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Objectives. To assess the diagnostic value of NR2 peptide as a biomarker for cerebral ischemia by studying its plasma concentration in patients with ischemic stroke (IS) and to determine changes in levels due to treatment with the low molecular weight neuroprotector Cortexin. Materials and Methods. A total of 120 patients aged 18-70 years were studied, of which 36 were diagnosed with transient ischemic attacks (TIA) and 84 with IS - 70 in the carotid basin and 14 in the vertebrobasilar basin with Wallenberg-Zakharchenko syndrome. Determination of neurological status included assessment on the NIHSS stroke scale. Plasma NR2 concentrations were estimated in all patients on admission and after courses of treatment and results were compared with CT and MRI neuroimaging studies. Results and Conclusions. NR2 peptide fragment concentrations in all patients were above the normal value (>1.5 ng/ml, p < 0.0001). A direct correlation was found between the concentration of NR2 peptide (from 3.38 ng/ml to 15.6 ng/ml) and the size of the ischemia zone from a few mm to 80 mm (rs = 0.73). After 10-day courses of treatment with Cortexin, NR2 peptide fragment concentrations decreased (from 8.5 to 5.9 ng/ml, p < 0.0001). These data lead to the conclusion that this blood test for cerebral ischemia is valid and that Cortexin has significant therapeutic efficacy. [ABSTRACT FROM AUTHOR]

Objective. To assess the diagnostic value of assaying immunoglobulin (IgG) light chains at the onset of multiple sclerosis (MS). Materials and methods. A total of 226 patients took part in the study; group 1 (n = 111) were patients with clinically isolated syndrome (CIS) with development to MS within the first two years; group 2 (n = 49) were patients with CIS who did not progress to MS in the first two years; group 3 (n = 20) consisted of patients with inflammatory diseases of the central nervous system. The reference group (group 4, n = 46) consisted of patients with noninflammatory CNS diseases. The following immunological indicators were assessed in the patients: the clonal nature of cerebrospinal fluid (CSF) IgG and the concentrations of free ϰ and λ light chains in the CSF and their ratio. Results. Synthesis of free light chains was significantly greater in group 1 than groups 2 and 4. Free light chain synthesis in group 3 was significantly greater than that in groups 2 and 4 but was not significantly different from that in group 1. Free light chain production was significantly greater in patients with oligoclonal IgG synthesis than in patients without oligoclonal synthesis. The level of production of free light chains in patients of group 1 was significantly greater than that in group 2, regardless of whether or not oligoclonal IgG was produced. The most valuable diagnostic markers were the concentration and the coefficient of CSF:serum concentrations of κ light chains. Use of these parameters along with assessment of the clonality of IgG synthesis produced a 50% reduction in number of false negative results. Independently of other factors, increases in κ chain levels led to a 9.718-fold increase in the probability of a diagnosis of MS. Conclusions. Assay of free light chains as a lab marker increases the accuracy of diagnoses of MS and provides an indirect evaluation of the risk that CIS will progress to complete MS in the next two years. [ABSTRACT FROM AUTHOR]