Exploring the association between plasma lipids changes and embolization recurrence following intravenous thrombolysis with alteplase in acute ischemic stroke based on lipidomics.

BACKGROUND

Alteplase is a widely used thrombolytic therapy for acute ischemic stroke (AIS). However, the efficacy of intravenous thrombolysis (IVT) with alteplase varies due to individual factors, and some patients are prone to embolization recurrence (ER) after IVT. The mechanisms underlying these variations are not fully understood.

METHODS

In this study, we analyzed changes in plasma lipid profiles of AIS patients treated with alteplase based on lipidomics, focusing on the association between plasma lipids changes and embolization recurrence.

RESULTS

Our findings revealed significant changes in several lipid species in patients who experienced ER, including triglycerides (TG), diglycerides (DG), phosphatidylcholine (PC), and sphingomyelin (SM). Notably, most TG and DG levels in ER group were significantly upregulated, PC and SM levels were downregulated. However, most PC was upregulated 24 h after IVT treatment, while DG, SM, TG remained downregulated. These differential lipid metabolites are mainly involved in lipid metabolism, immune response inflammation-related, and insulin resistance signaling pathways.

CONCLUSION

This study demonstrates that lipid alterations, particularly in TG, DG, PC, and SM, may be associated with ER after alteplase treatment. However, further studies are needed to elucidate the exact mechanisms through which these lipids influence the onset and recovery of AIS.