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Ginkgo biloba extract improved cognitive and neurological functions of acute ischaemic stroke: a randomised controlled trial
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  • Published on:
    Response to: Aspirin and Ginkgo Both Reduce Cortisol; Two is Better than One
    • Yun Xu, Doctor Drum Tower Hospital of Nanjing University Medical School

    Dear Editor,

    Thank you transfer a letter of James M. Howard to me. Here is my discussion.

    In this clinical research, we mainly focus on the efficacy and safety of Ginkgo in combination with aspirin in acute ischemic stroke and its impact on the recurrence of vascular events. However, the underlying molecular mechanisms are worth to be explored because of their effectiveness.

    Although there have been reviewed that cortisol levels are high for at least 7 days after stroke and elevated cortisol after stroke is associated with dependency, morbidity, and mortality [1] . There is insufficient evidence to relate the severity of ischemic stroke with cortisol because cortisol can be influenced by diurnal rhythm, food, life style and so on. There has been no evidence to ascribe cortisol both by Ginkgo and aspirin directly to improve cognitive and neurological function. There has been reported that lower levels of DHEAS were associated with an increased risk of ischemic stroke [2], but few literatures show that reductions in cortisol increase the positive effects of DHEA on brain functions.

    The potential mechanisms of Ginkgo and aspirin have not been clear. Notably, it has been found that Ginkgo plus aspirin can enhance the expressions of LOX-1 and p-p38MAPK correlated with the inhibition of ROS production, LOX-1 expression and p38MAPK phosphorylation in human coronaryartery endothelial cells [3]....

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    Conflict of Interest:
    None declared.
  • Published on:
    Aspirin and Ginkgo Both Reduce Cortisol; Two is Better than One

    I suggest the positive effect of combined aspirin and ginkgo post ischemic stroke is reduced cortisol. Aspirin and ginkgo both reduce cortisol. Increased reduction of cortisol by both produces more "improved cognitive and neurological functions" than aspirin alone. Furthermore, I suggest reductions in cortisol increase the positive effects of dehydroepiandrosterone (DHEA) on brain functions.

    Conflict of Interest:
    None declared.