Proteomic analysis of the chnages in blood induced by therapeutic hypothermia

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Therapeutic hypothermia after cardiac arrest is increasingly utilized, but its pleiotropic effects are as yet incompletely elucidated. In order to analyze these mechanisms, we comparatively investigated plasma proteomic changes induced by both induction of hypothermia and rewarming in nine patients undergoing therapeutic hypothermia. We utilized iTRAQ labeling tandem mass spectrometry to assess quantitative protein changes. In total, the analysis identified 188 proteins. Bioinformatic analyses showed significant up-regulation of serine protease inhibitor and defense/immunity protein at hypothermia. After rewarming, both apolipoprotein and complement component proteins were also significantly up-regulated. Out of nine patients, three patients have recovered without any neurological complications, but the other six patients have had serious neurological defects. These outcomes were associated with the levels of several proteins belonging to oxidative stress and innate immunity.