Effect of Pentoxifylline on inflammatory burden, oxidative stress and platelet aggregability in hypertensive type 2 diabetes mellitus patients.
OBJECTIVE
Inflammation and oxidative stress are main culprits behind atherosclerosis in diabetes mellitus. This study explores the effect of add-on Pentoxifylline on inflammatory burden and oxidative stress in hypertensive diabetic patients.


METHODS
60 hypertensive type 2 diabetic, aged > or = 45 years were evaluated for anthropometry, clinical parameters, C-reactive protein, total leukocyte count, erythrocyte sedimentation rate, serum albumin, plasma malondialdehyde, blood reduced glutathione, platelet aggregation and clot retraction profile. With informed consent and randomization, Pentoxifylline (400 mg) was prescribed to 30 patients orally twice daily with meals as add-on therapy to the standard therapeutic regimen for one month. The particular parameters were repeated in 26 patients in control group and 25 patients in Pentoxifylline group who completed the follow up. The study was a randomized, open, add-on clinical trial with parallel controls.


RESULTS
At one-month follow-up, in the Pentoxifylline group, there was 20.9% decrease (p<0.001) in C-reactive protein, 18% reduction (p<0.001) in erythrocyte sedimentation rate, 11.1% reduction (p<0.001) in total leukocyte count and 5.8% increase (p=0.003) in serum albumin. Pentoxifylline showed 20.2% reduction in plasma malondialdehyde and 4.6% increase in blood reduced glutathione level. In therapeutic dose range, Pentoxifylline exerted a significant anti-aggregatory effect and a dose dependent decrease in clot retraction in-vitro but there was no significant change in ex-vivo clot retraction. The control group showed no statistically significant change in parameters assessed.


CONCLUSIONS
This study reveals improvements in inflammatory markers, oxidative stress and platelet-aggregation by Pentoxifylline, thus preventing atherosclerosis in diabetes mellitus.
Maiti
Rituparna
R
Department of Pharmacology, Institute of Medical Sciences, Banaras Hindu University, Varanasi - 221005, India. rituparnamaiti@rediffmail.com
Agrawal
N K
NK
Dash
D
D
Pandey
B L
BL
D050197:Atherosclerosis / Q000517:prevention & control*; D001799:Blood Sedimentation / Q000187:drug effects; D002097:C-Reactive Protein / Q000187:drug effects / Q000378:metabolism; D003018:Clot Retraction / Q000187:drug effects; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005978:Glutathione / Q000097:blood / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy; D007249:Inflammation / Q000188:drug therapy; D007958:Leukocyte Count; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D008875:Middle Aged; D018384:Oxidative Stress / Q000187:drug effects*; D010431:Pentoxifylline / Q000008:administration & dosage / Q000494:pharmacology*; D010726:Phosphodiesterase Inhibitors / Q000008:administration & dosage / Q000494:pharmacology*; D010974:Platelet Aggregation / Q000187:drug effects; D012709:Serum Albumin / Q000187:drug effects / Q000378:metabolism
D010726:Phosphodiesterase Inhibitors; D012709:Serum Albumin; D008315:Malondialdehyde; D002097:C-Reactive Protein; D005978:Glutathione; D010431:Pentoxifylline