Irvine3 Labs, Department of Biomedical Sciences, Chieti - Pescara University, Pescara, Italy.
Panminerva Med. 2011 Sep;53(3 Suppl 1):51-5.
This study was performed to test the hypothesis that the heparin and phosphatidylcholine (PDC) included in Aescin gel formulations had the main role of allowing a better penetration of Aescin without important pharmacodynamic effects. Heparin and PDC should be considered as "enhancers". They do not have - at the dosage used - a specific or independent action. An open, registry study of patients - a group with chronic venous insufficiency (CVI) and a group of patients with diabetic microangiopathy were completed.
In patients with CVI and in patients with diabetic microangiopathy, we used a commercial gel preparation containing Aescin, PDC and heparin (group A). The first group of patients used the full complex. The second group used the complex without PDC (group B) and the third (group C) used the complex without heparin.
In both studies the different groups of patients were comparable. In CVI patients (mean age 44.5; SD 2.4; range 40-50) venous microangiopathy was present at the perimalleolar region. Aescin produced comparable microcirculatory results with and without the two other components. Transcutaneus PO2 [TcPO2] increased in all groups. Transcutaneus PCO2 (TcCO2) decreases. The increased Laser Doppler Flux (LDF) (typical of CVI) decreased towards normality. The local Plasma Free Radicals [PFR] levels decreased as the result of better skin perfusion (P<0.05). Comparable data were observed in subjects with diabetic microangiopathy (mean age 46.5; SD 3.1). In these patients the compound was applied at the dorsum of the foot. TcPO2 increased with treatment. TcPCO2, skin flux and PFR decreased towards normal levels (P<0.05).
In conclusion Aescin improves the microcirculation and PFR. Heparin and PDC - included in the gel - have an ancillary role. An improved perfusion and nutrition of the skin was observed both in diabetic and venous microangiopathy. This may possibly contribute in the reduction of the incidence of ulceration associated with diabetic and venous microangiopathy. Aescin-based products may be included in a more complex management plan, including several systemic and local treatments.
本研究旨在验证肝素和磷脂酰胆碱（PDC）在 AESCIN 凝胶制剂中的作用主要是允许 AESCIN 更好地渗透，而没有重要的药效学作用的假设。肝素和 PDC 应被视为“增强剂”。在使用的剂量下，它们没有特定或独立的作用。对慢性静脉功能不全（CVI）患者组和糖尿病微血管病变患者组进行了一项开放、登记研究。
在 CVI 患者和糖尿病微血管病变患者中，我们使用含有 AESCIN、PDC 和肝素的商业凝胶制剂（A 组）。第一组患者使用完整的复合物。第二组患者使用不含 PDC 的复合物（B 组），第三组患者（C 组）使用不含肝素的复合物。
在两项研究中，不同的患者组具有可比性。在 CVI 患者（平均年龄 44.5；标准差 2.4；范围 40-50）中，静脉微血管病变位于踝周区域。AESCIN 在有和没有其他两种成分的情况下产生了相似的微循环结果。所有组的经皮氧分压（TcPO2）均增加。经皮二氧化碳分压（TcCO2）降低。典型的 CVI 增加的激光多普勒通量（LDF）向正常水平下降。由于皮肤灌注改善，局部血浆自由基（PFR）水平降低（P<0.05）。在糖尿病微血管病变患者中观察到类似的数据（平均年龄 46.5；标准差 3.1）。在这些患者中，将复合物应用于足部背侧。治疗后 TcPO2 增加。TcPCO2、皮肤通量和 PFR 向正常水平下降（P<0.05）。
总之，AESCIN 改善了微循环和 PFR。包含在凝胶中的肝素和 PDC 起辅助作用。观察到糖尿病和静脉微血管病变患者的皮肤灌注和营养改善。这可能有助于降低与糖尿病和静脉微血管病变相关的溃疡发生率。基于 AESCIN 的产品可以包含在更复杂的管理计划中，包括几种全身和局部治疗。
