Proteomic investigations and biomarker discovery in transient ischaemic attack

Abstract

Between 15-26% of ischaemic strokes are preceded by transient ischaemic attack (TIA) making accurate and timely diagnosis of TIA important for stroke prevention. However, TIA diagnoses are highly reliant on subjective history gathering and clinical assessments to differentially diagnose true TIA conditions from mimic presentations. Unfortunately, the subjective nature of TIA diagnosis has created a surprisingly high amount of variability between diagnoses made by physicians and specialist neurologists. Use of biomarker tests could offer an objective quantitative measuring tool that reduces inter-observer variation through the establishment of standardised quantitative measures and improved reproducibility. When used in combination with comprehensive clinical assessments and neurological imaging, biomarkers may offer a useful adjunct to assist a treating clinician to accurately and reliably interpret the clinical finding and confidently diagnose and treat a TIA or mimic condition. This thesis proposes a framework for undertaking an exploration of the human plasma proteome, and performs the very first proteomic pilot study that identifies candidate plasma protein biomarkers associated with TIA, which could also be used to distinguish from mimic presentations.