Changes in cerebral autoregulation and blood biomarkers after remote ischemic preconditioning.
Guo, Zhen-Ni MD *; Guo, Wei-Tong MD *; Liu, Jia PhD; Chang, Junlei PhD; Ma, Hongyin MD; Zhang, Peng MD; Zhang, Fu-Liang MD, PhD; Han, Ke PhD; Hu, Han-Hwa MD; Jin, Hang PhD; Sun, Xin PhD; Simpson, David Martin PhD; Yang, Yi MD, PhD
93(1):e8-e19, July 02, 2019.
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Objective: To determine the effect of remote ischemic preconditioning (RIPC) on dynamic cerebral autoregulation (dCA) and various blood biomarkers in healthy adults.
Methods: A self-controlled interventional study was conducted. Serial measurements of dCA were performed at 7 time points (7, 9, and 11 AM; 2, 5, and 8 PM, and 8 AM on the next day) without or with RIPC, carried out at 7:20 to 8 AM. Venous blood samples were collected at baseline (7 AM) and 1 hour after RIPC, and blood biomarkers, including 5 neuroprotective factors and 25 inflammation-related biomarkers, were measured with a quantitative protein chip.
Results: Fifty participants were enrolled (age 34.54 /- 12.01 years, 22 men). Compared with the results on the day without RIPC, dCA was significantly increased at 6 hours after RIPC, and the increase was sustained for at least 24 hours. After RIPC, 2 neuroprotective factors (glial cell-derived neurotrophic factor and vascular endothelial growth factor-A) and 4 inflammation-related biomarkers (transforming growth factor-[beta]1, leukemia inhibitory factor, matrix metallopeptidase-9, and tissue inhibitor of metalloproteinase-1) were significantly elevated compared with their baseline levels. Conversely, monocyte chemoattractant protein-1 was significantly lower compared with its baseline level.
Conclusions: RIPC induces a sustained increase of dCA from 6 to at least 24 hours after treatment in healthy adults. In addition, several neuroprotective and inflammation-related blood biomarkers were differentially regulated shortly after RIPC. The increased dCA and altered blood biomarkers may collectively contribute to the beneficial effects of RIPC on cerebrovascular function.
ClinicalTrials.gov identifier: NCT02965547.
(C) 2019 American Academy of Neurology