Metabolic perturbations and inflammatory mediators play a fundamental role in both early and late adverse post-acute ischemic stroke outcomes. Using data from the observational MAGIC (MArker bioloGici nell'Ictus Cerebrale) study, we evaluated the effect of 130 serum metabolic features, using a nuclear magnetic spectroscopy approach, on the following outcomes: hemorrhagic transformation at 24 h after stroke, non-response to intravenous thrombolytic treatment with the recombinant tissue plasminogen activator (rt-PA), and the 3 month functional outcome. Blood circulating metabolites, lipoproteins, and inflammatory markers were assessed at the baseline and 24 h after rt-PA treatment. Adjusting for the major determinants for unfavorable outcomes (i.e., age, sex, time onset-to-treatment, etc.), we found that acetone and 3-hydroxybutyrate were associated with symptomatic hemorrhagic transformation and with non-response to rt-PA; while 24 h after rt-PA, levels of triglycerides high-density lipoprotein (HDL) and triglycerides low-density lipoprotein (LDL) were associated with 3 month mortality. Cholesterol and phospholipids levels, mainly related to smaller and denser very low-density lipoprotein (VLDL) and LDL subfractions were associated with 3 month poor functional outcomes. We also reported associations between baseline 24 h relative variation (Δ) in VLDL subfractions and ΔC-reactive protein, Δinterleukin-10 levels with hemorrhagic transformation. All observed metabolic changes reflect a general condition of energy failure, oxidative stress, and systemic inflammation that characterize the development of adverse outcomes.

Nuclear Magnetic Resonance-Based Metabolomics to Predict Early and Late Adverse Outcomes in Ischemic Stroke Treated with Intravenous Thrombolysis / Licari, Cristina; Tenori, Leonardo; Di Cesare, Francesca; Luchinat, Claudio; Giusti, Betti; Kura, Ada; De Cario, Rosina; Inzitari, Domenico; Piccardi, Benedetta; Nesi, Mascia; Sarti, Cristina; Arba, Francesco; Palumbo, Vanessa; Nencini, Patrizia; Marcucci, Rossella; Gori, Anna Maria; Sticchi, Elena. - In: JOURNAL OF PROTEOME RESEARCH. - ISSN 1535-3893. - ELETTRONICO. - (2022), pp. 0-0. [10.1021/acs.jproteome.2c00333]

Nuclear Magnetic Resonance-Based Metabolomics to Predict Early and Late Adverse Outcomes in Ischemic Stroke Treated with Intravenous Thrombolysis

Licari, Cristina;Tenori, Leonardo;Di Cesare, Francesca;Luchinat, Claudio;Giusti, Betti;Kura, Ada;De Cario, Rosina;Inzitari, Domenico;Piccardi, Benedetta;Nesi, Mascia;Sarti, Cristina;Arba, Francesco;Palumbo, Vanessa;Nencini, Patrizia;Marcucci, Rossella;Gori, Anna Maria;Sticchi, Elena
2022

Abstract

Metabolic perturbations and inflammatory mediators play a fundamental role in both early and late adverse post-acute ischemic stroke outcomes. Using data from the observational MAGIC (MArker bioloGici nell'Ictus Cerebrale) study, we evaluated the effect of 130 serum metabolic features, using a nuclear magnetic spectroscopy approach, on the following outcomes: hemorrhagic transformation at 24 h after stroke, non-response to intravenous thrombolytic treatment with the recombinant tissue plasminogen activator (rt-PA), and the 3 month functional outcome. Blood circulating metabolites, lipoproteins, and inflammatory markers were assessed at the baseline and 24 h after rt-PA treatment. Adjusting for the major determinants for unfavorable outcomes (i.e., age, sex, time onset-to-treatment, etc.), we found that acetone and 3-hydroxybutyrate were associated with symptomatic hemorrhagic transformation and with non-response to rt-PA; while 24 h after rt-PA, levels of triglycerides high-density lipoprotein (HDL) and triglycerides low-density lipoprotein (LDL) were associated with 3 month mortality. Cholesterol and phospholipids levels, mainly related to smaller and denser very low-density lipoprotein (VLDL) and LDL subfractions were associated with 3 month poor functional outcomes. We also reported associations between baseline 24 h relative variation (Δ) in VLDL subfractions and ΔC-reactive protein, Δinterleukin-10 levels with hemorrhagic transformation. All observed metabolic changes reflect a general condition of energy failure, oxidative stress, and systemic inflammation that characterize the development of adverse outcomes.
2022
0
0
Licari, Cristina; Tenori, Leonardo; Di Cesare, Francesca; Luchinat, Claudio; Giusti, Betti; Kura, Ada; De Cario, Rosina; Inzitari, Domenico; Piccardi, Benedetta; Nesi, Mascia; Sarti, Cristina; Arba, Francesco; Palumbo, Vanessa; Nencini, Patrizia; Marcucci, Rossella; Gori, Anna Maria; Sticchi, Elena
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Utilizza questo identificatore per citare o creare un link a questa risorsa: https://hdl.handle.net/2158/1293846
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