Gene expression in TIA could lead to biomarkers

Transient ischemic attacks (TIAs), sometimes described as mini-strokes, are caused by brief interruptions in the blood flow. The symptoms can be similar to those of strokes, but resolve within 24 hours and sometimes within a few minutes. Researchers have found genes that are expressed in the blood during TIAs which could potentially serve as biomarkers for these neurological episodes.

The research, carried out at the MIND Institute, University of California, Davis, showed differences in gene expression in people who have had TIAs compared with people who have vascular risk factors but no signs of a TIA or cardiovascular disease. Expression of a set of 34 genes differentiated the two groups of people, with 100% sensitivity and specificity, according to the researchers. There were also two groups of gene expression in the set of people who had TIAs that could shed light on causes and risks, but the researchers are not yet clear on the significance of this finding.

The genes are linked with systemic inflammation, platelet activation and prothrombin activation. It's still early, though, and these links could be a cause of the TIA, or a result of it. Around 90% of the genes are still expressed 72 hours after an attack, so the chronic inflammation in TIA could lead to longer-term cardiovascular disease.

TIAs can be warning signs for strokes, but are very difficult to diagnose. Access to biomarkers that could diagnose or predict these episodes could help doctors find the subset of patients that need to be watched in order to avoid strokes through prophylaxis, or to treat any subsequent strokes as early as possible. However, according to the authors of the editorial, this route could be long and complex.

- see the abstract
- read the article in Medscape
- look at the editorial in Neurology