Delia CINTEZA, Mihai BERTEANU, Suzana VLADOIU, Bogdan Nicolae MANOLESCU and Horatiu DINU

ABSTRACT

Objectives: Stroke is followed by an inflammatory response lasting up to several months. Moreover, many of the stroke-related comorbidities (i.e., diabetes mellitus, dyslipidemia, cardiovascular disease, and atherosclerosis) are characterized by an pro-inflammatory status.

Material and Methods: We designed this pilot study to evaluate the relation between the consumption of a nutritional supplement (ALAnerv®) and the dynamic of the inflammatory status in post-acute stroke patients undergoing rehabilitation. The study population comprised 28 patients which were assigned into two study groups, named (-) ALA and (+) ALA. All subjects followed the same rehabilitation program. There were no significant differences in respect to the standard medication between the groups. Moreover, patients from the (+) ALA group received ALAnerv® for two weeks (2 pills/day). We assessed IL-1α, IL-6, TNF-α, sICAM-1, and myeloperoxidase in blood samples taken at the beginning and at the end of the study period.

Outcomes: In the (+) ALA group only IL-1α (- 9.9% ± 3.7, P = 0.013) and IL-6 (- 26.5% ± 8.2, P = 0.003) significantly decreased during the study period. The multiple regression analysis indicated that the ALAnerv® treatment was responsible for the significant decrease of IL-6 level (P = 0.008). Moreover, the percentage of IL-6 variation between the study groups reached statistical significance (8.4% ± 11.5 vs. – 26.5% ± 8.2, P = 0.034).

Conclusions: These results indicate that ALAnerv® could be beneficial for the correction of the inflammatory status in post-acute stroke patients and underline the need of a longer treatment period with a higher dose.

Keywords: blood pressure variability, ventricular dysfunction, diabetes, hypertension

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Eliza OPREA, Delia CINTEZA, Mihai BERTEANU and Bogdan Nicolae MANOLESCU

ABSTRACT

Objectives: Diabetes mellitus is one of the most frequent stroke-related comorbid states, and it is characterized by accumulation of reactive carbonyl compounds (RCOs), leading to “carbonyl stress”. This pilot study was aimed to evaluate the effect of the consumption of the nutritional supplement ALAnerv® on some serum carbonyl stress markers, as well as on the activity of erythrocytes’ glyoxalases in post-acute stroke patients undergoing rehabilitation.

Material and Methods: We created a study population of 28 patients, organized into (-) ALA and (+) ALA groups. Patients from (+) ALA group received ALAnerv® for two weeks (2 pills/day). All the subjects followed the same rehabilitation program. In both groups, blood samples were taken at the hospitalization and at the discharge moments, respectively. On these samples we assessed lactic acid, fructosamine and RCOs concentrations, as well as the activities of glyoxalases 1 and 2 from erythrocytes’ lysates.

Outcomes: In (-) ALA group the concentrations of fructosamine and RCOs significantly increased (0.90 ± 0.04 vs. 1.02 ± 0.04, p = 0.020; 0.19 ± 0.03 vs. 0.28 ± 0.07, p = 0.027) during the study period. Also, glyoxalase 2 activity decreased in this group (27.04 ± 6.10 vs. 14.43 ± 3.02, p = 0.027). In (+) ALA group, the variation of these parameters did not reach statistical significance. Only, the activity of Glo1, which catalyzes the rate-limiting step in the glyoxalase pathway, had an increasing trend in (+) ALA group. The percentage of variation of fructosamine between (-) ALA and (+) ALA groups reached statistical significance (14.8 ± 5.2 vs. – 1.0 ± 13.3, p = 0.047). Regression analysis indicated that the activity of glyoxalase 2 was significantly influenced by the treatment with ALAnerv® (p < 0.001), while the concentration of RCOs was significantly influenced by diabetes mellitus (p = 0.030).

Conclusions: Our preliminary results suggest that ALAnerv® could be useful for the correction of the carbonyl stress status in post-acute stroke patients with diabetes. Also, this study underlines the need of a longer treatment period with a higher dose.

Keywords: stroke, rehabilitation, glyoxalase I, glyoxalase II, fructosamine, ALAnerv®

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