Serum microtubule associated protein tau and myelin basic protein as the potential markers of brain ischaemia-reperfusion injury in patients undergoing carotid endarterectomy

Introduction. In the prevention of ischaemic stroke the recommended surgical procedure is carotid endarterectomy (CEA). However, surgical treatment of atherosclerotic stenosis may cause neurological complications. The aim of the study was to investigate consequential brain ischaemia-reperfusion injury by measuring the cerebral specific markers, the microtubule associated protein tau (MAPt) and myelin basic protein (MBP) in the serum of patients that underwent CEA. Material and methods. This study involved 25 participants who underwent CEA due to internal carotid artery stenosis. Blood samples were taken from each patient at three different intervals; within 24 hours prior to surgery, 12 hours after the surgery, and 48 hours after the surgery. Serum MAPt and MBP levels were measured by a commercially available enzyme-linked immunosorbent assay (ELISA). Results. The study showed that serum MAPt and MBP levels were statistically significantly decreased 12 hours after CEA compared to the level before the surgery (p < 0.05), but MAPt and MBP levels were normalized 48 hours after CEA. There was statistically significant correlation in serum MAPt levels with the velocity of blood flow in the internal carotid artery 12 and 48 hours after CEA (p < 0.05). Conclusions. Data from our study showed that CEA affects serum neuromarkers levels, such as MAPt and MBP, in patients with significant internal carotid artery stenosis. MAPt and MBP levels showed characteristic time curve in patients who underwent CEA and did not experience any neurological deficit in perioperative period. Possible alterations of this time curve may potentially be an index of a neurological event occurrence.  Introduction. In the prevention of ischaemic stroke the recommended surgical procedure is carotid endarterectomy (CEA). However, surgical treatment of atherosclerotic stenosis may cause neurological complications. The aim of the study was to investigate consequential brain ischaemia-reperfusion injury by measuring the cerebral specific markers, the microtubule associated protein tau (MAPt) and myelin basic protein (MBP) in the serum of patients that underwent CEA. Material and methods. This study involved 25 participants who underwent CEA due to internal carotid artery stenosis. Blood samples were taken from each patient at three different intervals; within 24 hours prior to surgery, 12 hours after the surgery, and 48 hours after the surgery. Serum MAPt and MBP levels were measured by a commercially available enzyme-linked immunosorbent assay (ELISA). Results. The study showed that serum MAPt and MBP levels were statistically significantly decreased 12 hours after CEA compared to the level before the surgery (p < 0.05), but MAPt and MBP levels were normalized 48 hours after CEA. There was statistically significant correlation in serum MAPt levels with the velocity of blood flow in the internal carotid artery 12 and 48 hours after CEA (p < 0.05). Conclusions. Data from our study showed that CEA affects serum neuromarkers levels, such as MAPt and MBP, in patients with significant internal carotid artery stenosis. MAPt and MBP levels showed characteristic time curve in patients who underwent CEA and did not experience any neurological deficit in perioperative period. Possible alterations of this time curve may potentially be an index of a neurological event occurrence.

Serum glial fibrillary acidic protein as a marker of brain damage in patients after carotid endarterectomy

Introduction. Surgical treatment of the extracranial section of internal carotid artery stenosis is an effective method of preventing cerebral ischaemic stroke. However, this surgical procedure may cause vascular brain damage. The aim of the study was to measure glial fibrillary acidic protein (GFAP) as a marker of brain damage in the serum of patients that underwent internal carotid endarterectomy (CEA). Material and methods. This study involved 25 participants who underwent CEA because of internal carotid artery stenosis. Blood samples were taken from each patient at three different times; within 24 hours prior to surgery, 12 hours after the surgery, and 48 hours after the surgery. Serum GFAP levels were measured by a commercially available enzyme-linked immunosorbent assay (ELISA). Results. The study showed that serum GFAP levels were not statistically different between all the three measurements (p > 0.05). There was also no statistical significant difference in serum GFAP levels between symptomatic and asymptomatic patients (p > 0.05). There was no statistically significant correlation in serum GFAP level 12 and 48 hours after the surgery with the clamping time (p > 0.05). There was also no significant correlation in the serum GFAP levels with the velocity of blood flow in the internal carotid artery before CEA and after surgery (p > 0.05). Conclusions. The study revealed that CEA does not change serum GFAP levels. Thus, GFAP cannot be a biochemical marker of brain damage after this surgery