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Published in: Inflammopharmacology 6/2019

01-12-2019 | Stroke | Original Article

Functional improvement and immune-inflammatory cytokines profile of ischaemic stroke patients after treatment with boswellic acids: a randomized, double-blind, placebo-controlled, pilot trial

Authors: Somayeh Mahmoodi Baram, Saeed Karima, Somayeh Shateri, Abbas Tafakhori, Akbar Fotouhi, Behnam Safarpour Lima, Shima Rajaei, Meisam Mahdavi, Hessam Sepasi Tehrani, Vajiheh Aghamollaii, Seyed Hossein Aghamiri, Behnam Mansouri, Sina Gharahje, Samaneh Kabiri, Maryamosadat Hosseinizadeh, Shima Zare Shahamati, Amir Taher Alborzi

Published in: Inflammopharmacology | Issue 6/2019

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Abstract

Ischaemic stroke represents one of the main causes of disability. According to the broad investigations, it is widely assumed that the contribution of inflammatory mediators is strongly involved in its pathogenesis. Hence, it seems that stroke treatment needs more efficient and inflammatory-targeted compounds to modulate inflammatory-related pathways. Such strategies paved the way to achieve better clinical outcomes along with conventional therapies. Boswellic acids (BAs), the main bioactive compounds of Boswellia sp. resin; are triterpenoids with well-documented anti-inflammatory properties. Compared with NSAIDs, BAs cross blood–brain barrier yet they do not cause serious gastrointestinal adverse effects. Considering BAs anti-inflammatory features, we conducted a randomized double-blind placebo-controlled pilot trial of these compounds as a supplementary therapy. This trial randomized 80 ischaemic stroke patients (40–80-years old) with a 4–20 score according to the National Institutes of Health Stroke Scale (NIHSS), within 72 h of neurological sign onset, in 1-month follow-up period. We assessed NIHSS as primary and plasma levels of TNF-α, IL-1α, IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12p70, IFN-γ, IP-10, MCP-1, 8-isoprostane, and PGE2 as secondary outcomes. According to NIHSS evaluation, patients who were allocated to BA group had a significant recovery in neurological function during the 1-month follow-up, compared with the placebo. The levels of plasma inflammatory markers were significantly decreased in BA group after 7 days of intervention in TNF-α, IL-1β, IL-6, IL-8, and PGE2. As a preliminary controlled trial in ischaemic stroke, BAs could improve clinical outcome in the early phases of stroke along with promising changes in plasma inflammatory factors.
Clinical trial registrationhttps://​www.​irct.​ir Unique identifier: IRCT20170315033086N5. IRCT is a primary registry in the WHO registry network (https://​www.​who.​int/​ictrp/​network/​primary/​en/​)
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Metadata
Title
Functional improvement and immune-inflammatory cytokines profile of ischaemic stroke patients after treatment with boswellic acids: a randomized, double-blind, placebo-controlled, pilot trial
Authors
Somayeh Mahmoodi Baram
Saeed Karima
Somayeh Shateri
Abbas Tafakhori
Akbar Fotouhi
Behnam Safarpour Lima
Shima Rajaei
Meisam Mahdavi
Hessam Sepasi Tehrani
Vajiheh Aghamollaii
Seyed Hossein Aghamiri
Behnam Mansouri
Sina Gharahje
Samaneh Kabiri
Maryamosadat Hosseinizadeh
Shima Zare Shahamati
Amir Taher Alborzi
Publication date
01-12-2019
Publisher
Springer International Publishing
Keywords
Stroke
Cytokines
Published in
Inflammopharmacology / Issue 6/2019
Print ISSN: 0925-4692
Electronic ISSN: 1568-5608
DOI
https://doi.org/10.1007/s10787-019-00627-z

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