Background and Purpose: Ischemic stroke, such as Transient ischemic attack (TIA) and cerebral infarction (CI) , are the serious problems in the aging society. Therefore, development of biomarkers for TIA and CI is attempted.Methods: Candidate antigens recognized by IgG autoantibodies in the sera of nineteen TIA patients were screened by a human aortic endothelial cell cDNA library. Serum antibody levels against the antigens were examined by amplified luminescent proximity homogeneous assay-linked immunosorbent assay (AlphaLISA) in healthy donor (HD), TIA, and CI cohorts (n = 285, 92 and 529). A case-control study nested within the Japan Public Health Center-based Prospective Cohort Study (JPHC) was performed.Results: Aldolase A, fructose-bisphosphate (ALDOA) and fumarate hydratase (FH) were identified as the candidate antigens. AlphaLISA revealed that anti-ALDOA and anti-FH antibody levels were both higher in TIA or CI patients than in HDs ( P < 0.0001). The levels of anti-ALDOA [Odds ratio (OR): 2.46, P = 0.005] and anti-FH (OR: 2.49, P = 0.0037) were independent predictors of TIA by multivariate logistic regression analysis, similar results were found in CI. The case-control study showed the levels of anti-ALDOA (OR: 2.50, P < 0.01) and anti-FH (OR: 2.60, P < 0.01) were associated with risk of CI.Spearman's correlation analysis demonstrated an association between the anti-ALDOA and anti-FH levels and risk factors of ischemic stroke, such as age, smoking habit, coronary heart disease, and hypertension.Conclusions: Anti-ALDOA and anti-FH antibodies can serve as novel potential biomarkers for prediction of TIA and CI.
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