Metabolic Brain Disease

, Volume 34, Issue 1, pp 3–19 | Cite as

Alkaline phosphatase: a potential biomarker for stroke and implications for treatment

  • Allison L. Brichacek
  • Candice M. BrownEmail author
Review Article


Stroke is the fifth leading cause of death in the U.S., with more than 100,000 deaths annually. There are a multitude of risks associated with stroke, including aging, cardiovascular disease, hypertension, Alzheimer’s disease (AD), and immune suppression. One of the many challenges, which has so far proven to be unsuccessful, is the identification of a cost-effective diagnostic or prognostic biomarker for stroke. Alkaline phosphatase (AP), an enzyme first discovered in the 1920s, has been evaluated as a potential biomarker in many disorders, including many of the co-morbidities associated with stroke. This review will examine the basic biology of AP, and its most common isoenzyme, tissue nonspecific alkaline phosphatase (TNAP), with a specific focus on the central nervous system. It examines the preclinical and clinical evidence which supports a potential role for AP in stroke and suggests potential mechanism(s) of action for AP isoenzymes in stroke. Lastly, the review speculates on the clinical utility of AP isoenzymes as potential blood biomarkers for stroke or as AP-targeted treatments for stroke patients.


Stroke Alkaline phosphatase Biomarker Tissue nonspecific alkaline phosphatase Blood-brain barrer 



The project was supported by NIH T32AG052375 (ALB) and K01NS081014, U54GM104942, P20 GM109098 (CMB). We appreciate insightful feedback from Ashley B. Petrone PhD.


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Authors and Affiliations

  1. 1.Department of Microbiology, Immunology, and Cell Biology, Center for Basic and Translational Stroke Research, WVU Rockefeller Neuroscience InstituteWest Virginia University School of MedicineMorgantownUSA
  2. 2.Department of Neuroscience, Emergency Medicine, and Microbiology, Immunology and Cell Biology, Center for Basic and Translational Stroke Research, WVU Rockefeller Neuroscience InstituteWest Virginia University School of MedicineMorgantownUSA

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