcome after 3 months (r = 0.551 and p value = 0.001). Conclusion Thioredoxin as a marker of oxidative stress can be used as a new diagnostic and prognostic blood biomarker for stroke.

Keywords

• Stroke
• Thioredoxin
• Oxidative stress
• NIHSS
• mRS