Lessons from Metabonomics on the Neurobiology of Stroke

Abstract

The application of metabonomic science to interrogate stroke permits the study of metabolite entities, small enough to cross the blood-brain barrier, that provide insight into neuronal dysfunction, and may serve as reservoirs of biomarker discovery. This systematic review examines the applicability of metabolic profiling in ischemic stroke research. Six human studies utilizing metabolic profiling to analyze biofluids from ischemic stroke patients have been included, employing H-NMR and/or mass spectrometry to analyze plasma, serum, and/or urine in a targeted or untargeted fashion. Three are diagnostic studies, and one investigates prognostic biomarkers of stroke recurrence following transient ischemic attack. Two studies focus on metabolic distinguishers of depression or cognitive impairment following stroke. Identified biomarkers from blood and urine predominantly relate to homocysteine and folate, branched chain amino acid, and lipid metabolism. Statistical models are well fitted and reproducible, with excellent validation outcomes, demonstrating the feasibility of metabolic profiling to study a complex disorder with multicausal pathology, such as stroke.

The effect of acupuncture on depression and its correlation with metabolic alterations

“…Urine, on the other hand, is largely considered water, While the trace amounts of metabolites has a high diagnostic value of biological fluid and it can be used to search for biomarkers of central nervous system diseases. [ 13 , 14 ] So far, many researchers have used metabolomics successful identification of potential diagnostic biomarkers neuropsychiatric disorders, such as bipolar disorder and schizophrenia Autism. [ 15 , 16 ] Studies also found that differences in urine metabolites can be used to Distinguish between healthy and depressed patients.…”

Biomarker for Ischemic Stroke Using Metabolome: A Clinician Perspective

“…Use of such medications as statins was not considered by investigators. Statins may both produce signals in the plasma/serum and also induce a physiological response that may be detected in the plasma metabolome [85]. Although some studies elaborated on the timing of bodily fluid collection in relation to acute stroke, none of them accounted for the size of ischemic stroke and its possible effect on metabolome.…”

Metabolomics study in severe extracranial carotid artery stenosis

“…It is suggested that NMR metabolomics can be incorporated as a routine survey in large biobanks, which is beneficial both from the inexpensiveness and reproducibility [33, 34]. Successful examples include NMR metabolic profiling of cardiovascular events [35–38] and ischemic stroke [39]. Stegemann et al found three lipid species (triacylglycerols, cholesterol esters, and phosphatidylethanolamines) on top of traditional risk factors could improve risk discrimination and classification for cardiovascular disease [37].…”

“…Wurtz et al reported tyrosine and glutamine levels were cross-sectionally associated with carotid intima media thickness and the presence of angiographically ascertained CAD in independent populations [36]. Review article by Qureshi et al demonstrated certain metabolic pathways may be related to the pathological processes of stroke, particularly including branched chain amino acid, homocysteine, folate, anaerobic, and lipid metabolism [39]. Levels of plasma branched-chain amino acid, measured by NMR, were found elevated in type 2 diabetes and could be associated with carotid intima media thickness, a proxy of subclinical atherosclerosis [40].…”