Boselli Mirella, Aquilani Roberto, Maestri Roberto, Iadarola Paolo, Magistroni Alessandro, Ferretti Chiara, Pierobon Antonia, Cotta Ramusino Matteo, Costa Alfredo, Buonocore Daniela, Peviani Marco, Boschi Federica, Verri Manuela
Neuromotor Rehabilitation Unit, Istituti Clinici Scientifici Maugeri IRCCS, Montescano Institute, 27040 Montescano, Italy.
Department of Biology and Biotechnology "Lazzaro Spallanzani", University of Pavia, 27100 Pavia, Italy.
Metabolites. 2025 Sep 19;15(9):626. doi: 10.3390/metabo15090626.
Post-stroke inflammation and hypoalbuminemia can negatively affect neurocognitive recovery. This study evaluated whether oral amino acid (AA) supplementation with prevalently essential amino acids (EAAs, 82.1%) could improve inflammation and albumin levels in post-stroke patients undergoing neurorehabilitation. Sixty-four patients with subacute stroke (less than three 3 months from acute event) and elevated inflammation markers (C-reactive protein, CRP > 0.5 mg/dL) were enrolled. All underwent anthropometric assessments and blood tests for CRP (normal value < 0.5 mg/dL), albumin (normal range: 3.5-4.76 g/dL), prealbumin (18-32 mg/dL), and white blood cell count. Participants were randomly assigned to receive either oral EAAs (8.4 g/day) or placebo (maltodextrin, 8.4 g/day) for 55 days. Measurements were taken at baseline (T0) and at discharge (T1), approximately two months later. At baseline, both groups had comparable levels of systemic inflammation, albumin and prealbumin: CRP, 2.13 ± 1.82 mg/dL (placebo) vs. 2.89 ± 2.12 mg/dL (EAAs), = 0.13; albumin, 3.10 ± 0.46 g/dL (placebo) vs. 3.07 ± 0.57 g/dL (EAAs), = 0.82; prealbumin, 18.3 ± 6.2 mg/dL (placebo) vs. 16.9 ± 3.9 mg/dL (EAAs), = 0.28. During rehabilitation, only the EAA group showed significant reductions in CRP ( = 0.036 vs. placebo) and improvements in albumin ( = 0.033 vs. placebo) and prealbumin levels ( = 0.05 vs. placebo). However, full normalization of CRP and albumin was not achieved. This study demonstrates that a physiological dose of supplemented EAAs may attenuate, but not fully resolve, post-stroke inflammation and hypoalbuminemia. Further research is needed to determine whether higher EAA doses and/or modifications in EAA composition could enhance or normalize systemic inflammation.