THE ROLE OF TREATMENT OF THROMBOCYTE REACTIVITY IN THE PROGRESS OF DIABETIC MAKULOPATHY AND THE INITIALIZATION OF THE DIABETIC MACULAR EDEMA IN DIABETES MELLITUS 2 TYPE

Mogilevskyy S. Yu., Panchenko Yu. A., Ziablittsev S. V.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

The aim of the study was to elucidate the reactivity of platelets (PL) in the progression of diabetic maculopathy (DMP) with moderate and severe stages of non-proliferative diabetic retinopathy (NDPR) and development of diabetic macular edema (DME). Object and methods of investigation. The study included 29 patients (29 eyes) with diabetes mellitus (DM) of type 2 who, according to the results of the clinical and instrumental examination and according to the ETDRS classification, detected DMP with moderate (18 patients, 18 eyes) and severe (11 patients, 11 eyes) NPDR. For the study of PL in vitro, agonists involved in the pathogenesis of DM 2 type: adenosine diphosphate (ADP), epinephrine, angiotensin-2 (Ang-2), platelet activating factor (PAF), and collagen were used in vitro. The PL aggregation was evaluated by the turbidimetric method using the ChronoLog analyzer (USA). Results of the study. In patients with DMP with moderate and severe stages of NPDR, PL hyperreactivity was observed with respect to collagen, epinephrine, Ang-2 and PAF. The risk factor for the progression of DMP was an increase in the activity of the purineergic retinal system, which was manifested by an increase in the reactivity of adenosine receptors to ADP. The severity of the activation of the renin-angiotensin system and the inflammatory response, which was manifested by the hyperreactivity of PL in response to Ang-2 and PAF, was the reason for the development of DME. Conclusions. In the progression of DMP, activation of sympathetic-adrenal and renin-angiotensin systems, inflammation and remodeling of the intercellular matrix of retinal connective tissue, manifested itself in the growth of PL functional activity, capable of reproducing thrombosis and inflammation in the retina of the eye. Hyperreactivity of PL in response to Ang-2 and PAF was the reason for the development of DME, and, consequently, the sensitivity of AT1- and PAF-receptors of PL can be used to predict the development of DME.

diabetic maculopathy, diabetic macular edema, non-proliferative diabetic retinopathy, platelet aggregation

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«Bulletin of problems biology and medicine» Issue 4 part 1 (146), 2018 year, 107-111 pages, index UDK 617.735-002-02:616.633.66+616.155.2]-076.5

10.29254/2077-4214-2018-4-1-146-107-111