The Relationship Between Alanerv(®) Consumption and Erythrocytes' Glyoxalases I and II Activities and The Level of Some Serum Markers of Carbonyl Stress in Post-Acute Stroke Patients Undergoing Rehabilitation.

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.