ABSTRACT
The elderly population with declining health pose significant challenges for attending physicians. Often, the cause/s of the deterioration is not identifiable or is irreversible. Some elderly patients, including those who do not have acute illness or severe chronic disease, eventually undergo a process of functional decline, progressive apathy and a loss of desire to eat and drink. Declining health in the elderly may be multifactorial and may be caused by chronic concurrent diseases and functional impairments. Manifestations include weight loss, decreased appetite, poor nutrition and inactivity. Four syndromes are prevalent and predictive of adverse outcomes viz. impaired physical function, malnutrition, depression and cognitive impairment. A comprehensive initial assessment should include information on physical and psychologic health, functional ability, socioenvironmental factors and nutrition. Several medicines and food supplements are available for the elderly as per their individual requirements. Geriforte tablets with their beneficial effects in elderly patients contain herbs, which have potent antioxidant, neuroprotective, adaptogenic, nootropic, immunostimulatory and cardioprotective activities. In this review article, we summarize seven clinical studies of Geriforte tablets with an emphasis on geriatric stress and as tonic in the elderly.
ABSTRACT
Neurons and astrocytes differentially express isoenzymes of lactate dehydrogenase (LDH). The metabolic consequences for the variations in mRNA expression of LDH isoenzyme subtypes in neurons and astrocytes control cerebral vasoregulation. Moreover, cellular signalling consequences for functional neurovascular control may also be dependent on LDH isoenzyme subtype profiles. Initial computer simulations revealed glutamate-induced calcium waves in connected astrocytes, and showed concomitant changes in the expression of nitric oxide synthase (NOS) and lactic acid metabolism. To validate these findings, the nature and extent of glutamate-dependent signalling crosstalk in murine cell lines were investigated through correlated lactate levels and calcium upregulation. Neuro2A and C8D1A cells were separately treated with timed supernatant extracts from each other and their LDH1 and LDH5 isoenzyme responses were recorded. Western blot analysis showed LDH1/LDH5 isoenzyme ratio in the astrocytes to be positively correlated with Neuro2A-derived lactate levels estimated by the amplitude of 1.33-ppm spectral peak in 1H-NMR, and LDH1/LDH5 isoenzyme ratio in neurons is negatively correlated with C8D1A-derived lactate levels. Significant modulations of the calcium-responsive protein pCamKII levels were also observed in both cell lines, particularly correlations between pCamKII and lactate in C8D1A cells, thus explaining the calcium dependence of the lactate response. Together, these observations indicate that lactate is a key indicator of the metabolic state of these cell types, and may be a determinant of release of vasoregulatory factors.