Circulatory Cell-Free DNA as a New Prognostic Marker in Acute Stroke

Background: Prognostic value of blood markers in cerebral stroke is still a matter of controversies. Recently, much interest has developed in the potential use of plasma DNA as a prognostic tool in acute stroke. Objective: To assess the role of plasma DNA measured early after stroke for the correlation with clinical status of the patients at onset and for prediction of disease severity and mortality after 6 months. Methods: This study included 72 patients and 28 controls. On admission, all patients were subjected to; detailed history and examination; assessment of stroke severity at onset using Glasgow coma scale (GCS) and National Institutes of Health Stroke Scale (NIHSS); Plasma cell-free DNA levels were analyzed by real time quantitative PCR in patients in the first 24 hours after onset and in controls. 6 months later, patients were evaluated for detection of severity and mortality using modified Rankin scale (mRs). Results: The level of plasma cell-free DNA was higher in stroke patients compared to controls (mean±SD=7683.2±2326.8 Vs 432±254 GE/ml). Also, plasma DNA was hi was high and correlated significantly in patients with mRs=6 compared with survivors (P=0.001*). Using multiple logistic regression analysis, significant predictors of poor prognosis and high mortality were: NIHSS >8, lesion volume on CT and plasma DNA concentration. Conclusion: Plasma DNA increased after acute stroke and may be a potentially valuable prognostic marker for severity and mortality of these patients. (Egypt J Neurol Psychiat Neurosurg. 2010; 47(1): 155-162)