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Chronic hindlimb ischemia exacerbates ischemic stroke by disrupting cerebral hemodynamics and glycerophospholipid metabolism in mice
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  • Published: 14 January 2026

Chronic hindlimb ischemia exacerbates ischemic stroke by disrupting cerebral hemodynamics and glycerophospholipid metabolism in mice

  • Fei Xiang1 na1,
  • Yuxiang Cui3 na1,
  • Shiqi Yang1,
  • Yue Fang1,
  • Bing Wang1,
  • Binting Chen1 &
  • …
  • Hong Guo1,2 

Scientific Reports , Article number:  (2026) Cite this article

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We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply.

Subjects

  • Diseases
  • Neurology
  • Neuroscience

Abstract

While clinical data firmly establish that Peripheral artery disease is linked to a higher incidence and severity of ischemic stroke, the underlying hemodynamics and metabolic mechanisms remain poorly defined. This study aimed to elucidate how chronic limb ischemia remotely exacerbates ischemic stroke outcomes through these mechanisms. Computational fluid dynamics combined with high-resolution MRI was used to quantify cerebral hemodynamics, including wall shear stress (WSS), blood flow velocity, and wall pressure. Integrative omics was applied to analyze molecular changes. Focal cerebral ischemia was induced during chronic hindlimb ischemia to assess stroke outcomes. Our results showed that both WSS and blood flow velocity were significantly decreased in the model group compared with the sham group, particularly in the middle cerebral artery. Chronic hindlimb ischemia exacerbated brain edema, increased infarct volume by 1.5-fold, and worsened neurological deficits. Integrated omics analysis revealed disturbances in glycerophospholipid metabolism and identified phosphate cytidylyltransferase 2 (PCYT2) as a key upregulated protein. Crucially, in vivo functional validation demonstrated that silencing PCYT2 conferred significant neuroprotection, reducing infarct volume and improving neurological outcomes. These findings enhance our understanding of the pathogenesis mechanisms by which chronic limb ischemia aggravates ischemic stroke and provide new insights into its prevention and treatment.

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Data availability

The data supporting the findings of this study are available from the corresponding author upon reasonable request.

References

  1. Pu, L. et al. Projected global trends in ischemic stroke incidence, deaths and disability-adjusted life years from 2020 to 2030. Stroke 54(5), 1330–1339 (2023).

    Google Scholar 

  2. Mandaglio-Collados, D., Marin, F. & Rivera-Caravaca, J. M. Peripheral artery disease: Update on etiology, pathophysiology, diagnosis and treatment. Med. Clin. (Barc). 161(8), 344–350. https://doi.org/10.1016/j.medcli.2023.06.005 (2023).

    Google Scholar 

  3. Cheshire, B. L., Messeder, S. J., Pepper, C. J., Beishon L. C., Sayers R. D., Houghton, J. S., Association of cognitive impairment and peripheral artery disease (PAD): A systematic review. In Vascular medicine. (2025): 1358863X251336736.

  4. Song, J. Y. & Kwon, S. U. Intracranial atherosclerotic stenosis. Cerebrovasc Dis. Extra. 15(1), 62–67. https://doi.org/10.1159/000543356 (2025).

    Google Scholar 

  5. Yu, L. et al. Remote limb ischemic postconditioning inhibits microglia pyroptosis by modulating HGF after acute ischemia stroke. Bioeng Transl. Med. 8(6), e10590. https://doi.org/10.1002/btm2.10590 (2023).

    Google Scholar 

  6. Valsecchi, V. et al. The hypoxia sensitive metal transcription factor MTF-1 activates NCX1 brain promoter and participates in remote postconditioning neuroprotection in stroke. Cell Death Dis. 12(5), 423. https://doi.org/10.1038/s41419-021-03705-9 (2021).

    Google Scholar 

  7. Cuomo, O. et al. Systemic administration of blood-derived exosomes induced by remote ischemic post-conditioning, by delivering a specific cluster of miRNAs, ameliorates ischemic damage and neurological function. J. Cereb. Blood Flow Metab. 44(12), 1459–1471. https://doi.org/10.1177/0271678X241270284 (2024).

    Google Scholar 

  8. Saglietto, A. et al. Role of the vessel morphology on the lenticulostriate arteries hemodynamics during atrial fibrillation: A CFD-based multivariate regression analysis. Comput. Method. Programs Biomed. 254, 108303. https://doi.org/10.1016/j.cmpb.2024.108303 (2024).

    Google Scholar 

  9. Chen, Y. et al. Non-invasive assessment of intracranial wall shear stress using high-resolution magnetic resonance imaging in combination with computational fluid dynamics technique. Fundam. Res. 2(2), 329–334. https://doi.org/10.1016/j.fmre.2021.09.019 (2022).

    Google Scholar 

  10. Hattori, Y. et al. High middle cerebral artery wall shear stress in branch atheromatous disease: A computational fluid dynamics analysis. J. Atheroscler. Thromb. https://doi.org/10.5551/jat.65439 (2025).

    Google Scholar 

  11. Zhou, M. et al. Wall shear stress and its role in atherosclerosis. Front. Cardiovascular Med. 10, 1083547 (2023).

    Google Scholar 

  12. Paapstel, K. et al. Inverse relations of serum phosphatidylcholines and lysophosphatidylcholines with vascular damage and heart rate in patients with atherosclerosis. Nutr. Metab. Cardiovasc. Dis. 28(1), 44–52. https://doi.org/10.1016/j.numecd.2017.07.011 (2018).

    Google Scholar 

  13. Ismaeel, A. et al. Altered metabolomic profile in patients with peripheral artery disease. J. Clin. Med. 8(9), 1463. https://doi.org/10.3390/jcm8091463 (2019).

    Google Scholar 

  14. Yao, C. et al. Tryptophan metabolism and ischemic stroke: An intricate balance. Neur. Regen. Res. 21(2), 466–477. https://doi.org/10.4103/NRR.NRR-D-24-00777 (2026).

    Google Scholar 

  15. Wang, S. Q. et al. Assessing the causal relationships between lipid species and stroke by using mendelian randomization. Mol. Neurobiol. 62(6), 7174–7182. https://doi.org/10.1007/s12035-025-04697-9 (2025).

    Google Scholar 

  16. Ismaeel, A., Lavado, R. & Koutakis, P. Metabolomics of peripheral artery disease. Adv. Clin. Chem. 106, 67–89. https://doi.org/10.1016/bs.acc.2021.09.004 (2022).

    Google Scholar 

  17. Lin, S. et al. Neutrophil extracellular traps induced by IL-1beta promote endothelial dysfunction and aggravate limb ischemia. Hypertens Res. 47(6), 1654–1667. https://doi.org/10.1038/s41440-024-01661-3 (2024).

    Google Scholar 

  18. Li, Y. et al. A labeling strategy for the three-dimensional recognition and analysis of microvascular obstruction in ischemic stroke. Theranostics. 13(1), 403–416. https://doi.org/10.7150/thno.76879 (2023).

    Google Scholar 

  19. Longa, E. Z., Weinstein, P. R., Carlson, S. & Cummins, R. Reversible middle cerebral artery occlusion without craniectomy in rats. Stroke 20(1), 84–91 (1989).

    Google Scholar 

  20. Chen, Y., Liao, L., Wang, B. & Wu, Z. Identification and validation of immune and cuproptosis—Related genes for diabetic nephropathy by WGCNA and machine learning. Front. Immunol. 15, 1332279. https://doi.org/10.3389/fimmu.2024.1332279 (2024).

    Google Scholar 

  21. Wang, X. et al. POU class 2 Homeobox associating factor 1, as a hub candidate gene in OP relieves osteoblast apoptosis. Appl. Biochem. Biotechnol. 196(9), 6072–6096. https://doi.org/10.1007/s12010-023-04833-y (2024).

    Google Scholar 

  22. Xu, M. et al. Identification and validation of immune and oxidative stress-related diagnostic markers for diabetic nephropathy by WGCNA and machine learning. Front. Immunol. 14, 1084531. https://doi.org/10.3389/fimmu.2023.1084531 (2023).

    Google Scholar 

  23. Zhang, F. et al. Using machine learning to identify proteomic and metabolomic signatures of stroke in atrial fibrillation. Comput. Biol. Med. 173, 108375. https://doi.org/10.1016/j.compbiomed.2024.108375 (2024).

    Google Scholar 

  24. Wisniewski, K. et al. Computational fluid dynamics; A new diagnostic tool in giant intracerebral aneurysm treatment. Comput. Biol. Med. 181, 109053. https://doi.org/10.1016/j.compbiomed.2024.109053 (2024).

    Google Scholar 

  25. Salinet, A. S. et al. Impaired cerebral autoregulation and neurovascular coupling in middle cerebral artery stroke: Influence of severity. J. Cereb. Blood Flow Metab. 39(11), 2277–2285. https://doi.org/10.1177/0271678X18794835 (2019).

    Google Scholar 

  26. Xu, M. Y. et al. Urolithin A promotes atherosclerotic plaque stability by limiting inflammation and hypercholesteremia in Apolipoprotein E-deficient mice. Acta. Pharmacol. Sin. 45(11), 2277–2289. https://doi.org/10.1038/s41401-024-01317-5 (2024).

    Google Scholar 

  27. Villa-Roel, N. et al. Hypoxia inducible factor 1alpha inhibitor PX-478 reduces atherosclerosis in mice. Atherosclerosis 344, 20–30. https://doi.org/10.1016/j.atherosclerosis.2022.01.002 (2022).

    Google Scholar 

  28. Yang, J. et al. Ertugliflozin attenuates atherosclerosis in nondiabetic ApoE(-/-) mice by upregulating ABCA1 and LDLR via the PPARgamma/LXRalpha pathway. Biochim. Biophys. Acta. Mol. Basis Dis. 1871(7), 167927. https://doi.org/10.1016/j.bbadis.2025.167927 (2025).

    Google Scholar 

  29. Webb, A. J. S., Paolucci, M., Mazzucco, S., Li, L. & Rothwell, P. M. Oxford vascular study phenotyped C. Confounding of cerebral blood flow velocity by blood pressure during breath holding or hyperventilation in transient ischemic attack or stroke. Stroke 51(2), 468–474. https://doi.org/10.1161/STROKEAHA.119.027829 (2020).

    Google Scholar 

  30. Chuang, S. Y. et al. Blood pressure, carotid flow pulsatility, and the risk of stroke: A community-based study. Stroke 47(9), 2262–2268. https://doi.org/10.1161/STROKEAHA.116.013207 (2016).

    Google Scholar 

  31. Hartman, E. M. J. et al. Wall shear stress-related plaque growth of lipid-rich plaques in human coronary arteries: An near-infrared spectroscopy and optical coherence tomography study. Cardiovasc. Res. 119(4), 1021–1029. https://doi.org/10.1093/cvr/cvac178 (2023).

    Google Scholar 

  32. Woo, H. G. et al. Wall shear stress associated with stroke occurrence and mechanisms in middle cerebral artery atherosclerosis. J. Stroke. 25(1), 132–140. https://doi.org/10.5853/jos.2022.02754 (2023).

    Google Scholar 

  33. Sui, B. et al. Hemodynamics parameters distribution of upstream, stenosis center, and downstream sides of plaques in carotid artery with different stenosis: A MRI and CFD study. Acta. Radiol. 56(3), 347–354. https://doi.org/10.1177/0284185114526713 (2015).

    Google Scholar 

  34. Sandeep, S. & Shine, S. R. Effect of stenosis and dilatation on the hemodynamics parameters associated with left coronary artery. Comput. Method. Progr. Biomed. 204, 106052. https://doi.org/10.1016/j.cmpb.2021.106052 (2021).

    Google Scholar 

  35. Jia, Q. et al. Combination of magnetic resonance angiography and computational fluid dynamics may predict the risk of stroke in patients with asymptomatic carotid plaques. Med. Sci. Monit. 23, 479–488. https://doi.org/10.12659/msm.902995 (2017).

    Google Scholar 

  36. Sarkar, P., Kumar, A., Behera, P. S. & Thirumurugan, K. Phytotherapeutic targeting of the mitochondria in neurodegenerative disorders. Adv. Protein Chem. Struct. Biol. 136, 415–455. https://doi.org/10.1016/bs.apcsb.2023.02.013 (2023).

    Google Scholar 

  37. Zheng, M., Wang, W., Liu, J., Zhang, X. & Zhang, R. Lipid metabolism in cancer cells. Adv. Exp. Med. Biol. 1316, 49–69. https://doi.org/10.1007/978-981-33-6785-2_4 (2021).

    Google Scholar 

  38. Rangholia, N., Leisner, T. M. & Holly, S. P. Bioactive ether lipids: Primordial modulators of cellular signaling. Metabolites 11(1), 41. https://doi.org/10.3390/metabo11010041 (2021).

    Google Scholar 

  39. Tang, H. et al. Glycerophospholipid and sphingosine- 1-phosphate metabolism in cardiovascular disease: Mechanisms and therapeutic potential. J. Cardiovasc. Transl. Res. https://doi.org/10.1007/s12265-025-10620-3 (2025).

    Google Scholar 

  40. Lacolley, P., Regnault, V. & Laurent, S. Mechanisms of arterial stiffening: From Mechanotransduction to epigenetics. Arterioscler Thromb. Vasc. Biol. 40(5), 1055–1062. https://doi.org/10.1161/ATVBAHA.119.313129 (2020).

    Google Scholar 

  41. Du, L. D. et al. MMP-9 inhibitor SB-3CT improves neurological outcomes in ischemic stroke mice by modulation of astrocytic lipid metabolism. Acta. Pharmacol. Sin. 46(8), 2120–2135. https://doi.org/10.1038/s41401-025-01505-x (2025).

    Google Scholar 

  42. De Winter, J., Beijer, D., De Ridder, W., Synofzik, M., Zuchner, S. L., consortium P, et al. PCYT2 mutations disrupting etherlipid biosynthesis: phenotypes converging on the CDP-ethanolamine pathway. Brain. 2021;144(2):e17. Epub 2020/11/25. https://doi.org/10.1093/brain/awaa389. PubMed PMID: 33230519.

  43. Wei, Z. et al. p75NTR enhances cognitive dysfunction in a mouse Alzheimer’s disease model by inhibiting microRNA-210–3p-mediated PCYT2 through activation of NF-kappaB. Int. J. Biol. Macromol. 225, 404–415. https://doi.org/10.1016/j.ijbiomac.2022.11.078 (2023).

    Google Scholar 

  44. van Ijzendoorn SC, Agnetti J, Gassama-Diagne A. 2020 Mechanisms behind the polarized distribution of lipids in epithelial cells. Biochimica et Biophysica Acta (BBA) Biomembranes. 1862 (2): 183145.

  45. Hirata, T., Yamamoto, K., Ikeda, K. & Arita, M. Functional lipidomics of vascular endothelial cells in response to laminar shear stress. FASEB J. 35(2), e21301 (2021).

    Google Scholar 

  46. Knuplez, E. & Marsche, G. An updated review of pro-and anti-inflammatory properties of plasma lysophosphatidylcholines in the vascular system. Int. J. Mol. Sci. 21(12), 4501 (2020).

    Google Scholar 

  47. Parnova, R. Critical role of endothelial lysophosphatidylcholine transporter Mfsd2a in maintaining blood–brain barrier integrity and delivering omega 3 PUFA to the brain. J. Evol. Biochem. Physiol. 58(3), 742–754 (2022).

    Google Scholar 

  48. Zhang, L. et al. Vascular lipidomics analysis reveales increased levels of phosphocholine and lysophosphocholine in atherosclerotic mice. Nutr. Metab. 20(1), 1 (2023).

    Google Scholar 

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Funding

This work was supported by the National Natural Science Foundation of China (No.81874281 to Hong Guo).

Author information

Author notes
  1. Fei Xiang and Yuxiang Cui have equally contributed to this work.

Authors and Affiliations

  1. Department of Cardiology, The First Affiliated Hospital of Harbin Medical University, 23 Youzheng Street, Nangang District, Harbin, 150001, China

    Fei Xiang, Shiqi Yang, Yue Fang, Bing Wang, Binting Chen & Hong Guo

  2. Key Laboratory of Acoustic Photoelectric Magnetic Diagnosis and Treatment of Cardiovascular Diseases, The First Affiliated Hospital of Harbin Medical University, Heilongjiang Province, Harbin, 150001, China

    Hong Guo

  3. Department of Emergency Medicine, The First Affiliated Hospital of Harbin Medical University, 23 Youzheng Street, Nangang District, Harbin, 150001, China

    Yuxiang Cui

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Contributions

F. X. and Y. C.: Formal Analysis, Methodology, Writing—original draft, review and editing, Software. S. Y.: Methodology. Y. F.: Data Curation, Formal Analysis. B. W.: Data Curation. B.C.: Validation. H.G.: Funding Acquisition, Project administration, Writing—original draft, review and editing.

Corresponding author

Correspondence to Hong Guo.

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The authors declare no competing interests.

Ethical approval

All animal procedures were approved by the Institutional Animal Care and Use Committee of The First Affiliated Hospital of Harbin Medical University, Harbin, China, and performed in accordance with the Animal Research: Reporting of in vivo Experiments (ARRIVE) guidelines and institutional ethical standards. (Approval No.: 2024046).

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Xiang, F., Cui, Y., Yang, S. et al. Chronic hindlimb ischemia exacerbates ischemic stroke by disrupting cerebral hemodynamics and glycerophospholipid metabolism in mice. Sci Rep (2026). https://doi.org/10.1038/s41598-025-34372-x

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  • Received: 28 September 2025

  • Accepted: 28 December 2025

  • Published: 14 January 2026

  • DOI: https://doi.org/10.1038/s41598-025-34372-x

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Keywords

  • Peripheral arterial disease
  • Ischemic stroke
  • Hemodynamics
  • Blood flow velocity
  • Proteomics
  • Metabolomics
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