Department of Neurology, Cangzhou Central Hospital, Cangzhou, Hebei 061000, China.
Department of Neurology, Cangzhou Central Hospital, Cangzhou, Hebei 061000, China.
Clin Neurol Neurosurg. 2024 Jun;241:108291. doi: 10.1016/j.clineuro.2024.108291. Epub 2024 Apr 21.
Acute cerebral infarction (ACI) contributes to disability and death accross the globe. Remote ischemic preconditioning (RIPC) reduces cerebral infarct size and improves neurological function in ACI. We conducted this research to reveal the effects of RIPC intervention on serum levels of microRNA-582-5p (miR-582-5p)/high mobility group box-1 protein (HMGB1), inflammation, oxidative stress and neurological function in patients with ACI.
In this study, 158 patients with ACI were prospectively selected and randomized into the control (administered symptomatic medication alone) and the RIPC (underwent RIPC of the limbs based on medication) groups, with their clinical baseline data documented. Serum levels of miR-582-5p, and HMGB1 and inflammatory factors [tumor necrosis factor alpha (TNF-α)/interleukin-1beta (IL-1β)/IL-10] were assessed by RT-qPCR/ELISA, followed by comparisons of oxidative stress indices [glutathione-peroxidase (GSH-Px)/catalase (CAT)/superoxide dismutase (SOD)] using a fully automatic biochemical analyzer. Correlations between serum miR-582-5p with serum HMGB1, and between their levels with TNF-α/IL-1β/IL-10 were analyzed by Pearson analysis. The NIHSS score/Barthel Index scale were used to assess neurological function/daily living ability. Intervention safety for ACI patients was evaluated.
RIPC intervention increased serum miR-582-5p levels and decreased serum HMGB1 levels in ACI patients. RIPC intervention significantly reduced inflammation (diminished TNF-α/IL-1β levels, increased IL-10 level) and oxidative stress (elevated GSH-Px/CAT/SOD levels) in ACI patients. Serum miR-582-5p was negatively correlated with TNF-α and IL-1β levels, while positively correlated with IL-10 level, while HMGB1 was positively correlated with TNF-α and IL-1β levels, while negatively correlated with IL-10 level. miR-582-5p was negatively correlated with HMGB1. RIPC intervention improved neurological function (reduced NIHSS, increased Barthel scores) in ACI patients to some extent. RIPC had certain effectiveness and safety in the treatment of ACI.
After RIPC intervention, serum miR-582-5p levels were increased, HMGB1 levels were decreased, and inflammation and oxidative stress were reduced in ACI patients, which mitigated neurological deficits, improved patients' ability to perform life activities, and exerted neuroprotective effects to some extent.
急性脑梗死(ACI)在全球范围内可导致残疾和死亡。远程缺血预处理(RIPC)可减少 ACI 患者的脑梗死面积并改善神经功能。我们开展此项研究旨在揭示 RIPC 干预对 ACI 患者血清中微小 RNA-582-5p(miR-582-5p)/高迁移率族蛋白 B1(HMGB1)、炎症、氧化应激和神经功能的影响。
前瞻性选择 158 例 ACI 患者,随机分为对照组(单独给予对症药物治疗)和 RIPC 组(在药物治疗基础上进行肢体 RIPC),记录其临床基线数据。采用 RT-qPCR/ELISA 检测血清 miR-582-5p 和 HMGB1 及炎症因子[肿瘤坏死因子-α(TNF-α)/白细胞介素-1β(IL-1β)/白细胞介素-10(IL-10)]水平,全自动生化分析仪检测氧化应激指标[谷胱甘肽过氧化物酶(GSH-Px)/过氧化氢酶(CAT)/超氧化物歧化酶(SOD)]。采用 Pearson 分析方法分析血清 miR-582-5p 与血清 HMGB1 之间的相关性,以及它们与 TNF-α/IL-1β/IL-10 水平之间的相关性。采用美国国立卫生研究院卒中量表(NIHSS)评分/巴氏指数量表(Barthel Index scale)评估神经功能/日常生活能力。评估 ACI 患者的干预安全性。
RIPC 干预可增加 ACI 患者的血清 miR-582-5p 水平并降低血清 HMGB1 水平。RIPC 干预可显著降低 ACI 患者的炎症(TNF-α/IL-1β 水平降低,IL-10 水平升高)和氧化应激(GSH-Px/CAT/SOD 水平升高)。血清 miR-582-5p 与 TNF-α 和 IL-1β 水平呈负相关,与 IL-10 水平呈正相关,而 HMGB1 与 TNF-α 和 IL-1β 水平呈正相关,与 IL-10 水平呈负相关。miR-582-5p 与 HMGB1 呈负相关。RIPC 干预在一定程度上改善了 ACI 患者的神经功能(降低 NIHSS 评分,升高巴氏量表评分)。RIPC 对 ACI 有一定的有效性和安全性。
RIPC 干预后,ACI 患者血清 miR-582-5p 水平升高,HMGB1 水平降低,炎症和氧化应激减轻,从而减轻神经功能缺损,改善患者的生活活动能力,在一定程度上发挥神经保护作用。