Kuusik Karl, Kasepalu Teele, Zilmer Mihkel, Eha Jaan, Paapstel Kaido, Kilk Kalle, Rehema Aune, Kals Jaak
Department of Cardiology, Institute of Clinical Medicine, University of Tartu, Puusepa 8, 50406 Tartu, Estonia.
Heart Clinic, Tartu University Hospital, Puusepa 8, 50406 Tartu, Estonia.
Metabolites. 2023 Jul 18;13(7):856. doi: 10.3390/metabo13070856.
Remote ischemic preconditioning (RIPC) has demonstrated protective effects in patients with lower extremity arterial disease (LEAD) undergoing digital subtraction angiography (DSA) and/or percutaneous transluminal angioplasty (PTA). This study aimed to investigate the impact of RIPC on the metabolomical profile of LEAD patients undergoing these procedures and to elucidate its potential underlying mechanisms. A total of 100 LEAD patients were enrolled and randomly assigned to either the RIPC group (n = 46) or the sham group (n = 54). Blood samples were drawn before and 24 h after intervention. Targeted metabolomics analysis was performed using the AbsoluteIDQ p180 Kit, and changes in metabolite concentrations were compared between the groups. The RIPC group demonstrated significantly different dynamics in nine metabolites compared to the sham group, which generally showed a decrease in metabolite concentrations. The impacted metabolites included glutamate, taurine, the arginine-dimethyl-amide-to-arginine ratio, lysoPC a C24:0, lysoPC a C28:0, lysoPC a C26:1, PC aa C38:1, PC ae C30:2, and PC ae C44:3. RIPC exhibited a 'stabilization' effect, maintaining metabolite levels amidst ischemia-reperfusion injuries, suggesting its role in enhancing metabolic control. This may improve outcomes for LEAD patients. However, additional studies are needed to definitively establish causal relationships among these metabolic changes.
远程缺血预处理（RIPC）已在接受数字减影血管造影（DSA）和/或经皮腔内血管成形术（PTA）的下肢动脉疾病（LEAD）患者中显示出保护作用。本研究旨在调查RIPC对接受这些手术的LEAD患者代谢组学特征的影响，并阐明其潜在的机制。总共招募了100名LEAD患者，并随机分配到RIPC组（n = 46）或假手术组（n = 54）。在干预前和干预后24小时采集血样。使用AbsoluteIDQ p180试剂盒进行靶向代谢组学分析，并比较两组之间代谢物浓度的变化。与假手术组相比，RIPC组在9种代谢物中表现出明显不同的动态变化，假手术组通常显示代谢物浓度降低。受影响的代谢物包括谷氨酸、牛磺酸、精氨酸二甲基酰胺与精氨酸的比值、溶血磷脂酰胆碱a C24:0、溶血磷脂酰胆碱a C28:0、溶血磷脂酰胆碱a C26:1、磷脂酰胆碱aa C38:1、磷脂酰胆碱ae C30:2和磷脂酰胆碱ae C44:3。RIPC表现出一种“稳定”作用，在缺血再灌注损伤中维持代谢物水平，表明其在增强代谢控制中的作用。这可能会改善LEAD患者的预后。然而，需要更多的研究来明确确定这些代谢变化之间的因果关系。
