Blood and Brain Metabolites after Cerebral Ischemia
Abstract
:1. Introduction
2. Literature Used in This Work
3. Stroke in Humans and Animal Models of Cerebral Ischemia
4. Biochemical Changes in Metabolites in the Brain Detected in Cerebral Ischemic Conditions
4.1. Lactate—Proposed Dual Role in Neuronal Death and Survival
4.2. Glutamate, Glutamine, and GABA in the Brain in Relation to Ischemia/Reperfusion Brain Damage
4.3. Neuronal Damage via N-Acetyl Aspartate
5. Metabolic Changes Detected in Circulation after Cerebral Ischemia
5.1. Role of Blood Glucose in Human Stroke and Preclinical Models
5.2. Post-Ischemic Changes in Energy Metabolites
5.3. Post-Ischemic Changes in Circulating Amino Acids in the Liquid Blood Component
Metabolite | |||||
---|---|---|---|---|---|
Increase | Decrease | Study | Specimens | Analytical Technique | Reference |
glutamine, valine | patients after stroke < 72 h | liquid blood component | 1H NMR | [80] | |
histidine, isoleucine, leucine, methionine, proline, threonine | patients after stroke > 24 h | liquid blood component | MS | [181] | |
glutamine, proline, tyrosine | isoleucine, valine, tryptophan | post-stroke patients | liquid blood component | UHPLC/MS | [171] |
aspartate | isoleucine, phenylalanine, proline, serine, valine | depressed post-stroke patients | liquid blood component | GC/MS | [182] |
glutamate, tryptophan | alanine, leucine, isoleucine, methionine, proline, serine, tyrosine | post-stroke patients < 7 days | liquid blood component | GC/MS | [81] |
glycine, proline, serine, threonine, lysine, isoleucine, alanine | patients with acute stroke | liquid blood component | GC/MS | [183] | |
glutamate, cystine | proline | patients after stroke day 1 | liquid blood component | ion exchange chromatography | [184] |
glutamate, glycine, tyrosine, arginine, threonine, valine, leucine, phenylalanine | glutamine | patients after stroke day 5 | liquid blood component | ion exchange chromatography | [184] |
BCAAs, BCKAs | alanine, glutamine, tyrosine, lysine | rats 4VO, 3 h | liquid blood component | 1H NMR | [84,86] |
BCAAs, BCKAs, phenylalanine | alanine, glutamine, tyrosine, lysine | rats 4VO, 24 h | liquid blood component | 1H NMR | [84,86] |
BCAAs, phenylalanine, lysine | rats 4VO, 72 h | liquid blood component | 1H NMR | [84,86] | |
lysine | tyrosine | rat 3 months, day 2 after MCAO | liquid blood component | 1H NMR | [185] |
lysine, isoleucine | tyrosine, proline, threonine | rat 12 months, day 2 after MCAO | liquid blood component | 1H NMR | [185] |
glutamate, aspartate, GABA | cats, global model of cerebral ischemia, up to 20 h | extracellular dialysate | microdialysis | [186] | |
benign group increased arginine, asparagine, BCAAs, methionine, phenylalanine, serine, and threonine against malignant group | patients with large middle cerebral artery infarction | extracellular dialysate | microdialysis | [17] |
5.4. Issues Related to Metabolomic Studies of Cerebral Ischemia
- (i)
- (ii)
- In experimental studies, both the model selection, severity of ischemia, as well as the selection of suitable and relevant control groups affected the results. As we showed previously, differences in findings were observed in comparison to naïve animals and to sham-operated animals [84].
- (iii)
- In human studies, stroke risk factors, such as diabetes, hypertension, dyslipidemia, and metabolic and vascular diseases, conferred distinct metabolic profiles; it is not known whether groups matched for such characteristics would retain implied significant metabolic distinctions, particularly given the limited number of participants, as a small number of observations (samples) produced a large number of variables (metabolites) [14].
- (iv)
- The data presented from human studies are often a result obtained from a mixed population regardless of the gender of subjects. Although the generalized metabolic response to ischemia is assumed to be undifferentiated between females and males, it could partially differ when evaluating very low (a subtle) levels of metabolites in blood plasma [187]. One study presented gender-specific metabolic responses in the focal cerebral ischemia of rats in relation to plant extracts [188]. The fact is that experimental studies prefer to use only one gender, mainly male animals, to determine metabolic alterations; thus, the comparison between genders is not yet fully described. Although middle-aged women have a lower risk of stroke than middle-aged men, the menopausal transition is a time when many women develop cardiovascular risk factors. Additionally, during the 10 years after menopause, the risk of stroke roughly doubles in women [189]. During and after menopause, there may occur a significant change in body composition, and many women often gain weight (in the form of fat mass), which may further result in T2 diabetes mellitus development. All these facts surely highlight the need for gender-focused metabolomic phenotyping in relation to the metabolic response to cerebral ischemia and other disorders. Similarly, there is a lack of relevant metabolomic studies on cerebral ischemia focused on race and age comparisons.
- (v)
- The functioning of the human body depends on the interaction of all organs, and injury to one can impact the others and produce compensatory/adaptation effects or secondary injuries. There is increasing evidence that the cerebral ischemic event is linked to further remote body organ/tissue damage. Post-ischemic vascular injury and BBB breakdown appear to be one of the most relevant events influencing the composition of the blood, ECF, or CSF levels of metabolites [28,190,191,192]; moreover, post-ischemic spleen atrophy, vascular and cardiac disorders [193], renal and pulmonary dysfunctions, liver injury, and alterations in pancreatic enzymes [194] are all conditions that might evolve after cerebral ischemia and therewith participate in alterations in the whole blood metabolome. Therefore, a critical and careful assessment of the observed metabolomic changes in plasma and brain extracellular fluid is necessary.
- (vi)
- Practical issues: Inappropriate blood sampling procedures might increase blood lactate, or lactate might be increased by blood cells consuming glucose in the sampling tube if the blood is not processed within 2 h. Apart from this, particular metabolites are non-specifically bound to proteins. In NMR measurements in non-deproteinated plasma, they overtook the short transverse relaxation time T2 of the near protein and became invisible in cpmg-acquisition measurements [195]. The resulting signals originate only from ‘free’ metabolites. During the protein-removing procedure, the protein-bound metabolites are released, and the intensity of the signal arises; from there, the magnitude of the signal is dependent on the amount of protein that is present.
6. Analytical Platforms in Metabolomic Usable for Monitoring Cerebral Ischemia
7. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Baranovicova, E.; Kalenska, D.; Kaplan, P.; Kovalska, M.; Tatarkova, Z.; Lehotsky, J. Blood and Brain Metabolites after Cerebral Ischemia. Int. J. Mol. Sci. 2023, 24, 17302. https://doi.org/10.3390/ijms242417302
Baranovicova E, Kalenska D, Kaplan P, Kovalska M, Tatarkova Z, Lehotsky J. Blood and Brain Metabolites after Cerebral Ischemia. International Journal of Molecular Sciences. 2023; 24(24):17302. https://doi.org/10.3390/ijms242417302
Chicago/Turabian StyleBaranovicova, Eva, Dagmar Kalenska, Peter Kaplan, Maria Kovalska, Zuzana Tatarkova, and Jan Lehotsky. 2023. "Blood and Brain Metabolites after Cerebral Ischemia" International Journal of Molecular Sciences 24, no. 24: 17302. https://doi.org/10.3390/ijms242417302