Posibilidades de la terapia antioxidante en diabetes mellitus tipo 2. Estudio del estrés oxidativo en una muestra poblacional de pacientes diabéticos
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oxidative Stress
oxidative Stress Index
biomarkers
antioxidant therapy
diabetes mellitus
estrés oxidativo
índice de estrés oxidativo
biomarcadores
terapia antioxidante
diabetes mellitus
oxidative Stress Index
biomarkers
antioxidant therapy
diabetes mellitus
estrés oxidativo
índice de estrés oxidativo
biomarcadores
terapia antioxidante
diabetes mellitus
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Volume Title
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Intituto Tecnológico de Santo Domingo (INTEC)
Introducción: el organismo se expone cotidianamente a diferentes agentes que provocan reacciones oxidativas normalmente controladas. La sobreproducción de especies reactivas del oxígeno y/o la deficiencia de antioxidantes lleva al estrés oxidativo (EO) asociado a patologías crónicas que contribuye a un peor pronóstico de las enfermedades. Una de esas patologías crónicas es la diabetes mellitus (DM), en la que se ha demostrado una gran participación del EO en su fisiopatología y en el desarrollo de complicaciones. Se determinó el índice de EO (IEO) en individuos con DM y en un grupo sano control, para evaluar su posible correlación y grado de daño oxidativo, como estrategia para justificar una intervención potencial con una terapia antioxidante adyuvante al tratamiento convencional.
Materiales y métodos: se midió IEO en una población de 110 individuos con DM, constituida por 37 casos de DM tipo 1 (DMT1) y 73 del tipo 2 (DMT2) en edades entre 50 y 70 años escogidos al azar y se comparó con los valores de un grupo control de voluntarios sanos. El objetivo del ensayo clínico fue definir el grado de correlación entre los niveles del IEO y la severidad del daño oxidativo, ponderado a partir de una fórmula cualitativa, a través de la medición de nueve biomarcadores del EO en lisados de eritrocitos.
Discusión: la prevención o la detención de las comorbilidades de la DM puede que descanse en el futuro en la identificación precisa de los biomarcadores y su contrapartida reguladora. La incorporación de una terapia utilizando un protocolo con antioxidantes (AO) adyuvantes al manejo estándar de la DMT2 podría proveer resultados más eficaces para el control hiperglucémico y, por tanto, para inducir el equilibrio redox. Los resultados demuestran que ese tipo de terapia no sería eficaz en DMT1. Es determinante el reconocimiento de la extensión y tipo de daño oxidativo de las poblaciones específicas, mediante la creación y utilización de una línea de base con los biomarcadores alterados más frecuentemente. Esta línea de base ayudará a definir la mejor estrategia antioxidante a aplicar, porque el polimorfismo genético, el ambiente y los hábitos de vida actúan puntualmente en el tipo respuesta al EO. Una estrategia beneficiosa a valorar puede ser la del desarrollo de nuevos fármacos con efectos antioxidantes o de productos capaces de reforzar el sistema fisiológico de antioxidación a partir de sustratos naturales y la elaboración de combinaciones de dosis fijas de AO eficaces que ataquen las causas el EO en la DM. El objetivo final será el de revertir el daño oxidativo para prevenir la instalación de complicaciones o frenarlas.
Conclusiones: el uso del IEO con distintos marcadores ayuda a la especificidad del diagnóstico del EO, pero para que la elección de los marcadores sea la correcta, esta debe estar definida por el objetivo y el diseño del estudio, así como por la relevancia clínica en los sujetos seleccionados, tal cual fue el aplicado en el ensayo realizado. Los resultados obtenidos demuestran la potencialidad del uso de la terapia antioxidante en DMT2, pero no así en la DMT1. La importancia clínica de los biomarcadores del EO en humanos debe provenir de un análisis crítico de los marcadores que refleje el estado general de redox en condiciones particulares y una orientación para una terapia antioxidante efectiva.
Introduction: The body exposes daily to different agents that cause normally controlled oxidative reactions. Overproduction of reactive oxygen species and/or decrease in antioxidants induce oxidative stress (OS) associated with chronic pathologies contribute to a worse prognosis of the disease. One such chronic pathology is diabetes mellitus (DM) in which OS has shown to be highly involved in its pathophysiology and as part of the development of complications. The OS index (OSI) was determined in individuals with DM and in a healthy control group, to assess their possible correlation and degree of oxidative damage, as an initial supportive strategy for a potential antioxidant therapy as an adjunction to conventional treatment Methods: OSI was measured in a population of 110 individuals with DM, consisting of 37 cases of type 1 DM (DMT1) and 73 type 2 (DMT2) at ages between 50 and 70 years chosen at random and compared with the values of a healthy volunteer control group. The main goal of the clinical trial was to define the degree of correlation between OSI levels and oxidative damage severity, weighted from a qualitative formula, through the measurement of nine OS biomarkers in erythrocyte lysate. Discussion: The prevention or detention of DM comorbidities may rest in the future in the precise identification of biomarkers and their regulatory counterpart. The inclusion of a therapy using an antioxidant protocol adjuvant to the standard management of DMT2 could provide more effective results for hyperglycemic control and, therefore, to induce redox balance. The results show that this type of therapy would not be effective in DMT1. The recognition of the extent and type of oxidative damage in specific populations is decisive, through the creation and use of a baseline with the most frequently altered biomarkers. This baseline will help defining the best antioxidant strategy to be applied, because genetic polymorphism, the environment and styles of life act specifically in the type of response to the OS. A beneficial scheme to assess may be the development of new drugs with antioxidant effects or products capable of strengthening the physiological antioxidant system made from natural substrates and the making of effective fixed dose combinations of antioxidants that attack the causes of OS in DM. The final aim is to reverse oxidative damage in order to prevent the appearance of complications or slow them down. Conclusions: The use of OSI with different biomarkers helps to achieve the specificity of OS diagnosis, but for the choice of markers to be correct, these must be defined by the objective and design of the study, as well as by the clinical relevance in the selected subjects, as was the one applied in the actual trial. The results obtained demonstrate the potentiality of the use of antioxidant therapy in DMT2, but not in DMT1. The clinical importance of OS biomarkers in humans should come from a critical marker’s analysis that reflects the overall status of redox under particular conditions and guidance for effective antioxidant therapy.
Introduction: The body exposes daily to different agents that cause normally controlled oxidative reactions. Overproduction of reactive oxygen species and/or decrease in antioxidants induce oxidative stress (OS) associated with chronic pathologies contribute to a worse prognosis of the disease. One such chronic pathology is diabetes mellitus (DM) in which OS has shown to be highly involved in its pathophysiology and as part of the development of complications. The OS index (OSI) was determined in individuals with DM and in a healthy control group, to assess their possible correlation and degree of oxidative damage, as an initial supportive strategy for a potential antioxidant therapy as an adjunction to conventional treatment Methods: OSI was measured in a population of 110 individuals with DM, consisting of 37 cases of type 1 DM (DMT1) and 73 type 2 (DMT2) at ages between 50 and 70 years chosen at random and compared with the values of a healthy volunteer control group. The main goal of the clinical trial was to define the degree of correlation between OSI levels and oxidative damage severity, weighted from a qualitative formula, through the measurement of nine OS biomarkers in erythrocyte lysate. Discussion: The prevention or detention of DM comorbidities may rest in the future in the precise identification of biomarkers and their regulatory counterpart. The inclusion of a therapy using an antioxidant protocol adjuvant to the standard management of DMT2 could provide more effective results for hyperglycemic control and, therefore, to induce redox balance. The results show that this type of therapy would not be effective in DMT1. The recognition of the extent and type of oxidative damage in specific populations is decisive, through the creation and use of a baseline with the most frequently altered biomarkers. This baseline will help defining the best antioxidant strategy to be applied, because genetic polymorphism, the environment and styles of life act specifically in the type of response to the OS. A beneficial scheme to assess may be the development of new drugs with antioxidant effects or products capable of strengthening the physiological antioxidant system made from natural substrates and the making of effective fixed dose combinations of antioxidants that attack the causes of OS in DM. The final aim is to reverse oxidative damage in order to prevent the appearance of complications or slow them down. Conclusions: The use of OSI with different biomarkers helps to achieve the specificity of OS diagnosis, but for the choice of markers to be correct, these must be defined by the objective and design of the study, as well as by the clinical relevance in the selected subjects, as was the one applied in the actual trial. The results obtained demonstrate the potentiality of the use of antioxidant therapy in DMT2, but not in DMT1. The clinical importance of OS biomarkers in humans should come from a critical marker’s analysis that reflects the overall status of redox under particular conditions and guidance for effective antioxidant therapy.
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info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
info:eu-repo/semantics/publishedVersion
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Science and Health; Vol. 4 No. 3 (2020): Science and Health, september-december; 71-93
Ciencia y Salud; Vol. 4 Núm. 3 (2020): Ciencia y Salud, septiempre-diciembre; 71-93
2613-8824
2613-8816
10.22206/cysa.2020.v4i3
Ciencia y Salud; Vol. 4 Núm. 3 (2020): Ciencia y Salud, septiempre-diciembre; 71-93
2613-8824
2613-8816
10.22206/cysa.2020.v4i3