Glial Fibrillary Acidic Protein sebagai Penanda Prognostik pada Stroke Iskemik Akut

Lisda Amalia

Abstract


Stroke merupakan kegawatdaruratan neurologi yang timbul mendadak dan merupakan penyebab kematian nomor tiga terbanyak di negara dunia setelah penyakit jantung dan kanker. Stroke iskemik merupakan penyebab paling banyak yaitu 87% dari keseluruhan kasus stroke. Penanda biologik dibutuhkan untuk dapat menggambarkan kerusakan sel saraf otak sehingga dapat membantu klinisi untuk menegakkan diagnosis stroke iskemik. Salah satu penanda tersebut yaitu Glial Fibrillary Acidic Protein (GFAP) serum yang diekspresikan oleh sel glia otak yaitu astrosit. Astrosit merupakan sel glia yang terbanyak dalam sistem saraf pusat (SSP) yang berperan penting untuk menjaga fungsi fisiologis dan menjaga homeostasis otak. Astrosit adalah sel yang paling awal dan paling responsif bereaksi bila terjadi iskemia otak. Pada saat terjadi iskemia otak akan  terjadi hipertrofi sel astrosit yang disebut sebagai proses astrogliosis sehingga GFAP diproduksi dan diekskresikan ke dalam aliran darah. Peningkatan kadar GFAP serum dengan sensitifitas 91% dan spesifisitas 97% menandakan reaktivitas sel astrosit dengan threshold cut off 0,29 ng/mL dan ditandai dengan memberatnya derajat defisit neurologis serta memperburuk luaran klinis pada pasien stroke iskemik akut.

 

Glial Fibrillary Acidic Protein As Prognotic Marker In Acute Ischemic Stroke

Abstract

Stroke is a neurological emergency that occurs suddenly and is the third leading cause of death in the world after heart disease and cancer. Ischemic stroke is the most common cause, namely 87% of all stroke cases. Biological markers are needed to describe the damage to brain nerve cells so that they can help clinicians to make a diagnosis of ischemic stroke. One of these markers is serum Glial Fibrillary Acidic Protein (GFAP) which is expressed by brain glial cells, namely astrocytes. Astrocytes are the most abundant glial cells in the Central Nervous System (CNS) which play an important role in maintaining physiological functions and maintaining brain homeostasis. Astrocytes are the earliest and most responsive cells to react when brain ischemia occurs. At the time of brain ischemia there will be hypertrophy of astrocyte cells which is referred to as astrogliosis process so that GFAP is produced and excreted into the bloodstream. Increasing GFAP levels with a sensitivity of 91% and a specificity of 97% indicates astrocyte cell reactivity with a threshold cut off of 0.29 ng/mL and is characterized by a worsening of the degree of neurological deficit and worsening of clinical outcomes in acute ischemic stroke patients.


Keywords


Derajat defisit stroke, Glial Fibrilary Acidic Protein (GFAP), luaran klinis, prognosis, stroke iskemik akut

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References


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DOI: https://doi.org/10.24244/jni.v12i3.446

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