CDP-choline treatment increases circulating endothelial progenitor cells in acute ischemic stroke

Area of Science:

• Neuroscience
• Regenerative Medicine
• Cardiovascular Research

Background:

• Elevated circulating endothelial progenitor cells (EPCs) correlate with improved outcomes in acute ischemic stroke.
• Citicoline (CDP-choline) is known to enhance brain plasticity following experimental stroke.

Purpose of the Study:

• To investigate whether citicoline administration can elevate EPC concentrations in patients experiencing acute ischemic stroke.
• To assess the impact of citicoline, alone and in combination with rt-PA, on EPC levels.

Main Methods:

• A study involving 48 patients with first-ever non-lacunar ischemic stroke, treated within 12 hours of symptom onset.
• Patients received either oral citicoline (2000 mg/day) for 6 weeks or no treatment.
• EPCs, quantified as colony-forming unit-endothelial cells (CFU-ECs), were measured at admission and on day 7.

Main Results:

• Baseline EPC levels were comparable between citicoline-treated and non-treated groups.
• Patients receiving both citicoline and rt-PA demonstrated a significantly higher increase in EPCs compared to those treated with citicoline alone or no treatment (P < 0.0001).
• Logistic regression indicated that citicoline treatment (OR, 17.6) and combined citicoline-rt-PA therapy (OR, 108.5) were independently associated with a substantial EPC increment.

Conclusions:

• Citicoline administration effectively increases EPC concentrations in patients with acute ischemic stroke.
• Co-administration of citicoline and rt-PA shows a pronounced effect on boosting EPC levels, suggesting a synergistic therapeutic potential.