Salivary neuron specific enolase: an indicator for neuronal damage in patients with ischemic stroke and stroke-prone patients

Background: The blood-brain barrier is compromised in patients with stroke. The release of neuro-biochemical protein markers, such as neuron specific enolase (NSE) into the circulation may allow the pathophysiology and prognosis of patients with cerebrovascular diseases to be evaluated further. The present study was designed to measure the marker of neuronal damage, NSE, in saliva and serum of patients with acute ischemic stroke and patients with stroke related diseases as a diagnostic and/or monitoring tool for early prediction of ischemic stroke. Methods: Salivary and serum NSE concentrations were measured in 150 individuals. Fifty were patients recently diagnosed as having ischemic stroke, 75 were gender and age-matched risk-group patients (patients with hypertension, type 2 diabetes and ischemic heart disease). Another 25 were gender and age-matched healthy controls. Results: Salivary and serum NSE concentrations were significantly higher than that of healthy controls. The cut-off threshold for salivary NSE of 3.7 mg/L was optimum, showing 80% accuracy for differentiation of ischemic stroke from normal individuals. Conclusions: Salivary NSE (alone or in combination with serum) can be used as a valuable diagnostic and possibly prognostic tool for measurement of neuronal damage in patients with stroke and stroke-related diseases. Clin Chem Lab Med 2009;47:1519-24.