Efficiency mexidol in patients with endocrine polyneuropathy
Author:
E.B. KUZNETSOVA, I.I. SHOLOMOV, S.V. GERASIMOV, E.A. SALINA
Razumovsky Saratov State Medical University, Saratov; Clinical Hospital, Saratov
Summary:
Objective. To evaluate the efficacy of mexidol and necessity of using it in patients with endocrine polyneuropathies caused by primary hypothyroidism (PPHT). Materials and methods. We have examined 51 patients with confirmed diagnosis of PPHT and assessed their neurological status and indicators of metabolic homeostasis before and after treatment. Electroneuromyography (ENMG) was performed to assess the status of the peripheral nervous system. Results. The results indicate the presence of endocrine disorders of obligate metabolic homeostasis in patients with polyneuropathies. Antioxidants, in particular, mexidol, in a complex with other drugs can be used in the treatment of these disorders. Worsening of ENMG-parameters, demonstrating a trend towards the normalization in response to treatment antioxidants, are characteristics of this pathology. Conclusion. The efficacy of mexidol in patients with PPHT has been confirmed.
Keywords: endocrine polyneuropathies, metabolic homeostasis, mexidol, electroneuromyography.
Diagnosis and treatment of asthenic syndrome in elderly people after acute respiratory viral infection
Author:
I.E. POVERENNOVA, I.A. ZOLOTOVSKAYA, E.V. BEZGINA
Samara State Medical University, Samara; Samara City Policlinic, Samara; Medical X-Ray Center, Samara
Summary:
Objective: To study the characteristics of asthenic syndrome in elderly people after acute respiratory viral infection. Material and methods: We examined 87 patients with chronic cerebral ischemia and other comorbid disorders, aged from 63 to 78 years. Patients were randomized to two groups. Patients of the main group received mexidol (1 tablet (125 mg) 3 times a day during 3 weeks) along with standard treatment. Patients of the control group received standard treatment only. All patients underwent neuropsychological testing for the assessment of symptoms of asthenic syndrome. Results and Conclusion: A comparative analysis of the patient’s condition in both groups has demonstrated a reduction in symptoms of asthenia, autonomic lability and cognitive deficit in patients treated with mexidol.
Keywords: old age, asthenic syndrome, acute respiratory viral infection, treatment, mexidol.
An effect of mexidol on the expression of the transcription factor Nrf2 in cerebral cortex in ischemia
Author:
E.N. YAKUSHEVA, P.YU. MYLNIKOV, I.V. CHERNYKH, A.V. SHCHULKIN.
Ryazan State Medical University, Ryazan, Russia.
Summary:
Objective. To study an effect of the antioxidant and antihypoxant mexidol (ethylmethylhydroxypyridine succinate) on the transcription factor Nrf2 expression in neuronal nucleis of frontal cortex cells autor the common carotid artery unilateral occlusion. Material and methods. The study was performed on 64 male Wistar rats. The Nrf2 expression was determined immunohistochemically. Results. Single intraperitoneal mexidol (120 mg/kg b.w.) infusion and oral (100 mg/kg p.w. thrice a day for 14 days) administration of mexidol did not affect Nrf2 expression. Unilateral common carotid artery occlusion led to the increase in Nrf2 expression 4 h and 5 days after occlusion. Oral administration of mexidol in dose of 100 mg/kg b.w. thrice a day for 14 days before and after ischemia increased Nrf2 expression on the 4th h and on the 12th day in comparison with intact animals. Nrf2 expression was higher after 4 h and 12 days in comparison with the control occlusion group. Conclusion. Mexidol increases Nrf2 expression in the frontal cortex of rats not under normal conditions but in common carotid artery unilateral occlusion.
Keywords: mexidol, Nrf2, ethylmethylhydroxypyridine succinate, ischemia, occlusion, common carotid artery.
The study of the neuroprotective effect of mexidol on the cellular model of glutamate stress
Author:
O.A. GROMOVA, I.YU. TORSHIN, E.V. STELMASHUK, O.P. ALEXANDROVA, A.V. PRONIN, I.V. GOGOLEVA, L.G. HASPEKOV
Federal Research Center «Informatics and Cybernetics», RAS, Moscow, Russia; Scientific Center of Neurology, Moscow, Russia; Ivanovo State Medical Academy of the Ministry of Health of Russia, Ivanovo, Russia
Summary:
Purpose of the study. Study of neuroprotective properties of mexidol on a cellular model of glutamate stress. Material and methods. Cytological studies were carried out under the conditions of the model of glutamate stress in the culture of granular neurons of the cerebellum. Results. The addition of mexidol to the cultural medium increased the survival of neurons by 8-10% after the addition of glutamate (p<.05). The effect of mexidol was more pronounced when applied at the stage of growing the culture of neurons (5 days), when the survival of the cells in conditions of glutamate stress increased by an average of 20%. The conclusion. The results of the study confirm the direct neuroprotective effect of mexidol in the culture of neurons under the conditions of the glutamate stress.
Keywords: cellular stress, excitotoxicity, glutamate, mexidol.
Comparative chemoreactome analysis of mexidol
Author:
I.YU. TORSHIN, O.A. GROMOVA, I.S. SARDARYAN, L.E. FEDOTOVA
Moscow Institute of Physics and Technology, Dolgoprudny. Russia; Ivanovo State Medical Academy of the RF Ministry of Health, Ivanovo, Russia
Summary:
Objective. To compare mexidol with control molecules (choline alfoscerate, piracetam, glycine, semax) using chemoreactome analysis. Material and methods. The chemical structure of mexidol was compared to molecule metabolites extracted from the Human Metabolome Database (HMDB) and a drug database. More than 40 000 of metabolites from HMDB were used as a model of human metabolome. Results and conclusion. The chemoreactome analysis showed that mexidol may be (1) an agonist of acetylcholine and GABA-A receptors; (2) an anti-inflammatory agent, the effects of which are carried out by inhibiting the synthesis of pro-inflammatory prostaglandins; (3) a neurotrophic agent with neuroprotective properties; (4) a coagulation inhibitor; (5) a diabetes medication and (6) a hypolipidemic agent. Compared to «control» molecules, mexidol has a more pronounced safety profile (a lower impact on serotonin, dopamine and adrenergic receptors, a lesser degree of interaction with the potassium channels of the heart, MAO and P450 cytochromes). The results of modeling allow to specify the mechanisms of action of mexidol at the molecular level.
Keywords: mexidol, neuroprotection, chemoreactome analysis, chemoinformatics, forecasting.
Improvement of the efficacy of treatment of hypertensive encephalohathy by using mexidol
Author:
E.V. BOLOTOVA, N.YU. LUSHPAY, I.V. KOVRIGINA.
Kuban State Medical University under the Health Care Ministry of the Russia, Krasnodar, Russia; Reserch Institute - Territorial Clinical Hospital №1 med after Professor S.V. Ochapovski under the Health Ministry of the Russia, Krasnodar, Russia.
Summary:
Objective. To assess the efficacy and tolerability of mexidol used to improve cognitive impairment in patients with hypertension and clinical manifestations of chronic cerebral circulatory insufficiency. Material and methods. Forty-two patients with chronic cerebral circulatory insufficiency and cognitive impairment were examined. MMSE, МоСА and the clock drawing test were used to assess neuropsychological status. The Morisky-Green test was administered to evaluate medication adherence. Patients were stratified into two groups: patients of the first group (n=21) received standard treatment. Patients of the second group (n=21) received additionally mexidol in dose 200 mg (4 ml) in 100 ml of NaCl isotonic solution intravenously during 10 days and then in tablets (2 tablets 0,125 mg) twice a day during 8 weeks. Results. According to the 4-item Morisky Medication Adherence Scale (MMAS), 31% of respondents were not adherent to the treatment (MMAS score 0—2), 35.7% (n=15) of patients showed high adherence (MMAS score 4), 33.3% (n=14) demonstrated low adherence (MMAS score 3). The average score on the questionnaire was 2.85. In patients treated with mexidol, the absence of complaints increased by 3 times and headache regression increased by 90%. The improvement of memory, concentration and anxiety was observed in 50%, 55%, 67% of patients, respectively. Patients treated with mexidol demonstrated more significant changes during the clock drawing test. The average change in the scores increased by 0.95 compared to the control group, where the changes were 0.54 (p<0.02). The positive dynamics on MMSE and МоСА was shown in the mexidol group that indicated the positive effect of this drug on cognitive symptoms. Conclusion. The positive impact on cognitive symptoms and health in patients with chronic cerebral circulatory insufficiency allows to recommend mexidol as add-on to standard treatment of the main disease.
Keyword: mexidol, cognitive impairment, adherence.
Assessment of the efficacy of mexidol in the combination with hyperbaric oxygen in acute ischemic stroke
Author:
N.S. KULAI, E.YU. KOVALCHUK.
Saint-Petersburg I.I. Dzhanelidze research institute of emergency medicine, Saint-Petersburg, Russia.
Summary:
Objective. To study the efficacy of mexidol in the combination with hyperbaric oxygenation (HBO) in comparison with the standard HBO sessions in patients with acute ischemic stroke. Material and methods. One hundred and twelve patients were examined. In the main group, 48 patients underwent HBO and received treatment with mexidol. The control group consisted of 64 people who underwent the standard HBO sessions only. Results and conclusion. The use of combination therapy (HBO+mexidol) leads to the significantly more rapid normalization of acute phase indices which are correlated with neurological deficit reduction.
Keywords: ischemic stroke, hyperbaric oxygen therapy, mexidol.
The system stress-limiting action of mexidol in chronic cerebral ischemia
Author:
E.A. ANTIPENKO, A.V. DERUGINA, A.V. GUSTOV.
Nizhny Novgorod State Medical Academy of the Ministry of Public Health, Nizhny Novgorod; Lobachevsky Nizhny Novgorod State University, Nizhny Novgorod.
Summary:
Objective. To clarify the mechanisms of the action of anti-stress antioxidant agent (mexidol) in patients with chronic cerebral ischemia. Material and methods. Sixty-seven patients with chronic cerebral ischemia (TE stage II), 48 women and 19 men, mean age 48.2 years, were examined. To assess the state of multilevel stress system, the level of anxiety and depression, degree of autonomic imbalance, adaptive reactions of the blood and functional properties of erythrocyte membranes, level of average weight molecules in the blood plasma were studied. Therapeutic complexes consisted of standard therapy (vinpocetine and piracetam) and mexidol (10 ml intravenous drip 200 ml of physiological solution once a day every day for 10 days with subsequent transition to the oral ingestion of the drug (1 tablet (125 mg) 3 times a day for three months). Results and conclusion. In group 1 treated with additional antioxidant mexidol, the more pronounced and prolonged positive effect on the clinical symptoms of TE was observed. There were the persistent decrease in the level of anxiety and reduction of autonomic imbalance in the main group. The dynamics of adaptive reactions of blood indicated the activation of the adrenal cortex. There was a decrease in the content of average weight molecules and recovery of the sorption capacity of red blood cells. The results indicate the multi-component multi-level stress-limiting effect of mexidol in patients with chronic cerebral ischemia stage II.
Keywords: mexidol, chronic cerebral ischemia, treatment, stress.
An influence of submaximal (submineximal) doses of mexidol on oxidant stress and inflammation in the acute period of ischemic stroke
Author:
A.R. GODUNOVA, A.A. RAKHIMOVA, O.I. LEONTYEVA, I.G. TALIPOVA, R.M. YAKHIN, SH.G. MUSIN.
Emergency Hospital, Naberezhnye Chelny, Russia.
Summary:
Objective. To study an effect of submaximal doses of mexidol on the dynamics of biochemical markers of inflammation and damage to brain tissue in the acute period of ischemic stroke. Material and methods. A total of 60 patients admitted in the first 6h after disease onset with a verified ischemic stroke (7-9 points on the ASPECT scale) were enrolled in the study. Thirty patients in the study group received submaximal doses of mexidol: 750 mg infusion dropwise in 250 ml of 0.9% NaCl solution for 6 days. Thirty patients of the control group received standard therapy. Biomarkers and neurological status were evaluated within 60 minutes from the time of admission to the hospital and after 6 days. Results and conclusion. In both groups, the changes in CRP, IL-6, and fibrinogen did not contribute to the efficacy of mexidol. The brain natriuretic peptide (BNP) biomarker, plasma-A-associated pregnancy (PAPP-A) biomarker, average NIHSS score and mean cerebroasthenia score on the MFI-20 scale in the study group were significantly reduced compared to the control group. This study indicates a decrease in oxidative stress and signs of inflammation, a reduction of the severity of neurological deficit and an increase in physical activity of patients treated with submaximal doses of mexidol. Given the activation time of the damaged antioxidant system of the body, the recommended period of treatment is 3 months.
Keywords: antioxidant stress, inflammation, acute period, ischemic stroke, mexidol.
Mexidol effect on the factor induced by hypoxia HIF-1α expression in the rat cerebral cortex in its ischemia
Author:
E.N. YAKUSHEVA, P.YU. MYLNIKOV, I.V. CHERNYKH, A.V. SHCHULKIN.
Pavlov Ryazan State Medical University, Ryazan, Russia.
Summary:
The aim of the research – to study the Mexidol (ethylmethylhydroxypyridine succinate) effect on the factor induced by hypoxia (HIF-1α) expression in the frontal cortex of the brain in its ischemia. Material and methods. The work was performed on the 64 male Wistar rats. The expression of HIF-1α was determined immunohistochemically. Results and discussion. It is determined that single intraperitoneal administration of Mexidol at a dose 120 mg/kg and oral administration at a dose 100 mg/kg three times a day for 14 days is not affected the expression of HIF-1α. Unilateral occlusion of the common carotid artery increases the expression of HIF-1α at 4 hours after the occlusion. Oral administration of Mexidol at a dose 100 mg/kg three times a day for 14 days before and after ischemia increases the expression of HIF-1α after 4 and 12 hours in comparison with the norm, on the 5th day in comparison with occlusion control. Thus, it has been established that Mexidol increases the expression of HIF-1α in the frontal cortex of rat brain not under normal conditions, but in unilateral occlusion of the common carotid artery.
Keywords: mexidol, ethylmethylhydroxypyridine succinate, ischemia, occlusion of common carotid artery.