Identification of key genes and metabolites in acute ischemic stroke via integrated transcriptomic and metabolomic analysis

Background: Acute ischaemic stroke (AIS) remains a leading cause of death and disability. This exploratory study integrated transcriptomic and metabolomic analyses to identify candidate hub genes and metabolites associated with AIS and to provide preliminary insights into its molecular mechanisms and potential therapeutic targets. Methods: Metabolomic sequencing data were analyzed using orthogonal partial least squares discriminant analysis (OPLS-DA), together with multivariate and univariate analyses, to identify differentially expressed metabolites (DEMs). Differential gene expression analysis was performed using the GSE16561 dataset, and key genes were screened through protein-protein interaction network analysis, machine learning, expression validation, and diagnostic evaluation. Co-enrichment analysis of key genes and DEMs was then conducted, followed by immune infiltration analysis, molecular network construction, drug prediction, and RT-qPCR validation. Results: = 2). None of the patients underwent intravenous thrombolysis or mechanical thrombectomy, all received standard medical treatment for AIS. In addition, 28 candidate drugs, including paregoric and celecoxib, were predicted. Conclusion: This exploratory study identified candidate hub genes and metabolites associated with AIS and highlighted their related pathways, immune features, molecular networks, and candidate drugs. These findings provide preliminary insights into the molecular basis and potential therapeutic targets of AIS.