Markers of Oxidative Stress and Peripheral Artery Disease

Hajjari, Jamal; Tahhan, Ayman Samman; Alkhoder, Ayman; Kaseer, Belal; Abdelhadi, Naser; Almuwaqqat, Zakaria; Gafeer, Mohamad Mazen; Choudhary, Fahad; Patel, Keyur; Patel, Arti B.; Jafri, M. Saleet; Choudhary, Muaaz; Hasnain, Laila; Qadir, Saqib; Sidoti, Arianna; Lankford, Anjali; Bhimani, Ravila; Ko, Yi‐An; Vaccarino, Viola; Sperling, Laurence; Jones, Dean P.; Quyyumi, Arshed A

doi:10.1016/s0735-1097(18)32617-2

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“…Since oxo-Pro is a degradation product of the major intracellular antioxidant glutathione [22,40], the 0.63-fold decrease in serum oxo-Pro in PAD cases as compared to non-PAD controls may indicate increased glutathione depletion and the activation of the glutathione salvage pathway that is a hallmark of deleterious oxidative stress [41,42]. This is consistent with elevated serum cystine in CTLI as compared to IC (p = 0.014), which is a biomarker of systemic oxidative stress prevalent in PAD, and is associated with adverse clinical outcomes independent yet synergistic to inflammation [43]. An opposing trend was found for serum PAG with a 1.9-fold higher concentration in PAD as compared to CON (F = 5.4, p = 0.009, effect size = 0.32).…”

Section: Discussionmentioning

confidence: 67%

Serum Metabolic Signatures of Chronic Limb-Threatening Ischemia in Patients with Peripheral Artery Disease

Zamzam

Syed

Abdin

et al. 2020

JCM

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Peripheral artery disease (PAD) is characterized by the atherosclerotic narrowing of lower limb vessels, leading to ischemic muscle pain in older persons. Some patients experience progression to advanced chronic limb-threatening ischemia (CLTI) with poor long-term survivorship. Herein, we performed serum metabolomics to reveal the mechanisms of PAD pathophysiology that may improve its diagnosis and prognosis to CLTI complementary to the ankle–brachial index (ABI) and clinical presentations. Non-targeted metabolite profiling of serum was performed by multisegment injection–capillary electrophoresis–mass spectrometry (MSI–CE–MS) from age and sex-matched, non-diabetic, PAD participants who were recruited and clinically stratified based on the Rutherford classification into CLTI (n = 18) and intermittent claudication (IC, n = 20). Compared to the non-PAD controls (n = 20), PAD patients had lower serum concentrations of creatine, histidine, lysine, oxoproline, monomethylarginine, as well as higher circulating phenylacetylglutamine (p < 0.05). Importantly, CLTI cases exhibited higher serum concentrations of carnitine, creatinine, cystine and trimethylamine-N-oxide along with lower circulating fatty acids relative to well matched IC patients. Most serum metabolites associated with PAD progression were also correlated with ABI (r = ±0.24−0.59, p < 0.05), whereas the ratio of stearic acid to carnitine, and arginine to propionylcarnitine differentiated CLTI from IC with good accuracy (AUC = 0.87, p = 4.0 × 10−5). This work provides new biochemical insights into PAD progression for the early detection and surveillance of high-risk patients who may require peripheral vascular intervention to prevent amputation and premature death.

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