medigraphic.com
ISSN 2992-8036 (Electronic)
ISSN 2306-4102 (Print)
Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología

2014, Number 3

<< Back Next >>

Acta Ortop Mex 2014; 28 (3)

Efficacy of thiamine pyrophosphate or carboxylase in the salvage of diabetic foot

Carmona-Cervantes J

Language: Spanish
References: 20
Page: 168-172
PDF size: 179.95 Kb.


ABSTRACT

Diabetic foot represents one of the most common complications in patients with a long standing disease. The etiology is neuropathy, infections and ischemia that together contribute to the sequence of tissue necrosis, ulceration and gangrene. Since treatment is very difficult, we must look for several options to solve these problems caused by chronic hyperglycemia. Thiamine pyrophosphate or carboxylase perform multiple metabolic and non-metabolic activities that are considered important in the resolution of diabetic impairments, therefore, this work shows the results when using it in patients with diabetic foot. 29 patients with diabetic foot were treated between January 1998 and July 2012: 19 Wagner type III and 12 Wagner type IV. Management was the administration of antibiotics, partial surgical procedures and thiamine pyrophosphate. The infectious process was controlled, the appearance of granulation tissue and scarring of the lesion in a period of 2 to 6 months depending on the severity of the problem. Given the clinical data and evolution of the patients, we conclude that the administration of thiamine pyrophosphate was able to control metabolic and non-metabolic dysfunctions that lead to complications in diabetic patients, therefore we must consider it a tool in the treatment of diabetic patients in general and for diabetic foot salvage in particular.


REFERENCES

  1. Simmons Z, Feldman E: Update on diabetic neuropathy. Curr Opin Neurol. 2002; 15: 595-603.

  2. Feldman EL, Russell JW, Sullivan KA, Golovoy D: New insights into the pathogenesis of diabetic neuropathy. Curr Opin Neurol. 1999; 15: 553-63.

  3. Huijberts MS, Schaper NC, Schalkwijk CG: Advanced glycation end products and diabetic foot disease. Diabetes Metab Res Rev. 2008; 24(S1): 19-24.

  4. Clayton W. Jr., Elasy TA: A review of the pathophysiology, classification, and treatment of foot ulcers in diabetic patients. Clin Diabetes. 2009; 27(2): 52-8.

  5. Panju A: Does the clinical examination predict lower extremity peripheral arterial disease? JAMA. 2006; 295(5): 536-46.

  6. Pryce TD: A case of perforating ulcers of both feet associated with diabetes and ataxic symptoms. Lancet. 1887; 11: 11-2.

  7. Levin ME: An overview of the diabetic foot: pathogenesis, management and prevention of lesions. Int J Diab Dev Countries. 1994; 14: 40-8.

  8. Bowering G: Diabetic foot ulcers. Pathophysiology, assessment, and therapy. Can Fam Physician. 2001; 47: 1007-16.

  9. Hammes HP, Du X, Edelstein D, Taguchi T, Matsumura T: Benfotiamine blocks three major pathways of hyperglycemic damage and prevents experimental diabetic retinopathy. Nat Med. 2003; 9: 294-9.

  10. Thornalley PJ: Advanced glycation end products: what is their relevance to diabetic complications? Diabetes Obes Metab. 2007; 9(3): 233-45.

  11. Thornalley PJ: High dose thiamine therapy for patients with type 2 diabetes and microalbuminuria: a randomised, double-blind placebo-controlled pilot study. Diabetologia. 2009; 52: 208-12.

  12. Oyibo SO, Jude EB, Tarawneh I, Nguyen HC, Harkless LB, Boulton AJ: A comparison of two diabetic foot ulcer classification systems: the Wagner and the University of Texas wound classification systems. Diabetes Care. 2001; 24: 84-8.

  13. Ciszak EM, Korotchkina LG, Dominiak PM, Sidhu S, Patel MS: Structural basis for flip-flop action of thiamin pyrophosphate-dependent enzymes revealed by human pyruvate dehydrogenase J Biol Chem. 2003; 278(23): 21240-6.

  14. Naito E, Ito E, Yokota I, Saijo T, Matsuda J, Kuroda Y: Thiamine-responsive lactic acidaemia: role of pyruvate dehydrogenase complex. Eur J Pediatr. 1998; 157: 648-52.

  15. Hirabara SM, Curi R, Maechler P: Saturated fatty acid-induced insulin resistance is associated with mitocondrial dysfunction in skeletal muscle cells. J Cell Physiol. 2010; 222(1): 187-94.

  16. Fraccascia P, Casteels M, De Schtyver, Van Veldhoven PP: Role of thiamine pyrophosphate in oligomerisation, functioning and import of peroxisomal 2- hydroxyacyl-CoA-lyase. Biochim Biophys Acta. 2011; 1814(10): 1226-33.

  17. Price DL, Rhett PM, Thorpe SR, Baynes JW: Chelating activity of advanced glycation end-products inhibitors. J Biol Chem. 2001; 276(52): 48967-72.

  18. Booth AA, Khalifah RG, Hudson BG: Thiamine pyrophosphate and pyridoxamine inhibit the formation of antigenic advanced glycation end products: comparison with aminoguanidine. Biochem Biophys Res Commun. 1996; 220: 113-9.

  19. Booth AA, Khalifah RG, Todd P, Hudson BG: In vitro kinetic studies of formation of antigenic advanced glycation end products (AGEs) - Novel inhibition of post-Amadori glycation pathways. J Biol Chem. 1997; 272(9): 5430-7.

  20. Shapoval GS, Babii LV, Kruglyak OS, Vovk AI: Antioxidant activity of thiamine and its structural analogs in reactions with electrochemically generated hydroxyl radicals and hydrogen peroxide. Theor Exp Chem. 2011; 47(1): 55-60.




2020     |     www.medigraphic.com