Molecular Biomarkers for Prognosis, Diagnosis, and Therapy in Hemorrhagic Stroke

Authors

Aqilla Nasywa Nabila Sugiyanto , Nafisya Ayu Evana , Afdhila Anugerah Fawaiz

DOI:

10.29303/jbt.v25i4.10277

Published:

2025-10-01

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Abstract

Hemorrhagic stroke is an acute condition characterized by the rupture of blood vessels in the brain and has a high mortality rate. The bleeding leads to the formation of hematoma and perihematomal edema, which significantly worsen the patient's prognosis. Early diagnosis and management are crucial to improving clinical outcomes. In recent years, blood-based molecular biomarkers have become a major focus of research due to their potential to support diagnosis, evaluate etiology, predict hematoma growth, and assess inflammatory responses. Biomarkers such as GFAP and S100B have proven effective in distinguishing hemorrhagic stroke from ischemic stroke in the hyperacute phase. Meanwhile, β-amyloid and MMP play roles in identifying the etiology of bleeding, especially related to cerebral amyloid angiopathy. Additionally, levels of calcium, magnesium, LDL-C, and ApoE ε2 are known to be associated with the risk of hematoma expansion. Inflammatory biomarkers such as CRP, NLR, gelsolin, and CD163 reflect neuroinflammatory processes and blood-brain barrier damage that worsen secondary injury. The clinical use of these biomarkers opens opportunities for faster, more accurate, and personalized diagnostic and therapeutic approaches in hemorrhagic stroke.

Keywords:

Blood biomarkers, hemorrhagic stroke, molecular biomarkers.

References

Anindhita, T. & Wiratman, W. (2017). Buku Ajar Neurologi, Jilid 2. Edisi Pertama. Jakarta: Departemen Neurologi FK UI.

Ariyanto, C.R., Novela, C., Yohan, D., Wahyu, I.D. & Alhaq, I., (2023). Biomarker terkini untuk membedakan diagnosis stroke iskemik dan hemoragik pada pasien dewasa dan lansia: Sebuah review. HIJP: Health Information Jurnal Penelitian, 15. Available at: https://myjurnal.poltekkes-kdi.ac.id/index.php/hijp

Babić, A., Bonifačić, D., Komen, V., Kovačić, S., Mamić, M., & Vuletić, V. (2025). Blood Biomarkers in Ischemic Stroke Diagnostics and Treatment—Future Perspectives. Medicina, 61(3), 514. https://doi.org/10.3390/medicina61030514

Boccardi, E., Cenzato, M., Curto, F., Longoni, M., Motto, C., Oppo, V., ... & Vidale, S. (2017). Hemorrhagic stroke (No. 25033). Springer International Publishing. 10.1007/978-3-319-32130-1

Boswell, K. (2020). Stroke: ischemic and hemorrhagic. In Emergency Department Critical Care (pp. 359-372). Cham: Springer International Publishing.

Chen, Y., Chen, S., Chang, J., Wei, J., Feng, M., & Wang, R. (2021). Perihematomal edema after intracerebral hemorrhage: an update on pathogenesis, risk factors, and therapeutic advances. Frontiers in immunology, 12, 740632. 10.3389/fimmu.2021.740632

Dagonnier, M., Donnan, G. A., Davis, S. M., Dewey, H. M., & Howells, D. W. (2021). Acute stroke biomarkers: are we there yet?. Frontiers in neurology, 12, 619721. https://doi.org/10.3389/fneur.2021.619721

di Biase, L., Bonura, A., Pecoraro, P. M., Carbone, S. P., & Di Lazzaro, V. (2023). Unlocking the potential of stroke blood biomarkers: early diagnosis, ischemic vs. haemorrhagic differentiation and haemorrhagic transformation risk: a comprehensive review. International Journal of Molecular Sciences, 24(14), 11545. https://doi.org/10.3390/ijms241411545

Ding, S., Chen, Q., Chen, H., Luo, B., Li, C., Wang, L., & Asakawa, T. (2021). The neuroprotective role of neuroserpin in ischemic and hemorrhagic stroke. Current Neuropharmacology, 19(8), 1367-1378. 10.2174/1570159X18666201008113052

Duan, M., Xu, Y., Li, Y., Feng, H., & Chen, Y. (2024). Targeting brain-peripheral immune responses for secondary brain injury after ischemic and hemorrhagic stroke. Journal of Neuroinflammation, 21(1), 102. https://jneuroinflammation.biomedcentral.com/articles/10.1186/s12974-024-03101-y

Franjić, S. (2025). Aneurysm is the Name for the Expansion of Blood Vessels. International journal of Complementary and Internal Medicine, 6(2), 332-342. https://doi.org/10.35702/gas.10013

Gao, Y., Zhang, M., Li, X., Zeng, P., Wang, P., & Zhang, L. (2019). Serum PSA levels in patients with prostate cancer and other 33 different types of diseases. Progress in Molecular Biology and Translational Science, 162, 377-390. 10.1016/bs.pmbts.2018.12.013

Garton, T., Keep, R. F., Hua, Y., & Xi, G. (2017). CD163, a hemoglobin/haptoglobin scavenger receptor, after intracerebral hemorrhage: functions in microglia/macrophages versus neurons. Translational stroke research, 8(6), 612-616. https://link.springer.com/article/10.1007/s12975-017-0535-5

Gurevitz, C., Auriel, E., Elis, A., & Kornowski, R. (2022). The association between low levels of low density lipoprotein cholesterol and intracerebral hemorrhage: cause for concern?. Journal of Clinical Medicine, 11(3), 536. 10.3390/jcm11030536

Kamtchum-Tatuene, J., & Jickling, G. C. (2019). Blood biomarkers for stroke diagnosis and management. Neuromolecular medicine, 21(4), 344-368. https://doi.org/10.1007/s12017-019-08530-0

Lv, X. N., Li, Z. Q., & Li, Q. (2023). Blood-based biomarkers in intracerebral hemorrhage. Journal of Clinical Medicine, 12(20), 6562. https://doi.org/10.3390/jcm12206562

Magid-Bernstein, J., Girard, R., Polster, S., Srinath, A., Romanos, S., Awad, I. A., & Sansing, L. H. (2022). Cerebral hemorrhage: pathophysiology, treatment, and future directions. Circulation research, 130(8), 1204-1229. https://doi.org/10.1161/CIRCRESAHA.121.319949

Maida, C. D., Norrito, R. L., Rizzica, S., Mazzola, M., Scarantino, E. R., & Tuttolomondo, A. (2024). Molecular pathogenesis of ischemic and hemorrhagic strokes: background and therapeutic approaches. International journal of molecular sciences, 25(12), 6297. 10.3390/ijms25126297

Murphy, S. J., & Werring, D. J. (2020). Stroke: causes and clinical features. Medicine, 48(9), 561-566. 10.1016/j.mpmed.2020.06.002

Mutiarasari, D. (2019). Ischemic Stroke: Symptoms, Risk Factors, and Prevention. Medika Tadulako: Jurnal Ilmiah Kedokteran Fakultas Kedokteran dan Ilmu Kesehatan, 6 (1), 60–73. https://scispace.com/pdf/ischemic-stroke-symptoms-risk-factors-and-prevention-2p7ng32k0f.pdf

National Center for Health Statistics, 2024. Multiple Cause of Death 2018–2022 on CDC WONDER Database. [online] Available at: https://wonder.cdc.gov/mcd.html .

Roy‐O'Reilly, M., Zhu, L., Atadja, L., Torres, G., Aronowski, J., McCullough, L., & Edwards, N. J. (2017). Soluble CD163 in intracerebral hemorrhage: biomarker for perihematomal edema. Annals of clinical and translational neurology, 4(11), 793-800. https://doi.org/10.1002/acn3.485

Rymer, M. M. (2011). Hemorrhagic stroke: intracerebral hemorrhage. Missouri medicine, 108(1), 50. https://pubmed.ncbi.nlm.nih.gov/21462612/

Setiawan, P. A. (2021). Diagnosis dan tatalaksana stroke hemoragik. Jurnal Medika Hutama, 3(01 Oktober), 1660-1665. https://jurnalmedikahutama.com/index.php/JMH/article/view/336

Sherina, N., Ramdan, D., Hidayat, N., Madani, M., & Ciamis, M. (2022). Assistancy of medical surgical nursing for patients with nervous system disorders (hemorrhagic stroke) in Flamboyant Room, General Hospital of Banjar. Kolaborasi Jurnal Pengabdian Masyarakat, 2(2), 175-197. https://doi.org/10.56359/kolaborasi.v2i2.55

T Pan, W., Zhang, M., Guo, Z., Xiao, W., You, C., & Xue, L. (2022). Association between apolipoprotein E polymorphism and clinical outcome after ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage. Cerebrovascular Diseases, 51(3), 313-322. 10.1159/000520053

Troiani, Z., Ascanio, L., Rossitto, C. P., Ali, M., Mohammadi, N., Majidi, S., ... & Kellner, C. P. (2021). Prognostic utility of serum biomarkers in intracerebral hemorrhage: a systematic review. Neurorehabilitation and Neural Repair, 35(11), 946-959. https://doi.org/10.1177/15459683211041314

Tsao, C.W. et al., 2023. Heart disease and stroke statistics—2023 update: A report from the American Heart Association. Circulation, 147, pp.e93–e621.

Xie, W. J., Yu, H. Q., Zhang, Y., Liu, Q., & Meng, H. M. (2016). CD163 promotes hematoma absorption and improves neurological functions in patients with intracerebral hemorrhage. Neural Regeneration Research, 11(7), 1122-1127. https://doi.org/10.4103/1673-5374.187047

Zeng, Z., Chen, J., Qian, J., Ma, F., Lv, M., & Zhang, J. (2023). Risk factors for anticoagulant-associated intracranial hemorrhage: a systematic review and meta-analysis. Neurocritical Care, 38(3), 812-820. 10.1007/s12028-022-01671-4.

Author Biographies

Aqilla Nasywa Nabila Sugiyanto, Universitas Mataram

Author Origin : Indonesia

Nafisya Ayu Evana, Universitas Mataram

Author Origin : Indonesia

Afdhila Anugerah Fawaiz, Universitas Mataram

Author Origin : Indonesia

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How to Cite

Sugiyanto, A. N. N., Evana, N. A., & Fawaiz, A. A. (2025). Molecular Biomarkers for Prognosis, Diagnosis, and Therapy in Hemorrhagic Stroke. Jurnal Biologi Tropis, 25(4), 5067–5074. https://doi.org/10.29303/jbt.v25i4.10277

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