Assessment of Proteinase-Inhibitory System and Plasma Fibrinolytic Activity in Patients with Gastroesophageal Reflux Disease and Diabetes Mellitus Type 2
Aim: investigation of proteinase-inhibitory system and plasma fibrinolytic activity in patients with gastroesophageal reflux disease (GERD) combined with diabetes mellitus (DM) type 2. Methods. The study involved 112 patients with GERD aged 33 to 76 years, who subsequently were divided into groups depending on the form of GERD. The state of proteinase-inhibitory blood system was evaluated by K.N. Veremeyenko et al.. The state of enzymatic and non-enzymatic fibrinolysis in plasma was evaluated by N. Titsa method. Results. We found that patients with erosive form of GERD independent on DM type 2 more likely have higher level of low molecular and macromolecular proteins lysis as well as collagen lysis compared to the healthy person and patients with non-erosive form of GERD (p < 0.05). The changes in the concentration of α2-MG in GERD were multidirectional: reduced concentration of α2-MG in GERD combined with DM type 2, and vice versa, increased level of α2-MG in patients with GERD without comorbid pathology compared with the healthy person. Assessment of plasma fibrinolytic activity found that patients with erosive form of GERD combined with DM type 2 had significantly increased fibrinolytic activity compared to the healthy person (p < 0.05), and in patients with nonerosive form of GERD and DM type 2 just had trend to increase in these indicators (p > 0.05). Novelty. First studying changes of proteolytic and fibrinolytic activity of blood and inhibitor of proteolysis allowed reveal new mechanisms of pathogenesis and progression of GERD in patients with DM type 2. Conclusion. Thus, in patients with GERD combined with DM type 2 met unbalanced growth of the intensity of proteolysis under the conditions of reduced expression of its inhibitor, increased plasma fibrinolytic activity.
Full Text:PDF (Українська)
Akbasheva O.E., Zagromova T.A., Serebrov V.Yu. Pokazateli proteoliza i fenotipy α1-proteinaznogo ingibitora pri yazvennoy bolezni dvenadcetipersnoy kishki [Indicators proteolysis and phenotypes of α1-proteinase inhibitor with duodenal ulcer]. Voprosu biologicheskoy, medicinskoy i pharmacevticheskoy khimii. - Questions of biological, medical and pharmaceutical chemistry, 2007, no. 2, pp. 41-44.
Ametov A.S., Solovyeva O.L. Okislitelnyi stres pri saharnom diabete 2-go tipa i puti ego korekcii [Oxidative Stresa with diabetes mellitus type 2 and ways of its correction]. Prolemu endokrinologii - Problems endocrinology, 2011, no. 6, pp. 52-56.
Babak O.Ya., Kolesnikova E.V. Gastroesophagealnaya refluxnaya bolezn: ot ponimaniya mehanizmov razvitiya zabolevaniya k ymensheniyu klinicheskih simptomov [Gastroesophageal reflux disease: from understanding the mechanisms of disease development in a reduction of clinical symptoms]. Suchasna gastroenterologiya - Modern gastroenterology, 2012, no. 3, pp. 32-38.
Bezsheyko V.G. Gastroesophagealnaya refluxnaya bolezn: modifikaciya obraza gizni i pharmacoterapiya s pozicui dokazatelnoy medicinu [Gastroesophageal reflux disease: lifestyle modification and pharmacotherapy with evidence-based medicine]. Ukrainskuy meduchnuy chasopus - Ukrainian medical magazine, 2013, no. 3, pp. 81-85.
Bychkov M.A., Bychkov Yu.A., Bychkova S.V. Cinnist neinvazyvnyh metodiv diagnostyky gastroesophagealnoyi refluxnoyi khoroby [The value of non-invasive methods of diagnosis of gastroesophageal reflux disease]. Ukrainskuy meduchnuy chasopus - Ukrainian Medical magazine, 2013, no. 5 (97), pp. 124-126.
Korotko G.F. Proteoliz v regulyacii funcyi sistemu pischevareniya [Proteolysis in the regulation of the digestive system functions]. Experementalna i klinichna gastroenterologiya - Experimental and clinical gastroenterology, 2013, no. 10, pp. 23-27.
Lembrik I.S., Tymoschuk O.V., Ciciura O.O. Zminy systemy perekysnogo okyslennya lipidiv u ditey z khronichnym gastroduodenitom, asociiovanum z Helicobaccter pylori [The changes of lipid peroxidation in children with chronic gastroduodenitis associated with Helicobaccter pylori]. Arhiv klinichnoi meducunu - Archive clinical medicine, 2009, no. 1, pp. 66-69.
Manischenkova Yu.A., Shkala L.V., Dudich T.I. [and other]. Oksidantnyi stres u bolnyh s saharnym diabetom 2 tipa, sochetanym s obostreniem khronicheskogo pielonefrita [Oxidative stress in patients with diabetes mellitus type 2, combined with acute exacerbation of chronic pyelonephritis]. Mignarodnuy endokrunologichnuy gurnal - The international endocrinology magazine, 2013, no. 3, pp. 19-22.
Phadeenko G.D., Galchynska G.Yu., Kushnir I.E. [and other] Osoblyvosti morphologichnogo stanu slyzovoi obolonky stravohodu u khvoryh na gastroesophagealnu refluxnu khorobu [Features of the morphological status of the esophageal mucosa in patients with gastroesophageal reflux disease]. Suchasna gastroenterologiya - Modern hastroenterology, 2012, no. 5, pp. 13-19.
Ostroglyad A.V., Svincuckuy A.S., Vdovuchenko V.I. Gastroesophagealna refluxna khoroba [Gastroesophageal reflux disease], Lviv, 2011, 199 p.
Paliy I.G., Zaika S.V., Prymak O.S. Kyslotozalegni zakhvoryuvannya u khoryh na metabolichnuy sundrom: ne vyrishenni problemy i suchasni moglyvosti likuvannya [Acid disease in patients with metabolic syndrome, unresolved issues and current treatment options]. Suchasna gastroenterologiya - Modern hastroenterology, 2014, no. 1, pp. 83-92.
Paliy I.G. Klinichni masky gastroesophagealnoyi refluxnoyi khoroby [Clinical mask gastroesophageal reflux disease]. Suchasna gastroenterologiya - Modern hastroenterology, 2011, no. 5, pp. 69-76.
Acid Pocket: a target for treatment in reflux disease? P.J. Kahrilas, K. McColl, M. Fox [et al.] Am. J. Gastroenterol., 2013, Vol. 10, P. 132-136.
Development of consensus guidelines for the histologic recognition of microscopic esophagitis in patients with gastroesophageal reflux disease: the Esohisto project. R. Fiocca, L. Mastracci, R. Riddell [et al.]. Hum. Pathol., 2010, Vol. 41, P. 223-231.
Donnellan C., Preston C., Moayyedi P. Medical treatments for the maintenance therapy of reflux oesophagitis and endoscopic negative reflux disease. Cochrane Database Syst. Rev., 2010, Vol. 2, CD003245.
Heidelbaugh J.J., van Harrison R., McQuillan M.A., Nostrant T.T. Gastroesophageal reflux disease guideline. University of Michigan Health System. 2012. Available at: http://www.med.umich.edu/1info/fhp/practiceguides/gerd/gerd.12.pdf.
Herbella F.A. Critical analysis of esophageal multichannel intraluminal impedance monitoring 20 years later. ISRN Gastroenterol., 2012, Vol. 12, P. 903240.
Kawabata A., Matsunami M., Sekiguchi F. Gastrointestinal roles for proteinase-activated receptors in health and disease. Review. Br. J. Pharmacol., 2008, Vol. 153, P. 230-240.
Sifrim D., Zerbib F. Diagnosis and management of patients with reflux symptoms refractory to proton pump inhibitors. Gut., 2012, Vol. 61 (9), P. 1340-1354.
Update on the pathophysiology and management of gastroesophageal reflux disease: the role of prokinetic therapy. G.N. Tytgat, J. Janssens, J. Reynolds [et al.]. Eur. J. Gastroenterol. Hepatol., 2010, Vol. 8, P. 603-611.
Copyright (c) 2016 GASTROENTEROLOGY
This work is licensed under a Creative Commons Attribution 4.0 International License.
© Publishing House Zaslavsky, 1997-2019