Early predictive blood markers of hemorrhagic stroke — influence of cytoflavin therapy

Abstract

Examination of the patterns of free-radical processes (FRP) and changes of the early screening markers to predict the course of hemorrhagic stroke (HS) and applied pathophysiologically based therapy, can be of great practical importance. This study aimed to determine early changes in the parameters of oxidative stress and routine biochemistry blood tests in patients with HS and to assess their relationship with clinical outcome. The effects of early applied cytoflavin were also investigated. The prospective study included 151 patients with HS. 48% of patients in the standard conservative therapy was added cytoflavin antioxidant energy therapy from the first day of hospitalization. The neurological status, neuroimaging, biochemical blood tests and free radical processes were assessed on days 1, 5, 10, 20 of hospitalization. In patients with HS, an imbalance of all stages of FRP was detected proportionately to the severity of HS. The MDA concentration above 5.3 μmol/l, the number of leukocytes above 15.8 thousand, glucose above 11.9 mmol/l, lactate dehydrogenase above 574 IU/l, lactate above 2.5 mmol/l, detected on the 1st day, predetermined a high risk of death. Additional cytoflavin treatment allowed stabilizing the clinical-laboratory picture of HS, improved the treatment results and reduced hospital mortality rate.

Oxidative Stress and Free Radical Processes in Tumor and Non-Tumor Obstructive Jaundice: Influence of Disease Duration, Severity and Surgical Treatment on Outcomes

“…In addition to analyzing the standard blood biochemical parameters (total bilirubin, alkaline phosphatase, GGT, ALT, AST, etc. ), we assessed the indices of free radical processes (FRP) using methods described previously [ 25 , 26 , 27 , 28 ]. FRP include malondialdehyde (MDA) and luminescence indices: basal chemiluminescence intensity indicator (bCLII), zymosan-stimulated chemiluminescence intensity indicator (sCLII), leukocyte activity coefficient (AC) and anti-peroxide plasma activity (APA).…”

“…Malondialdehyde (malonic dialdehyde; MDA) is a secondary product of lipid peroxidation, characterizing the level of cell intoxication and death [ 25 , 26 , 27 , 29 , 30 ]. The MDA titer was determined in secondary plasma via its reaction with 2-thiobarbituric acid and the formation of a chromogen complex with an absorption maximum in the red region of the visible spectrum (532 nm).…”

Efficacy and safety of the combined metabolic medication, containing inosine, nicotinamide, riboflavin and succinic acid, for the treatment of diabetic neuropathy: a multicenter randomized, double-blind, placebo-controlled parallel group clinical trial (CYLINDER)

“…The present study is the first clinical trial of the combination of SINR in type 2 diabetes. The antioxidant potential of this combination was previously demonstrated in other neurological conditions, for example, in intracerebral hemorrhage 29 30. In DPN, clinical effect of SINR was moderate, compared with alpha-lipoic acid; a possible explanation is that alpha-lipoic acid may be a more potent antioxidant, which has an inherent mechanism of direct antioxidation via free radical scavenging and diverse indirect mechanisms,9 including metal chelation, cofactoring mitochondrial antioxidant system, etc.…”

“…The antioxidant potential of this combination was previously demonstrated in other neurological conditions, for example, in intracerebral hemorrhage. 29 30 In DPN, clinical effect of SINR was moderate, compared with alpha-lipoic acid; a possible explanation is that alpha-lipoic acid may be a more potent antioxidant, which has an inherent mechanism of direct antioxidation via free radical scavenging and diverse indirect mechanisms, 9 including metal chelation, cofactoring mitochondrial antioxidant system, etc. The studied combination of SINR acts mostly in an indirect way: succinic acid inactivates peroxidases in mitochondria and increases the activity of NAD-dependent enzymes, while nicotinamide and riboflavin, as intermediates of electron transport system, enhance the pharmacological activity of succinic acid.…”