{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T02:24:36Z","timestamp":1784082276877,"version":"3.55.0"},"reference-count":75,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T00:00:00Z","timestamp":1773532800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"European Union-NextGenerationEU","award":["BG-RRP-2.004-0009-C02"],"award-info":[{"award-number":["BG-RRP-2.004-0009-C02"]}]},{"name":"Medical University of Varna, Science Fund","award":["21015"],"award-info":[{"award-number":["21015"]}]},{"name":"Medical University of Varna, Science Fund","award":["24007"],"award-info":[{"award-number":["24007"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CIMB"],"abstract":"<jats:p>Ischemic stroke (IS) is associated with pronounced oxidative stress and lipid peroxidation, which contribute to secondary neuronal damage. This study explored the effects of a six-month intervention with a new formulation containing citicoline, vitamin C, and extracts from green tea and aronia (Cytodeox\u2122) on arachidonic acid (AA) metabolism, lipid peroxidation assessed by total 8-iso-prostaglandin F2\u03b1 (8-iso-PGF2\u03b1), and Sirtuin-1 (SIRT1) expression in healthy controls (n = 43) and patients with IS (n = 53), both with and without comorbidities. AA and 8-iso-PGF2\u03b1 were quantified in serum using UPLC\u2013MS and ELISA, respectively, and the fold change in SIRT1 expression was assessed in peripheral blood mononuclear cells (PBMCs) by RT-qPCR. In healthy controls, Cytodeox\u2122 significantly lowered AA and 8-iso-PGF2\u03b1 levels. IS patients showed markedly increased baseline 8-iso-PGF2\u03b1, indicating severe oxidative stress. Following supplementation, 8-iso-PGF2\u03b1 levels increased in patients with comorbidities, particularly diabetes mellitus (DM), whereas an exploratory analysis suggested a decreasing trend in patients without comorbidities. SIRT1 expression was significantly upregulated in IS patients, with the most pronounced increase observed in the DM subgroup, while remaining unchanged in controls. These findings suggest a protective, antioxidant, and membrane stabilising effect of Cytodeox\u2122 under conditions of preserved or moderately impaired redox homeostasis, supporting its potential role as a preventive or early supportive intervention.<\/jats:p>","DOI":"10.3390\/cimb48030314","type":"journal-article","created":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T10:10:43Z","timestamp":1773655843000},"page":"314","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Effects of Citicoline-Based Supplementation on Lipid Peroxidation Markers and Sirtuin-1 Expression in Ischemic Stroke"],"prefix":"10.3390","volume":"48","author":[{"given":"Todorka","family":"Sokrateva","sequence":"first","affiliation":[{"name":"Department of Biochemistry, Molecular Medicine and Nutrigenomics, Faculty of Pharmacy, Medical University \u201cProf. Dr Paraskev Stoyanov\u201d-Varna, 9002 Varna, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bogdan","family":"Roussev","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Molecular Medicine and Nutrigenomics, Faculty of Pharmacy, Medical University \u201cProf. Dr Paraskev Stoyanov\u201d-Varna, 9002 Varna, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-0218-2792","authenticated-orcid":false,"given":"Daniela V.","family":"Vankova","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Molecular Medicine and Nutrigenomics, Faculty of Pharmacy, Medical University \u201cProf. Dr Paraskev Stoyanov\u201d-Varna, 9002 Varna, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6542-538X","authenticated-orcid":false,"given":"Deyana G.","family":"Vankova","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Molecular Medicine and Nutrigenomics, Faculty of Pharmacy, Medical University \u201cProf. Dr Paraskev Stoyanov\u201d-Varna, 9002 Varna, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4502-081X","authenticated-orcid":false,"given":"Diana","family":"Ivanova","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Molecular Medicine and Nutrigenomics, Faculty of Pharmacy, Medical University \u201cProf. Dr Paraskev Stoyanov\u201d-Varna, 9002 Varna, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9898-3962","authenticated-orcid":false,"given":"Mihael","family":"Tsalta-Mladenov","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neuroscience, Faculty of Medicine, Medical University \u201cProf. Dr Paraskev Stoyanov\u201d-Varna, 9002 Varna, Bulgaria"},{"name":"Second Clinic of Neurology with ICU and Stroke Center, University Hospital \u201cSt. Marina\u201d, 9010 Varna, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darina","family":"Georgieva","sequence":"additional","affiliation":[{"name":"Second Clinic of Neurology with ICU and Stroke Center, University Hospital \u201cSt. Marina\u201d, 9010 Varna, Bulgaria"},{"name":"Department of Clinical Medical Sciences, Faculty of Dental Medicine, Medical University \u201cProf. Dr Paraskev Stoyanov\u201d-Varna, 9002 Varna, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miglena N.","family":"Nikolova","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Molecular Medicine and Nutrigenomics, Faculty of Pharmacy, Medical University \u201cProf. Dr Paraskev Stoyanov\u201d-Varna, 9002 Varna, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Galya","family":"Mihaylova","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Molecular Medicine and Nutrigenomics, Faculty of Pharmacy, 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