[Options for correction of endothelial dysfunction and oxidative stress in patients with primary open-angle glaucoma]

Vestn Oftalmol. Sep-Oct 2014;130(5):67-70, 72-3.
[Article in Russian]

Abstract

Objective: To evaluate the efficacy of Tanakan in patients with primary open-angle glaucoma (POAG) with respect to its influence on vascular endothelial function and oxidative stress.

Material and methods: Oxidative stress severity and antioxidant status were investigated in 52 patients with POAG divided into two groups. The effect of different treatment schemes on flow-dependent vasodilation and dynamic level of endotelin-1 (ET-1), which is a marker of endothelial dysfunction, was studied.

Results: In the main group glaucomatous optic neuropathy progressed significantly as compared to the baseline (p<0.05). A trend for a decrease in malondialdehyde-modified low-density lipoproteins (MDA-LDL) and plasma malondialdehyde (MDA) levels (p<0.1) was also found, which indicates the activation of antioxidant response and resolution of oxidative stress. Due to endothelial dysfunction, plasma ET-1 levels in glaucoma patients are on average 5 times higher than the corresponding median physiological concentration. After the treatment started plasma ET-1 levels reduced and 3 months later approached the normal range. Reactive hyperemia testing and assessment of flow-dependent vasodilation revealed a poor initial endothelial response in 64.6% of patients. During the treatment paradoxical vasoconstriction was noted in 12.4% of patients. After the treatment patients from the main group demonstrated a statistically significant increase in brachial artery diameter.

Conclusion: Tanakan is showed to produce a positive effect on vascular remodeling in patients with POAG, which indicates its high antioxidant and antihypoxic activity. A significantly increased flow-dependent vasodilation found in the main group (especially 1-3 months after the beginning of the therapy) is thought to be due to an improved vasodilating ability of the vascular endothelium as the result of Tanakan use.

MeSH terms

  • Aged
  • Antioxidants / administration & dosage
  • Antioxidants / adverse effects
  • Biomarkers / blood
  • Drug Monitoring
  • Endothelin-1 / blood*
  • Endothelium, Vascular* / metabolism
  • Endothelium, Vascular* / physiopathology
  • Female
  • Glaucoma, Open-Angle* / complications
  • Glaucoma, Open-Angle* / drug therapy
  • Glaucoma, Open-Angle* / metabolism
  • Humans
  • Male
  • Malondialdehyde / blood
  • Optic Nerve Diseases* / drug therapy
  • Optic Nerve Diseases* / etiology
  • Optic Nerve Diseases* / metabolism
  • Oxidative Stress / drug effects*
  • Plant Extracts* / administration & dosage
  • Plant Extracts* / adverse effects
  • Treatment Outcome
  • Vasodilation / drug effects

Substances

  • Antioxidants
  • Biomarkers
  • Endothelin-1
  • Plant Extracts
  • Ginkgo biloba extract
  • Malondialdehyde