Effects of Citicoline-Based Supplementation on Lipid Peroxidation Markers and Sirtuin-1 Expression in Ischemic Stroke

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™) on arachidonic acid (AA) metabolism, lipid peroxidation assessed by total 8-iso-prostaglandin F₂α (8-iso-PGF₂α), and Sirtuin-1 (<i>SIRT1</i>) expression in healthy controls (<i>n</i> = 43) and patients with IS (<i>n</i> = 53), both with and without comorbidities. AA and 8-iso-PGF₂α were quantified in serum using UPLC-MS and ELISA, respectively, and the fold change in <i>SIRT1</i> expression was assessed in peripheral blood mononuclear cells (PBMCs) by RT-qPCR. In healthy controls, Cytodeox™ significantly lowered AA and 8-iso-PGF₂α levels. IS patients showed markedly increased baseline 8-iso-PGF₂α, indicating severe oxidative stress. Following supplementation, 8-iso-PGF₂α levels increased in patients with comorbidities, particularly diabetes mellitus (DM), whereas an exploratory analysis suggested a decreasing trend in patients without comorbidities. <i>SIRT1</i> 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™ under conditions of preserved or moderately impaired redox homeostasis, supporting its potential role as a preventive or early supportive intervention.