Trace Elements in Medicine (Moscow)
2021, 22(4): 27-36
TOPICAL PAPERS

PROTEIN C, D-DIMERS AND TRACE ELEMENTS IN ISCHEMIC STROKE: LITERATURE REVIEW

A.N. Mazilina¹, A.D. Fesyun^2,3, M.Yu. Yakovlev^3,4, L.L. Klimenko⁵

¹ Clinical Hospital №. 123 FMBA of Russia, Odintsovo, Moscow Region, Russia
² National Medical Research Center of Rehabilitation and Balneology of the Ministry of Health of the Russian Federation
³ Medical Institute of Continuing Education, Moscow State University of Food Production
⁴ I.M. Sechenov First Moscow State Medical University (Sechenov University)
⁵ Institution of the Russian Academy of Sciences Institute of Chemical Physics named after N.N. Semenova RAS

DOI: 10.19112/2413-6174-2021-22-4-27-36 

ABSTRACT. The molecular and submolecular mechanisms of the etiopathogenesis of ischemic stroke have been investigated. Coagulation factors  protein C and D-dimers  are involved in the formation of an ischemic focus. The concentration of protein C in patients with ischemic stroke increases: activated protein C has pleiotropic neuroregenerative and neuroprotective effects in stroke and correlates with an improvement in functional status. Neurospecific proteins D-dimers are a marker of platelet activation: an excess of D-dimer indicates activation of fibrinolysis and is associated with inflammation in ischemic stroke. Metal ligand homeostasis has a modulating effect on the structure and function of proteins of the multicomponent blood coagulation system. Zinc serves as an effector of coagulation, anticoagulation and fibrinolysis and is a cofactor for antioxidant enzymes that protect the brain from oxidative stress. Zinc ions enhance the binding of activated protein C to the protein C receptor of endothelial cells. Selenium is a part of glutathione enzymes involved in antioxidant protection in vascular pathology: selenium-containing enzymes are modulators of brain function. Copper ions modulate the blood coagulation system as well as the antioxidant system. Low magnesium concentration is a risk factor for stroke, i.e. marker-harbinger. Both a deficiency and an excess of iron in the nervous tissue lead to an increase in prooxidant processes. High serum ferritin levels are a risk factor for stroke. Thus, the trace elements balance underlies the molecular mechanisms of ischemic stroke.

KEYWORDS: protein C, D-dimers, macroelements, trace elements.