GROUND-stroke

GROUND-stroke, Région Normandie – FEDER 2022
Project coordinator:
Dr Benoit Roussel, INSERM U1237, Blood and Brain Caen Normandie Institute, Caen, France.
Project Partner :
Dr Louis-Marie Rocque, Loopdeescience, Caen, France/

Here is the scientific English translation of your text:

Stroke is the leading cause of acquired disabilities in adults in France and Europe, and the second leading cause of death (the first among women). In France, one stroke occurs every 4 minutes, with significant heterogeneity in patient outcomes: within the first year, 20% of patients die and 80% survive with varying degrees of disability. This condition is the primary cause of non-traumatic neurological emergencies, and it is estimated that during a stroke, 2 million neurons die per minute.
There are two types of strokes. Hemorrhagic stroke, accounting for 15% of cases, occurs due to the rupture of a blood vessel in the brain. In 85% of cases, the stroke is ischemic (ischemic stroke, IS), which is caused by the blockage of a cerebral blood vessel by a clot. The result is a reduction in blood supply, which delivers oxygen and glucose essential for neuronal survival. This leads to the sudden onset of neurological deficits, such as facial distortion, speech disorders, vision impairment, or limb paralysis. To date, there are only two emergency treatments for IS. The first is thrombolysis, which involves the administration of a drug capable of ‘unblocking’ the blood vessel. However, this treatment must be administered within 4.5 hours of the onset of symptoms and is effective in restoring arterial blood flow in only 15-20% of cases. Additionally, this treatment increases the risk of hemorrhagic transformation. The second is mechanical thrombectomy, in which the artery is mechanically unblocked under arteriography by an interventional neuroradiologist. This procedure requires significant resources (often available only in university hospitals) and is limited to occlusions of large cerebral vessels. It must be performed within 6 hours of the onset of IS. The management of hemorrhagic strokes, in contrast, is typically surgical.
Before any treatment, the priority is to identify the type of stroke, whether ischemic or hemorrhagic, to guide appropriate therapy. For this, the patient must urgently undergo brain imaging (CT scan or MRI). After a call to emergency medical services, the patient must be transported to a specialized center for brain imaging and treatment as quickly as possible. Unfortunately, before brain imaging is performed, it is impossible in the prehospital setting (i.e., at home or in the ambulance) to determine whether the stroke is hemorrhagic or ischemic, and thus provide the correct therapeutic indication. Therefore, identifying a biomarker that is easily measurable in the ambulance or upon arrival at the emergency department would enable better therapeutic decision-making, reduce time to treatment, and ultimately lead to less severe neurological deficits for IS victims.
Our INSERM U1237 laboratory located in Caen (GIP CYCERON) has identified a biomarker for ischemic stroke (Jauquet et al, 2024). This biomarker is currently the subject of a patent application with INSERM-Transfert. We have detected a significant increase in this blood marker in patients with ischemic stroke compared to healthy donors from the French Blood Establishment (EFS). Currently, this assay is performed using ELISA (Enzyme-Linked Immunosorbent Assay), a highly sensitive method that has the drawback of taking several hours to complete, rendering it incompatible with our current objective of testing in the ambulance.
The main objective of our project is therefore to develop an innovative and rapid technique for the measurement and detection of the circulating biomarker, and to validate its levels as a sensitive and specific diagnostic biomarker for ischemic stroke. »