Effects of vitamin C and aspirin in ischemic stroke-related lipid peroxidation: Results of the AVASAS (Aspirin Versus Ascorbic acid plus Aspirin in Stroke) Study

Issue title: HNE and Further Lipid Peroxidation Products

Article type: Research Article

Authors: Polidori, M. Cristina | Praticó, Domenico | Ingegni, Tiziana | Mariani, Elena | Spazzafumo, Liana | Sindaco, Paola Del | Cecchetti, Roberta | Yao, Yuemang | Ricci, Stefano | Cherubini, Antonio | Stahl, Wilhelm | Sies, Helmut | Senin, Umberto | Mecocci, Patrizia

Affiliations: Institute of Biochemistry and Molecular Biology I, Heinrich-Heine University, Düsseldorf, Germany | Center for Experimental Therapeutics, Department of Pharmacology, University of Pennsylvania, Philadelphia, PA, USA | Institute of Gerontology and Geriatrics, University of Perugia, Perugia, Italy | INRCA (National Institute for Research and Cure for the Elderly), Ancona, Italy | Department of Internal Medicine, Hospital of Todi (Perugia), Italy | Stroke Service, ASL 2, Perugia, Italy

Abstract: A condition of oxidative stress is known to occur in ischemic stroke, the current therapeutic intervention of which is largely limited to thrombolysis. To assess the effect of vitamin C – in conjunction to aspirin – in ischemic stroke-related lipid peroxidation, we measured plasma levels of ascorbate, of 8,12-isoprostanes F_{2&alpha;}-VI (8,12-iPF_{2&alpha;}-VI) and activities and levels of a broad spectrum of antioxidant enzymes and micronutrients in stroke patients randomized to receive, from stroke onset and up to three months, either vitamin C (200 mg/day) plus aspirin (300 mg/day) or only aspirin (300 mg/day). By the end of the first week, patients treated with vitamin C plus aspirin had higher vitamin C levels (p = 0.02) and lower 8,12-iPF_{2&alpha;}-VI levels (p = 0.01) than patients treated with aspirin alone. The significance was maintained for the increase of vitamin C after three months of therapy (p < 0.01). The clinical functional outcome for both groups of patients similarly ameliorated after three months of treatment. We conclude that vitamin C, at the dose of 200~mg/day and in conjunction with aspirin, significantly decreases ischemic stroke-related lipid peroxidation in humans. Further studies are warranted to clarify whether the use of vitamin C may add clinical long-term beneficial effects in patients with stroke.

Keywords: Aspirin, ischemic stroke, isoprostanes, oxidative stress, vitamin C

Journal: BioFactors, vol. 24, no. 1-4, pp. 265-274, 2005