基于脂质组学探讨急性缺血性卒中患者血浆脂质变化与阿替普酶静脉溶栓后栓塞复发的关系

IF 2 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases Pub Date : 2025-04-08 DOI:10.1016/j.jstrokecerebrovasdis.2025.108310

Chuanfeng Shao , Saizhen Wu , Tingting Liu , Ming Zheng , Xiaoyang Zhi , Jinli Miao , Lufeng Hu , Lingli Ge

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引用次数: 0

摘要

替普酶是一种广泛应用于急性缺血性脑卒中（AIS）的溶栓药物。然而，阿替普酶静脉溶栓（IVT）的疗效因个体因素而异，部分患者IVT后易发生栓塞复发（ER）。这些变化背后的机制尚不完全清楚。方法在本研究中，我们基于脂质组学分析了阿替普酶治疗AIS患者的血脂变化，重点分析了血脂变化与栓塞复发的关系。结果我们的研究结果显示，在经历ER的患者中，几种脂质发生了显著的变化，包括甘油三酯（TG）、二甘油三酯（DG）、磷脂酰胆碱（PC）和鞘磷脂（SM）。值得注意的是，ER组大部分TG和DG水平显著上调，PC和SM水平下调。然而，IVT处理24 h后，大多数PC上调，而DG、SM、TG仍下调。这些差异脂质代谢物主要参与脂质代谢、免疫反应炎症相关、胰岛素抵抗等信号通路。结论本研究表明，阿替普酶治疗后，脂质改变，特别是TG、DG、PC和SM可能与ER有关。然而，需要进一步的研究来阐明这些脂质影响AIS发病和恢复的确切机制。

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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.

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来源期刊

Journal of Stroke & Cerebrovascular Diseases Medicine-Surgery

CiteScore

5.00

自引率

4.00%

发文量

583

审稿时长

62 days

期刊介绍： The Journal of Stroke & Cerebrovascular Diseases publishes original papers on basic and clinical science related to the fields of stroke and cerebrovascular diseases. The Journal also features review articles, controversies, methods and technical notes, selected case reports and other original articles of special nature. Its editorial mission is to focus on prevention and repair of cerebrovascular disease. Clinical papers emphasize medical and surgical aspects of stroke, clinical trials and design, epidemiology, stroke care delivery systems and outcomes, imaging sciences and rehabilitation of stroke. The Journal will be of special interest to specialists involved in caring for patients with cerebrovascular disease, including neurologists, neurosurgeons and cardiologists.