Leveraging Metabolic Biomarkers in Ischemic Stroke: From Mechanistic Insights to Therapeutic Strategies

Abstract:

One of the leading causes of death and disability is Ischemic Stroke (IS), which exhibits a complex pathophysiology, making timely diagnosis more difficult and therapeutic options limited. Precise detection of small metabolites is empowering researchers to unmask key molecular patterns in a disease that exhibits complex pathophysiology, such as IS, owing to recent advances in computational chemistry and metabolomic techniques. Using these approaches, several key dysregulated metabolic pathways involving host and microbiota-derived compounds have been identified, providing a valuable pool of biomarkers to improve diagnosis, stroke subtyping, and functional prediction. The detection of these modified pathways could provide meaningful insights into disease mechanisms, such as neuroinflammation, excitotoxicity, and oxidative stress, thereby identifying novel therapeutic targets. This review highlights the importance of metabolomics in deepening the understanding of IS pathophysiology and its role in paving the way for developing precise mechanism-based approaches. This review also discusses how these metabolome-based approaches could provide acute neuroprotection and support long-term recovery and addresses how current challenges could be resolved for translating current discoveries into clinical practice.