Plasma proteomic analysis of the critical limb ischemia markers in diabetic patients with hemodialysis

Critical limb ischemia (CLI) is a severe obstruction of the arteries resulting from seriously decreased blood flow to the extremities, progressing to the point of pain and even skin ulcers or sores. CLI is associated with a high percentage of limb loss and mortality; however, no reliable biochemical indices are available to monitor the stages of CLI. We developed a strategy involving comparative proteomic analysis to detect CLI associated plasma biomarkers. 2D-DIGE and subsequent MALDI-TOF MS analyses provided 50 differentially expressed plasma proteins (including alkaline phosphatase and haptoglobin), between hemodialytic diabetic patients with and without CLI. Interestingly, more than half of the differentially expressed plasma proteins are associated with inflammatory responses. Our results show that CLI is strongly correlated to inflammation, indicating a strong potential for proteomics analysis in the diagnosis of CLI. To the best of our knowledge, this is the first report presenting a proteomics approach to monitor differentially expressed plasma proteins associated with CLI.