High blood glutamate oxaloacetate transaminase levels are associated with good functional outcome in acute ischemic stroke

The capacity of the blood enzyme glutamate oxaloacetate transaminase ( GOT) to remove glutamate from the brain by means of blood glutamate degradation has been shown in experimental models to be an efficient and novel neuroprotective tool against ischemic stroke; however, the beneficial effects of this enzyme should be tested in patients with stroke to validate these results. This study aims to investigate the association of GOT levels in blood with clinical outcome in patients with acute ischemic stroke. In two clinical independent studies, we found that patients with poor outcome show higher glutamate and lower GOT levels in blood at the time of admission. Lower GOT levels and higher glutamate levels were independently associated with poorer functional outcome at 3 months and higher infarct volume. These findings show a clear association between high blood glutamate levels and worse outcome and vice versa for GOT, presumably explained by the capacity of this enzyme to metabolize blood glutamate. Journal of Cerebral Blood Flow & Metabolism (2011) 31, 1387-1393; doi:10.1038/jcbfm.2011.4; published online 26 January 2011