Transcriptome profiling of remote ischaemic preconditioning effects for heart surgery

Despite advances in surgery support there are unmet needs for cardiopulmonary bypass (CPB) patients being at risk of perioperative ischemia. Remote ischemic preconditioning (RIPC) is considered as adjuvant therapy, but its effects are still underexplored. Thus, we monitored transcriptomic responses from the RIPC procedure during and after cardiac surgery in a pilot study, comprising 34 samples and 10 for validation from patients. We systematically compared the response between CTRL and RIPC including individual effects and dynamics. We gratefully acknowledge the support from the study participants as part of the clinical trial (ClinicalTrials.gov ID: NCT01067703). Different individual and time-resolved patterns were found for preconditioned patients (RIPC) comprising alternated cytokine, ribosomal and stress related genes. This was confirmed by a tailored method for ranking candidates by integrating variance and expression changes at once. RNA from blood of RIPC or CTRL patients was extracted and subjected to microarray analysis for comparison of transcriptomic responses of patients undergoing CPB. RNA samples of circulating leukocytes covering time points before (T1), directly after CPB (T2) and on the first postoperative day (T3) were subject to multifactorial microarray data analysis: Differences in dynamics of transcripts were assessed by contrasting time-specific and individual-resolved changes.