Glial Fibrillary Acidic Protein (GFAP): Neuroinflammation Biomarker in Acute Ischemic Stroke

Overview

Journal J Inflamm Res

Publisher Dove Medical Press

Date 2022 Jan 10

PMID 35002283

Authors

Lisda Amalia

Affiliations

Soon will be listed here.

Abstract

Introduction: Blockage of the cerebral arteries due to thrombosis and embolism resulting in decreased blood flow to the brain, reduced oxygen supply to the brain, resulting in neuronal damage and causes astrocyte cells to secrete glial fibrillary acidic protein (GFAP). The objective of this study was to determine the correlation between GFAP levels serum and clinical outcome in patients with acute ischemic stroke.

Methods: This was observational with a cross-sectional design on acute ischemic stroke patients confirmed by CT scans and divided into large vessel occlusion and small-vessel occlusion. Clinical outcome was measured using the National Institutional Health Stroke Scale (NIHSS) tool. Statistical analysis uses Spearman's rank correlation test and Mann Whitney's test, significant if p < 0.05.

Results: After collecting 33 research subjects, we found 16 people with large vessel occlusion and 17 people with small vessel occlusion. Serum GFAP levels were 0.2-1.9 ng/mL, 9.1% with a mild neurological deficit, 45.45% were moderate neurological deficits, and 45.45% were severe neurological deficits. There was a significant positive correlation (r = 0.522; p = 0.002) between serum GFAP levels and the degree of neurological deficit in ischemic stroke patients. There was a statistically significant difference between serum GFAP levels in ischemic stroke patients with CT scan results of large artery occlusion compared to small artery occlusion (0.7 vs 0.4ng/mL; p = 0.001).

Conclusion: There was a positive correlation between GFAP level serum and NIHSS score on acute ischemic stroke. The higher the value of GFAP serum level, the higher the value for NIHSS and correlated with stroke severity and the extent of brain damage in ischemic stroke patients.

Citing Articles

Advances in the detection of biomarkers for ischemic stroke.

Liang Y, Chen J, Chen Y, Tong Y, Li L, Xu Y Front Neurol. 2025; 16:1488726.

PMID: 40066310 PMC: 11891058. DOI: 10.3389/fneur.2025.1488726.

Breaking Barriers in Stroke Therapy: Recent Advances and Ongoing Challenges.

Bakka A, Patil S, Rachakonda B, Patil A, Bolleddula J, Nandyala P Cureus. 2025; 17(1):e78288.

PMID: 40026944 PMC: 11872241. DOI: 10.7759/cureus.78288.

Investigation of the Acute Effects of Two Different Preoxygenation Methods on Neurodegenerative Biomarkers in Laparoscopic Cholecystectomy Surgery.

Pehlivan V, Pehlivan B, Celik H, Duran E, Taskin A, Taskin S Medicina (Kaunas). 2025; 61(2).

PMID: 40005285 PMC: 11857148. DOI: 10.3390/medicina61020167.

The role of astrocyte metabolic reprogramming in ischemic stroke (Review).

Chen W, Mao T, Ma R, Xiong Y, Han R, Wang L Int J Mol Med. 2025; 55(3).

PMID: 39930815 PMC: 11781528. DOI: 10.3892/ijmm.2025.5490.

Hong S, De Souza B, Penberthy K, Hwang L, Procaccini D, Kheir J Neurotherapeutics. 2025; 22(1):e00521.

PMID: 39765416 PMC: 11840354. DOI: 10.1016/j.neurot.2024.e00521.

References

Li L, Lundkvist A, Andersson D, Wilhelmsson U, Nagai N, Pardo A . Protective role of reactive astrocytes in brain ischemia. J Cereb Blood Flow Metab. 2007; 28(3):468-81. DOI: 10.1038/sj.jcbfm.9600546. View

Gaude E, Nogueira B, Ladreda Mochales M, Graham S, Smith S, Shaw L . A Novel Combination of Blood Biomarkers and Clinical Stroke Scales Facilitates Detection of Large Vessel Occlusion Ischemic Strokes. Diagnostics (Basel). 2021; 11(7). PMC: 8306880. DOI: 10.3390/diagnostics11071137. View

Petzold A, Keir G, Green A, Giovannoni G, Thompson E . An ELISA for glial fibrillary acidic protein. J Immunol Methods. 2004; 287(1-2):169-77. DOI: 10.1016/j.jim.2004.01.015. View

Wunderlich M, Wallesch C, Goertler M . Release of glial fibrillary acidic protein is related to the neurovascular status in acute ischemic stroke. Eur J Neurol. 2006; 13(10):1118-23. DOI: 10.1111/j.1468-1331.2006.01435.x. View

Liu G, Geng J . Glial fibrillary acidic protein as a prognostic marker of acute ischemic stroke. Hum Exp Toxicol. 2018; 37(10):1048-1053. DOI: 10.1177/0960327117751236. View

Oppenheim R, Houenou L, Parsadanian A, Prevette D, Snider W, Shen L . Glial cell line-derived neurotrophic factor and developing mammalian motoneurons: regulation of programmed cell death among motoneuron subtypes. J Neurosci. 2000; 20(13):5001-11. PMC: 6772300. View

Pekny M, Pekna M . Astrocyte reactivity and reactive astrogliosis: costs and benefits. Physiol Rev. 2014; 94(4):1077-98. DOI: 10.1152/physrev.00041.2013. View

Mozaffarian D, Benjamin E, Go A, Arnett D, Blaha M, Cushman M . Heart disease and stroke statistics--2015 update: a report from the American Heart Association. Circulation. 2014; 131(4):e29-322. DOI: 10.1161/CIR.0000000000000152. View

Chen Y, Swanson R . Astrocytes and brain injury. J Cereb Blood Flow Metab. 2003; 23(2):137-49. DOI: 10.1097/01.WCB.0000044631.80210.3C. View

10.

Norenberg M, Rama Rao K, Jayakumar A . Mechanisms of ammonia-induced astrocyte swelling. Metab Brain Dis. 2005; 20(4):303-18. DOI: 10.1007/s11011-005-7911-7. View

11.

Wakasa S, Shiiya N, Tachibana T, Ooka T, Matsui Y . A semiquantitative analysis of reactive astrogliosis demonstrates its correlation with the number of intact motor neurons after transient spinal cord ischemia. J Thorac Cardiovasc Surg. 2009; 137(4):983-90. DOI: 10.1016/j.jtcvs.2008.10.002. View

12.

Oleszak E, Zaczynska E, Bhattacharjee M, Butunoi C, Legido A, Katsetos C . Inducible nitric oxide synthase and nitrotyrosine are found in monocytes/macrophages and/or astrocytes in acute, but not in chronic, multiple sclerosis. Clin Diagn Lab Immunol. 1998; 5(4):438-45. PMC: 95596. DOI: 10.1128/CDLI.5.4.438-445.1998. View

13.

Struzynska L . A glutamatergic component of lead toxicity in adult brain: the role of astrocytic glutamate transporters. Neurochem Int. 2009; 55(1-3):151-6. DOI: 10.1016/j.neuint.2009.01.025. View

14.

Myer D, Gurkoff G, Lee S, Hovda D, Sofroniew M . Essential protective roles of reactive astrocytes in traumatic brain injury. Brain. 2006; 129(Pt 10):2761-72. DOI: 10.1093/brain/awl165. View

15.

Herrmann M, Vos P, Wunderlich M, de Bruijn C, Lamers K . Release of glial tissue-specific proteins after acute stroke: A comparative analysis of serum concentrations of protein S-100B and glial fibrillary acidic protein. Stroke. 2000; 31(11):2670-7. DOI: 10.1161/01.str.31.11.2670. View

16.

Dvorak F, Haberer I, Sitzer M, Foerch C . Characterisation of the diagnostic window of serum glial fibrillary acidic protein for the differentiation of intracerebral haemorrhage and ischaemic stroke. Cerebrovasc Dis. 2008; 27(1):37-41. DOI: 10.1159/000172632. View

17.

Petzold A . Glial fibrillary acidic protein is a body fluid biomarker for glial pathology in human disease. Brain Res. 2014; 1600:17-31. DOI: 10.1016/j.brainres.2014.12.027. View

18.

Foerch C, Niessner M, Back T, Bauerle M, De Marchis G, Ferbert A . Diagnostic accuracy of plasma glial fibrillary acidic protein for differentiating intracerebral hemorrhage and cerebral ischemia in patients with symptoms of acute stroke. Clin Chem. 2011; 58(1):237-45. DOI: 10.1373/clinchem.2011.172676. View

19.

Saenger A, Christenson R . Stroke biomarkers: progress and challenges for diagnosis, prognosis, differentiation, and treatment. Clin Chem. 2009; 56(1):21-33. DOI: 10.1373/clinchem.2009.133801. View

20.

Araque A, Carmignoto G, Haydon P . Dynamic signaling between astrocytes and neurons. Annu Rev Physiol. 2001; 63:795-813. DOI: 10.1146/annurev.physiol.63.1.795. View