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Abstract

This paper argues that “ASEA redox Supplement” (ARS) may show comparable or even stronger beneficial effects (with less or none adverse effects) than corticosteroids in children with Duchenne Muscular Dystrophy (DMD) and Becker muscular dystrophy (BMD). This paper presents a second case report on the effects of an ionized “saline water” called “ASEA redox Supplement®” (ARS) oral solution in a ~5-year-old boy with DMD from Bucharest, Romania. In vitro studies showed that ARS is a very potent selective NRF2 activator, thus a very potent (indirect) antioxidant and cytoprotective: the studies conducted in vivo also support this main pharmacological mechanism of ARS, with no toxicity up to high doses, in contrast with the much more toxic corticosteroids. From the first months of ARS treatment the main rhabdomyolysis markers (with very high initial serum levels) dropped significantly, with no found toxicity until present. The main conclusions of this second case report (on ARS effect in boys with DMD) are: (1) ARS has remarkable antioxidant and immunomodulatory effects and should be studied on larger groups of children with DMD under the age of 4 years old (but also on other age groups of children and even young adults), as an alternative to early corticosteroids; (2) Given its immunomodulatory effect (NRF2 selective activation and NF-kB inhibition), ARS deserves future cohort studies on its potential to replace corticosteroids and other non-steroidal immunosuppressants (at least partially) in many types of pulmonary/renal/hepatic/ articular/skin autoimmune and even malignant diseases of both children and adults; (3) Given its very strong antioxidant effects (by highly selective NRF2 potent activation), ARS deserves future cohort studies on acute/chronic diseases that imply high levels of tissular oxidative stress, especially some acute/chronic cardiovascular and respiratory diseases like acute myocardial infarction with acute/chronic heart failure, stroke, Chronic Obstructive Pulmonary Disease (COPD), asthma etc. of both children and adults (so that ARS may help millions and even billions worldwide). The latest version of this preprint is available at this URL: http://dragoii.com/ALDragoi_ASEA_in_DMD_2nd_case_latest.pdf This preprint is also available on Academia.edu at this URL: https://www.academia.edu/40213866 This paper belongs to a series of three cases on Asea effects in DMD children-patients: https://www.researchgate.net/publication/325371161 (1st case - preprint), https://www.researchgate.net/publication/334596031 (1st case - CJBRT article), https://www.researchgate.net/publication/334773748 (1st case - periodic updates), https://www.researchgate.net/publication/335502350 (2nd case - preprint), https://www.researchgate.net/publication/340902127 (3rd case - preprint); See also: https://www.researchgate.net/publication/336990483 and https://www.researchgate.net/publication/337026408 (ppt on Asea), https://www.researchgate.net/publication/339592997 (on possible testing of NRF2 activators in COVID-19)
1
A Second Case Report Regarding the Effects of “ASEA redox Supplement” in
a ~5-year old boy with Duchenne Muscular Dystrophy from Bucharest,
Romania (preprint)
*
DOI: 10.13140/RG.2.2.18399.41128
*
This article preprint version: 1.0 (30.08.2019)
(latest article version is always available at this URL)
*
Authors: Andrei-Lucian Drăgoi
1
,*
Affiliations: * Independent MD pediatrician specialist (from Bucharest, Romania), with no
institutional affiliation in the present. *Correspondence to: dr.dragoi@yahoo.com
*
1st motto: „ASEA works at some fundamental level in the body that we may never understand”
(2011, Dr. Chase N. Peterson MD [1999-2014], the former president of the University of Utah
from 1983 to 1991)
2nd motto: „ASEA is based on technology that the scientist don’t yet understand.” (2013, Dr.
A.S. Narain Naidu MD Phd, microbiologist, immunologist and researcher, author of the
reference volume „Redox Life”)
3rd motto: „We didn’t think that drinking ASEA would shift metabolites chronically. We
thought it would do something during exercise, but not after a week of drinking it [without
concomitant exercise: author’s note]. After working with the bioinformatics statistical division,
we were able to determine that drinking ASEA over one week caused a shift in 43 metabolites,
not a little shift: it was a large shift that caught us by surprise.” (David Christopher Nieman [URL2,
URL3] PhD and full professor at the College of Health Sciences at Appalachian State University,
and director of the Human Performance Lab at the North Carolina Research Campus (NCRC) in
Kannapolis, NC) (video interview URL, from minute 5:40)
4th motto: „Pediatrics – what a joy, what a feeling of accomplishment when helping Nature heal
its children or prevent their diseases and accidents!” (Andrei-Lucian Drăgoi, pediatrician
specialist and independent researcher)
[
1
] Email: dr.dragoi@yahoo.com; Main pages: [Science] www.dragoii.com; www.rg.dragoii.com;
www.academia.dragoii.com; www.vixra.dragoii.com; www.gsj.dragoii.com; [Music] www.smp.dragoii.com,
www.se.dragoii.com; [CVs] www.cvrg.dragoii.com; www.ej.dragoii.com, www.bj.dragoii.com;
2
Abstract
This paper argues that “ASEA redox Supplement” (ARS) may
show comparable or even stronger beneficial effects (with less or
none adverse effects) than corticosteroids in children with
Duchenne Muscular Dystrophy (DMD) and Becker muscular
dystrophy (BMD). This paper presents a second case report on the
effects of an ionized “saline water” called “ASEA redox
Supplement®” (ARS) oral solution in a ~5-year-old boy with DMD
from Bucharest, Romania. In vitro studies showed that ARS is a
very potent selective NRF2 activator, thus a very potent (indirect)
antioxidant and cytoprotective: the studies conducted in vivo also
support this main pharmacological mechanism of ARS, with no
toxicity up to high doses, in contrast with the much more toxic
corticosteroids.
From the first months of ARS treatment the main
rhabdomyolysis markers (with very high initial serum levels)
dropped significantly, with no found toxicity until present.
The main conclusions of this second case report (on ARS
effect in boys with DMD) are:
(1) ARS has remarkable antioxidant and immunomodulatory
effects and should be studied on larger groups of children with
DMD under the age of 4 years old (but also on other age groups of
children and even young adults), as an alternative to early
corticosteroids;
(2) Given its immunomodulatory effect (NRF2 selective
activation and NF-kB inhibition), ARS deserves future cohort
studies on its potential to replace corticosteroids and other non-
steroidal immunosuppressants (at least partially) in many types of
pulmonary/renal/hepatic/ articular/skin autoimmune and even
malignant diseases of both children and adults;
(3) Given its very strong antioxidant effects (by highly selective
NRF2 potent activation), ARS deserves future cohort studies on
acute/chronic diseases that imply high levels of tissular oxidative
stress, especially some acute/chronic cardiovascular and respiratory
diseases like acute myocardial infarction with acute/chronic heart
failure, stroke, Chronic Obstructive Pulmonary Disease (COPD),
asthma etc. of both children and adults (so that ARS may help
millions and even billions worldwide).
*
For an introduction to DMD, NF-kB, NRF2, ARS and the 1st
case report on ARS effects in DMD see the main reference of this
paper [
1
,
2
]. All the essential aspects of this 2nd case report on ARS
effects in DMD are included in the next table.
3
Table 1. The essential aspects of this 2nd case report on ARS effects in DMD
PEDIATRIC
CONSULTS
by Dr. Andrei-
Lucian Drăgoi
Anamnestic and clinical
essential aspects of this case
Paraclinical essential
aspects of this case
Consult no. 1 by
dr. Dragoi on
9.12.2018 (home
consult)
Age: 4 years & 8 months (birth
date: 17.03.2014)
Sex: male
Location: Bucharest, Romania
*
Diagnosis: Duchenne muscular
dystrophy (DMD) (genetic testing
in November 2011 with DMD
genotype confirmation in February
2017) *
Anamnesis:
- last neurologic consult in
January 2018 at Clinical Hospital
"Prof. Dr. Alex Obregia” -
Pediatric Neurology Department
(Bucharest, Romania)
- parents refused oral corticoids
(OCs) when proposed by the
neurologist for their body with
DMD and requested me a
pediatric consult for an adjuvant
therapy alternative to OCs with
fewer or none adverse effects;
-mother with gestational diabetes
diagnosed in the 2nd trimester of
this carriage (with normal
glycemic levels after giving birth
to this DMD boy)
-up-to-date vaccine status
*
Clinical aspects (the essentials):
Body mass (BM): ~15 kg
(percentile ~25: under average,
but normal BM)
Body exam: loss of muscular
strength (predominantly in axial
muscles and lower limbs),
pseudohypertrophy of calf
muscles,
low endurance, positive Gower’s
sign (clearly demonstrating
weakness of the proximal muscles
of the lower limbs); normal cranial
nerves, normal intellect;
Previous treatment (until
9.12.2018) (all given at the
initiative of boy’s parents):
Vitamin C (~100 mg/day),
Coenzyme Q10 (120 mg /day),
hemp oil with 1.35% Cannabidiol
Genetic test result (Nov.
2016-Feb. 2018; Age:~4
years): hemizygous
duplication of all exons from
8th to 43rd of dystrophin gene
(dys-gene) which is a
relatively rare type of
(DMD) dys-gene mutation
accounting for ~5% of the
total known number of
DMD cases [URL1, URL2]
which duplications can be
detected by multiplex
ligation-dependent probe
amplification (MLPA)
screening of the dys-gene;
the boy’s mother was also
demonstrated to carry
exactly the same exons
duplication; *
Heart ultrasound
(selection) (Age: 3
months): large stenosis of
the right pulmonary artery
with no hemodynamic
significance, thus no clinical
signs *
LABS (11.10.2014):
Hgb: 14.5 g/dl;
ASAT serum level: 279 U/l
ALAT serum level: 285 U/l
GGT serum levels: 8 U/l
(within the normal range for
age and sex) *
LABS (2.11.2016):
CK serum level: 27 609 U/l
CK-MB serum level: 704
U/l
LDH serum levels: 4572
U/l (a non-specific marker
for tissular damage,
including rhabdomyolysis,
especially myocardium
damage)
GGT serum levels: 10 U/l
(within the normal range for
age and sex)
4
(CBD) concentration (5 ml/day),
omega-3 dietary supplement (1
capsule x 3/day), laminin dietary
supplement (1 capsule/day), a
brain/memory stimulating dietary
supplement (containing a mix of:
UMP, a bitartrate salt of DMAE,
Acetyl-L-carnitine, Vinpocetine,
Alpha-GPC and standardized
extracts of
Huperzine A, Ginkgo biloba,
Ashwagandha and Wild
Blueberry), homeopathic
remedies, acupuncture sessions
*
Specific clinical test results:
North Star Ambulatory
Assessment (NSAA) score (Jan
2018): 17 points, which represent
50% of the maximum possible
score of 34 points.
The 6-minute walk test (6MWT)
(Jan 2018): the 6-minute walk
distance (6MWD) 292 meters
(m), without any stops, falls and
no need for any external physical
support during testing. Important
note. According to a multicenter
study published in 2013 [URL1,
URL2], a baseline 6MWD<350 m
was associated with greater
functional decline: loss of
ambulation was observed only in
the group with baseline 6MWD
<325 m.
5
Consult no. 2 by dr.
Dragoi (23.07.2019)
(short online consult
for minimal
anamnesis and labs
reading)
Age: 5 years & 4 months (birth
date: 17.03.2014)
*
Anamnesis:
-meals with a high percentage of
raw fruits and vegetables,
gluten-free and sugar-free
aliments, milk derivates;
- after: ~7 months of ARS P.O.
60 ml/day (~4 ml/body_kg/day
from January 2019 until
present), physical therapy
sessions (1 hour/ session, 2
sessions/week, from Feb. 2018
until present), therapeutic
swimming (hydrotherapy)
sessions (45-60 minutes/
session; 2-3 sessions/week;
from the summer 2018 until
present), *Vitamin C (1g/day in
the interval [iti] 9.12.2018-
31.01.2019), Coenzyme Q10
(250 mg/day iti 15.02.2019-
15.04.2019), *L-carnitine (340
mg/day iti 15.02.2019-
15.04.2019), *whole-grain
lipids and sterols supplement
(1 cps/day iti 01.02.2019-
15.05.2019), *homeopathic
remedies (iti 01.02.2019
present), *Milena fungus
tincture (10 drops x 2/day iti
01.02.2019 present),
*Calcarea carbonica (2
granules/day, 7 days / month iti
9.12.2018-31.01.2019), *Kal-
Mag plus D (iti 01.02.2019-
15.05.2019), *Liquid Gold”®
omega-3, 6, vitamins K2 (its
MK-7 subvariant), *D3 (1/2
teaspoon/day iti 21.03.2019 -
present), *”Laminine”® oral
supplement (produced by
Lifepharm® and containing
laminin) (1 cps/day iti
15.05.2019 present),
*”Laminine Immune +++”®
oral supplement (produced by
Lifepharm® and containing
laminin, Polysaccharide
Complex and Reishi, Maitake
and Turkey Tail Mushrooms
[URL1, URL2]) (1 tablet/day iti
15.05.2019 present), *raw bee
pollen (5 ml/day iti summer
2018 - present), hemp oil with
LABS (11.03.2019)
(after ~3.5 months of
ARS P.O. 60 ml/day (~4
ml/body_kg/day):
Hgb: 13.8 g/dl;
ASAT serum level: 213
U/l
ALAT serum level: 264
U/l
CK serum level: 8979
U/l
CK-MB serum level:
295 U/l
LDH serum levels: 806
U/l
GGT serum levels: 10
U/l (within the normal
range for age and sex)
ASLO: 317 IU/ml
Ferritin: 87 ng/ml
6
1.35% Cannabidiol (CBD)
concentration (5 ml x 3/day iti
summer 2018 - present)
(*all these marked treatments
were administered by parent’s
own initiative)
- hasn’t repeated NSAA and
6MWT from 9.12.2018 until the
date of this online consult by
Dr. Dragoi (23.07.2019)
- the mothers states that her boy
“can walks for ~1 hour [almost
without any pause]”
- the mother states that her boy
was given ARS 60 ml/day from
Jan 2019 until present
(23.07.2019)
- the mother states that her boy
also continues physical therapy,
hydrotherapy and acupuncture
Meeting no. 3 by dr.
Dragoi (29.07.2019)
Age: 5 years & 4 months
Note. The purpose of this
scheduled meeting was to
perform the 6MWT on a
professional stadium.
*
Important note: On 29.07.2019
we’ve found the proper
technical conditions for this boy
to repeat the 6MWT for the 2nd
time (after the 1st 6MWT from
January 2018). *
Technical condition
description: we had access to a
professional stadium with
multiple 60-meter plane tracks
covered with anti-shock rubber.
*
6MWT result: In the first ~ 4
minutes (min), the boy walked
4 tracks (of 60 m each), thus a
total distance of 240 m (=60 m *
4), with an average speed of 1
track/min=60 m/min. The boy
fell down at minute 4:18 (when
we has at his 5th track): after a
pause of about ~20 seconds
(when he was encouraged by his
mother) he restarted the walk so
that he accomplished ~5.3
tracks (~320 m) in 6 minutes
(which is better than the 6MWT
result of 294 m from January
2018, if not considering that
fall). After the 6 minutes, the
7
boy wanted however to continue
the test so that he accomplished
~5.6 tracks until minute 6:20
(considering the 20 seconds of
initial pause). The boy had
finished 6 tracks (360 m) in ~6
minutes and 55 seconds.
***
Results and Interpretations
1. The ARS-based treatment in the first ~3.5 months (from a
total of 8 months of ARS po: from the ~middle of January
2019 until present) was associated with:
a. * a slight ALT serum level total decrease of ~8% (from
285 U/l [on 11.10.2014, the last determination before
starting ARS] to 264 U/l [on 11.03.2019])
b. * a significant AST serum level total decrease of ~31%
(from 279 U/l [on 11.10.2014, the last determination
before starting ARS] to 213 U/l [on 11.03.2019]) (with
normal GGT serum levels from 11.10.2014 [8 U/l] until
11.03.2019 [10 U/l], thus no detectable liver toxicity of
ARS at least in the Jan-March 2019 interval)
c. * a marked CK serum level total decrease of ~307%
(from 27 609 U/l [on 2.11.2016, the last determination
before starting ARS] to 8979 U/l [on 11.03.2019])
d. * a very significant CK-MB serum level decrease of
~239% (from 704 U/l U/l [on 2.11.2016, the last
determination before starting ARS] to 295 U/l [on
11.03.2019])
e. * a spectacular LDH serum level (a non-specific marker
for tissular damage, including rhabdomyolysis, especially
myocardium damage) decrease of ~567% (from 4572 U/l
[on 2.11.2016, the last determination before starting ARS]
to 806 U/l [on 11.03.2019])
f. (all * markings): under the reserve that boy’s mother
refused to determine all the rhabdomyolysis markers
immediately before the initiation of ARS P.O.:
additionally myoglobin (MG) serum/urinary level was
never determined by the mother and never specifically
requested by any doctor except dr. Drăgoi;
g. These significant decreases of the (previously) listed
rhabdomyolysis markers (especially CK, CK-MB and
LDH) may be explained by the fact that ARS has strong
global NRF2 activation effect (on all types of
muscles/myocytes) and a very strong NRF2 activation
effect on the myocardium, where the expression of NRF2
is larger than in skeletal muscles, an additional indirect
subtle potential “proof” that ARS acts via NRF2 pathway).
These results suggest that ARS may have very potent
muscular (including myocardial) protective effects (the
basis of which we propose the study of ARS on large
cohorts with acute or chronic cardiac diseases),
significantly limiting the muscular damage in DMD
patients, with the potential of even stronger effects in
(milder) BMD phenotypes: this comes in the “same pack”
with no liver toxicity, no adverse effect on growth and
development of the child and no other adverse effects in
other clinical spheres until the present.
h. For extensive interpretations of ARS effects in these two
DMD cases (published by the author) see reference [1]
(section ”Results and Interpretations”).
i. The next labs are scheduled in the last week of August
2019 and are still under work.
***
Discussions
1. For previous extensive discussions on ARS effects in these
two DMD cases (published by the author) see reference [1]
(section ”Discussion”).
2. Pathophysiology. The pathological mechanisms of DMD are
generally complex and dramatic: the main hallmark of DMD
is a very high oxidative stress (OS) level in DMD-phenotype
myocytes including cardiomyocytes (leading to chronic
muscle inflammation, repeated cycles of degeneration and
impaired muscle regeneration) [URL1, URL2, URL3, URL4,
URL5, URL5, URL6, URL7, URL8, URL9, URL10, URL11,
URL12, URL13, URL14, URL15, URL16]
a. OS is two sided: whereas excessive OS causes
intracellular molecular damage, maintenance of a
physiological level of oxidant challenge (mainly by
superoxide molecules generation), termed oxidative
eustress (OES), is essential for governing life
8
processes through redox signaling. “Redox balance is
maintained by prevention, interception, and repair, and
concomitantly the regulatory potential of molecular
thiol-driven master switches such as NRF2/Keap1 or
NF-κB/IκB is used for system-wide OS response. Non-
radical species such as hydrogen peroxide (H2O2) or
singlet molecular oxygen, rather than free-radical
species, perform major second messenger functions.
Chemokine-controlled NADPH oxidases and
metabolically controlled mitochondrial sources of H2O2
as well as glutathione- and thioredoxin-related
pathways, with powerful enzymatic back-up systems,
are responsible for fine-tuning physiological redox
signaling. This makes for a rich research field spanning
from biochemistry and cell biology into nutritional
sciences, environmental medicine, and molecular
knowledge-based redox medicine. [URL1, URL2,
URL3].
b. ARS contains both superoxide and H2O2 species (in
small concentrations<1%) and not only hyper-activates
NRF2, but also "injects" cells with various free radical
species, thus keeping OES while preventing a possible
cytotoxic reductive stress (RS): that is what makes
ARS unique from all known natural/artificial
antioxidants; in contrast, common antioxidants may
easily induce RS when given/administered in excess or
when too strongly activating the NRF2 pathway
[URL1, URL2, URL3, URL4, URL5, URL6, URL7,
URL8] (although there may be cases in which a slight
RS may prevent OS: see URL). More specifically,
even if ARS is a solution in which there is a relatively
good redox balance between free oxidant species
(FOS) and free reductive species (FRS), ARS has an
~3-4 acid ph (as its superoxide and other FOS slightly
predominate over FRS). The direct antioxidant effect
of ARS is probably low, although "injecting" ARS in a
cell under oxidative stress actually (and at least
partially) restores the balance between FOS and FRS in
that cell. In the same time FOS from ARS strongly
(and very selectively) activates NRF2 and all the
endogenous antioxidant enzymatic systems controlled
by NRF2: apparently this may lead to RS, but this
probably does not happen in case of ARS just because
ARS ALSO injects cells with some additional FOS
(which probably remain partially non-neutralized by
endogenous antioxidant systems) and that is unique
among all direct antioxidants and among all known
NRF2 activators. In a cell under high OS, ARS
strongly lowers the global oxidative level/potential
from/of that cell (not mainly by direct mechanism, but
mainly by NRF2 activation and consequent
endogenous antioxidant enzymes genetic
overexpression) and in the same time "injects"
additional FOS species in the cell, thus preventing
reductive stress. It is true that ARS also "injects" FRS
in that same cell, but those FRS are in minority (when
compared to FOS predominance in ARS). Prudence is
however advised so that ARS should be
administered in progressively higher doses
(correlated with the body mass of the patient) so
that to effectively treat OS without causing RS:
(explanation 1) RS may have also caused the slight
re-increase of ASAT, ALAT, CK and CK-MB (in
the last 8-9 months) in the 1st published case of an
ARS-treated boy with DMD [1]; (explanation 2)
another possible explanation for this slight re-increase
(of those rhabdomyolysis markers) may be an
autoimmune response to a possible increase in the
number of normal dys revertant fibers (plausibly
induced by ARS) to which organisms with DMD
phenotypes (DPs) haven’t normally gained an immune
tolerance because the low levels of normal dys in these
DPs (a phenomenon already demonstrated after
exonskipping therapy in a mdx mouse model: see
URL). Furthermore, there is a very high variability
between human individuals in their cellular response to
physical exercise (PE) (aka “redox individuality”):
because ARS grossly contains the same redox
molecules that are usually produced in cells by PE, the
response to ARS is also expected to be very variable
(concerning the possible induction of OS and/or RS) in
general, and even more variable in DMD cases in
which there is a very large spectrum of possible dys
gene mutations (affecting dys structure and functions in
the human cells). Given its uniqueness in possibly
preventing RS, ARS should replace common
antioxidants in all those past studies (which should
be redesigned by including ARS) in which those
tested antioxidants or NRF2 activators were
demonstrated to not help and even to induce RS.
c. The spectrum of diseases (including genetic syndromes)
which have an important component of acute and/or
chronic OS is immense, that is why ARS has a
significant potential to help in all these diseases, and
that is why ARS deserves systematic extensive studies
in many diseases from this OS-centered spectrum of
diseases.
d. ARS is such a potent indirect antioxidant (via NRF2
pathway) that it can be also used as a research tool to
indicate/verify if any disease has a significant oxidative
stress component or not: for example, the significant
decrease of all rhabdomyolysis markers (when under
ARS P.O.) in these published cases of DMD clearly
indicates that DMD has an important oxidative stress
component. More specifically, ARS can be
administered in any clinical case even when no
9
specific/exact diagnostic is known: if there will be any
clinical or paraclinical amelioration in that clinical case
with unknown diagnosis, then OS is probably one
important link in the pathophysiology of that
unknown/undiagnosed disease.
3. Additional lab/imaging and other tools for studying DMD
cases treated with ARS. Impaired muscle regeneration is a
hallmark in DMD, that is why several indices of regeneration
(centronucleation, fibre size, embryonic myosin, utrophin
serum levels [URL]) can also be measured in ARS-treated
DMD/BMD cases.
a. LDH [URL2], which is expressed extensively in almost all
body tissues: it is released from the intracellular medium
during tissue damage, it is a marker of common injuries
and disease such as muscles damage (from DMD/BMD),
heart failure etc. [URL1a, URL1b, URL2, URL3, URL4,
URL5]
b. Diaphragm ultrasonography may also be used in the
future as a practical non-invasive assessment of the
diaphragm function in ARS-treated DMD cases [URL].
c. Various questionnaires and scores can be used to
quantify the quality of life in children and adults with
DMD [URL].
d. FORT [URL2] and FORD [URL2] tests may also be
used to periodically monitor the antioxidant properties in
any ARS-treated patient (not only in ARS-treated
DMD/BMD patients).
e. hand-held myometry [URL1, URL2, URL3, URL4,
URL5]
f. 6 Minute Walk Test [URL2] (6MWT) [URL1, URL2a,
URL2b, URL3, URL4a, URL4b, URL5, URL6, URL7,
URL8, URL9, URL10, URL11] and its 2MWT variant
(URL1)
4. Additional diets and molecules which may have synergic
effects with ARS. Possible synergic combinations between
ARS and other therapeutic molecules also deserve extensive
studies:
a. Various diet-charts for DMD patients [URL]
b. Specific physical therapies [URL]
c. creatine monohydrate (URL)
d. simvastatin (URL1, URL2)
e. N-acetylcysteine (NAC) (URL; ARS may even be
studied in combination with [or as a replaces of] NAC
in paracetamol/acetaminophen intoxication/poisoning,
because, similarly to NAC, ARS also increases the
concentration of glutathione in all cells, including
hepatocytes by activating glutathione synthase via
NRF2 pathway)
f. melatonin [URL]
g. Medical laser [URL]
h. SIRT1 activators [URL]
i. Protandim® (a NRF2 activating combination of herbal
dietary supplements) [URL]
5. Other potential uses of ARS.
a. Given the spectrum of NRF2 cellular/tissular different
concentrations (kidney > muscles > lungs > heart > liver
> brain), ARS (as a very efficient NRF2 activator with
excellent bioavailability in all these listed vital organs)
has a significant therapeutic potential in renal, hepatic,
pulmonary, heart, liver and even brain infectious and/or
inflammatory and/or degenerative diseases (possibly also
including mental disorders like depression, anxiety etc).
Given that kidneys have the highest NRF2 tissular
concentration, ARS deserves a special focus in studying
the treatment with ARS PO in various
nephrologic/kidney disease like: various types of
(progressive) glomerulonephritis, nephrotic syndrome,
urinary tract infections (UTIs) (especially
pyelonephritis), chronic kidney disease (CKD) and even
hemolytic-uremic syndrome (HUS), so that to prevent
renal scaring or other possible mild or serious
complications of these kidney diseases.
b. Given its “hybrid” antimicrobial and anti-inflammatory
effects (plus its demonstrated stability in nebulized
form), ARS deserves extensive studies on its possible
capacity to prevent airway tract infections similarly to
inhaled antibiotics in recent specific studies on DMD
patients with respiratory distress/insufficiency [URL]
c. ARS may be tested in various doses (2-3-4-5-..10 ml x 1-
2-3/day) as adjuvant treatment with possible good results
on pulmonary/airways inflammation (because of its anti-
inflammatory properties via NRF2 pathway) and
viral/bacterial infections (because of its direct
bactericidal and virucidal properties).
d. Given its corticoid-like anti-inflammatory effects, ARS
also deserves extensive studies (alone or in various
combinations with inhalatory, oral or parenteral
corticosteroids) in all diseases which usually respond to
corticoids, like pulmonary sarcoidosis, primary or
secondary pulmonary fibrosis, cystic fibrosis (because
of its hybrid anti-microbial and anti-inflammatory
mechanism), scleroderma with pulmonary determination
(because ARS significantly diminishes chronic
inflammation and thus may prevent fibrosis). The results
may be even better when ARS nebulizations are
associated with ARS consumption PO. Of course that
ARS may be first tested on various mouse models of
chronic pulmonary inflammation of various infectious,
autoimmune, genetic and non-genetic diseases.
e. ARS may also have some interesting effects on
extracellular matrix (EM) and interstitial (stromal) cells
(ICs), especially on telocytes, which are a novel defined
type of ICs (in the field of stem cells), with very long
10
(tens to hundreds of micrometres) and very thin
prolongations called “telopodes: these telopodes present
an alternation of thin segments called “podomeres (with
caliber mostly < 200 nm, below the resolving power of
light microscopy) and dilated segments called “podoms,
which accommodate a relatively large number of
mitochondria (on which ARS was proven to have some
significant effects via NRF2 pathway but also via other
genetic pathways [see the 1st published case on ARS
effects in DMD]), (rough) endoplasmic reticulum and
caveolae - the so-called "Ca2+ uptake/release units".
***
Final conclusions
1. ARS is plausibly the strongest (artificial) NRF2 selective
activator ever produced by humans in a lab: that is why ARS
may be regarded as a very important discovery in redox
medicine and human/animal medicine/biology in general.
2. ARS effects in DMD patients appear to be reproducible,
because the response to ARS is quite similar in both these
published ARS-treated DMD cases: that makes ARS a very
promising new strategy in DMD and BMD
treatment/management. Furthermore, we predict that ARS
effects in BMD patients (which have a less affected
phenotype) may be even more spectacular.
3. Obviously, further extensive studies are needed to better
understand the cellular effects of various ARS dosages and
ARS combinations with other (possibly synergistic)
therapeutic molecules/drugs.
4. ARS therapy is significantly more expensive than
corticosteroids but ARS therapy has the advantage to have
zero toxicity (in principle) and to be significantly less
expensive than ataluren or exon skipping therapy for example.
***
Acknowledgments
1. Funding: All the pediatric consults and all the dietary
supplements (including ARS) given/administered to this boy
were financially supported by his parents, because these
therapeutic substances are not supported by the Romanian
National Health Insurance System (RNHIS); a part of the
rhabdomyolysis markers (which were sampled periodically,
but not supported by RNHIS) were also paid by the parents;
2. Author contributions: The conceptualization, data curation,
formal analysis, investigation, methodology, project
administration, software (used for keeping the evidence of all
patients, including this boy), supervision, validation,
visualization, writing (the original draft plus review & editing)
were all done by dr. Andrei-Lucian Drăgoi, the single author
of this article. Funding acquisition and resources were mainly
supported by the parents of this boy and secondarily supported
by RNHIS; we have also obtained the oral consent of the
mother to publish this medical case in both English and
Romanian, with the only condition to not mention the names
of the boy, parents or other relatives;
3. Competing interests: the author of this paper was invited a
couple of times to present ARS and his clinical experience
with ARS, but with no financial remuneration and no
competing interests. ***
References
(most of the references were already included as hyperlinks/URLs
in the text)
[
1
] Andrei-Lucian Drăgoi (July 2019). (ASEA in DMD - CJBRT
article - 20.07.2019) The Remarkable Effects of “ASEA redox
Supplement” In A Child with Duchenne Muscular Dystrophy
A Case Report, Canadian Journal of Biomedical Research and
Technology (CJBRT) 2019; volume 1, issue 4:8. URLs: URL1a,
URL1b, URL1c (CJBRT original sources); URL2a (Research
Gate source); URL2b & URL2c (Academia sources); URL2d
(Vixra source); URL3 (Research Gate preprint source).
[
2
] Andrei-Lucian Drăgoi (May 2018). (ASEA in DMD preprint
version 1.1 1.08.2018 13 pages) The clinical and biological
effects of ASEA ionized water /”redox supplement” (co-
administered with L-carnitine and omega-3 fatty acids plus
multivitamins dietary supplements) in a ~3-year-old boy with
Duchenne muscular dystrophy (DMD) from Romania a case
report. Research Gate preprint. DOI:
10.13140/RG.2.2.21420.36486. URL (Research Gate source). The
article based on this preprint was published in July 20th, 2019
under the title “The Remarkable Effects of “ASEA redox
Supplement” In A Child with Duchenne Muscular Dystrophy
A Case Report” in the Canadian Journal of Biomedical
Research and Technology (CJBRT) 2019; volume 1, issue 4:8.
URLs: URL1a, URL1b, URL1c (CJBRT original sources); URL2
(Research Gate source)
ResearchGate has not been able to resolve any citations for this publication.
Preprint
Full-text available
This paper presents a case report on the remarkable clinical and biological effects of “ASEA redox supplement” (ASEA-rs) oral solution (co-administered with L-carnitine and omega-3 fatty acids plus multivitamins dietary supplements) in a ~3-year-old boy with Duchenne muscular dystrophy (DMD) from Romania. ASEA-rs was tested on both animals and humans. In vitro studies on various human cells showed that ASEA-rs is a very potent NRF2 selective activator (with transient effect): the studies conducted in vivo (on both animals and humans) also support this main pharmacological mechanism of ASEA-rs, with no toxicity up to high doses (in contrast with corticosteroids which are usually reserved in Romania for DMD children with age above 4 years, given their toxicity profile and adverse effects including immunosuppression, growth delay, osteopenia, osteoporosis and overweight) and a satisfactory bioavailability especially in the vital organs (in which NRF2 also reaches its highest intracellular cytoplasmatic concentrations), which assures the strong NRF2 activation effects of ASEA-rs indirectly observed in vivo. ASEA was clearly demonstrated to activate tissular lipases (probably also via NRF2 pathway) and to significantly increase some fatty acids serum levels that are further internalized by skeletal muscles and myocardium and used as “fuel” by muscular cells (myocytes) (and cardiomyocytes), partially sparing the glycogen reserves of myocytes/cardiomyocytes and so raising the resistance of skeletal muscles to effort and possibly the resistance and contractility of myocardium. Based on its demonstrated potent selective NRF2 activation effect, its beneficial effects on muscle effort resistance and its safety profile, I have prescribed ASEA-rs to this ~3-year-old child with DMD, with a minimal set of clinical signs at his age, but with significant biological alternations in the biochemical markers of muscular damage (rhabdomyolysis): the results (after the first 3 months with ASEA-rs, associated with L-carnitine and omega-3 fatty acids plus multivitamins supplements) were a significant reduction in the creatine (phospho)kinase (CK/CPK) and CK-MB isoform serum levels. Keywords: ASEA redox supplement (ASEA-rs) oral solution, 3-year-old boy, Duchenne muscular dystrophy (DMD), Romania, NRF2 selective activator, tissular lipase activator, skeletal muscles and myocytes, myocardium and cardiomyocytes, corticosteroids, creatine (phospho)kinase (CK/CPK), CK-MB isoform This paper belongs to a series of three cases on Asea effects in DMD children-patients: https://www.researchgate.net/publication/325371161 (1st case - preprint), https://www.researchgate.net/publication/334596031 (1st case - CJBRT article), https://www.researchgate.net/publication/334773748 (1st case - periodic updates), https://www.researchgate.net/publication/335502350 (2nd case - preprint), https://www.researchgate.net/publication/340902127 (3rd case - preprint); See also: https://www.researchgate.net/publication/336990483 and https://www.researchgate.net/publication/337026408 (ppt on Asea), https://www.researchgate.net/publication/339592997 (on possible testing of NRF2 activators in COVID-19)
ASEA redox Supplement" In A Child with Duchenne Muscular Dystrophy -A Case Report
  • Andrei-Lucian Drăgoi
Andrei-Lucian Drăgoi (July 2019). (ASEA in DMD -CJBRT article -20.07.2019) The Remarkable Effects of "ASEA redox Supplement" In A Child with Duchenne Muscular Dystrophy -A Case Report, Canadian Journal of Biomedical Research and Technology (CJBRT) 2019; volume 1, issue 4:8. URLs: URL1a, URL1b, URL1c (CJBRT original sources);