Cancer-related ischemic stroke has a distinct blood mRNA expression profile Journal Article


Authors: Navi, B. B.; Mathias, R.; Sherman, C. P.; Wolfe, J.; Kamel, H.; Tagawa, S. T.; Saxena, A.; Ocean, A. J.; Iadecola, C.; DeAngelis, L. M.; Elkind, M. S. V.; Hull, H.; Jickling, G. C.; Sharp, F. R.; Ander, B. P.; Stamova, B.
Article Title: Cancer-related ischemic stroke has a distinct blood mRNA expression profile
Abstract: Background and Purpose- Comorbid cancer is common in patients with acute ischemic stroke (AIS). As blood mRNA profiles can distinguish AIS mechanisms, we hypothesized that cancer-related AIS would have a distinctive gene expression profile. Methods- We evaluated 4 groups of 10 subjects prospectively enrolled at 3 centers from 2009 to 2018. This included the group of interest with active solid tumor cancer and AIS and 3 control groups with active cancer only, AIS only, or vascular risk factors only. Subjects in the AIS-only and cancer-only groups were matched to subjects in the cancer-stroke group by age, sex, and cancer type (if applicable). Subjects in the vascular risk factor group were matched to subjects in the cancer-stroke and stroke-only groups by age, sex, and vascular risk factors. Blood was drawn 72 to 120 hours after stroke. Total RNA was processed using 3' mRNA sequencing. ANOVA and Fisher least significant difference contrast methods were used to estimate differential gene expression between groups. Results- In the cancer-stroke group, 50% of strokes were cryptogenic. All groups had differentially expressed genes that could distinguish among them. Comparing the cancer-stroke group to the stroke-only group and after accounting for cancer-only genes, 438 genes were differentially expressed, including upregulation of multiple genes/pathways implicated in autophagy signaling, immunity/inflammation, and gene regulation, including IL (interleukin)-1, interferon, relaxin, mammalian target of rapamycin signaling, SQSTMI1 (sequestosome-1), and CREB1 (cAMP response element binding protein-1). Conclusions- This study provides evidence for a distinctive molecular signature in blood mRNA expression profiles of patients with cancer-related AIS. Future studies should evaluate whether blood mRNA can predict detection of occult cancer in patients with AIS. Clinical Trial Registration- URL: https://clinicaltrials.gov. Unique identifier: NCT02604667.
Keywords: neoplasms; gene expression; risk factors; stroke; humans
Journal Title: Stroke
Volume: 50
Issue: 11
ISSN: 0039-2499
Publisher: Lippincott Williams & Wilkins  
Date Published: 2019-11-01
Start Page: 3259
End Page: 3264
Language: English
DOI: 10.1161/strokeaha.119.026143
PUBMED: 31510897
PROVIDER: scopus
PMCID: PMC6817410
DOI/URL:
Notes: Article -- Source: Scopus
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  1. Babak Navi
    40 Navi
  2. Julia Catherine Wolfe
    15 Wolfe