Barinova M. Pathogenesis of wound process impairment under conditions of diabetes mellitus

Object of investigation - wound process under diabetes, reactivity of organism; aim - to establish mechanisms of wound healing violations in patients with diabetic foot syndrome dependently on reactivity of organism and to identify perspectives of healing correction; methods -biochemical, morphological, immunocytochemical, immunoenzymological, statistical; newness and results - the criteria of reactivity in patients with diabetic foot revealed patterns of neutrophils dysfunction, studied the dynamics of L-arginine metabolism and modulating effects of the A2A adenosine receptors, AT1 type of angiotensin II, role proteinkinases A and C, phosphodiesterase-5, 5-lipoxygenase and cyclooxygenase in response to LPS in patients with burn wounds and diabetic foot; it was shown that reduction of basal and LPS-stimulated iNOS activity is a risk factor of violations of wound healing in diabetic patients, the possibility of evaluation of AT1 receptors and the sensitivity of intracellular signaling systems to predict high risk of progression of injury and reveals important diagnostic morphological criteria for evaluating the potential of tissue regeneration in diabetic foot syndrome, firstly a positive effect of AT1 receptor blockade to limit alterations and inflammation in the diabetic wounds in rats, stimulating effect of PDE-5 inhibitor on angiogenesis and granulation formation, wound phases recovery by A2A receptor stimulation due to antiinflammatory effects, optimization of granulation and dermis remodeling were proved; introduced - in practice of Institute of urgent and recovery medicine surgery NAMS of Ukraine, Institute of traumatology and orthopedics of Donetsk National Medical University, and in educational process at departments of pathophysiology of medical universities in Odessa, Crym, Kharkov, Zaporozhe, Lugansk, and Bukovina; scope of use - diagnostic and medical process of surgical, endocrinological and therapeutic departments, educational process at departments of pathophysiology at the Highest Schools of Medicine.