Quantitative proteomic analysis of plasma after remote ischemic conditioning in acute ischemic stroke

Remote ischemic conditioning (RIC) has been demonstrated to be effective in acute ischemic stroke, and numerous biomarkers have been investigated; however, few studies have simultaneously detected several biomarkers and observed their dynamic changes. We aimed to identify serum biomarkers whose changes are associated with RIC following stroke. This was an exploratory analysis of the RICAMIS trial, in which patients with serum samples collected were enrolled and divided into treatment groups. Serum samples were collected at admission, 3 days after randomization, and at discharge. Serum biomarkers with significantly different changes between groups were identified. Of the 25 enrolled patients, 9 patients were assigned to the RIC group, while 16 patients were assigned to the Control group. Compared with Control group, 9 serum biomarkers were found to significantlychange at admission versus 3 days after randomization, as well as at admission versus discharge in the RIC group. These included neurological biomarkers (V-type proton ATPase subunit G3 and secretogranin-3), vascular-related biomarkers (angiopoietin-related protein 6, Histone-lysine N-methyltransferase 2D, keratin type I cytoskeletal 18, and mitogen-activated protein kinase 3), inflammatory biomarkers (macrophage receptor and Nonspecific cytotoxic cell receptor protein-1), and trypsin-1. This is the first study to identify changes in serum biomarkers after RIC treatment in patients with acute ischemic stroke by quantitative proteomic analysis, which will provide the guidance for selecting target population in future clinical trials. The relationship of identified biomarkers with RIC efficacy warrants further investigation.