Serum progranulin as an early diagnostic biomarker in acute stroke

Abstract

Aim: Rapid differentiation between ischemic stroke (IS) and intracerebral hemorrhage (ICH) is crucial for early management. Progranulin, a multifunctional glycoprotein with neuroprotective and anti-inflammatory effects, is involved in neuronal survival and the control of inflammation. Although animal studies suggest a protective role, its diagnostic and prognostic value in acute human stroke remains uncertain. This study aimed to evaluate the diagnostic and prognostic significance of serum progranulin in acute IS and ICH within six hours of onset.

Materials and Methods: Forty-two acute stroke patients and forty-four healthy controls were enrolled. Inclusion criteria were an acute focal neurological deficit, a presentation within six hours, and imaging confirmation of the subtype. Exclusion criteria included prior stroke, trauma, tumors, systemic failure, or major comorbidities. Serum progranulin was measured by ELISA. Statistical analyses included t-tests, Mann–Whitney U tests, ANOVA, chi-square tests, and ROC analyses.

Results: Serum progranulin was significantly higher in stroke patients than in controls (69.6±15.4 pg/mL vs 52.2±18.9 pg/mL; p<0.001). ROC analysis yielded a cut-off value of 53 pg/mL (sensitivity, 64%; specificity, 84%; AUC, 0.778; 95% CI, 0.676–0.861). Progranulin levels did not differ between IS and ICH, nor by severity. No correlations were observed with mortality, ICU admission, or hospital stay; only the Glasgow Coma Scale correlated with clinical outcomes.

Conclusion: An elevated level of progranulin early in stroke supports its potential as a diagnostic biomarker, but it does not distinguish stroke type or predict prognosis. Larger longitudinal studies are needed to clarify its clinical utility.