Profilin-1 as a Potential Biomarker in Acute Ischemic Stroke: Predictive Value for Large Vessel Occlusion and Mechanical Thrombectomy

BACKGROUND: This study aimed to investigate the diagnostic and prognostic value of serum Profilin-1 (PFN-1) levels in patients with acute ischemic stroke. Ischemic stroke is a serious condition requiring rapid diagnosis and reperfusion therapy (particularly mechanical thrombectomy [MT]). However, appropriate patient selection and accurate determination of symptom onset can be challenging. PFN-1, previously shown to be elevated in other vas-cular diseases, was clinically investigated for the first time in ischemic stroke through this study. METHODS: This prospective observational study included 152 patients with radiologically confirmed AIS and 66 age- and gender-matched healthy controls. Serum PFN-1 levels were measured upon admission. The study assess-ed PFN-1 concentrations across subgroups (large vessel occlusion [LVO] presence, MT performed, symptom duration ≤ 6 hours versus > 6 hours) and conducted ROC analyses to determine predictive performance. RESULTS: PFN-1 levels were significantly higher in stroke patients than in controls (p < 0.001). Moreover, PFN-1 levels were markedly elevated in patients with LVO compared to those without (p < 0.001), in patients who underwent MT compared to those who did not (p = 0.003), and in patients presenting within 6 hours of symptom onset versus those who presented later (p < 0.001). Receiver operating characteristic analysis indicated that PFN-1 levels, using specific cutoff values, could predict stroke diagnosis, LVO presence, MT requirement, and the 6-hours symptom window. CONCLUSIONS: These findings suggest that PFN-1 is associated with increased thrombus burden. In conclusion, serum PFN-1 is a readily measurable biomarker with potential utility in the emergency management of IS, assisting in diagnosis, identifying LVO and MT candidates, and estimating symptom duration. However, validation through larger, multicenter studies is warranted.