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  • 1 Budapesti Műszaki és Gazdaságtudományi Egyetem, Budapest
  • 2 Semmelweis Egyetem, Általános Orvostudományi Kar, Budapest, Pf. 260, 1444
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Absztrakt:

A 2017-ben mintegy 451 millió, diabetesben szenvedő emberben potenciálisan kialakuló hosszú távú szövődmények és a hyperglykaemia között fennálló kapcsolatot a nagyobb mértékben keletkező késői glikációs végtermékek, valamint a fokozott oxidatív és karbonilstressz jelentheti. A részben karbonilstressz révén keletkező késői glikációs végtermékek szerepét olyan szövődményekben írták le, mint az érfalvastagodás, a megnövekedett érfal-áteresztőképesség, a fokozott mértékű angiogenezis vagy a csökkent érfalrugalmasság okozta nephropathia, neuropathia, retinopathia. A sort folytathatnánk a megnövekedett thrombocytaaggregációval, a csökkent fibrinolízis kiváltotta fokozott koagulációs aktivitással vagy az atherosclerosissal, illetve a mitokondriális diszfunkcióval. Mind az oxidatív, mind a nem oxidatív késői glikációs végtermék képződésének legpotensebb támadási pontja az α,β-telítetlen aldehidek befogása lehet. Sajnálatos módon a befogó molekulák prototípusát jelentő aminoguanidin, bár különböző állatmodelleken sikeresnek bizonyult, a klinikai teszteken nem bizonyított, a vele kapcsolatos klinikai vizsgálatokat közel 20 évvel ezelőtt leállították. Az aminoguanidin mellett nagy várakozás övezte az endogén dipeptid L-karnozint, amely szintén hatásosan csökkenti a karbonilstresszt. Ez esetben a humán alkalmazást az emberekben jelen lévő specifikus szérumkarnozinázok, az alacsony szérumstabilitás és a biológiai hasznosulás limitálta. A múlt év végén a molekula karboxilcsoportjának hidroxilcsoportra történő cseréjével sikerült elérni, hogy ellenálló legyen a karnozinázoknak, ugyanakkor megőrizze biológiai biztonságát és karbonilstresszt csökkentő hatását. Bár a karnozinol kifejlesztése óta eltelt mindössze fél év nem tette lehetővé, hogy klinikai teszteken bizonyítson, a molekulával kapcsolatban elért in vitro és in vivo eredmények alapján ígéretes hatóanyagnak tűnik a diabetes szövődményeinek mérséklésére, megelőzésére, így a klinikusnak is érdemes nyomon követni a vele kapcsolatos híreket, eredményeket. Orv Hetil. 2019; 160(40): 1567–1573.

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