Blood Test Could Increase use of Effective Stroke Treatment

Researchers at the University of Geneva (UNIGE), in collaboration with UK company Proteome Sciences plc (PS) have described a simple blood test that could substantially increase the number of patients eligible for highly effective ischaemic stroke therapy in a landmark paper*, “Blood Glutathione S-Transferase-p (GSTP) as a Time Indicator of Stroke Onset.”

Ischaemic stroke (which accounts for around 85% of strokes) can only be treated effectively with the ‘clot busting’ drug, rt-PA, if administered within a time window of up to 4.5 hours after symptoms start in the UK (up to 3 hours in the US).
Approximately 35% of stroke victims are currently ineligible for treatment with
rt-PA as they do not know the time of onset as it may occurs during sleep or the onset symptoms may not have been obvious.

The University of Geneva study reports the outcome of a long-running trial of 29 blood proteins that Proteome Sciences and its partners have previously identified as early markers of brain damage associated with stroke. In particular, the authors sought to identify readily available protein markers that help establish the time of onset of the stroke as an aid to select appropriate thrombolytic treatment. This will be particularly useful in cases where patients do not know when the stroke occurred.

One protein, GSTP, showed an almost instantaneous increase in the blood of stroke patients, peaking at 3 hours after onset and returning to normal levels within approximately 6 hours. The study indicated that testing for GSTP on all suspected stroke victims at admission, or preferably during initial assessment during transport to the hospital, could result in as many as five times more people being eligible for the highly effective rt-PA treatment for ischaemic stroke.

Leader of the study, Prof. Jean-Charles Sanchez, said: “This is a major step towards improving the management of ischaemic stroke patients using the drugs that we already have available. A simple blood test that matches the therapeutic window of rt-PA is a major advance that we encourage clinicians, pharmaceutical and diagnostics companies to unite to rapidly bring this into routine practice to improve patient outcomes.”

Report in PLoS ONE