Substantiation of the use of antioxidant therapy in the complex conservative treatment of diabetic foot syndrome

25 січня 2022
767
Спеціальності :
Резюме

Aim: to study the state of the antioxidant system of patients with diabetic foot syndrome and to improve the results of their complex treatment.

Object and methods of research. The study included 134 patients with diabetic foot syndrome. Patients were divided by sex and age: men — 85 (63.4%), women — 49 (36.6%), the average age was (64.3±7.3 years). To study the antioxidant system, we determined for 1, 7, 14 days in the wound and serum the content of metabolites of reactive oxygen species of TBA-active products in blood plasma, the activity of the antioxidant system superoxide dismutase. Peripheral blood monocyte functional activity was assessed in the nitrosine tetrazolium reduction test in two modifications: spontaneous and lipopolysaccharide-induced.

Results. When determining the activity of superoxide dismutase in peripheral blood in patients who received glutathione in complex treatment, we found a decrease in its activity relative to reference values 1.56 times (p<0.001).

Conclusions. Oxidative stress leads to a cascade of pathomorphological changes in the body, which dictates the need to use antioxidant therapy in the treatment of diabetic foot syndrome.

References

  • 1. International Diabetes Federation (2019) Diabetes Atlas. 9th ed.
  • 2. Kryzhevskyi Y., Bilyayeva O., Rykov S. et al. (2021) Study of new pathogenetic mechanisms of diabetic retinopathy development in patients with diabetic foot syndrome. J. Educat. Health Sport, 11(04): 233–246. DOI dx.doi.org/10.12775/JEHS.2021.11.04.024.
  • 3. Biliaieva O.O., Rybianets Yu.V., Kryzhevskyi Ye.le. (2017) Porivnialna otsinka mistsevoho likuvannia hniino-nekrotychnykh uskladnen pry syndromi diabetychnoi stopy za dopomohoiu aplikatsiinykh sorbentiv. Suchasn. med. tekhnol., 4(35): 9–12 (In Ukr.).
  • 4. Sibbald R., Ayello E. (2018) The Reduction of Diabetic Foot Amputations Starts with Preventing Foot Ulcers. Adv. Skin Wound Care, 31(9): 389. DOI: 10.1097/01.ASW.0000544473.65179
  • 5. Prystupiuk O.M. (2002) Oksydantnyi stres za naiavnosti tsukrovoho diabetu. UMJ, 3(29): 23–25.
  • 6. Bolotova D.G., Lobanov S.L., Morozov E.Ju. (2007) Analiz lechenija gnojno-nekroticheskih form sindroma diabeticheskoj stopy. Bjul. VSNC SO RAMN, 4: 38–39.
  • 7. Bregovskij V.B., Zajcev A.A., Zelevskaja A.G. (2004) Porazhenie nizhnih konechnostej pri saharnom diabete. Medicina, 354 s.
  • 8. Kozlov V.I. (2003) Gistofiziologiya sistemy mikrocirkulyacii. Regionarnoe krovoobrashchenie i mikrocirkulyaciya, 4: 79–85.
  • 9. Pereira M.A., Sanomiya P., Leme J.G. (1987) Inhibition of leukocyte chemotasis by factor in alloxan-induced diabetic rat plasma. Diabete, 36(8): 1307–1314.
  • 10. Kryzyna O.V. (2018). Patomorfologichni osoblyvosti krovopostachannja m’jakyh tkanyn nyzhnih kincivok pry cukrovomu diabeti. Visn. probl. biol. med., 4(1): 20–24.
  • 11. Lankin V.Z., Tikhaze A.K., Belenkov Yu.N. (2000) Free radical processes in diseases of the cardiovascular system. Cardiology, 40(7): 48–61 (In Rus.).
  • 12. Shih E.V., Petunina N.A., Nedosugova L.V. et al. (2020) Spontannaja i inducirovannaja sekrecija provospalitel’nyh i protivovospalitel’nyh citokinov u pacientov s saharnym diabetom 2 tipa i sindromom diabeticheskoj stopy. Saharnyj diabet, 23(3): 210–222 (In Rus.).
  • 13. Kulinskij V.I. (1999) Aktivnye formy kisloroda i oksidativnaya modifikaciya makromolekul: pol’za, vred i zashchita. Sorosovskij obrazovatel’nyj zhurnal, 1: 2–7.
  • 14. Anderson M.E. (1989) Enzymatic and chemical methods for the determination of glutathione. Glutathion, pt A.: 339–366.
  • 15. Tsunada S., Iwakiri R., Noda T. et al. (2003) Chronic exposure to subtoxic levels of peroxidized lipids suppresses mucosal cell turnover in rat small intestine and reversal by glutathione. 48(1): 210–222. doi: 10.1023/a:1021775524062
  • 16. Meister A., Anderson M.E. (1983) Glutathione. Ann. Rev. Biochem., 52: 711–760. doi: 10.1146/annurev.bi.52.070183.003431.
  • 17. Kulinskij V.I., Kolesnichenko L.S. (2009) Sistema glutationa 1. Sintez, transport glutationtransferazy, glutationperoksidazy. Biomed. himiya, 55(3): 255–277 (In Rus.).
  • 18. Deneke S.M., Fanburg B.Y. (1989) Regulation of cellular glutathione. Am. J. Physiol., 257(4 Pt. 1): 163–173. doi: 10.1152/ajplung.1989.257.4.L163.
  • 19. Sies H., Graf P. (1985) Hepatic thiol and glutathione efflux under the influence of vasopressin, phenylephrine and adrenaline. Biochem. J., 226(2): 545–549. doi: 10.1042/bj2260545
  • 20. Meggitt B. (1976) Surgical management of the diabetic foot. Br. J. Hosp. Med., 16: 227–332.
  • 21. Wagner F. (1979) A classification and treatment program for diabetic, neuropathic, and dysvascular foot problems. Instr. Course Lect., 28(1): 143–165.
  • 22. Monteiro-Soares M., Boyko E., Jeffcoate W. et al. (2020) Diabetic foot ulcer classifications: A critical review. Diabetes Metab. Res. Rev., 36 Suppl. 1: e3272. doi: 10.1002/dmrr.3272
  • 23. American Diabetes Association (2003) Peripheralarterial disease in people with diabetes. Diabetes Care, 26: 3333–3341. DOI: 10.2337/diacare.26.12.3333.
  • 24. Selyutina S.N., Selyutin A.Y., Pal A.I. (2000) Modification of the determination of the concentration of TBA-active products of blood serum. Klin. lab. Diagnostics, 2: 8–11.
  • 25. Kostjuk V. A., Potapovich A. I., Kovaleva Zh. V. (1990) Prostoj i chuvstvitel’nyj metod opredelenija aktivnosti superoksiddismutazy, osnovannyj na reakcii okislenija kvercetina. Voprosy medicinskoj himii, 36(2): 88–91 (In Rus.).
  • 26. Vanin A.F. (1998) Dinitrozil’nye kompleksy zheleza i S-nitrozotioly — dve vozmozhnye formy stabilizacii i transporta oksida azota v biosistemah. Biohimija, 63(7): 924–938 (In Rus.).
  • 27. Jourd’heuil D., Hallén K., Feelisch M., Grisham M.B. (2000) Dynamic state of S-nitrosothiols in human plasma and whole blood. Free Radic. Biol. Med., 28(3): 409–417. doi: 10.1016/s0891-5849(99)00257-9.
  • 28. Koval’chuk L.V. i dr. (2010) Immunologija: praktikum. GJeONTAR-media, 176 s. (In Rus.).
  • 29. Dedov I.I., Udovichenko O.V., Galstyan G.R. (2005) Diabeticheskaya stopa. Prakt. Medicina, 197 s. (In Rus.).