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Turner N, Farrow B, Betrie AH, Finnis ME, Lankadeva YR, Sharman J, Tan P, Abdelhamid YA, Deane AM, Plummer MP. Cerebrospinal fluid and plasma ascorbate concentrations following subarachnoid haemorrhage. CRIT CARE RESUSC 2023; 25:175-181. [PMID: 38234324 PMCID: PMC10790009 DOI: 10.1016/j.ccrj.2023.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 10/08/2023] [Indexed: 01/19/2024]
Abstract
Background Ascorbate, the biologically active form of vitamin C, is the primary neural anti-oxidant. Ascorbate concentrations have never been quantified following aneurysmal subarachnoid haemorrhage (aSAH). Objective To quantify plasma and cerebrospinal fluid (CSF) ascorbate concentrations in patients following SAH. Design Setting Participants Main Outcome Measures Cohort study in which plasma and CSF ascorbate concentrations were measured longitudinally in 12 aSAH patients admitted to a quaternary referral intensive care unit and compared to one-off samples obtained from 20 pregnant women prior to delivery in a co-located obstetric hospital. Data are median [interquartile range] or median (95 % confidence intervals). Results Forty-eight plasma samples were obtained from the 12 aSAH patients (eight females, age 62 [53-68] years). Eight participants with extra-ventricular drains provided 31 paired CSF-plasma samples. Single plasma and CSF samples were obtained from 20 pregnant women (age 35 [31-37] years). Initial plasma and CSF ascorbate concentrations post aSAH were less than half those in pregnant controls (plasma: aSAH: 31 [25-39] μmol/L vs. comparator: 64 [59-77] μmol/L; P < 0.001 and CSF: 116 [80-142] μmol/L vs. 252 [240-288] μmol/L; P < 0.001). Post aSAH there was a gradual reduction in the CSF:plasma ascorbate ratio from ∼4:1 to ∼1:1. Six (50 %) patients developed vasospasm and CSF ascorbate concentrations were lower in these patients (vasospasm: 61 (25, 97) vs. no vasospasm: 110 (96, 125) μmol/L; P = 0.01). Conclusion Post aSAH there is a marked reduction in CSF ascorbate concentration that is most prominent in those who develop vasospasm.
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Affiliation(s)
- Natasha Turner
- Intensive Care Unit, Royal Melbourne Hospital, Melbourne, Victoria 3050, Australia
| | - Brodie Farrow
- Intensive Care Unit, Royal Melbourne Hospital, Melbourne, Victoria 3050, Australia
| | - Ashenafi H. Betrie
- Pre-clinical Critical Care Unit, Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria 3052, Australia
- Translational Neurodegeneration Laboratory, Florey Institute of Neuroscience and Mental Health, Health, Melbourne, Victoria 3052, Australia
| | - Mark E. Finnis
- Department of Critical Care, Melbourne Medical School, University of Melbourne, Melbourne, Victoria 3010, Australia
- Intensive Care Unit Research, Royal Adelaide Hospital, Adelaide, South Australia 5000, Australia
| | - Yugeesh R. Lankadeva
- Pre-clinical Critical Care Unit, Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria 3052, Australia
- Department of Critical Care, Melbourne Medical School, University of Melbourne, Melbourne, Victoria 3010, Australia
| | - Jeremy Sharman
- Intensive Care Unit, Royal Melbourne Hospital, Melbourne, Victoria 3050, Australia
| | - Patrick Tan
- Department of Critical Care, Melbourne Medical School, University of Melbourne, Melbourne, Victoria 3010, Australia
- Department of Anaesthesia, The Royal Women's Hospital, Grattan Street & Flemington Road, Melbourne, Victoria 3052, Australia
| | - Yasmine Ali Abdelhamid
- Intensive Care Unit, Royal Melbourne Hospital, Melbourne, Victoria 3050, Australia
- Department of Critical Care, Melbourne Medical School, University of Melbourne, Melbourne, Victoria 3010, Australia
| | - Adam M. Deane
- Intensive Care Unit, Royal Melbourne Hospital, Melbourne, Victoria 3050, Australia
- Department of Critical Care, Melbourne Medical School, University of Melbourne, Melbourne, Victoria 3010, Australia
| | - Mark P. Plummer
- Department of Critical Care, Melbourne Medical School, University of Melbourne, Melbourne, Victoria 3010, Australia
- Intensive Care Unit Research, Royal Adelaide Hospital, Adelaide, South Australia 5000, Australia
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Sadeghzadeh J, Hosseini L, Mobed A, Zangbar HS, Jafarzadeh J, Pasban J, Shahabi P. The Impact of Cerebral Ischemia on Antioxidant Enzymes Activity and Neuronal Damage in the Hippocampus. Cell Mol Neurobiol 2023; 43:3915-3928. [PMID: 37740074 DOI: 10.1007/s10571-023-01413-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 09/09/2023] [Indexed: 09/24/2023]
Abstract
Cerebral ischemia and subsequent reperfusion, leading to reduced blood supply to specific brain areas, remain significant contributors to neurological damage, disability, and mortality. Among the vulnerable regions, the subcortical areas, including the hippocampus, are particularly susceptible to ischemia-induced injuries, with the extent of damage influenced by the different stages of ischemia. Neural tissue undergoes various changes and damage due to intricate biochemical reactions involving free radicals, oxidative stress, inflammatory responses, and glutamate toxicity. The consequences of these processes can result in irreversible harm. Notably, free radicals play a pivotal role in the neuropathological mechanisms following ischemia, contributing to oxidative stress. Therefore, the function of antioxidant enzymes after ischemia becomes crucial in preventing hippocampal damage caused by oxidative stress. This study explores hippocampal neuronal damage and enzymatic antioxidant activity during ischemia and reperfusion's early and late stages.
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Affiliation(s)
- Jafar Sadeghzadeh
- Department of Neuroscience and Cognition, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran
| | - Leila Hosseini
- Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran
| | - Ahmad Mobed
- Physical Medicine and Rehabilitation Research Center, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran
| | - Hamid Soltani Zangbar
- Department of Neuroscience and Cognition, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran
| | - Jaber Jafarzadeh
- Department of Community Nutrition Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran
| | - Jamshid Pasban
- Department of Neuroscience and Cognition, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran
| | - Parviz Shahabi
- Department of Physiology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran.
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Elhamrawy EA, Shoman H, Abdel-Tawab H, Bahbah EI, Elattar RS, Hussein NR, Sonbol M, Elsheikh AA. Oxidative stress and early mortality in acute ischemic stroke: A prospective cohort study. Neurol Res 2023; 45:1003-1010. [PMID: 37652662 DOI: 10.1080/01616412.2023.2252284] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 08/21/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND Malondialdehyde (MDA) is an oxidative stress biomarker, which represents a unifying mechanism of brain injury that occurs throughout the ischemic stroke cascade. The current study aimed to examine whether or not acute ischemic stroke (AIS) patients who had elevated serum MDA levels at admission had an increased risk of mortality and a worse functional outcome three months later. METHODS An observational, prospective cohort study that enrolled 90 patients with AIS. The patients were examined in the first 24 hours and then followed up for three months to assess mortality, short-term neurological functional outcome, and neurological disability by the Modified Rankin Scale (MRS). RESULTS The mean of serum MDA level among AIS patients was 6.3 ± 3.7 nmol/ml. Non-survivor cases were associated with statistically significantly higher serum MDA levels compared to survivors (9.7 ± 4.3 vs. 5.3 ± 2.8, p < 0.001), respectively. Patients with severe stroke, according to NIHSS score, were associated with significantly (p < 0.05) higher MDA levels compared to moderate and mild cases (7.4 ± 4.3 vs. 5.4 ± 2.6 vs. 3.3 ± .6). At a cutoff point of ≥ 6.7 nmol/ml, the area under the curve (AUC) for serum MDA levels as a predictor of mortality was 0.8 (0.69-0.91; p < 0.05). The sensitivity, specificity, positive predictive value, and negative predictive value were 77%, 80%, 89.5%, and 48.5%, respectively. Multivariate regression demonstrated that MDA level was a significant independent predictor of mortality among patients with AIS (OR = 1.29, 95% CI: 1.01 to 1.65; p = 0.041). CONCLUSION MDA serum level was significantly higher in non-survivors than in survivors patients, so MDA could be used as a predictor for early mortality and short-term outcome of cases with AIS.
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Affiliation(s)
- Eman A Elhamrawy
- Department of Neurology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Heba Shoman
- Department of Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Hayam Abdel-Tawab
- Department of Neurology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Eshak I Bahbah
- Faculty of Medicine, Al-Azhar University, Damietta, Egypt
| | - Rasha Sobhy Elattar
- Department of Neurology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Naema R Hussein
- Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Marwa Sonbol
- Department of Radiology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Asmaa AbdElghany Elsheikh
- Department of Community and Occupational Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
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4
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Feng S, Yang M, Liu S, He Y, Deng S, Gong Y. Oxidative stress as a bridge between age and stroke: A narrative review. JOURNAL OF INTENSIVE MEDICINE 2023; 3:313-319. [PMID: 38028635 PMCID: PMC10658045 DOI: 10.1016/j.jointm.2023.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 12/09/2022] [Accepted: 02/07/2023] [Indexed: 12/01/2023]
Abstract
Stroke is the third most common cause of death globally and a leading cause of disability. The cellular and molecular changes following stroke and causes of neuronal death are not fully understood, and there are few effective treatments currently available. A rapid increase in the levels of reactive oxygen species (ROS) post stroke can overwhelm antioxidant defenses and trigger a series of pathophysiologic events including the inflammatory response, blood-brain barrier (BBB) disruption, apoptosis, and autophagy, ultimately leading to neuron degeneration and apoptosis. It is thought that beyond a certain age, the ROS accumulation resulting from stroke increases the risk of morbidity and mortality. In the present review, we summarize the role of oxidative stress (OS) as a link between aging and stroke pathogenesis. We also discuss how antioxidants can play a beneficial role in the prevention and treatment of stroke by eliminating harmful ROS, delaying aging, and alleviating damage to neurons.
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Affiliation(s)
- Shengjie Feng
- Department of Critical Care Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Miaoxian Yang
- Department of Critical Care Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Shengpeng Liu
- Department of Pediatrics, Shenzhen People's Hospital, The Second Clinical Medical College of Jinan University, Shenzhen, Guangdong, 518020,China
| | - Yu He
- Department of Critical Care Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Shuixiang Deng
- Department of Critical Care Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Ye Gong
- Department of Critical Care Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai 200040, China
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5
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Li Y, Schappell LE, Polizu C, DiPersio J, Tsirka SE, Halterman MW, Nadkarni NA. Evolving Clinical-Translational Investigations of Cerebroprotection in Ischemic Stroke. J Clin Med 2023; 12:6715. [PMID: 37959180 PMCID: PMC10649331 DOI: 10.3390/jcm12216715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 10/17/2023] [Accepted: 10/19/2023] [Indexed: 11/15/2023] Open
Abstract
Ischemic stroke is a highly morbid disease, with over 50% of large vessel stroke (middle cerebral artery or internal carotid artery terminus occlusion) patients suffering disability despite maximal acute reperfusion therapy with thrombolysis and thrombectomy. The discovery of the ischemic penumbra in the 1980s laid the foundation for a salvageable territory in ischemic stroke. Since then, the concept of neuroprotection has been a focus of post-stroke care to (1) minimize the conversion from penumbra to core irreversible infarct, (2) limit secondary damage from ischemia-reperfusion injury, inflammation, and excitotoxicity and (3) to encourage tissue repair. However, despite multiple studies, the preclinical-clinical research enterprise has not yet created an agent that mitigates post-stroke outcomes beyond thrombolysis and mechanical clot retrieval. These translational gaps have not deterred the scientific community as agents are under continuous investigation. The NIH has recently promoted the concept of cerebroprotection to consider the whole brain post-stroke rather than just the neurons. This review will briefly outline the translational science of past, current, and emerging breakthroughs in cerebroprotection and use of these foundational ideas to develop a novel paradigm for optimizing stroke outcomes.
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Affiliation(s)
- Yinghui Li
- Department of Neurology, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794-8651, USA; (Y.L.); (L.E.S.); (C.P.); (J.D.); (M.W.H.)
| | - Laurel E. Schappell
- Department of Neurology, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794-8651, USA; (Y.L.); (L.E.S.); (C.P.); (J.D.); (M.W.H.)
- Department of Pharmacological Sciences, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794-8651, USA;
| | - Claire Polizu
- Department of Neurology, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794-8651, USA; (Y.L.); (L.E.S.); (C.P.); (J.D.); (M.W.H.)
| | - James DiPersio
- Department of Neurology, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794-8651, USA; (Y.L.); (L.E.S.); (C.P.); (J.D.); (M.W.H.)
| | - Stella E. Tsirka
- Department of Pharmacological Sciences, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794-8651, USA;
| | - Marc W. Halterman
- Department of Neurology, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794-8651, USA; (Y.L.); (L.E.S.); (C.P.); (J.D.); (M.W.H.)
| | - Neil A. Nadkarni
- Department of Neurology, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794-8651, USA; (Y.L.); (L.E.S.); (C.P.); (J.D.); (M.W.H.)
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6
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Farashi S, Shahidi S, Sarihi A, Zarei M. Association of vitamin A and its organic compounds with stroke - a systematic review and meta-analysis. Nutr Neurosci 2023; 26:960-974. [PMID: 36004815 DOI: 10.1080/1028415x.2022.2111746] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
PURPOSE The main purpose of this systematic review was to evaluate the association between the stroke (risk of stroke and the mortality due to stroke) and vitamin A, its organic compounds and its provitamins. METHOD Major databases including PubMed, Scopus, and Web of Science were searched. Studies with human samples were included for risk assessment. The association was assessed using odds ratio (log(OR)) and a random-effect model. I2 statistic, variance (tau2) and prediction interval were used for heterogeneity assessment. The funnel plot was used for publication bias. RESULTS Twenty-one studies including 5789 stroke patients were retrieved. Twenty studies had sufficient information for quantitative analyses. The pooled effect showed an inverse association between vitamin A and its organic compound with the risk of stroke (log(OR) = -0.46 95%CI (-0.81;-0.12)) and with the risk of mortality due to stroke (log(OR) = -0.39 95%CI (-0.74;-0.04)). However, according to subgroup analyses, the association was dependent on the compound in a way that retinol and beta-carotene were the most effective compounds. The effects of several confounding factors and the threshold levels for vitamin A and its organic compound on the effectiveness were discussed. CONCLUSION Insufficiency of retinol and beta-carotene significantly increased the risk of stroke; however, due to heterogeneity between studies more studies are needed for evaluating clinical significance of this outcome.
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Affiliation(s)
- Sajjad Farashi
- Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
- Autism Spectrum Disorders Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Siamak Shahidi
- Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
- Department of Physiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Abdolrahman Sarihi
- Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
- Department of Physiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohammad Zarei
- Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
- Department of Physiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
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Bagheri S, Haddadi R, Saki S, Kourosh-Arami M, Rashno M, Mojaver A, Komaki A. Neuroprotective effects of coenzyme Q10 on neurological diseases: a review article. Front Neurosci 2023; 17:1188839. [PMID: 37424991 PMCID: PMC10326389 DOI: 10.3389/fnins.2023.1188839] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 05/22/2023] [Indexed: 07/11/2023] Open
Abstract
Neurological disorders affect the nervous system. Biochemical, structural, or electrical abnormalities in the spinal cord, brain, or other nerves lead to different symptoms, including muscle weakness, paralysis, poor coordination, seizures, loss of sensation, and pain. There are many recognized neurological diseases, like epilepsy, Alzheimer's disease (AD), Parkinson's disease (PD), multiple sclerosis (MS), stroke, autosomal recessive cerebellar ataxia 2 (ARCA2), Leber's hereditary optic neuropathy (LHON), and spinocerebellar ataxia autosomal recessive 9 (SCAR9). Different agents, such as coenzyme Q10 (CoQ10), exert neuroprotective effects against neuronal damage. Online databases, such as Scopus, Google Scholar, Web of Science, and PubMed/MEDLINE were systematically searched until December 2020 using keywords, including review, neurological disorders, and CoQ10. CoQ10 is endogenously produced in the body and also can be found in supplements or foods. CoQ10 has antioxidant and anti-inflammatory effects and plays a role in energy production and mitochondria stabilization, which are mechanisms, by which CoQ10 exerts its neuroprotective effects. Thus, in this review, we discussed the association between CoQ10 and neurological diseases, including AD, depression, MS, epilepsy, PD, LHON, ARCA2, SCAR9, and stroke. In addition, new therapeutic targets were introduced for the next drug discoveries.
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Affiliation(s)
- Shokufeh Bagheri
- Department of Neuroscience, School of Science and Advanced Technologies in Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Rasool Haddadi
- Department of Pharmacology, School of Pharmacy, Hamadan University of Medical Science, Hamadan, Iran
| | - Sahar Saki
- Department of Neuroscience, School of Science and Advanced Technologies in Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Masoumeh Kourosh-Arami
- Department of Neuroscience, School of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Masome Rashno
- Asadabad School of Medical Sciences, Asadabad, Iran
- Student Research Committee, Asadabad School of Medical Sciences, Asadabad, Iran
| | - Ali Mojaver
- Department of Neuroscience, School of Science and Advanced Technologies in Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Alireza Komaki
- Department of Neuroscience, School of Science and Advanced Technologies in Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
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Kim M, Jeon H, Chung Y, Lee SU, Park W, Park JC, Ahn JS, Lee S. Efficacy of Acetylcysteine and Selenium in Aneurysmal Subarachnoid Hemorrhage Patients: A Prospective, Multicenter, Single Blind Randomized Controlled Trial. J Korean Med Sci 2023; 38:e161. [PMID: 37270916 DOI: 10.3346/jkms.2023.38.e161] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 02/16/2023] [Indexed: 06/06/2023] Open
Abstract
BACKGROUND Subarachnoid hemorrhage (SAH) patients have oxidative stress results in inflammation, tissue degeneration and neuronal damage. These deleterious effects cause aggravation of the perihematomal edema (PHE), vasospasm, and even hydrocephalus. We hypothesized that antioxidants may have a neuroprotective role in acute aneurysmal SAH (aSAH) patients. METHODS We conducted a prospective, multicenter randomized (single blind) trial between January 2017 and October 2019, investigating whether antioxidants (acetylcysteine and selenium) have the potential to improve the neurologic outcome in aSAH patients. The antioxidant patient group received antioxidants of acetylcysteine (2,000 mg/day) and selenium (1,600 µg/day) intravenously (IV) for 14 days. These drugs were administrated within 24 hours of admission. The non-antioxidant patient group received a placebo IV. RESULTS In total, 293 patients were enrolled with 103 patients remaining after applying the inclusion and exclusion criteria. No significant differences were observed in the baseline characteristics between the antioxidant (n = 53) and non-antioxidant (n = 50) groups. Among clinical factors, the duration of intensive care unit (ICU) stay was significantly shortened in patients who received antioxidants (11.2, 95% confidence interval [CI], 9.7-14.5 vs. 8.3, 95% CI, 6.2-10.2 days, P = 0.008). However, no beneficial effects were observed on radiological outcomes. CONCLUSION In conclusion, antioxidant treatment failed to show the reduction of PHE volume, mid-line shifting, vasospasm and hydrocephalus in acute SAH patients. A significant reduction in ICU stay was observed but need more optimal dosing schedule and precise outcome targets are required to clarify the clinical impacts of antioxidants in these patients. TRIAL REGISTRATION Clinical Research Information Service Identifier: KCT0004628.
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Affiliation(s)
- Moinay Kim
- Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hanwool Jeon
- Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Department of Medical Science, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yeongu Chung
- Department of Neurosurgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Si Un Lee
- Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Wonhyoung Park
- Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jung Cheol Park
- Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae Sung Ahn
- Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seungjoo Lee
- Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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van Wijk N, Studer B, van den Berg CA, Ripken D, Lansink M, Siebler M, Schmidt-Wilcke T. Evident lower blood levels of multiple nutritional compounds and highly prevalent malnutrition in sub-acute stroke patients with or without dysphagia. Front Neurol 2023; 13:1028991. [PMID: 36703642 PMCID: PMC9872791 DOI: 10.3389/fneur.2022.1028991] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 11/15/2022] [Indexed: 01/11/2023] Open
Abstract
Introduction Malnutrition is prevalent after stroke, particularly if post-stroke oropharyngeal dysphagia (OD) reduces nutritional intake. To further understand stroke-related malnutrition, a thorough nutritional assessment was performed in ischemic stroke patients with or without OD during sub-acute inpatient rehabilitation. Methods In this exploratory, observational, cross-sectional, multi-center study in Germany (NTR6802), ischemic stroke patients with (N = 36) or without (N = 49) OD were age- and sex-matched to healthy reference subjects. Presence of (risk of) malnutrition (MNA-SF), blood concentration of stroke-relevant nutritional compounds and metabolites, nutritional intake, quality of life (EQ-5D-5L), and activities of daily living (Barthel index) were assessed. Results More than half of the stroke patients displayed (risk of) malnutrition, with higher prevalence in patient with OD vs. without OD. Fasted blood concentrations of vitamins B1, B2, B6, A, D, and E, selenium, choline, coenzyme Q10, albumin, pre-albumin, transferrin, docosahexaenoic acid, and eicosapentaenoic acid were all lower in stroke patients compared to their matched healthy reference subjects, irrespective of OD status. Reported energy, macronutrient, and water intake were lower in stroke patients vs. healthy reference subjects. As expected, quality of life and activities of daily living scores were lower in stroke vs. healthy reference subjects, with OD scoring worse than non-OD patients. Discussion This study shows that malnutrition is highly prevalent in sub-acute stroke patients during rehabilitation. Even though patients with OD were more likely to be malnourished, blood levels of specific nutritional compounds were similarly lower in stroke patients with or without OD compared to healthy reference subjects. Furthermore, subgroup analysis showed similarly lower blood levels of specific nutritional compounds in patients that are normal nourished vs. patients with (risk of) malnutrition. This might imply disease-specific changes in blood levels on top of overall protein-energy malnutrition. The results of the current study underline that it is important to screen for nutritional impairments in every stroke patient, either with or without OD.
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Affiliation(s)
- Nick van Wijk
- Danone Nutricia Research, Utrecht, Netherlands,*Correspondence: Nick van Wijk
| | - Bettina Studer
- St. Mauritius Therapieklinik, Meerbusch, Germany,Medical Faculty, Institute for Clinical Neuroscience, University of Düsseldorf, Düsseldorf, Germany
| | | | - Dina Ripken
- Danone Nutricia Research, Utrecht, Netherlands
| | | | - Mario Siebler
- Neurologie und Neurorehabilitation, Fachklinik Rhein Ruhr, Essen, Germany,Department of Neurology, University of Düsseldorf, Düsseldorf, Germany
| | - Tobias Schmidt-Wilcke
- St. Mauritius Therapieklinik, Meerbusch, Germany,Neurologisches Zentrum, Mainkofen, Germany
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Lu HY, Ho UC, Kuo LT. Impact of Nutritional Status on Outcomes of Stroke Survivors: A Post Hoc Analysis of the NHANES. Nutrients 2023; 15:nu15020294. [PMID: 36678164 PMCID: PMC9864300 DOI: 10.3390/nu15020294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 12/19/2022] [Accepted: 12/28/2022] [Indexed: 01/11/2023] Open
Abstract
Stroke, a neurological emergency, is a leading cause of death and disability in adults worldwide. In acute or rehabilitative stages, stroke survivors sustain variable neurological recovery with long-term disabilities. The influence of post-stroke nutritional status on long-term survival has not been confirmed. Using the United States National Health and Nutrition Examination Survey data (2001−2010), we conducted a matched-cohort analysis (929 and 1858 participants in stroke and non-stroke groups, respectively) to investigate the influence of nutritional elements on post-stroke survival. With significantly lower nutrient consumption, the mortality risk was 2.2 times higher in stroke patients compared to non-stroke patients (Kaplan−Meier method with Cox proportional hazards model: adjusted hazard ratio, 2.208; 95% confidence interval: 1.887−2.583; p < 0.001). For several nutritional elements, the lower consumption group had significantly shorter survival than the higher consumption stroke subgroup; moreover, stroke patients with the highest 25% nutritional intake for each nutritional element, except moisture and total fat, had significantly shorter survival than non-stroke patients with the lowest 25% nutrition. Malnutrition is highly prevalent in stroke patients and is associated with high mortality rates. The dynamic change in energy requirements throughout the disease course necessitates dietary adjustment to ensure adequate nutritional intake.
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Affiliation(s)
- Hsueh-Yi Lu
- Department of Industrial Engineering and Management, National Yunlin University of Science and Technology, Yunlin 640, Taiwan
| | - Ue-Cheung Ho
- Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital Yunlin Branch, Yunlin 640, Taiwan
| | - Lu-Ting Kuo
- Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital Yunlin Branch, Yunlin 640, Taiwan
- Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital, Taipei 100, Taiwan
- Correspondence: ; Tel.: +886-2-2312-3456
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11
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Antioxidant Phytochemicals as Potential Therapy for Diabetic Complications. Antioxidants (Basel) 2023; 12:antiox12010123. [PMID: 36670985 PMCID: PMC9855127 DOI: 10.3390/antiox12010123] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 12/10/2022] [Accepted: 12/21/2022] [Indexed: 01/06/2023] Open
Abstract
The global prevalence of diabetes continues to increase partly due to rapid urbanization and an increase in the aging population. Consequently, this is associated with a parallel increase in the prevalence of diabetic vascular complications which significantly worsen the burden of diabetes. For these diabetic vascular complications, there is still an unmet need for safe and effective alternative/adjuvant therapeutic interventions. There is also an increasing urge for therapeutic options to come from natural products such as plants. Hyperglycemia-induced oxidative stress is central to the development of diabetes and diabetic complications. Furthermore, oxidative stress-induced inflammation and insulin resistance are central to endothelial damage and the progression of diabetic complications. Human and animal studies have shown that polyphenols could reduce oxidative stress, hyperglycemia, and prevent diabetic complications including diabetic retinopathy, diabetic nephropathy, and diabetic peripheral neuropathy. Part of the therapeutic effects of polyphenols is attributed to their modulatory effect on endogenous antioxidant systems. This review attempts to summarize the established effects of polyphenols on endogenous antioxidant systems from the literature. Moreover, potential therapeutic strategies for harnessing the potential benefits of polyphenols for diabetic vascular complications are also discussed.
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12
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Zuo W, Wang Y, Sun J, Zhang Y. Effects and mechanism of myeloperoxidase on microglia in the early stage of intracerebral hemorrhage. Front Neurosci 2022; 16:1046244. [PMID: 36570834 PMCID: PMC9783921 DOI: 10.3389/fnins.2022.1046244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 11/07/2022] [Indexed: 12/13/2022] Open
Abstract
Objectives (1) To clarify the dynamic relationship between the expression of myeloperoxidase (MPO) and microglial activation of intracerebral hemorrhage (ICH), (2) to explore the effect of inhibition of MPO on microglial activation, and (3) to observe the improvement in the neurobehavior of mice with inhibition of MPO. Methods C57 BL/6 mice and CX3CR1 + /GFP mice were used to establish a phosphate-buffered saline (PBS) group, an ICH group, and a 4-aminobenzoic acid hydrazide (ABAH) group. Longa score, open field locomotion, hind-limb clasping test, immunohistochemistry, immunofluorescence, blood routine detection, and flow cytometry were used. Results The neurobehavior of the mice was significantly impaired following ICH (P < 0.01); the expression of MPO was significantly increased following ICH, and reached a peak value at 6 h post-injury (P < 0.001). Moreover, the microglial activation increased significantly following ICH, and reached a peak level at 24 h post-injury (P < 0.01). Following inhibition of MPO, the activation of microglia in the ICH group decreased significantly (P < 0.001). Moreover, the neurobehavior of the ICH group was significantly improved with MPO inhibition (P < 0.05). Conclusion MPO may be an upstream molecule activated by microglia and following inhibition of MPO can improve secondary injury resulting from ICH.
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Affiliation(s)
- Wei Zuo
- Department of Neuro-Oncological Surgery, Neurosurgery Center, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Yunchang Wang
- Xiangya Hospital, Central Southern University, Changsha, China,Department of Neurosurgery, Lanzhou University Second Hospital, Lanzhou, China
| | - Jiali Sun
- College of Life Sciences, Central Southern University, Changsha, China
| | - Yinian Zhang
- Department of Neuro-Oncological Surgery, Neurosurgery Center, Zhujiang Hospital of Southern Medical University, Guangzhou, China,Department of Neurosurgery, Lanzhou University Second Hospital, Lanzhou, China,*Correspondence: Yinian Zhang,
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13
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Knepp B, Ander BP, Jickling GC, Hull H, Yee AH, Ng K, Rodriguez F, Carmona-Mora P, Amini H, Zhan X, Hakoupian M, Alomar N, Sharp FR, Stamova B. Gene expression changes implicate specific peripheral immune responses to Deep and Lobar Intracerebral Hemorrhages in humans. BRAIN HEMORRHAGES 2022; 3:155-176. [PMID: 36936603 PMCID: PMC10019834 DOI: 10.1016/j.hest.2022.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
The peripheral immune system response to Intracerebral Hemorrhage (ICH) may differ with ICH in different brain locations. Thus, we investigated peripheral blood mRNA expression of Deep ICH, Lobar ICH, and vascular risk factor-matched control subjects (n = 59). Deep ICH subjects usually had hypertension. Some Lobar ICH subjects had cerebral amyloid angiopathy (CAA). Genes and gene networks in Deep ICH and Lobar ICH were compared to controls. We found 774 differentially expressed genes (DEGs) and 2 co-expressed gene modules associated with Deep ICH, and 441 DEGs and 5 modules associated with Lobar ICH. Pathway enrichment showed some common immune/inflammatory responses between locations including Autophagy, T Cell Receptor, Inflammasome, and Neuroinflammation Signaling. Th2, Interferon, GP6, and BEX2 Signaling were unique to Deep ICH. Necroptosis Signaling, Protein Ubiquitination, Amyloid Processing, and various RNA Processing terms were unique to Lobar ICH. Finding amyloid processing pathways in blood of Lobar ICH patients suggests peripheral immune cells may participate in processes leading to perivascular/vascular amyloid in CAA vessels and/or are involved in its removal. This study identifies distinct peripheral blood transcriptome architectures in Deep and Lobar ICH, emphasizes the need for considering location in ICH studies/clinical trials, and presents potential location-specific treatment targets.
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Affiliation(s)
- Bodie Knepp
- Department of Neurology, School of Medicine, University of California at Davis, Sacramento, CA, USA
| | - Bradley P. Ander
- Department of Neurology, School of Medicine, University of California at Davis, Sacramento, CA, USA
| | - Glen C. Jickling
- Department of Medicine, Division of Neurology, University of Alberta, Edmonton, Canada
| | - Heather Hull
- Department of Neurology, School of Medicine, University of California at Davis, Sacramento, CA, USA
| | - Alan H. Yee
- Department of Neurology, School of Medicine, University of California at Davis, Sacramento, CA, USA
| | - Kwan Ng
- Department of Neurology, School of Medicine, University of California at Davis, Sacramento, CA, USA
| | - Fernando Rodriguez
- Department of Neurology, School of Medicine, University of California at Davis, Sacramento, CA, USA
| | - Paulina Carmona-Mora
- Department of Neurology, School of Medicine, University of California at Davis, Sacramento, CA, USA
| | - Hajar Amini
- Department of Neurology, School of Medicine, University of California at Davis, Sacramento, CA, USA
| | - Xinhua Zhan
- Department of Neurology, School of Medicine, University of California at Davis, Sacramento, CA, USA
| | - Marisa Hakoupian
- Department of Neurology, School of Medicine, University of California at Davis, Sacramento, CA, USA
| | - Noor Alomar
- Department of Neurology, School of Medicine, University of California at Davis, Sacramento, CA, USA
| | - Frank R. Sharp
- Department of Neurology, School of Medicine, University of California at Davis, Sacramento, CA, USA
| | - Boryana Stamova
- Department of Neurology, School of Medicine, University of California at Davis, Sacramento, CA, USA
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14
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Li Z, Bi R, Sun S, Chen S, Chen J, Hu B, Jin H. The Role of Oxidative Stress in Acute Ischemic Stroke-Related Thrombosis. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:8418820. [PMID: 36439687 PMCID: PMC9683973 DOI: 10.1155/2022/8418820] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 10/13/2022] [Accepted: 11/02/2022] [Indexed: 09/22/2023]
Abstract
Acute ischemic stroke is a serious life-threatening disease that affects almost 600 million people each year throughout the world with a mortality of more than 10%, while two-thirds of survivors remain disabled. However, the available treatments for ischemic stroke are still limited to thrombolysis and/or mechanical thrombectomy, and there is an urgent need for developing new therapeutic target. Recently, intravascular oxidative stress, derived from endothelial cells, platelets, and leukocytes, has been found to be tightly associated with stroke-related thrombosis. It not only promotes primary thrombus formation by damaging endothelial cells and platelets but also affects thrombus maturation and stability by modifying fibrin components. Thus, oxidative stress is expected to be a novel target for the prevention and treatment of ischemic stroke. In this review, we first discuss the mechanisms by which oxidative stress promotes stroke-related thrombosis, then summarize the oxidative stress biomarkers of stroke-related thrombosis, and finally put forward an antithrombotic therapy targeting oxidative stress in ischemic stroke.
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Affiliation(s)
- Zhifang Li
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Rentang Bi
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Shuai Sun
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Shengcai Chen
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Jiefang Chen
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Bo Hu
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Huijuan Jin
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
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15
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Guan Y, Zuo W, Jia K, Yu C, Liu F, Lv Z, Wang D, Shi FD, Wang X. Association of Red Blood Cell Distribution Width with Stroke Prognosis Among Patients with Small Artery Occlusion: A Hospital-Based Prospective Follow-Up Study. Int J Gen Med 2022; 15:7449-7457. [PMID: 36172083 PMCID: PMC9512034 DOI: 10.2147/ijgm.s381160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 09/07/2022] [Indexed: 11/24/2022] Open
Abstract
Objective Stroke is the leading cause of mortality and disability worldwide. However, there is no study on the relationship between red blood cell distribution width and the prognosis of small artery occlusion, which is a stroke subtype. This study aimed to assess the association of red blood cell distribution width at admission with outcomes among patients with small artery occlusion. Methods In this hospital-based follow-up study, all included patients were diagnosed with small artery occlusion. Outcomes included death, recurrence, and dependency at 3, 12, and 36 months after stroke onset. Multivariate analysis was performed to explore the association of red blood cell distribution width with stroke outcomes. Results This study included 1576 patients with small artery occlusion who were followed up at 3, 12, and 36 months. For every unit increase in red blood cell distribution width, the risk of stroke recurrence and dependency increased by 5.1% (95% CI 1.002–1.102, P=0.039) at 3 months after stroke onset. At the 12-month follow-up, for every unit increase in red blood cell distribution width, the risk of stroke recurrence increased by 3.4% (95% CI 1.000–1.069, P=0.047). However, the relationship between red blood cell distribution width and mortality rate was not significant at 36 months after stroke onset after adjustment of covariates. Conclusion Red blood cell distribution width is an important hematological index of small artery occlusion. It may be used to predict the recurrence of acute ischemic stroke in small artery occlusion. Therefore, patients with higher baseline values of red blood cell distribution width may need more risk factor control to reduce recurrence and dependency.
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Affiliation(s)
- Yalin Guan
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, 300350, People’s Republic of China
| | - Wenchao Zuo
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, 300350, People’s Republic of China
| | - Kun Jia
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, 300350, People’s Republic of China
| | - Changshen Yu
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, 300350, People’s Republic of China
| | - Feng Liu
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, 300350, People’s Republic of China
| | - Zhaoyang Lv
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, 300350, People’s Republic of China
| | - Dong Wang
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China
| | - Fu-Dong Shi
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China
- Fu-Dong Shi, Department of Neurology, Tianjin Medical University General Hospital, 154 Anshan Road, Heping District, Tianjin, 300052, People’s Republic of China, Tel +86-22-60362255, Fax +86-22-60362400, Email
| | - Xinping Wang
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, 300350, People’s Republic of China
- Correspondence: Xinping Wang, Department of Neurology, Tianjin Huanhu Hospital, 6 Jizhao Road, Jinnan District, Tianjin, 300350, People’s Republic of China, Tel +86-22-59065906, Fax +86-22-59065662, Email
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16
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Yan X, Ren Z, Wen Q, Jin X, Wang Y, Zhang W. Uric Acid and Cognitive Impairment in Patients with Acute Ischemic Stroke: A Meta-Analysis. Horm Metab Res 2022; 54:316-324. [PMID: 35533675 DOI: 10.1055/a-1798-0387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Serum uric acid (UA) has been suggested to be correlated with outcomes after stroke. We performed a meta-analysis to evaluate the association between serum UA and post-stroke cognitive impairment (PSCI) in patients with acute ischemic stroke (AIS). Relevant observational studies were identified by search of electronic databases including PubMed, Embase, and Web of Science. A randomized-effect model incorporating the possible between-study heterogeneity was used to pool the results. Overall, eleven studies with 4246 patients of AIS were included, 2073 (48.8%) of them had PSCI. Pooled results showed that patients with PSCI had significantly higher level of serum UA as compared to those without PSCI (mean difference: 35.70 μmol/l, 95% confidence interval (CI): 8.36 to 63.01, p=0.01; I2=95%). Subgroup analysis showed significant higher level of serum UA in patients with PSCI evaluated during follow-up of 3 months to 3 years, but not for those evaluated during hospitalization (p for subgroup difference=0.01). In addition, results of meta-analysis also showed that compared to patients with lower serum UA, AIS patients with higher serum UA had increased risk of PSCI (odds ratio: 1.33, 95% CI: 1.02 to 1.73, p=0.04; I2=72%). Higher level of serum UA after disease onset may be a marker of increased risk of PSCI in patients with AIS. Although these findings need to be validated in large-scale prospective studies, the possible mechanisms underlying the association between UA and PSCI should be also investigated.
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Affiliation(s)
- Xue Yan
- Center of Cerebral Diseases, the Third Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China
| | - Zhong Ren
- Center of Cerebral Diseases, the Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China
| | - Quan Wen
- Center of Cerebral Diseases, the Third Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China
| | - Xi Jin
- Center of Cerebral Diseases, the Third Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China
| | - Ying Wang
- Center of Cerebral Diseases, the Third Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China
| | - Weimin Zhang
- Center of Cerebral Diseases, the Third Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China
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17
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Wang A, Zhao W, Yan K, Huang P, Zhang H, Ma X. Preclinical Evidence of Paeoniflorin Effectiveness for the Management of Cerebral Ischemia/Reperfusion Injury: A Systematic Review and Meta-Analysis. Front Pharmacol 2022; 13:827770. [PMID: 35462929 PMCID: PMC9032804 DOI: 10.3389/fphar.2022.827770] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 03/24/2022] [Indexed: 01/01/2023] Open
Abstract
Background: Vessel recanalization is the main treatment for ischemic stroke; however, not all patients benefit from it. This lack of treatment benefit is related to the accompanying ischemia-reperfusion (I/R) injury. Therefore, neuroprotective therapy for I/R Injury needs to be further studied. Paeonia lactiflora Pall. is a commonly used for ischemic stroke management in traditional Chinese medicine; its main active ingredient is paeoniflorin (PF). We aimed to determine the PF’s effects and the underlying mechanisms in instances of cerebral I/R injury.Methods: We searched seven databases from their inception to July 2021.SYRCLE’s risk of bias tool was used to assess methodological quality. Review Manager 5.3 and STATA 12.0 software were used for meta-analysis.Results: Thirteen studies, including 282 animals overall, were selected. The meta-analyses showed compared to control treatment, PF significantly reduced neurological severity scores, cerebral infarction size, and brain water content (p = 0.000). In the PF treatment groups, the apoptosis cells and levels of inflammatory factors (IL-1β) decreased compared to those in the control groups (p = 0.000).Conclusion: Our results suggest that PF is a promising therapeutic for cerebral I/R injury management. However, to evaluate the effects and safety of PF in a more accurate manner, additional preclinical studies are necessary.
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Affiliation(s)
- Anzhu Wang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Graduate School, China Academy of Chinese Medical Sciences, Beijing, China
| | - Wei Zhao
- Yidu Central Hospital of Weifang, Weifang, China
| | - Kaituo Yan
- Yidu Central Hospital of Weifang, Weifang, China
| | - Pingping Huang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Graduate School, China Academy of Chinese Medical Sciences, Beijing, China
| | - Hongwei Zhang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Graduate School, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiaochang Ma
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- National Clinical Research Center for Chinese Medicine Cardiology, Beijing, China
- *Correspondence: Xiaochang Ma,
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18
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Taheri F, Sattari E, Hormozi M, Ahmadvand H, Bigdeli MR, Kordestani-Moghadam P, Anbari K, Milanizadeh S, Moghaddasi M. Dose-Dependent Effects of Astaxanthin on Ischemia/Reperfusion Induced Brain Injury in MCAO Model Rat. Neurochem Res 2022; 47:1736-1750. [DOI: 10.1007/s11064-022-03565-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 02/22/2022] [Accepted: 02/28/2022] [Indexed: 12/20/2022]
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19
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Haematological Indices and Antioxidant Enzyme Activity in Ghanaian Stroke Patients. BIOMED RESEARCH INTERNATIONAL 2022; 2022:1203120. [PMID: 35281592 PMCID: PMC8913147 DOI: 10.1155/2022/1203120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 02/17/2022] [Accepted: 02/22/2022] [Indexed: 02/07/2023]
Abstract
Background Stroke is a cardiovascular disorder causing mortality globally and long-lasting harm worldwide. The disease occurs when the blood flow to the brain is either interrupted or blocked. This disruption leads to the increase in reactive oxygen species (ROS), especially superoxide free radicals, resulting in oxidative stress. The superoxide radicals are removed by superoxide dismutase (SOD), a key antioxidant enzyme. In this work, we investigated haematological indices and superoxide dismutase enzyme activity in Ghanaian patients with stroke and healthy control participants. Materials and Methods Thirty stroke patients attending a stroke clinic and thirty apparently healthy control participants were recruited into the study. Blood samples were collected to determine haematological indices and SOD enzyme activity in red blood cells. Results The stroke patients had significantly high blood parameters such as white blood cell (p < 0.001), neutrophil (p < 0.001), lymphocyte (p = 0.003), and eosinophil (p < 0.001) comparing with study participants without stroke, who were the control group in the study. Other blood parameters such as red blood cell, (p < 0.001), haemoglobin (p < 0.001), and haematocrit (p < 0.001) levels and mean cell haemoglobin concentration (p = 0.030), platelet (p = 0.010), and plateletcrit (p = 0.027) were high in stroke patients comparing with study control participants and statistically significant. Blood lymphocyte levels observed in stroke patients correlated negatively and significantly with SOD activity levels. SOD activity levels were significantly lower in stroke patients compared with the control group (p < 0.001). Low values of the antioxidant enzyme SOD activity levels, lymphocytes, and high values of plateletcrit were significant predictors of stroke. Conclusion Haematological parameters such as WBC, lymphocyte, platelet levels, and red cell indices were significantly different in the stroke patients being studied. There was negative correlation between lymphocyte significantly with SOD activity and high oxidative stress in stroke patients compared with the control group. Lymphocytes and plateletcrit levels were also good predictors of the occurrence of stroke.
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20
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Ivanov AV, Maksimova MY, Nikiforova KA, Ochtova FR, Suanova ET, Alexandrin VV, Kruglova MP, Piradov MA, Kubatiev AA. Plasma glutathione as a risk marker for the severity and functional outcome of acute atherothrombotic and cardioembolic stroke. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2022. [DOI: 10.1186/s41983-022-00452-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Objective
Glutathione (GSH) is a major intracellular thiol-containing antioxidant. We tried to determine whether blood plasma GSH level is a marker for the severity of the two subtypes of acute stroke (large-artery atherosclerosis, LA and cardioembolic, CE). Forty-three patients with LA and 36 patients with CE aged 65 (47–82) years were included in the study. Thirty-one patients with cerebral microangiopathy were included for comparison. Total (t) and reduced (r) GSH levels were determined at admission. Neurological deficit was assessed by the National Institutes of Health Stroke Scale (NIHSS) on the first day, functional outcome and independence were assessed by the modified Rankin scale (mRs) and Bartel index (BI), respectively, after 21 days.
Results
The tGSH and rGSH levels in acute stroke were significantly lower than cerebral microangiopathy patients. Low tGSH (≤ 1.45 μM) and rGSH (≤ 30 nM) levels were risk markers for stroke severity at admission (NIHSS > 10) in patients with LA: age and gender adjusted odds ratio (AOR) was 4.95, 95% coincidence interval (CI) 1.31–18.7, AOR = 9.141, CI 1.84–45.3 for t- and rGSH, respectively. A low level of rGSH (≤ 30 nM) was found as risk marker for functional independence (BI ≤ 60: AOR = 15.9, CI 2.22–114.2) in patients with LA. Low tGSH level (≤ 1.1 μM) was associated with the reduction of poor outcome risk (mRs > 2: AOR = 0.154, CI 0.029–0.809) in CE group.
Conclusions
Low t- and rGSH levels may be considered potential risk markers for severity and insufficient functional independence in LA. Conversely, low tGSH level reduce the risk of poor stroke outcome only for CE.
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Liu Y, Liu X, Jia J, Guo J, Li G, Zhao X. Uric Acid and Clinical Outcomes in Young Patients with Ischemic Stroke. Neuropsychiatr Dis Treat 2022; 18:2219-2228. [PMID: 36199274 PMCID: PMC9529006 DOI: 10.2147/ndt.s373493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 09/14/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND AND PURPOSE There is limited available evidence for the relationship between uric acid (UA) levels and ischemic stroke in young adults. We aimed to explore the association between UA levels and acute ischemic stroke (AIS) in young patients. MATERIALS AND METHODS This was a prospective and observational study. We recruited young patients aged 18-45 years with AIS at our tertiary hospital. Patients were categorized into four groups according to quartiles of UA levels. The primary outcome was functional outcome at 3 months. The secondary outcomes included stroke severity, in-hospital complications, and functional outcome at discharge. Modified Rankin Scale (mRS) scores were used to assess functional outcome as poor (mRS=2-6) or favorable(mRS=0-1). RESULTS A total of 636 patients were enrolled in the current analysis. The four groups were defined as follows: Q1≤289.8 µmol/L, 289.8 µmol/ L<Q2≤349.0 µmol/L, 349.0 µmol/L<Q3≤421 µmol/L, and Q4>421 µmol/L. Multiple logistic regression analysis showed that UA levels were not significantly predictive of functional outcome either at discharge or at 3 months after AIS. However, compared to Q1, higher UA levels were significantly negatively associated with the rate of moderate-severe stroke (NIHSS≥5) at admission (p for trend =0.016). Furthermore, a reduction in the risk for in-hospital pneumonia was significantly associated with higher UA levels compared to Q1 (P for trend < 0.0001). CONCLUSION Serum UA was a protective factor for stroke severity and in-hospital pneumonia after AIS in young patients. However, we were unable to identify the predictive significance of UA for functional outcome either at discharge or at 3 months after AIS.
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Affiliation(s)
- Yanfang Liu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China.,China National Clinical Research Center for Neurological Diseases, Beijing, People's Republic of China.,Research Unit of Artificial Intelligence in Cerebrovascular Disease, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Xinmin Liu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China.,China National Clinical Research Center for Neurological Diseases, Beijing, People's Republic of China
| | - Jiaokun Jia
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China.,China National Clinical Research Center for Neurological Diseases, Beijing, People's Republic of China.,Research Unit of Artificial Intelligence in Cerebrovascular Disease, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Jiahuan Guo
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China.,China National Clinical Research Center for Neurological Diseases, Beijing, People's Republic of China
| | - Guangshuo Li
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China.,China National Clinical Research Center for Neurological Diseases, Beijing, People's Republic of China
| | - Xingquan Zhao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China.,China National Clinical Research Center for Neurological Diseases, Beijing, People's Republic of China.,Research Unit of Artificial Intelligence in Cerebrovascular Disease, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.,Beijing Institute of Brain Disorders, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, People's Republic of China
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22
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Zhang M, Wang Y, Wang K, Yin R, Pan X, Ma A. Association between uric acid and the prognosis of acute ischemic stroke: A systematic review and meta-analysis. Nutr Metab Cardiovasc Dis 2021; 31:3016-3023. [PMID: 34625360 DOI: 10.1016/j.numecd.2021.07.031] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 07/06/2021] [Accepted: 07/25/2021] [Indexed: 12/22/2022]
Abstract
AIMS Meta-analysis was performed to assess the value of serum uric acid in the prognosis of ischemic stroke. DATA SYNTHESIS We searched the databases of PubMed, Embase, and Web of Science. The literature we searched was published from the establishment of the database to January 2021. The references of the included literature were also collected. Two researchers sifted through the literature according to the inclusion and exclusion criteria and extracted the data. Stata 16.0 software was used for meta-analysis, and funnel plots were used to evaluate publication bias. Ten studies fulfilled the research criteria and were eventually included, and the analysis results showed that there was no significant association between serum uric acid and the functional outcome (OR = 0.99, 95% CI; 0.97-1.10), poor outcome (OR = 1.07, 95% CI; 0.99-1.15), vascular events (OR = 0.86, 95% CI; 0.52-1.41), and mortality (OR = 1.08, 95% CI; 0.93-1.24) related to ischemic stroke. CONCLUSIONS There was no significant correlation between serum uric acid level and prognosis of ischemic stroke.
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Affiliation(s)
- Meng Zhang
- Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao 266000, China.
| | - Yuan Wang
- Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao 266000, China.
| | - Kun Wang
- Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao 266000, China.
| | - Ruihua Yin
- Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao 266000, China.
| | - Xudong Pan
- Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao 266000, China.
| | - Aijun Ma
- Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao 266000, China.
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23
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Pacifici F, Rovella V, Pastore D, Bellia A, Abete P, Donadel G, Santini S, Beck H, Ricordi C, Daniele ND, Lauro D, Della-Morte D. Polyphenols and Ischemic Stroke: Insight into One of the Best Strategies for Prevention and Treatment. Nutrients 2021; 13:nu13061967. [PMID: 34201106 PMCID: PMC8229516 DOI: 10.3390/nu13061967] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 06/01/2021] [Accepted: 06/03/2021] [Indexed: 12/18/2022] Open
Abstract
Ischemic stroke (IS) is still among the leading causes of death and disability worldwide. The pathogenic mechanisms beyond its development are several and are complex and this is the main reason why a functional therapy is still missed. The beneficial effects of natural compounds against cardiovascular diseases and IS have been investigated for a long time. In this article, we reviewed the association between the most studied polyphenols and stroke protection in terms of prevention, effect on acute phase, and rehabilitation. We described experimental and epidemiological studies reporting the role of flavonols, phenolic acid, and stilbens on ischemic mechanisms leading to stroke. We analyzed the principal animal models used to evaluate the impact of these micronutrients to cerebral blood flow and to molecular pathways involved in oxidative stress and inflammation modulation, such as sirtuins. We reported the most significant clinical trials demonstrated as the persistent use of polyphenols is clinically relevant in terms of the reduction of vascular risk factors for IS, such as Atrial Fibrillation. Interestingly, different kinds of polyphenols provide brain protection by activating different pathways and mechanisms, like inducing antithrombotic effect, such as Honokiol. For this reason, we discussed an appropriate integrative use of them as a possible therapeutic alternative against stroke.
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Affiliation(s)
- Francesca Pacifici
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (F.P.); (V.R.); (D.P.); (A.B.); (N.D.D.); (D.L.)
| | - Valentina Rovella
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (F.P.); (V.R.); (D.P.); (A.B.); (N.D.D.); (D.L.)
- Department of Medical Sciences, Fondazione Policlinico Tor Vergata, 00133 Rome, Italy;
| | - Donatella Pastore
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (F.P.); (V.R.); (D.P.); (A.B.); (N.D.D.); (D.L.)
| | - Alfonso Bellia
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (F.P.); (V.R.); (D.P.); (A.B.); (N.D.D.); (D.L.)
- Department of Medical Sciences, Fondazione Policlinico Tor Vergata, 00133 Rome, Italy;
| | - Pasquale Abete
- Department of Translational Medical Sciences, University of Naples “Federico II”, 80138 Naples, Italy;
| | - Giulia Donadel
- Department of Clinical Science and Translational Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy;
| | - Silvia Santini
- Department of Medical Sciences, Fondazione Policlinico Tor Vergata, 00133 Rome, Italy;
| | - Heinz Beck
- Campus Principe di Napoli, Università Unipegaso, 80132 Napoli, Italy;
| | - Camillo Ricordi
- Diabetes Research Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA;
| | - Nicola Di Daniele
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (F.P.); (V.R.); (D.P.); (A.B.); (N.D.D.); (D.L.)
- Department of Medical Sciences, Fondazione Policlinico Tor Vergata, 00133 Rome, Italy;
| | - Davide Lauro
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (F.P.); (V.R.); (D.P.); (A.B.); (N.D.D.); (D.L.)
- Department of Medical Sciences, Fondazione Policlinico Tor Vergata, 00133 Rome, Italy;
| | - David Della-Morte
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (F.P.); (V.R.); (D.P.); (A.B.); (N.D.D.); (D.L.)
- Department of Neurology and Evelyn F. McKnight Brain Institute, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
- Interdisciplinary Center for Advanced Studies on Lab-on-Chip and Organ-on-Chip Applications (ICLOC), University of Rome “Tor Vergata”, 00133 Rome, Italy
- Department of Human Sciences and Quality of Life Promotion, San Raffaele Roma Open University, 00166 Rome, Italy
- Correspondence: ; Tel.: +1-305-243-4790
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24
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Hyperuricaemia as a prognostic factor for acute ischaemic stroke. NEUROLOGÍA (ENGLISH EDITION) 2021. [DOI: 10.1016/j.nrleng.2018.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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25
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La Russa D, Montesano D, Pellegrino D, Frisina M, Bagetta G, Fallarino F, Amantea D. Systemic administration of sunflower oil exerts neuroprotection in a mouse model of transient focal cerebral ischaemia. J Pharm Pharmacol 2021; 74:1776-1783. [PMID: 33749789 DOI: 10.1093/jpp/rgab007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 01/13/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Natural products are valuable sources of nutraceuticals for the prevention or treatment of ischemic stroke, a major cause of death and severe disability worldwide. Among the mechanisms implicated in cerebral ischemia-reperfusion damage, oxidative stress exerts a pivotal role in disease progression. Given the high antioxidant potential of most components of sunflower oil, we have explored its effects on ischemic brain injury produced in the mouse by transient occlusion of the middle cerebral artery (MCAo). KEY FINDINGS Intraperitoneal (i.p.) administration of sunflower oil at doses of 3 ml/kg (48 h, 24 h and 1 h before MCAo) significantly reduced brain infarct volume and oedema assessed 24 h after the insult. This neuroprotective treatment schedule also prevented the elevation of brain lipid peroxidation produced by MCAo-reperfusion injury. By contrast, doses of 0.03 ml/kg of sunflower oil resulted ineffective on both cerebral damage and lipid peroxidation. Although sunflower oil did not affect serum levels of Diacron-reactive oxygen metabolites (d-ROMs), both 0.03 and 3 ml/kg dosing regimens resulted in the preservation of serum biological antioxidant potential (BAP) that was otherwise dramatically reduced 24 h after MCAo. CONCLUSIONS Sunflower oil represents a promising source of neuroprotective extracts/compounds that can be exploited for the prevention and/or treatment of cerebral ischemia.
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Affiliation(s)
- Daniele La Russa
- Section of Preclinical and Translational Pharmacology, Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende, Cosenza, Italy
| | - Domenico Montesano
- Department of Pharmaceutical Sciences, Section of Food Science and Nutrition, University of Perugia, Perugia, Italy
| | - Daniela Pellegrino
- Department of Biology, Ecology and Earth Sciences, University of Calabria, Rende, Cosenza, Italy
| | - Marialaura Frisina
- Section of Preclinical and Translational Pharmacology, Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende, Cosenza, Italy
| | - Giacinto Bagetta
- Section of Preclinical and Translational Pharmacology, Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende, Cosenza, Italy
| | | | - Diana Amantea
- Section of Preclinical and Translational Pharmacology, Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende, Cosenza, Italy
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26
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Kangisser L, Tan E, Bellomo R, Deane AM, Plummer MP. Neuroprotective Properties of Vitamin C: A Scoping Review of Pre-Clinical and Clinical Studies. J Neurotrauma 2021; 38:2194-2205. [PMID: 33544035 DOI: 10.1089/neu.2020.7443] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
There is a need for novel neuroprotective therapies. We aimed to review the evidence for exogenous vitamin C as a neuroprotective agent. MEDLINE, Embase, and Cochrane library databases were searched from inception to May 2020. Pre-clinical and clinical reports evaluating vitamin C for acute neurological injury were included. Twenty-two pre-clinical and 11 clinical studies were eligible for inclusion. Pre-clinical studies included models of traumatic and hypoxic brain injury, subarachnoid and intracerebral hemorrhage, and ischemic stroke. The median [IQR] maximum daily dose of vitamin C in animal studies was 120 [50-500] mg/kg. Twenty-one animal studies reported improvements in biomarkers, functional outcome, or both. Clinical studies included single reports in neonatal hypoxic encephalopathy, traumatic brain injury, and subarachnoid hemorrhage and eight studies in ischemic stroke. The median maximum daily dose of vitamin C was 750 [500-1000] mg, or ∼10 mg/kg for an average-size adult male. Apart from one case series of intracisternal vitamin C administration in subarachnoid hemorrhage, clinical studies reported no patient-centered benefit. Although pre-clinical trials suggest that exogenous vitamin C improves biomarkers of neuroprotection, functional outcome, and mortality, these results have not translated to humans. However, clinical trials used approximately one tenth of the vitamin C dose of animal studies.
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Affiliation(s)
- Lauren Kangisser
- Department of Intensive Care, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Elinor Tan
- Department of Intensive Care, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Rinaldo Bellomo
- Department of Intensive Care, Royal Melbourne Hospital, Parkville, Victoria, Australia.,Centre for Integrated Critical Care, Department of Medicine and Radiology, University of Melbourne, Melbourne, Victoria, Australia
| | - Adam M Deane
- Department of Intensive Care, Royal Melbourne Hospital, Parkville, Victoria, Australia.,Centre for Integrated Critical Care, Department of Medicine and Radiology, University of Melbourne, Melbourne, Victoria, Australia
| | - Mark P Plummer
- Department of Intensive Care, Royal Melbourne Hospital, Parkville, Victoria, Australia.,Centre for Integrated Critical Care, Department of Medicine and Radiology, University of Melbourne, Melbourne, Victoria, Australia
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27
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Kim M, Byun J, Chung Y, Lee SU, Park JE, Park W, Park JC, Ahn JS, Lee S. Reactive Oxygen Species Scavenger in Acute Intracerebral Hemorrhage Patients: A Multicenter, Randomized Controlled Trial. Stroke 2021; 52:1172-1181. [PMID: 33626901 DOI: 10.1161/strokeaha.120.032266] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Moinay Kim
- Department of Neurosurgery (M.K., J.B., W.P., J.C.P., J.S.A., S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Joonho Byun
- Department of Neurosurgery (M.K., J.B., W.P., J.C.P., J.S.A., S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Yeongu Chung
- Department of Neurosurgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (Y.C.)
| | - Si Un Lee
- Department of Neurosurgery, Seoul National University Bundang Hospital, Republic of Korea (S.U.L.)
| | - Ji Eun Park
- Department of Radiology (J.E.P.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Wonhyoung Park
- Department of Neurosurgery (M.K., J.B., W.P., J.C.P., J.S.A., S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jung Cheol Park
- Department of Neurosurgery (M.K., J.B., W.P., J.C.P., J.S.A., S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jae Sung Ahn
- Department of Neurosurgery (M.K., J.B., W.P., J.C.P., J.S.A., S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Seungjoo Lee
- Department of Neurosurgery (M.K., J.B., W.P., J.C.P., J.S.A., S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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28
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Wang C, Cui T, Wang L, Zhu Q, Wang A, Yuan Y, Hao Z, Wu B. Prognostic significance of uric acid change in acute ischemic stroke patients with reperfusion therapy. Eur J Neurol 2020; 28:1218-1224. [PMID: 33176022 DOI: 10.1111/ene.14643] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 10/26/2020] [Accepted: 11/04/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND Uric acid (UA) is an important endogenous free radical scavenger that has been found to have a neuroprotective effect. However, there is uncertainty about the relationship between UA change and outcome in acute ischemic stroke (AIS) patients with reperfusion therapy. METHODS We consecutively enrolled AIS patients with reperfusion therapy. UA was measured upon admission and during hospitalization. The change in UA levels (ΔUA) was determined by calculating the difference between admission UA and the lowest UA among all follow-up measurements, with a positive ΔUA suggesting a decrease in UA levels. Functional outcome was assessed by modified Rankin Scale (mRS) at 3 months. Poor outcome was defined as mRS >2. RESULTS A total of 361 patients were included (mean age 68.7 ± 13.9 years, 54.3% males). The mean UA on admission was 355 ± 96.1 μmol/L. The median ΔUA was 121 μmol/L (IQR 50-192 μmol/L) and 18 (5%) patients had increased UA levels. UA on admission was positively associated with good outcome (p for trend = 0.017). When patients were classified into quartiles by ΔUA, patients with the largest decrease in UA (Q4: 199-434 μmol/L) had a higher risk of poor outcome at 3 months compared to patients with the least decrease in UA (Q1: 0-57 μmol/L) (OR 2.55, 95% CI 1.09-5.98, p = 0.031). The risk of poor outcome increased with ΔUA (p for trend = 0.048). CONCLUSIONS In patients with reperfusion therapy, high UA on admission was associated with a good 3-month outcome, while a greater decrease in UA was associated with poor outcome.
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Affiliation(s)
- Changyi Wang
- Center of Cerebrovascular Diseases, Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ting Cui
- Center of Cerebrovascular Diseases, Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lu Wang
- Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qiange Zhu
- The Second Department of Neurology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
| | - Anmo Wang
- Center of Cerebrovascular Diseases, Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ye Yuan
- Center of Cerebrovascular Diseases, Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zilong Hao
- Center of Cerebrovascular Diseases, Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Bo Wu
- Center of Cerebrovascular Diseases, Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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29
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Du J, Yin G, Hu Y, Shi S, Jiang J, Song X, Zhang Z, Wei Z, Tang C, Lyu H. Coicis semen protects against focal cerebral ischemia-reperfusion injury by inhibiting oxidative stress and promoting angiogenesis via the TGFβ/ALK1/Smad1/5 signaling pathway. Aging (Albany NY) 2020; 13:877-893. [PMID: 33290255 PMCID: PMC7835068 DOI: 10.18632/aging.202194] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 09/28/2020] [Indexed: 12/16/2022]
Abstract
Background: Ischemic stroke is a devastating disease that causes long-term disability. However, its pathogenesis is unclear, and treatments for ischemic stroke are limited. Recent studies indicate that oxidative stress is involved in the pathological progression of ischemic stroke and that angiogenesis participates in recovery from ischemic stroke. Furthermore, previous studies have shown that Coicis Semen has antioxidative and anti-inflammatory effects in a variety of diseases. In the present study, we investigated whether Coicis Semen has a protective effect against ischemic stroke and the mechanism of this protective effect. Results: Coicis Semen administration significantly decreased the infarct volume and mortality and alleviated neurological deficits at 3, 7 and 14 days after MCAO. In addition, cerebral edema at 3 days poststroke was ameliorated by Coicis Semen treatment. DHE staining showed that ROS levels in the vehicle group were increased at 3 days after reperfusion and then gradually declined, but Coicis Semen treatment reduced ROS levels. The levels of GSH and SOD in the brain were increased by Coicis Semen treatment, while MDA levels were reduced. Furthermore, Coicis Semen treatment decreased the extravasation of EB dye in MCAO mouse brains and elevated expression of the tight junction proteins ZO-1 and Occludin. Double immunofluorescence staining and western blot analysis showed that the expression of angiogenesis markers and TGFβ pathway-related proteins was increased by Coicis Semen administration. Consistent with the in vivo results, cytotoxicity assays showed that Coicis Semen substantially promoted HUVEC survival following OGD/RX in vitro. Additionally, though LY2109761 inhibited the activation of TGFβ signaling in OGD/RX model animals, Coicis Semen cotreatment markedly reversed the downregulation of TGFβ pathway-related proteins and increased VEGF levels. Methods: Adult male wild-type C57BL/6J mice were used to develop a middle cerebral artery occlusion (MCAO) stroke model. Infarct size, neurological deficits and behavior were evaluated on days 3, 7 and 14 after staining. In addition, changes in superoxide dismutase (SOD), GSH and malondialdehyde (MDA) levels were detected with a commercial kit. Blood-brain barrier (BBB) permeability was assessed with Evans blue (EB) dye. Western blotting was also performed to measure the levels of tight junction proteins of the BBB. Additionally, ELISA was performed to measure the level of VEGF in the brain. The colocalization of CD31, angiogenesis markers, and Smad1/5 was assessed by double immunofluorescent staining. TGFβ pathway-related proteins were measured by western blotting. Furthermore, the cell viability of human umbilical vein endothelial cells (HUVECs) following oxygen-glucose deprivation/reoxygenation (OGD/RX) was measured by Cell Counting Kit (CCK)-8 assay. Conclusions: Coicis Semen treatment alleviates brain damage induced by ischemic stroke through inhibiting oxidative stress and promoting angiogenesis by activating the TGFβ/ALK1 signaling pathway.
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Affiliation(s)
- Jin Du
- Department of Neurosurgery, The People’s Hospital of Chizhou, Chizhou 247000, Anhui, China
| | - Guobing Yin
- Department of Anesthesiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, Anhui, China
| | - Yida Hu
- Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei, China
| | - Si Shi
- Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei, China
| | - Jiazhen Jiang
- Department of Emergency, Huashan Hospital North, Fudan University, Shanghai 201907, China
| | - Xiaoyan Song
- Department of Neurology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201620, China
| | - Zhetao Zhang
- Department of Pharmacy, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230036, Anhui, China
| | - Zeyuan Wei
- Department of Pharmacy, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230036, Anhui, China
| | - Chaoliang Tang
- Department of Anesthesiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, Anhui, China
| | - Haiyan Lyu
- Department of Neurology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201620, China
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30
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Gudarzi S, Jafari M, Pirzad Jahromi G, Eshrati R, Asadollahi M, Nikdokht P. Evaluation of modulatory effects of saffron ( Crocus sativus L.) aqueous extract on oxidative stress in ischemic stroke patients: a randomized clinical trial. Nutr Neurosci 2020; 25:1137-1146. [PMID: 33151132 DOI: 10.1080/1028415x.2020.1840118] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Saffron (Crocus sativus L.) has been widely used in traditional medicine as a treatment of nervous disorders. Saffron as an antioxidant can be considered effective for treatment of oxidative stress in ischemia stroke. Therefore, the aim of the present study was to investigate the role of aqueous extract of saffron in reducing oxidative stress in ischemic strokes patients. METHODS Forty patients with acute ischemic stroke were randomly divided into two groups including control group and saffron group. During 4 days of experiment, control group received routine stroke care and saffron group received routine care plus capsule of saffron 400 mg/day (200 mg twice per day). Then, two groups were compared using the National Institute of Health Stoke Scale (NIHSS) and serum oxidative stress biomarkers, at the time of hospital admission and 4 days later as well. RESULTS On the fourth day after ischemic stroke onset, antioxidant enzymes activities and glutathione (GSH) and total antioxidant capacity (TAC) levels were higher in the saffron group compared to the control group, while malondialdehyde (MDA) level was lower. In addition, the severity of stroke, based on the NIHSS scores, was significantly reduced after 4 days in the saffron group. The severity of stroke was negatively correlated with the levels of GSH and TAC and positively correlated with MDA level. CONCLUSIONS Saffron has modulatory effects on ischemic-induced oxidative stress due to its free radical scavenging and antioxidant properties. Thus, saffron extract can be considered as a potential candidate therapy of the ischemic brain.
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Affiliation(s)
- Saeed Gudarzi
- Faculty of Medicine, Department of Biochemistry, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mahvash Jafari
- Faculty of Medicine, Department of Biochemistry, Baqiyatallah University of Medical Sciences, Tehran, Iran.,Chemical Injuries Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Gila Pirzad Jahromi
- Neuroscience Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Reza Eshrati
- Faculty of Medicine, Department of Biochemistry, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mostafa Asadollahi
- Neurology, Electrophysiology Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Parisa Nikdokht
- Department of Neurology, Shahid Beheshti University of Medical Science, Tehran, Iran
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31
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The relationship between oxidative stress and acute ischemic stroke severity and functional outcome. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2020. [DOI: 10.1186/s41983-020-00206-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Abstract
Background
Cerebral ischemia initiates an oxidative stress response in the brain which is a composite process that involves many oxidative stress biomarkers. High levels of malondialdehyde (MDA) in patients with acute ischemic stroke had been found. The evaluation of oxidative stress in the acute stage may contribute to improve the post ischemic stroke outcome.
Objective
The aim of the current study to assess MDA level, as an oxidative stress biomarker, in acute ischemic stroke on admission and its relation with stroke severity on admission and also, its relation with three months short-term outcome.
Methods
Forty-two patients (20 males and 22 females) with acute ischemic stroke were prospectively enrolled in follow-up cohort study. Serum MDA was measured within 24 h after admission. We studied the relationship between MDA and stroke severity and functional outcome after 3 months assessed by National Institute of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) respectively.
Results
Serum MDA levels correlated significantly with clinical short-term stroke outcome after 3 months (p < 0.001).
Conclusion(s)
These data provide evidence that the MDA (an oxidative stress biomarker) may be used as predictor for functional outcome in acute ischemic stroke.
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32
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Menon B, Ramalingam K, Kumar R. Evaluating the Role of Oxidative Stress in Acute Ischemic Stroke. J Neurosci Rural Pract 2020; 11:156-159. [PMID: 32140020 PMCID: PMC7055613 DOI: 10.1055/s-0039-3402675] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background
The role of oxidative stress in neuronal injury due to ischemic stroke has been an interesting topic in stroke research. Malondialdehyde (MDA) has emerged as a sensitive oxidative stress biomarker owing to its ability to react with the lipid membranes. Total antioxidant power (TAP) is another biomarker to estimate the total oxidative stress in stroke patients. We aimed to determine the oxidative stress in acute stroke patients by measuring MDA and TAP.
Materials and Methods
MDA and TAP were determined in 100 patients with ischemic stroke and compared with that in 100 age- and sex-matched healthy adults. Demographic data, stroke severity measured by the National Institutes of Health Stroke Scale (NIHSS), and disability measured by the Barthel index (BI) were recorded. The association of MDA and TAP with other variables was analyzed by paired
t
-test.
Results
Of the whole sample, 74% represented males. The mean NIHSS score was 13.11 and BI was 38.87. MDA was significantly higher in stroke patients (7.11 ± 1.67) than in controls (1.64 ± 0.82;
p
= 0.00). TAP was significantly lower in stroke patients (5.72 ± 1.41) than in controls (8.53 ± 2.4;
p
= 0.00). The lipid profile and blood sugar levels were also significantly higher in stroke patients. There was no association of MDA and TAP with other variables.
Conclusion
We found that oxidative stress was associated with acute ischemic stroke. However, we could not establish an association between oxidative stress and the severity of acute stroke.
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Affiliation(s)
- Bindu Menon
- Department of Neurology, Apollo Speciality Hospitals, Nellore, Andhra Pradesh, India
| | - Krishnan Ramalingam
- Department of Biochemistry, Narayana Medical College, Nellore, Andhra Pradesh, India
| | - Rajeev Kumar
- Unit of Psychiatry and Addiction Medicine, Australian National University Medical School, Canberra, Australia
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Sabetghadam M, Mazdeh M, Abolfathi P, Mohammadi Y, Mehrpooya M. Evidence for a Beneficial Effect of Oral N-acetylcysteine on Functional Outcomes and Inflammatory Biomarkers in Patients with Acute Ischemic Stroke. Neuropsychiatr Dis Treat 2020; 16:1265-1278. [PMID: 32547030 PMCID: PMC7244239 DOI: 10.2147/ndt.s241497] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Accepted: 05/01/2020] [Indexed: 01/22/2023] Open
Abstract
PURPOSE Numerous preclinical studies have demonstrated the potential neuroprotective effects of N-acetylcysteine (NAC) in the treatment of brain ischemia. Accordingly, the present study aimed to assess the potential therapeutic effects of oral NAC in patients with acute ischemic stroke. PATIENTS AND METHODS In a randomized, double-blind, placebo-controlled trial study, 68 patients with acute ischemic stroke with the onset of symptoms less than 24 hours were randomly assigned to either the NAC-treated group or placebo-treated group. NAC and matched placebo were administrated by a 72-hour oral protocol (initially 4 grams loading dose and after on, 4 g in 4 equal divided doses for more 2 days). The primary outcomes were quantification of any neurologic deficit by the use of the National Institute of Health Stroke Scale (NIHSS) score and functional disability by the use of the modified Rankin scale (mRS) at 90 days after stroke. Additionally, serum levels of markers of oxidative stress and inflammation as a main mechanism of its action were assessed at baseline and the end of 3-day treatment protocol. RESULTS NAC-treated patients in comparison with placebo-treated patients showed a significantly lower mean NIHSS scores at day 90 after stroke. A favorable functional outcome which was defined as an mRS score of 0 or 1, also in favor of NAC compared to placebo was noted on day 90 after stroke (57.6% in the NAC-treated group compared with 28.6% in the placebo-treated group). Further, compared to the placebo, NAC treatment significantly decreased serum levels of proinflammatory biomarkers such as interleukin 6 (IL-6), soluble intercellular cell adhesion molecule-1 (sICAM-1), nitric oxide (NO), malondialdehyde (MDA), and neuron-specific enolase (NSE) and significantly increased serum levels of anti-oxidant biomarkers such as superoxide dismutase (SOD), glutathione peroxidase (GPx), and total thiol groups (TTG). CONCLUSION The pattern of results suggests that oral NAC administration early after an acute ischemic stroke is associated with a better outcome profile in terms of acute neurological deficit and disability grade compared to placebo. NAC may improve neurological outcomes of patients with stroke at least in part by its antioxidant and anti-inflammatory effects.
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Affiliation(s)
- Maryam Sabetghadam
- Department of Clinical Pharmacy, School of Pharmacy, Medicinal Plants and Natural Products Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mehrdokht Mazdeh
- Department of Neurology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Parnaz Abolfathi
- Department of Clinical Pharmacy, School of Pharmacy, Medicinal Plants and Natural Products Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Younes Mohammadi
- Modeling of Noncommunicable Diseases Research Center, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Maryam Mehrpooya
- Department of Clinical Pharmacy, School of Pharmacy, Medicinal Plants and Natural Products Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
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Lin SP, Tu C, Huang W, Wu Y, Lin PY, Ye S, Long Y, Xu W, Chen S, Wen YS, Ou Y, Li X, Chen XH. Acute-phase serum superoxide dismutase level as a predictive biomarker for stroke-associated infection. Int J Neurosci 2019; 130:186-192. [PMID: 31696761 DOI: 10.1080/00207454.2019.1667790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background and Purpose: Oxidative stress is involved in the development of infections. However, whether oxidative stress indicators can be used as markers of stroke-associated infection (SAI) is still unclear. The purpose of this study was to test the predictive values of superoxide dismutase (SOD) and malondialdehyde (MDA) levels for SAI incidence.Methods: A total of 45 consecutive patients with ischemic stroke who were admitted to our hospital were enrolled. A prospective study was carried out to observe the occurrence of SAI during the first 7 days after stroke. Accordingly, the patients were divided into SAI and non-SAI groups. The relationship between SOD and MDA serum levels and SAI was analyzed.Results: The patients in the SAI group had significantly higher serum SOD levels than those in the non-SAI group (41.638 ± 3.428 U/ml vs. 36.542 ± 9.114 U/ml, p = 0.033). However, there were no significant differences in MDA levels between the SAI and non-SAI group (p > 0.05). The discriminating ability of serum SOD level for SAI was measured using an ROC curve. Serum level of SOD >38.16 U/ml was useful in diagnosing SAI with a sensitivity of 88% and a specificity of 61%. Kaplan-Meier curves showed that the group with serum SOD level >38.16 U/ml had higher rates of SAI incidence (χ2 = 9.688, p = 0.002; log rank test). Furthermore, Cox regression analysis indicated that a serum SOD level >38.16 U/ml was an independent risk factor for SAI (hazard ratio = 5.836; 95% CI, 1.298-26.244; p = 0.021).Conclusions: Acute-phase serum SOD level could be a predictor of SAI.
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Affiliation(s)
- Shao-Peng Lin
- Department of Emergency, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, P.R. China
| | | | - Wenyao Huang
- Guangzhou Medical University, Guangzhou, P.R. China
| | - Yi Wu
- Department of Emergency, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, P.R. China
| | - Pei-Yi Lin
- Department of Emergency, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, P.R. China
| | - Shan Ye
- Department of Geriatrics, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, P.R. China
| | - Youming Long
- Department of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, P.R. China
| | - Weiqiang Xu
- Guangzhou Medical University, Guangzhou, P.R. China
| | - Shishi Chen
- Guangzhou Medical University, Guangzhou, P.R. China
| | | | - Yongqi Ou
- Guangzhou Medical University, Guangzhou, P.R. China
| | - Xiujin Li
- Guangzhou Medical University, Guangzhou, P.R. China
| | - Xiao-Hui Chen
- Department of Emergency, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, P.R. China
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Lorenzano S, Rost NS, Khan M, Li H, Batista LM, Chutinet A, Green RE, Thankachan TK, Thornell B, Muzikansky A, Arai K, Som AT, Pham LDD, Wu O, Harris GJ, Lo EH, Blumberg JB, Milbury PE, Feske SK, Furie KL. Early molecular oxidative stress biomarkers of ischemic penumbra in acute stroke. Neurology 2019; 93:e1288-e1298. [PMID: 31455665 DOI: 10.1212/wnl.0000000000008158] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 04/28/2019] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVES To assess whether plasma biomarkers of oxidative stress predict diffusion-perfusion mismatch in patients with acute ischemic stroke (AIS). METHODS We measured plasma levels of oxidative stress biomarkers such as F2-isoprostanes (F2-isoPs), total and perchloric acid Oxygen Radical Absorbance Capacity (ORACTOT and ORACPCA), urinary levels of 8-oxo-7,8-dihydro-2'-deoxyguoanosine, and inflammatory and tissue-damage biomarkers (high-sensitivity C-reactive protein, matrix metalloproteinase-2 and -9) in a prospective study of patients with AIS presenting within 9 hours of symptom onset. Diffusion-weighted (DWI) and perfusion-weighted (PWI) MRI sequences were analyzed with a semiautomated volumetric method. Mismatch was defined as baseline mean transit time volume minus DWI volume. A percent mismatch cutoff of >20% was considered clinically significant. A stricter definition of mismatch was also used. Mismatch salvage was the region free of overlap by final infarction. RESULTS Mismatch >20% was present in 153 of 216 (70.8%) patients (mean [±SD] age 69.2 ± 14.3 years, 41.2% women). Patients with mismatch >20% were more likely to have higher baseline plasma levels of ORACPCA (p = 0.020) and F2-isoPs (p = 0.145). Multivariate binary logistic regression demonstrated that lnF2-isoP (odds ratio [OR] 2.44, 95% confidence interval [CI] 1.19-4.98, p = 0.014) and lnORACPCA (OR 4.18, 95% CI 1.41-12.41, p = 0.010) were independent predictors of >20% PWI-DWI mismatch and the stricter mismatch definition, respectively. lnORACTOT significantly predicted mismatch salvage volume (>20% mismatch p = 0.010, stricter mismatch definition p = 0.003). CONCLUSIONS Elevated hyperacute plasma levels of F2-isoP and ORAC are associated with radiographic evidence of mismatch and mismatch salvage in patients with AIS. If validated, these findings may add to our understanding of the role of oxidative stress in cerebral tissue fate during acute ischemia.
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Affiliation(s)
- Svetlana Lorenzano
- From the J. Philip Kistler Stroke Research Center (S.L., N.S.R., L.M.B., A.C., R.E.G., T.K.T., B.T.), Department of Neurology, and Department of Radiology (H.L., G.J.H.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Neurology (M.K., K.L.F.), Rhode Island Hospital, Alpert Medical School of Brown University, Providence; Massachusetts General Hospital Biostatistics Center (A.M.), Boston; Neuroprotection Research Laboratory (K.A., A.T.S., L.-D.D.P., E.H.L.), Neuroscience Center, Departments of Neurology and Radiology, Massachusetts General Hospital and Harvard Medical School; Athinoula A. Martinos Center for Biomedical Imaging (O.W.), Massachusetts General Hospital and Harvard Medical School, Charlestown; Antioxidant Research Laboratory (J.B.B.), Jean Mayer USDA Human Nutrition Research Center on Aging, and Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy (P.E.M.), Tufts University; and Department of Neurology (S.K.F.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
| | - Natalia S Rost
- From the J. Philip Kistler Stroke Research Center (S.L., N.S.R., L.M.B., A.C., R.E.G., T.K.T., B.T.), Department of Neurology, and Department of Radiology (H.L., G.J.H.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Neurology (M.K., K.L.F.), Rhode Island Hospital, Alpert Medical School of Brown University, Providence; Massachusetts General Hospital Biostatistics Center (A.M.), Boston; Neuroprotection Research Laboratory (K.A., A.T.S., L.-D.D.P., E.H.L.), Neuroscience Center, Departments of Neurology and Radiology, Massachusetts General Hospital and Harvard Medical School; Athinoula A. Martinos Center for Biomedical Imaging (O.W.), Massachusetts General Hospital and Harvard Medical School, Charlestown; Antioxidant Research Laboratory (J.B.B.), Jean Mayer USDA Human Nutrition Research Center on Aging, and Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy (P.E.M.), Tufts University; and Department of Neurology (S.K.F.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Muhib Khan
- From the J. Philip Kistler Stroke Research Center (S.L., N.S.R., L.M.B., A.C., R.E.G., T.K.T., B.T.), Department of Neurology, and Department of Radiology (H.L., G.J.H.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Neurology (M.K., K.L.F.), Rhode Island Hospital, Alpert Medical School of Brown University, Providence; Massachusetts General Hospital Biostatistics Center (A.M.), Boston; Neuroprotection Research Laboratory (K.A., A.T.S., L.-D.D.P., E.H.L.), Neuroscience Center, Departments of Neurology and Radiology, Massachusetts General Hospital and Harvard Medical School; Athinoula A. Martinos Center for Biomedical Imaging (O.W.), Massachusetts General Hospital and Harvard Medical School, Charlestown; Antioxidant Research Laboratory (J.B.B.), Jean Mayer USDA Human Nutrition Research Center on Aging, and Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy (P.E.M.), Tufts University; and Department of Neurology (S.K.F.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Hua Li
- From the J. Philip Kistler Stroke Research Center (S.L., N.S.R., L.M.B., A.C., R.E.G., T.K.T., B.T.), Department of Neurology, and Department of Radiology (H.L., G.J.H.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Neurology (M.K., K.L.F.), Rhode Island Hospital, Alpert Medical School of Brown University, Providence; Massachusetts General Hospital Biostatistics Center (A.M.), Boston; Neuroprotection Research Laboratory (K.A., A.T.S., L.-D.D.P., E.H.L.), Neuroscience Center, Departments of Neurology and Radiology, Massachusetts General Hospital and Harvard Medical School; Athinoula A. Martinos Center for Biomedical Imaging (O.W.), Massachusetts General Hospital and Harvard Medical School, Charlestown; Antioxidant Research Laboratory (J.B.B.), Jean Mayer USDA Human Nutrition Research Center on Aging, and Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy (P.E.M.), Tufts University; and Department of Neurology (S.K.F.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Leonardo M Batista
- From the J. Philip Kistler Stroke Research Center (S.L., N.S.R., L.M.B., A.C., R.E.G., T.K.T., B.T.), Department of Neurology, and Department of Radiology (H.L., G.J.H.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Neurology (M.K., K.L.F.), Rhode Island Hospital, Alpert Medical School of Brown University, Providence; Massachusetts General Hospital Biostatistics Center (A.M.), Boston; Neuroprotection Research Laboratory (K.A., A.T.S., L.-D.D.P., E.H.L.), Neuroscience Center, Departments of Neurology and Radiology, Massachusetts General Hospital and Harvard Medical School; Athinoula A. Martinos Center for Biomedical Imaging (O.W.), Massachusetts General Hospital and Harvard Medical School, Charlestown; Antioxidant Research Laboratory (J.B.B.), Jean Mayer USDA Human Nutrition Research Center on Aging, and Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy (P.E.M.), Tufts University; and Department of Neurology (S.K.F.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Aurauma Chutinet
- From the J. Philip Kistler Stroke Research Center (S.L., N.S.R., L.M.B., A.C., R.E.G., T.K.T., B.T.), Department of Neurology, and Department of Radiology (H.L., G.J.H.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Neurology (M.K., K.L.F.), Rhode Island Hospital, Alpert Medical School of Brown University, Providence; Massachusetts General Hospital Biostatistics Center (A.M.), Boston; Neuroprotection Research Laboratory (K.A., A.T.S., L.-D.D.P., E.H.L.), Neuroscience Center, Departments of Neurology and Radiology, Massachusetts General Hospital and Harvard Medical School; Athinoula A. Martinos Center for Biomedical Imaging (O.W.), Massachusetts General Hospital and Harvard Medical School, Charlestown; Antioxidant Research Laboratory (J.B.B.), Jean Mayer USDA Human Nutrition Research Center on Aging, and Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy (P.E.M.), Tufts University; and Department of Neurology (S.K.F.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Rebecca E Green
- From the J. Philip Kistler Stroke Research Center (S.L., N.S.R., L.M.B., A.C., R.E.G., T.K.T., B.T.), Department of Neurology, and Department of Radiology (H.L., G.J.H.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Neurology (M.K., K.L.F.), Rhode Island Hospital, Alpert Medical School of Brown University, Providence; Massachusetts General Hospital Biostatistics Center (A.M.), Boston; Neuroprotection Research Laboratory (K.A., A.T.S., L.-D.D.P., E.H.L.), Neuroscience Center, Departments of Neurology and Radiology, Massachusetts General Hospital and Harvard Medical School; Athinoula A. Martinos Center for Biomedical Imaging (O.W.), Massachusetts General Hospital and Harvard Medical School, Charlestown; Antioxidant Research Laboratory (J.B.B.), Jean Mayer USDA Human Nutrition Research Center on Aging, and Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy (P.E.M.), Tufts University; and Department of Neurology (S.K.F.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Tijy K Thankachan
- From the J. Philip Kistler Stroke Research Center (S.L., N.S.R., L.M.B., A.C., R.E.G., T.K.T., B.T.), Department of Neurology, and Department of Radiology (H.L., G.J.H.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Neurology (M.K., K.L.F.), Rhode Island Hospital, Alpert Medical School of Brown University, Providence; Massachusetts General Hospital Biostatistics Center (A.M.), Boston; Neuroprotection Research Laboratory (K.A., A.T.S., L.-D.D.P., E.H.L.), Neuroscience Center, Departments of Neurology and Radiology, Massachusetts General Hospital and Harvard Medical School; Athinoula A. Martinos Center for Biomedical Imaging (O.W.), Massachusetts General Hospital and Harvard Medical School, Charlestown; Antioxidant Research Laboratory (J.B.B.), Jean Mayer USDA Human Nutrition Research Center on Aging, and Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy (P.E.M.), Tufts University; and Department of Neurology (S.K.F.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Brenda Thornell
- From the J. Philip Kistler Stroke Research Center (S.L., N.S.R., L.M.B., A.C., R.E.G., T.K.T., B.T.), Department of Neurology, and Department of Radiology (H.L., G.J.H.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Neurology (M.K., K.L.F.), Rhode Island Hospital, Alpert Medical School of Brown University, Providence; Massachusetts General Hospital Biostatistics Center (A.M.), Boston; Neuroprotection Research Laboratory (K.A., A.T.S., L.-D.D.P., E.H.L.), Neuroscience Center, Departments of Neurology and Radiology, Massachusetts General Hospital and Harvard Medical School; Athinoula A. Martinos Center for Biomedical Imaging (O.W.), Massachusetts General Hospital and Harvard Medical School, Charlestown; Antioxidant Research Laboratory (J.B.B.), Jean Mayer USDA Human Nutrition Research Center on Aging, and Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy (P.E.M.), Tufts University; and Department of Neurology (S.K.F.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Alona Muzikansky
- From the J. Philip Kistler Stroke Research Center (S.L., N.S.R., L.M.B., A.C., R.E.G., T.K.T., B.T.), Department of Neurology, and Department of Radiology (H.L., G.J.H.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Neurology (M.K., K.L.F.), Rhode Island Hospital, Alpert Medical School of Brown University, Providence; Massachusetts General Hospital Biostatistics Center (A.M.), Boston; Neuroprotection Research Laboratory (K.A., A.T.S., L.-D.D.P., E.H.L.), Neuroscience Center, Departments of Neurology and Radiology, Massachusetts General Hospital and Harvard Medical School; Athinoula A. Martinos Center for Biomedical Imaging (O.W.), Massachusetts General Hospital and Harvard Medical School, Charlestown; Antioxidant Research Laboratory (J.B.B.), Jean Mayer USDA Human Nutrition Research Center on Aging, and Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy (P.E.M.), Tufts University; and Department of Neurology (S.K.F.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Ken Arai
- From the J. Philip Kistler Stroke Research Center (S.L., N.S.R., L.M.B., A.C., R.E.G., T.K.T., B.T.), Department of Neurology, and Department of Radiology (H.L., G.J.H.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Neurology (M.K., K.L.F.), Rhode Island Hospital, Alpert Medical School of Brown University, Providence; Massachusetts General Hospital Biostatistics Center (A.M.), Boston; Neuroprotection Research Laboratory (K.A., A.T.S., L.-D.D.P., E.H.L.), Neuroscience Center, Departments of Neurology and Radiology, Massachusetts General Hospital and Harvard Medical School; Athinoula A. Martinos Center for Biomedical Imaging (O.W.), Massachusetts General Hospital and Harvard Medical School, Charlestown; Antioxidant Research Laboratory (J.B.B.), Jean Mayer USDA Human Nutrition Research Center on Aging, and Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy (P.E.M.), Tufts University; and Department of Neurology (S.K.F.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Angel T Som
- From the J. Philip Kistler Stroke Research Center (S.L., N.S.R., L.M.B., A.C., R.E.G., T.K.T., B.T.), Department of Neurology, and Department of Radiology (H.L., G.J.H.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Neurology (M.K., K.L.F.), Rhode Island Hospital, Alpert Medical School of Brown University, Providence; Massachusetts General Hospital Biostatistics Center (A.M.), Boston; Neuroprotection Research Laboratory (K.A., A.T.S., L.-D.D.P., E.H.L.), Neuroscience Center, Departments of Neurology and Radiology, Massachusetts General Hospital and Harvard Medical School; Athinoula A. Martinos Center for Biomedical Imaging (O.W.), Massachusetts General Hospital and Harvard Medical School, Charlestown; Antioxidant Research Laboratory (J.B.B.), Jean Mayer USDA Human Nutrition Research Center on Aging, and Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy (P.E.M.), Tufts University; and Department of Neurology (S.K.F.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Loc-Duyen D Pham
- From the J. Philip Kistler Stroke Research Center (S.L., N.S.R., L.M.B., A.C., R.E.G., T.K.T., B.T.), Department of Neurology, and Department of Radiology (H.L., G.J.H.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Neurology (M.K., K.L.F.), Rhode Island Hospital, Alpert Medical School of Brown University, Providence; Massachusetts General Hospital Biostatistics Center (A.M.), Boston; Neuroprotection Research Laboratory (K.A., A.T.S., L.-D.D.P., E.H.L.), Neuroscience Center, Departments of Neurology and Radiology, Massachusetts General Hospital and Harvard Medical School; Athinoula A. Martinos Center for Biomedical Imaging (O.W.), Massachusetts General Hospital and Harvard Medical School, Charlestown; Antioxidant Research Laboratory (J.B.B.), Jean Mayer USDA Human Nutrition Research Center on Aging, and Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy (P.E.M.), Tufts University; and Department of Neurology (S.K.F.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Ona Wu
- From the J. Philip Kistler Stroke Research Center (S.L., N.S.R., L.M.B., A.C., R.E.G., T.K.T., B.T.), Department of Neurology, and Department of Radiology (H.L., G.J.H.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Neurology (M.K., K.L.F.), Rhode Island Hospital, Alpert Medical School of Brown University, Providence; Massachusetts General Hospital Biostatistics Center (A.M.), Boston; Neuroprotection Research Laboratory (K.A., A.T.S., L.-D.D.P., E.H.L.), Neuroscience Center, Departments of Neurology and Radiology, Massachusetts General Hospital and Harvard Medical School; Athinoula A. Martinos Center for Biomedical Imaging (O.W.), Massachusetts General Hospital and Harvard Medical School, Charlestown; Antioxidant Research Laboratory (J.B.B.), Jean Mayer USDA Human Nutrition Research Center on Aging, and Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy (P.E.M.), Tufts University; and Department of Neurology (S.K.F.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Gordon J Harris
- From the J. Philip Kistler Stroke Research Center (S.L., N.S.R., L.M.B., A.C., R.E.G., T.K.T., B.T.), Department of Neurology, and Department of Radiology (H.L., G.J.H.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Neurology (M.K., K.L.F.), Rhode Island Hospital, Alpert Medical School of Brown University, Providence; Massachusetts General Hospital Biostatistics Center (A.M.), Boston; Neuroprotection Research Laboratory (K.A., A.T.S., L.-D.D.P., E.H.L.), Neuroscience Center, Departments of Neurology and Radiology, Massachusetts General Hospital and Harvard Medical School; Athinoula A. Martinos Center for Biomedical Imaging (O.W.), Massachusetts General Hospital and Harvard Medical School, Charlestown; Antioxidant Research Laboratory (J.B.B.), Jean Mayer USDA Human Nutrition Research Center on Aging, and Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy (P.E.M.), Tufts University; and Department of Neurology (S.K.F.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Eng H Lo
- From the J. Philip Kistler Stroke Research Center (S.L., N.S.R., L.M.B., A.C., R.E.G., T.K.T., B.T.), Department of Neurology, and Department of Radiology (H.L., G.J.H.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Neurology (M.K., K.L.F.), Rhode Island Hospital, Alpert Medical School of Brown University, Providence; Massachusetts General Hospital Biostatistics Center (A.M.), Boston; Neuroprotection Research Laboratory (K.A., A.T.S., L.-D.D.P., E.H.L.), Neuroscience Center, Departments of Neurology and Radiology, Massachusetts General Hospital and Harvard Medical School; Athinoula A. Martinos Center for Biomedical Imaging (O.W.), Massachusetts General Hospital and Harvard Medical School, Charlestown; Antioxidant Research Laboratory (J.B.B.), Jean Mayer USDA Human Nutrition Research Center on Aging, and Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy (P.E.M.), Tufts University; and Department of Neurology (S.K.F.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
| | - Jeffrey B Blumberg
- From the J. Philip Kistler Stroke Research Center (S.L., N.S.R., L.M.B., A.C., R.E.G., T.K.T., B.T.), Department of Neurology, and Department of Radiology (H.L., G.J.H.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Neurology (M.K., K.L.F.), Rhode Island Hospital, Alpert Medical School of Brown University, Providence; Massachusetts General Hospital Biostatistics Center (A.M.), Boston; Neuroprotection Research Laboratory (K.A., A.T.S., L.-D.D.P., E.H.L.), Neuroscience Center, Departments of Neurology and Radiology, Massachusetts General Hospital and Harvard Medical School; Athinoula A. Martinos Center for Biomedical Imaging (O.W.), Massachusetts General Hospital and Harvard Medical School, Charlestown; Antioxidant Research Laboratory (J.B.B.), Jean Mayer USDA Human Nutrition Research Center on Aging, and Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy (P.E.M.), Tufts University; and Department of Neurology (S.K.F.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Paul E Milbury
- From the J. Philip Kistler Stroke Research Center (S.L., N.S.R., L.M.B., A.C., R.E.G., T.K.T., B.T.), Department of Neurology, and Department of Radiology (H.L., G.J.H.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Neurology (M.K., K.L.F.), Rhode Island Hospital, Alpert Medical School of Brown University, Providence; Massachusetts General Hospital Biostatistics Center (A.M.), Boston; Neuroprotection Research Laboratory (K.A., A.T.S., L.-D.D.P., E.H.L.), Neuroscience Center, Departments of Neurology and Radiology, Massachusetts General Hospital and Harvard Medical School; Athinoula A. Martinos Center for Biomedical Imaging (O.W.), Massachusetts General Hospital and Harvard Medical School, Charlestown; Antioxidant Research Laboratory (J.B.B.), Jean Mayer USDA Human Nutrition Research Center on Aging, and Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy (P.E.M.), Tufts University; and Department of Neurology (S.K.F.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Steven K Feske
- From the J. Philip Kistler Stroke Research Center (S.L., N.S.R., L.M.B., A.C., R.E.G., T.K.T., B.T.), Department of Neurology, and Department of Radiology (H.L., G.J.H.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Neurology (M.K., K.L.F.), Rhode Island Hospital, Alpert Medical School of Brown University, Providence; Massachusetts General Hospital Biostatistics Center (A.M.), Boston; Neuroprotection Research Laboratory (K.A., A.T.S., L.-D.D.P., E.H.L.), Neuroscience Center, Departments of Neurology and Radiology, Massachusetts General Hospital and Harvard Medical School; Athinoula A. Martinos Center for Biomedical Imaging (O.W.), Massachusetts General Hospital and Harvard Medical School, Charlestown; Antioxidant Research Laboratory (J.B.B.), Jean Mayer USDA Human Nutrition Research Center on Aging, and Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy (P.E.M.), Tufts University; and Department of Neurology (S.K.F.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Karen L Furie
- From the J. Philip Kistler Stroke Research Center (S.L., N.S.R., L.M.B., A.C., R.E.G., T.K.T., B.T.), Department of Neurology, and Department of Radiology (H.L., G.J.H.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Neurology (M.K., K.L.F.), Rhode Island Hospital, Alpert Medical School of Brown University, Providence; Massachusetts General Hospital Biostatistics Center (A.M.), Boston; Neuroprotection Research Laboratory (K.A., A.T.S., L.-D.D.P., E.H.L.), Neuroscience Center, Departments of Neurology and Radiology, Massachusetts General Hospital and Harvard Medical School; Athinoula A. Martinos Center for Biomedical Imaging (O.W.), Massachusetts General Hospital and Harvard Medical School, Charlestown; Antioxidant Research Laboratory (J.B.B.), Jean Mayer USDA Human Nutrition Research Center on Aging, and Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy (P.E.M.), Tufts University; and Department of Neurology (S.K.F.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
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Chen L, Geng L, Chen J, Yan Y, Yang L, Zhao J, Sun Q, He J, Bai L, Wang X. Effects of Urinary Kallidinogenase on NIHSS score, mRS score, and fasting glucose levels in acute ischemic stroke patients with abnormal glucose metabolism: A prospective cohort study. Medicine (Baltimore) 2019; 98:e17008. [PMID: 31464958 PMCID: PMC6736392 DOI: 10.1097/md.0000000000017008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Urinary kallidinogenase may assist recovery acute ischemic stroke. This study evaluated the effect of urinary kallidinogenase on National Institute of Health Stroke Scale (NIHSS) score, modified Rankin scale (mRS) score, and fasting glucose levels in patients with acute ischemic stroke (AIS) combined with diabetes mellitus and impaired fasting glucose.Patients with AIS and abnormal glucose metabolism were enrolled in this prospective cohort study and divided into 2 groups. The human urinary kallidinogenase (HUK) group were treated with urinary kallidinogenase and standard treatment; the control group received standard treatment. NIHSS scores, mRS scores, and fasting blood glucose were evaluated and compared.A total of 113 patients were included: 58 in the HUK group and 55 in the control group. NIHSS scores decreased with treatment in both groups (time effect P < .05), but were lower in the HUK group (main effect P = .026). The mRS score decreased in both groups from 10 until 90 days after treatment (time effect P < .05); the 2 groups were similar (main effect, P = .130). Blood glucose levels decreased in both groups 10 days after treatment (time effect, P < .05), but there was no significant treatment effect (main effect, P = .635). Multivariate analysis showed blood uric acid >420 μmol/L (odds ratio [OR]: 0.053, 95% confidence interval [CI]: 0.008-0.350; P = .002) and application of HUK (OR: 0.217, 95% CI: 0.049-0.954; P = .043) were associated with 90% NIHSS recovery. Baseline NIHSS score was independently associated with poor curative effect.Urinary kallidinogenase with conventional therapy significantly improved NIHSS scores in patients with AIS. Urinary kallidinogenase also showed a trend toward lower fasting blood glucose levels, although the level did not reach significance.
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Affiliation(s)
- Lei Chen
- Department of Neurology, The Second Hospital of Hebei Medical University
- Department of Neurology, The first hospital of Shijiazhuang, Shijiazhuang
| | - Lianxia Geng
- Department of Neurology, The Second Hospital of Hebei Medical University
| | - Junmin Chen
- Department of Neurology, The Second Hospital of Hebei Medical University
| | - Yan Yan
- Department of Neurology, Xingtai People's Hospital, Xingtai, China
| | - Lan Yang
- Department of Neurology, The Second Hospital of Hebei Medical University
| | - Jing Zhao
- Department of Neurology, The Second Hospital of Hebei Medical University
| | - Qian Sun
- Department of Neurology, The Second Hospital of Hebei Medical University
| | - Junna He
- Department of Neurology, The Second Hospital of Hebei Medical University
| | - Lin Bai
- Department of Neurology, The Second Hospital of Hebei Medical University
| | - Xiaopeng Wang
- Department of Neurology, The Second Hospital of Hebei Medical University
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Fernández-Gajardo R, Matamala JM, Gutiérrez R, Lozano P, Cortés-Fuentes IA, Sotomayor CG, Bustamante G, Pasten JA, Vargas G, Guerrero R, Reyes P, Cavada G, Feuerhake W, Rodrigo R. Relationship between infarct size and serum uric acid levels during the acute phase of stroke. PLoS One 2019; 14:e0219402. [PMID: 31295304 PMCID: PMC6622494 DOI: 10.1371/journal.pone.0219402] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 06/21/2019] [Indexed: 01/13/2023] Open
Abstract
Introduction Uric acid has gained considerable attention as a potential neuroprotective agent in stroke during the last decades, however, its role in the pathophysiology of ischemic stroke remains poorly understood. A serial evaluation of uric acid levels during the acute phase of stroke and its association with infarct size on magnetic resonance imaging is lacking. Methods We present a cohort study of 31 patients with ischemic stroke who were not candidates for thrombolysis according to current criteria at the time. We performed daily measurements of serum uric acid and total antioxidant capacity of plasma during the first week after symptoms onset and 30 days after. Infarct size was determined in the acute phase by a DWI sequence and the final infarct size with a control MRI (FLAIR) at day 30. Results Uric acid significantly decreases between days 2 to 6 compared to day 1, after adjustment by sex, age and DWI at diagnosis, with a nadir value at 72h. A mixed model analysis showed a negative association between DWI at diagnosis and uric acid evolution during the first week after stroke. Moreover, multivariable linear regression of uric acid values during follow up on DWI volumes demonstrated that DWI volume at diagnosis is negatively associated with uric acid levels at day 3 and 4. There were no significant associations between total antioxidant capacity of plasma and DWI at diagnosis, or FLAIR at any point. Discussion Patients with larger infarcts exhibited a significant decrease in serum uric acid levels, accounting for a more prominent reactive oxygen species scavenging activity with subsequent consumption and decay of this antioxidant. The different kinetics of total antioxidant capacity of plasma and serum uric acid levels suggests a specific role of uric acid in the antioxidant response in ischemic stroke.
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Affiliation(s)
- Rodrigo Fernández-Gajardo
- Department of Neurological Sciences, Faculty of Medicine, University of Chile, Santiago, Chile
- Biomedical Neuroscience Institute (BNI), Faculty of Medicine, University of Chile, Santiago, Chile
- Molecular and Clinical Pharmacology Program, Institute of Biomedical Sciences, Faculty of Medicine, University of Chile, Santiago, Chile
| | - José Manuel Matamala
- Department of Neurological Sciences, Faculty of Medicine, University of Chile, Santiago, Chile
- Biomedical Neuroscience Institute (BNI), Faculty of Medicine, University of Chile, Santiago, Chile
- Department of Neuroscience, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Rodrigo Gutiérrez
- Molecular and Clinical Pharmacology Program, Institute of Biomedical Sciences, Faculty of Medicine, University of Chile, Santiago, Chile
| | | | - Ignacio A. Cortés-Fuentes
- Molecular and Clinical Pharmacology Program, Institute of Biomedical Sciences, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Camilo G. Sotomayor
- Molecular and Clinical Pharmacology Program, Institute of Biomedical Sciences, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Gonzalo Bustamante
- Department of Neurological Sciences, Faculty of Medicine, University of Chile, Santiago, Chile
- Department of Neurology, Clínica Santa María, Santiago, Chile
| | - Juan A. Pasten
- Department of Neurology, Clínica Santa María, Santiago, Chile
| | - Gabriel Vargas
- Department of Neurology, Clínica Santa María, Santiago, Chile
| | | | - Pablo Reyes
- Department of Neurological Sciences, Faculty of Medicine, University of Chile, Santiago, Chile
- Department of Neurology, Clínica Santa María, Santiago, Chile
| | - Gabriel Cavada
- School of Public Health, University of Chile, Santiago, Chile
| | - Walter Feuerhake
- Department of Neurological Sciences, Faculty of Medicine, University of Chile, Santiago, Chile
- Department of Neurology, Clínica Santa María, Santiago, Chile
- * E-mail: (WF); (RR)
| | - Ramón Rodrigo
- Molecular and Clinical Pharmacology Program, Institute of Biomedical Sciences, Faculty of Medicine, University of Chile, Santiago, Chile
- * E-mail: (WF); (RR)
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Yu Y, Zhang H, Song Y, Lin T, Zhou Z, Guo H, Liu L, Wang B, Liu C, Li J, Zhang Y, Huo Y, Wang C, Wang X, Hou FF, Qin X, Xu X. Plasma retinol and the risk of first stroke in hypertensive adults: a nested case-control study. Am J Clin Nutr 2019; 109:449-456. [PMID: 30624586 DOI: 10.1093/ajcn/nqy320] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 10/12/2018] [Indexed: 12/30/2022] Open
Abstract
Background Identification of novel risk factors is needed to further lower stroke risk. Data concerning the association between plasma retinol concentrations and the risk of stroke are limited. Objectives We aimed to evaluate the effect of plasma retinol on the risk of first stroke and to examine any possible effect modifiers in hypertensive patients. Methods The study sample population was drawn from the China Stroke Primary Prevention Trial (CSPPT), using a nested case-control design, including 620 cases with first stroke and 620 matched controls. In the CSPPT, a total of 20,702 hypertensive patients were randomly assigned to a double-blind, daily treatment with either 10 mg enalapril and 0.8 mg folic acid or 10 mg enalapril alone. The median treatment duration was 4.5 y. Results There was a significant inverse association between plasma retinol and the risk of first stroke (per 10-μg/dL increment; OR: 0.92; 95% CI: 0.86, 0.97) and first ischemic stroke (OR: 0.92; 95% CI: 0.86, 0.98). When retinol was assessed as quartiles, significantly lower risks of first stroke (OR: 0.64; 95% CI: 0.46, 0.88) and first ischemic stroke (OR: 0.67; 95% CI: 0.46, 0.96) were found in participants in quartiles 2-4 compared with those in quartile 1. Furthermore, a stronger inverse association between plasma retinol and first stroke was observed in participants with baseline total homocysteine (<10 compared with ≥10 μmol/L; P-interaction = 0.049). However, plasma retinol had no significant effect on first hemorrhagic stroke (per 10-μg/dL increment; OR: 0.98; 95% CI: 0.79, 1.18). Conclusions Our data showed a significant inverse association between plasma retinol and the risk of first stroke among Chinese hypertensive adults. This study was registered at clinicaltrials.gov as NCT00794885.
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Affiliation(s)
- Yaren Yu
- National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Hao Zhang
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Yun Song
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Tengfei Lin
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Ziyi Zhou
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Huiyuan Guo
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Lishun Liu
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Binyan Wang
- National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China.,Institute of Biomedicine, Anhui Medical University, Hefei, China
| | | | - Jianping Li
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Yan Zhang
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Chaofu Wang
- Department of Cardiology, Xingyi People's Hospital, Guizhou, China
| | - Xiaobin Wang
- Department of Population, Family, and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Fan Fan Hou
- National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xianhui Qin
- National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China.,Institute of Biomedicine, Anhui Medical University, Hefei, China
| | - Xiping Xu
- National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China.,Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China.,Institute of Biomedicine, Anhui Medical University, Hefei, China
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Martinkova P, Kostelnik A, Pohanka M. Nanomaterials as Pseudocatalysts in the Construction of Electrochemical Nonenzymatic Sensors for Healthcare: A Review. ANAL LETT 2018. [DOI: 10.1080/00032719.2018.1542434] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Pavla Martinkova
- Faculty of Military Health Science, University of Defense, Hradec Kralove, Czech Republic
| | - Adam Kostelnik
- Faculty of Military Health Science, University of Defense, Hradec Kralove, Czech Republic
| | - Miroslav Pohanka
- Faculty of Military Health Science, University of Defense, Hradec Kralove, Czech Republic
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Ramezani M, Sahraei Z, Simani L, Heydari K, Shahidi F. Coenzyme Q10 supplementation in acute ischemic stroke: Is it beneficial in short-term administration? Nutr Neurosci 2018; 23:640-645. [PMID: 30404563 DOI: 10.1080/1028415x.2018.1541269] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Backgrounds and aims: Clinical studies demonstrated that the efficacy of Coenzyme Q10 (CoQ10) as an adjuvant therapeutic agent in several neurological diseases such as Parkinson disease (PD), Huntington disease (HD), and migraine. The purpose of this study is to investigate oxidative stress effects, antioxidant enzymes activity, neuroinflammatory markers levels, and neurological outcome in acute ischemic stroke (AIS) patients following administration of CoQ10 (300 mg/day). Methods: Patients with AIS (n = 60) were randomly assigned to a placebo group (wheat starch, n = 30) or CoQ10-supplemented group (300 mg/day, n = 30). The intervention was administered for 4 weeks. Serum CoQ10 concentration, malondialdehyde (MDA), superoxide dismutase (SOD) activity, glial fibrillary acidic protein (GFAP) levels as primary outcomes and National Institute of Health Stroke Scale (NIHSS), Modified Ranking Scale (MRS), and Mini-Mental State Examination (MMSE) as secondary outcome were measured at the both beginning and end of the study. Results: Forty-four subjects with AIS completed the intervention study. A significant increase in CoQ10 level was observed in the supplement-treated group compared with placebo group (mean difference = 26.05 ± 26.63 ng/ml, 14.12 ± 14.69 ng/ml, respectively; P = 0.01), moreover CoQ10 supplementation improved NIHSS and MMSE scores significantly (P = 0.05, P = 0.03 respectively). but there were no statistically significant differences in MRS score, MDA, SOD, and GFAP levels between the two groups. Conclusions: CoQ10 probably due to low dose and short duration of supplementation, no favorable effects on MDA level, SOD activity and GFAP level.
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Affiliation(s)
- Mahtab Ramezani
- Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Sahraei
- Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Leila Simani
- Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Brain Mapping Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kamran Heydari
- Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Shahidi
- Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Simani L, Ryan F, Hashemifard S, Hooshmandi E, Madahi M, Sahraei Z, Rezaei O, Heydari K, Ramezani M. Serum Coenzyme Q10 Is Associated with Clinical Neurological Outcomes in Acute Stroke Patients. J Mol Neurosci 2018; 66:53-58. [PMID: 30094579 DOI: 10.1007/s12031-018-1115-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Accepted: 07/10/2018] [Indexed: 12/22/2022]
Abstract
Disruption of prooxidant-antioxidant balance may lead to oxidative stress which is known as a mechanism contributing to ischemic stroke. Coenzyme Q10 (CoQ10) is an endogenous antioxidant that could be effective in preventing oxidative stress. However, the contribution of serum levels of CoQ10 in clinical neurological outcomes following ischemic stroke has not been clearly established. This study aims at measuring serum concentration of CoQ10 along with major indicators of antioxidant and oxidant among patients within 24 h after onset of the stroke symptoms, and investigating their relation with the clinical status of patients. Serum levels of CoQ10, superoxide dismutase (SOD), and malondialdehyde (MDA) were measured in 76 patients and 34 healthy individuals. Severity of the neurological deficit, functional disability, and cognitive status in ischemic subjects were respectively studied with the National Institutes of Health stroke scale (NIHSS), modified Rankin Scale (MRS), and Mini-Mental State Examination (MMSE). Stroke patients had significantly lower serum level of CoQ10 and SOD as compared to controls (27.34 ± 35.40 ng/ml, 18.58 ± 0.76 μ/ml, respectively; p < 0.05), whereas the serum MDA level was significantly higher (38.02 ± 2.61 μm, p < 0.05). A significant negative correlation was detected between the serum CoQ10 level and scores of NIHSS and MRS. A similar association was discerned between the SOD level and the neurological deficit score. The serum MDA level was also found to be strongly correlated with all three neurological scales. These findings suggest that the serum level of CoQ10 like other antioxidant and oxidant markers can significantly change early after ischemic stroke and they are substantially associated with clinical neurological outcomes.
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Affiliation(s)
- Leila Simani
- Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, South Kargar Ave., Kamali St., Tehran, 1333635445, Iran.,Brain Mapping Research Center, Shahid Beheshti University of Medical Sciences, South Kargar Ave., Kamali St., Tehran, Iran
| | - Fari Ryan
- Centre for Research in Neuroscience, The Research Institute of the McGill University Health Center, 1650 Cedar Ave., Montreal, Quebec, Canada
| | - Shadab Hashemifard
- Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Etrat Hooshmandi
- Neurophysiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Madahi
- Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, South Kargar Ave., Kamali St., Tehran, 1333635445, Iran
| | - Zahra Sahraei
- Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Omidvar Rezaei
- Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, South Kargar Ave., Kamali St., Tehran, 1333635445, Iran
| | - Kamran Heydari
- Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, South Kargar Ave., Kamali St., Tehran, 1333635445, Iran.
| | - Mahtab Ramezani
- Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, South Kargar Ave., Kamali St., Tehran, 1333635445, Iran.
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Zhou Z, Liang Y, Lin J, Zhang X, Qu H, Xu J, Zhao C, Zhao M. Serum uric acid concentrations and risk of intracerebral hemorrhage: A systematic review and meta-analysis. Atherosclerosis 2018; 275:352-358. [PMID: 30015299 DOI: 10.1016/j.atherosclerosis.2018.07.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Revised: 06/01/2018] [Accepted: 07/03/2018] [Indexed: 01/01/2023]
Abstract
BACKGROUND AND AIMS The relationship between serum uric acid (UA) and the risk of intracerebral hemorrhage (ICH) remains controversial. The aim of our systematic review and meta-analysis was to ascertain the association between serum UA concentrations and the risk of ICH. METHODS We systematically searched databases of Embase, Pubmed, Web of Science and Cochrane Library up to December 30, 2017, and additional papers were identified through a manual search. Mean difference (MD) for serum UA levels with 95% confidence intervals (CI) was calculated. Six studies, including 345 ICH patients, 574 ischemic stroke patients and 535 healthy controls, were identified for meta-analysis. RESULTS Our results revealed no statistically significant differences in the comparison of UA between ICH and healthy controls (95% CI = -9.04-15.61); UA levels in patients with ischemic stroke were significantly higher than those in healthy controls (95% CI = 3.91-56.32); further subgroup analysis of age showed higher UA levels in ICH patients over 65 years than healthy controls (age≥65: 95% CI = 1.44-35.96). Subgroup of ethnicity (Asians: CI = -9.06-21.00; Caucasians: 95% CI = -68.43-8.43), gender (Men: 95% CI = -56.08-4.73; Women: 95% CI = -27.19-35.91) and sample size (large samples: 95% CI = -20.54-41.05; small samples: 95% CI = -25.41-13.78) with respect to UA levels between ICH and healthy controls did not change these results. CONCLUSIONS This meta-analysis showed that serum UA levels did not increase the risk of ICH probably because of the dual roles of UA, i.e. pro-oxidant and antioxidant, in the progression of atherosclerosis. However, serum UA may be a potential risk factor for ICH in the elderly. There were no race-specific differences in UA levels between Asians and Caucasians as well as gender-related differences between men and women in the risk of ICH.
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Affiliation(s)
- Zhike Zhou
- Department of Geriatrics, The First Affiliated Hospital, China Medical University, Shenyang, 110001, Liaoning, PR China
| | - Yifan Liang
- Department of Neurology, The First Affiliated Hospital, China Medical University, Shenyang, 110001, Liaoning, PR China
| | - Jueying Lin
- Department of Emergency, Zhongshan Hospital Xiamen University, Xiamen, 361004, Fujian, PR China
| | - Xiaoqian Zhang
- Department of Neurology, The First Affiliated Hospital, China Medical University, Shenyang, 110001, Liaoning, PR China
| | - Huiling Qu
- Department of Neurology, People's Hospital of Liaoning Province, Shenyang, 110016, Liaoning, PR China
| | - Junjie Xu
- Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, Shenyang, 110001, Liaoning, PR China
| | - Chuansheng Zhao
- Department of Neurology, The First Affiliated Hospital, China Medical University, Shenyang, 110001, Liaoning, PR China.
| | - Mei Zhao
- Department of Cardiology, The Shengjing Affiliated Hospital, China Medical University, Shenyang, 110004, Liaoning, PR China.
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Cabrera Naranjo FH, Saavedra Santana P, González Hernández A, Fabre Pi O, Sosa-Henríquez M. Hyperuricaemia as a prognostic factor for acute ischaemic stroke. Neurologia 2018. [PMID: 29526317 DOI: 10.1016/j.nrl.2018.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
INTRODUCTION Recent studies on uric acid as a biomarker for the prognosis of acute stroke have found conflicting results. METHODS We collected blood samples from 600 consecutively admitted patients at our tertiary hospital and analysed the relationship between uric acid levels and functional prognosis (measured using the modified Rankin Scale [mRS]). Patients who had received reperfusion therapy were excluded since this may have influenced uric acid levels. RESULTS A total of 73% of patients had mRS scores ≤2; the mean uric acid level was 5.22mg/dL. We found a nonlinear relationship between functional prognosis at discharge and serum uric acid levels at admission when the National Institutes of Health Stroke Scale score was excluded from the analysis. CONCLUSIONS Serum uric acid levels in patients with acute ischaemic stroke are significantly associated with functional prognosis at discharge, although this relationship is nonlinear. In fact, poorer prognosis is associated both with very low and with very high concentrations of uric acid. This suggests a dual role of uric acid in relation to stroke: on the one hand, as an associated risk factor, and on the other, as a possible neuroprotective factor due to its antioxidant effect.
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Affiliation(s)
- F H Cabrera Naranjo
- Servicio de Neurología, Hospital Universitario Dr. Negrín, Las Palmas de Gran Canaria, España.
| | - P Saavedra Santana
- Departamento de Matemáticas, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, España
| | | | - O Fabre Pi
- Servicio de Neurología, Hospital Universitario Dr. Negrín, Las Palmas de Gran Canaria, España
| | - M Sosa-Henríquez
- Universidad de Las Palmas de Gran Canaria, Instituto Universitario de Investigaciones Biomédicas y Sanitarias, Las Palmas de Gran Canaria, España
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Mecocci P, Boccardi V, Cecchetti R, Bastiani P, Scamosci M, Ruggiero C, Baroni M. A Long Journey into Aging, Brain Aging, and Alzheimer's Disease Following the Oxidative Stress Tracks. J Alzheimers Dis 2018; 62:1319-1335. [PMID: 29562533 PMCID: PMC5870006 DOI: 10.3233/jad-170732] [Citation(s) in RCA: 156] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2017] [Indexed: 12/13/2022]
Abstract
The Editors of the Journal of Alzheimer's Disease invited Professor Patrizia Mecocci to contribute a review article focused on the importance and implications of her research on aging, brain aging, and senile dementias over the last years. This invitation was based on an assessment that she was one of the journal's top authors and a strong supporter of the concept that oxidative stress is a major contributor to several alterations observed in age-related conditions (sarcopenia, osteoporosis) and, more significantly, in brain aging suggesting a pivotal role in the pathogenesis and progression of one of the most dramatic age-related diseases, Alzheimer's disease (AD). Her first pioneering research was on the discovery of high level of 8-hydroxy-2'-deoxyguanosine (OH8dG), a marker of oxidation in nucleic acids, in mitochondrial DNA isolated from cerebral cortex. This molecule increases progressively with aging and more in AD brain, supporting the hypothesis that oxidative stress, a condition of unbalance between the production of reactive oxygen species and antioxidants, gives a strong contribution to the high incidence of AD in old age subjects. OH8dG also increases in peripheral lymphocyte from AD subjects, suggesting that AD is not only a cerebral but also a systemic disease. The role of antioxidants, particularly vitamin E and zinc, were also studied in longevity and in cognitive decline and dementia. This review shows the main findings from Mecocci's laboratory related to oxidative stress in aging, brain aging, and AD and discusses the importance and implications of some of the major achievements in this field of research.
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Affiliation(s)
- Patrizia Mecocci
- Department of Medicine, Institute of Gerontology and Geriatrics, University of Perugia, Perugia, Italy
| | - Virginia Boccardi
- Department of Medicine, Institute of Gerontology and Geriatrics, University of Perugia, Perugia, Italy
| | - Roberta Cecchetti
- Department of Medicine, Institute of Gerontology and Geriatrics, University of Perugia, Perugia, Italy
| | - Patrizia Bastiani
- Department of Medicine, Institute of Gerontology and Geriatrics, University of Perugia, Perugia, Italy
| | - Michela Scamosci
- Department of Medicine, Institute of Gerontology and Geriatrics, University of Perugia, Perugia, Italy
| | - Carmelinda Ruggiero
- Department of Medicine, Institute of Gerontology and Geriatrics, University of Perugia, Perugia, Italy
| | - Marta Baroni
- Department of Medicine, Institute of Gerontology and Geriatrics, University of Perugia, Perugia, Italy
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Gao J, Xu W, Han K, Zhu L, Gao L, Shang X. Changes of serum uric acid and total bilirubin in elderly patients with major postischemic stroke depression. Neuropsychiatr Dis Treat 2018; 14:83-93. [PMID: 29343960 PMCID: PMC5749573 DOI: 10.2147/ndt.s149712] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND This was a longitudinal study which investigated the relationship between serum uric acid (SUA) and total bilirubin (Tbil) upon admission in elderly stroke patients and the occurrence of postischemic stroke depression (IPSD) at 3, 6, and 9 months of post-stroke follow-up. SUBJECTS AND METHODS Data were analyzed for 525 acute ischemic stroke patients. Beck Depression Inventory (BDI) scores >17 and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) were used separately to screen and diagnose IPSD at 3, 6, and 9 months post-stroke. Once IPSD was diagnosed, follow-up activities were terminated. RESULTS High levels of SUA (odds ratio [OR]=2.08, P<0.01) and Tbil (OR=2.31, P<0.01) in the first 3 months post-stroke and low levels of SUA (OR=2.05, P=0.03) and Tbil (OR=2.79, P<0.01) from 3 to 6 months post-stroke were identified as risk factors for major IPSD. At 3 months, patients with SUA levels ≥406.5 μmol/L (males with SUA levels of ≥409.5 μmol/L and females with SUA levels ≥385.5 μmol/L) and Tbil levels ≥23.65 μmol/L were more likely to develop major IPSD. At 6 months, both SUA (area under curve [AUC]=0.625, P=0.005, cutoff =194.0 μmol/L) and Tbil (AUC=0.681, P=0.004, cutoff =6.75 μmol/L) had minor diagnostic values (AUC<0.700), although SUA levels ≤214.5 μmol/L (AUC=0.756, P=0.001) in female patients had a good diagnostic value (AUC=0.722, P=0.006) for major IPSD. At 9 months, major IPSD showed no statistical relationship with either SUA (χ2=2.33, P=0.13) or Tbil (χ2=0.41, P=0.84). CONCLUSION Higher levels of SUA and Tbil on admission were closely related to the occurrence of major IPSD within 3 months of stroke. Lower levels of these two biomarkers on admission were characteristic for the occurrence of major IPSD between 3 and 6 months post-stroke, while 6 months after stroke, there was no relationship between major IPSD and these two biomarkers.
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Affiliation(s)
- Jie Gao
- Department of Neurology, The First Affiliated Hospital, China Medical University, Shenyang, China
| | - Wei Xu
- Department of Neurology, The First Affiliated Hospital, China Medical University, Shenyang, China
| | - Kun Han
- Department of Neurology, The First Affiliated Hospital, China Medical University, Shenyang, China
| | - Lu Zhu
- Department of Neurology, The First Affiliated Hospital, China Medical University, Shenyang, China
| | - Lili Gao
- Department of Neurology, The First Affiliated Hospital, China Medical University, Shenyang, China
| | - Xiuli Shang
- Department of Neurology, The First Affiliated Hospital, China Medical University, Shenyang, China
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Shoeibi A, Razmi N, Ghabeli Juibary A, Hashemy SI. The Evaluation and Comparison of Oxidative Stress in Hemorrhagic and Ischemic Stroke. CASPIAN JOURNAL OF NEUROLOGICAL SCIENCES 2017. [DOI: 10.29252/nirp.cjns.3.11.206] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Feng GH, Li HP, Li QL, Fu Y, Huang RB. Red blood cell distribution width and ischaemic stroke. Stroke Vasc Neurol 2017; 2:172-175. [PMID: 28989807 PMCID: PMC5628378 DOI: 10.1136/svn-2017-000071] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 04/28/2017] [Accepted: 05/07/2017] [Indexed: 12/14/2022] Open
Abstract
The red blood cell distribution width (RDW) is a measure of red blood cell (RBC) size heterogeneity, which is easily calculated by dividing the SD of erythrocyte volumes for the mean corpuscular volume. Recent reporter suggested that, besides haematological diseases and anaemia, many human disorders may be closely associated with the elevated RDW. A literature review has revealed the RDW may be closely related to the development of ischaemic stroke, carotid artery atherosclerosis and cerebral embolism. Higher RDW could independently predict adverse outcomes in patients in these conditions.
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Affiliation(s)
- Gang-Hua Feng
- Department of Neurology, The First People’s Hospital of Chenzhou, University of South China, Chenzhou, China
| | - Hai-Peng Li
- Department of Neurology, The First People’s Hospital of Chenzhou, University of South China, Chenzhou, China
| | - Qiu-Li Li
- Department of Neurology, The First People’s Hospital of Chenzhou, University of South China, Chenzhou, China
| | - Ying Fu
- Thyroid Medicine Department/Radionuclide Therapy Department (Ward 31), Hunan Provincial Tumor Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Ren-Bin Huang
- Department of Neurology, The First People’s Hospital of Chenzhou, University of South China, Chenzhou, China
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Daglia M, Di Lorenzo A, Nabavi SF, Sureda A, Khanjani S, Moghaddam AH, Braidy N, Nabavi SM. Improvement of Antioxidant Defences and Mood Status by Oral GABA Tea Administration in a Mouse Model of Post-Stroke Depression. Nutrients 2017; 9:nu9050446. [PMID: 28468264 PMCID: PMC5452176 DOI: 10.3390/nu9050446] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Revised: 04/02/2017] [Accepted: 04/24/2017] [Indexed: 11/16/2022] Open
Abstract
Green GABA (GGABA) and Oolong GABA (OGABA) teas are relatively new varieties of tea, whose chemical composition and functional properties are largely under-studied, despite their promising health capacities. Post stroke depression (PSD) is a complication of stroke with high clinical relevance, yielding increasing mortality and morbidity rates, and a lower response to common therapies and rehabilitation. Methods: Two chemically characterized commercial samples of GGABA and OGABA were investigated for effects on mood following oral administration using a mouse model of PSD, through common validated tests including the Despair Swimming Test and Tail Suspension Test. Moreover, the antioxidant activity of GGABA and OGABA was evaluated by determining the levels of lipid peroxidation products and the activity of antioxidant enzymes in the mouse brain in vivo. Results: GGABA and OGABA attenuated depressed mood by influencing behavioral parameters linked to depression. GGABA was more active than OGABA in this study, and this effect may be likely due to a higher content of polyphenolic substances and amino acids in GGABA compared to OGABA. GGABA also exerted a greater antioxidant activity. Conclusions: Our data suggests that GABA tea is a promising candidate that can be used as an adjuvant in the management of PSD.
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Affiliation(s)
- Maria Daglia
- Department of Drug Sciences, Medicinal Chemistry and Pharmaceutical Technology Section, Pavia University, VialeTaramelli 12, 27100 Pavia, Italy.
| | - Arianna Di Lorenzo
- Department of Drug Sciences, Medicinal Chemistry and Pharmaceutical Technology Section, Pavia University, VialeTaramelli 12, 27100 Pavia, Italy.
- KOLINPHARMA S.p.A., Lainate, Corso Europa 5, 20020 Lainate (MI), Italy.
| | - Seyed Fazel Nabavi
- Applied Biotechnology Research Center, Baqiyatallah University of Medical Sciences, P.O. Box 19395-5487, Tehran 19395-5487, Iran.
| | - Antoni Sureda
- Grup de Nutrició Comunitària i Estrès Oxidatiu and CIBEROBN (Physiopathology of Obesity and Nutrition), Universitat de les Illes Balears, Palma de E-07122 Mallorca, Spain.
| | - Sedigheh Khanjani
- Department of Physiology, Faculty of Biological Sciences, Shahid Behshti University, P.O. Box 19615-1178, Tehran 19615-1178, Iran.
| | - Akbar Hajizadeh Moghaddam
- Department of Biology, Faculty of Basic Sciences, University of Mazandaran, 47416-95447 Babolsar, Iran.
| | - Nady Braidy
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Australia.
- CHeBA NPI, Euroa Centre, Prince of Wales Hospital, Barker Street, Randwick, NSW 2031, Australia.
| | - Seyed Mohammad Nabavi
- Applied Biotechnology Research Center, Baqiyatallah University of Medical Sciences, P.O. Box 19395-5487, Tehran 19395-5487, Iran.
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Lee Y, Khan A, Hong S, Jee SH, Park YH. A metabolomic study on high-risk stroke patients determines low levels of serum lysine metabolites: a retrospective cohort study. MOLECULAR BIOSYSTEMS 2017; 13:1109-1120. [DOI: 10.1039/c6mb00732e] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Metabolic alteration at early neurological deterioration during cerebral ischemia.
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Affiliation(s)
- Yeseung Lee
- Metabolomics Laboratory
- College of Pharmacy
- Korea University
- Sejong City
- Korea
| | - Adnan Khan
- Metabolomics Laboratory
- College of Pharmacy
- Korea University
- Sejong City
- Korea
| | - Seri Hong
- Department of Epidemiology and Health Promotion and Institute of Health Promotion
- Graduate School of Public Health
- Yonsei University
- Seoul
- Korea
| | - Sun Ha Jee
- Department of Epidemiology and Health Promotion and Institute of Health Promotion
- Graduate School of Public Health
- Yonsei University
- Seoul
- Korea
| | - Youngja H. Park
- Metabolomics Laboratory
- College of Pharmacy
- Korea University
- Sejong City
- Korea
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Jena I, Nayak SR, Behera S, Singh B, Ray S, Jena D, Singh S, Sahoo SK. Evaluation of ischemia-modified albumin, oxidative stress, and antioxidant status in acute ischemic stroke patients. J Nat Sci Biol Med 2017; 8:110-113. [PMID: 28250685 PMCID: PMC5320811 DOI: 10.4103/0976-9668.198346] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background: Oxidative stress is characterized by increased production of reactive oxygen species resulting in the generation of lipid peroxides such as malondialdehyde (MDA). The studies have shown that ischemia-modified albumin (IMA), which has widely been studied as a marker of ischemia, also increases as result of oxidative stress. Hence, the current study was done to evaluate the serum MDA, IMA along with serum uric acid, and albumin, which are important metabolic antioxidants. Materials and Methods: Fifty patients with acute ischemic stroke were taken as cases and compared with 50 age- and sex-matched controls. Serum MDA, IMA, uric acid, and albumin were estimated both in cases and controls. Serum MDA was estimated by the method of Satoh and IMA by Bar-Or et al. The results were analyzed statistically. Results: Serum MDA and IMA values were significantly increased in cases (P < 0.0001), whereas serum uric acid and albumin values were significantly decreased (P < 0.05) in comparison to controls. There was also highly significant positive correlation between serum IMA and MDA (r = 0.843,P < 0.0001), whereas there were significant negative correlations between serum IMA and uric acid (r = −0.237,P < 0.05), and albumin (r = −0.326,P < 0.05). Conclusion: Hence, we conclude the oxidative stress plays a major role in the etiopathogenesis of acute ischemic stroke, and the deranged oxidant-antioxidant balance further contributes to its severity.
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Affiliation(s)
- Itishri Jena
- Department of Biochemistry, IMS and SUM Hospital, SOA University, Bhubaneswar, Odisha, India
| | - Sarthak Ranjan Nayak
- Department of Biochemistry, IMS and SUM Hospital, SOA University, Bhubaneswar, Odisha, India
| | - Sudeshna Behera
- Department of Biochemistry, IMS and SUM Hospital, SOA University, Bhubaneswar, Odisha, India
| | - Bratati Singh
- Department of Biochemistry, IMS and SUM Hospital, SOA University, Bhubaneswar, Odisha, India
| | - Subhashree Ray
- Department of Biochemistry, IMS and SUM Hospital, SOA University, Bhubaneswar, Odisha, India
| | - Diptimayee Jena
- Department of Biochemistry, MKCG Medical College, Berhampur University, Berhampur, Odisha, India
| | - Santosh Singh
- Department of Medicine, IMS and SUM Hospital, SOA University, Bhubaneswar, Odisha, India
| | - Subrat Kumar Sahoo
- Department of Pediatrics Surgery, IMS and SUM Hospital, SOA University, Bhubaneswar, Odisha, India
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