Neuron-specific enolase (NSE)
Neuron-specific enolase (NSE) is a cytoplasmatic glycolytic enzyme expressed mainly in neurons and neuron-derived cells. It is found in smaller quantities in erythrocytes and platelets. NSE has been established in clinical routine as a tumor-marker for small cell lung cancer. A number of publications have investigated the usefulness of NSE as a marker of acute ischemic stroke. These efforts have recently been nicely reviewed by Anand, 2005. In summary, only one small study with 10 thrombembolic stroke patients showed significantly elevated NSE levels as early as 4h after stroke onset (Stevens 1999). Others could not detect differences at 4h, but reported an NSE increase from 8h to 72h (Fassbender, 1997). Three studies showed a significant NSE increase when blood was drawn within the first 24h after ischemic stroke onset (Oh, 2003; Hill, 2000; Missler, 1997). Differences between serum levels in ischemic and hemorrhagic stroke were found in one study at 48h and 72h after symptom onset, but not at hospital admission. Due to a considerable overlap of NSE levels between groups, the authors however advised against using serum NSE as a biomarker to distinguish between hemorrhagic and ischemic stroke (Cunningham, 1996).
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