Peripheral blood AKAP7 expression as an early marker for lymphocyte-mediated post-stroke blood brain barrier disruption

O’Connell, Grant C.; Treadway, Madison B.; Petrone, Ashley B.; Tennant, Connie S.; Lucke-Wold, Noelle; Chantler, Paul D.; Barr, Taura L.

Of the 16 candidate genes, only the total expression levels of AKAP7, a gene encoding a protein kinase A (PKA)-binding scaffolding molecule known as A kinase anchoring protein 7 (AKAP7), were significantly associated with the development of post-stroke severe HARM after controlling for age, dyslipidemia, and rtPA (p = 0.025*, Odds ratio = 4.0, 95% confidence interval = 1.1-56.8, Fig. 2A ). Specifically, elevated whole blood expression levels of total AKAP7 at emergency department admission were associated with increased degree of HARM at 24 hour follow up (Fig. 2B) . Furthermore, early total expression levels of AKAP7 showed a modest ability to predict post-stroke BBB disruption, demonstrating 100% sensitivity (95% confidence interval = 63.1-100%) and 68.1% specificity (95% confidence interval = 43.5-87.0%) for the development of severe HARM (Fig. 2C ).