Wednesday, July 23, 2025

Spermidine: A Predictor for Neurological Outcome and Infarct Size in Focal Cerebral Ischemia?

 Did your competent? doctor and hospital DO ANYTHING with this from 2001? NO? So, incompetence reigned! And the board of directors is so incompetent that they allow doing nothing to continue for decades!

Found spermidine this from this article: How to get the anti-ageing benefits of fasting without having to give up eating


Spermidine: A Predictor for Neurological Outcome and Infarct Size in Focal Cerebral Ischemia?

Originally Published 1 January 2001

Abstract

Background and Purpose—Polyamines are mainly restricted to the intracellular space. During focal cerebral ischemia, polyamines are released from the intracellular compartment. Experimental studies have implicated a marked elevation in brain tissue and blood. The aim of our study was to investigate whether the elevation of polyamines in the blood of patients with focal cerebral ischemia correlates with the clinical outcome and the infarct volume.
Methods—Polyamines were measured in 16 patients with focal cerebral ischemia and in 8 healthy control subjects. Blood samples for polyamine measurement were taken at admission and at fixed time points for the next 28 days. Polyamines were analyzed in red blood cells by a high-pressure liquid chromatography system. Clinical findings were recorded with the NIH Stroke Scale score. Volume of infarction was analyzed from cranial CT at admission and on days 4 to 6 after ischemia.
Results—A significant increase of the spermidine level in the peripheral blood could be observed in all patients with focal cerebral ischemia as compared with control subjects (P<0.01), starting with the admission. Spermidine values correlated positively with the clinical outcome at several time points in the first 48 hours (r=0.90 to 0.40; P<0.01) and with the infarct volume in cranial CT on days 4 to 6 (r=0.91; P<0.01).
Conclusions—As hypothesized from experimental data, polyamine levels in blood increase in patients after focal cerebral ischemia. The results indicate that the peripheral spermidine level is closely associated with the clinical outcome as well as with the infarction volume. Therefore, polyamines may be used as a novel predictor for the prognosis of patients with focal cerebral ischemia.
The endogenous polyamines putrescine, spermidine, and spermine are low-molecular-weight aliphatic amines that are found in high concentrations in the brain.1 Polyamine metabolism is regulated by the activity of the first key enzyme ornithine decarboxylase (ODC).2 Polyamines are predominantly found intracellularly, whereas only smaller amounts could be observed in the extracellular space or in the peripheral blood.3 Animal studies have shown that polyamines play an important role in the ischemic cascade.4 5 Polyamines activate N-methyl-d-aspartate (NMDA) receptors,6 7 8 9 followed by a calcium influx. Other possible mechanisms are calcium-related events at the cell membrane10 11 and release of neurotransmitters from nerve endings.11 However, polyamines have not been determined in clinical studies of cerebral ischemia, and their clinical significance is thus unknown.
Because polyamines are released from the intracellular compartment during focal cerebral ischemia, the aim of our study was to analyze their value as a marker of neuronal tissue destruction in the peripheral blood and a potential predictor for clinical outcome in the acute stage of stroke.

Subjects and Methods

Patients

The polyamine level was determined in 16 patients (6 women and 10 men; mean age±SD, 70.4±8.3 years) with a first-ever acute focal cerebral ischemia (<6 hours) of the middle cerebral artery (MCA) as determined by clinical signs and cranial CT. Adults of any age were included, and informed consent was obtained according to the Helsinki Declaration of Ethical Requirements. CT as well as blood samples were part of the routine workup.
Exclusion criteria were (1) brain stem or lacunar stroke, (2) a transient neurological deficit with rapid recovery during workup, (3) a previous ischemia in the same territory, and (4) primary or secondary cerebral hemorrhage with preexisting disability.
All patients underwent a complete cerebrovascular workup, including extracranial and transcranial Doppler ultrasound, electrocardiography, echocardiography, and serum investigations for exclusion of coagulation disorders.
An age-matched healthy group (68.8±15.3, n=8) with no previous neurological disorder or severe general disease served as control subjects. The level of polyamines was determined at the same time points as in the patient group.
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