A personalized approach to the treatment and prevention of diabetic foot: molecular mechanisms and the role of taxifolin

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Abstract

Aim. To substantiate the pathogenetic rationale for including aqueous solution of dihydroquercetin (taxifolin) in the comprehensive treatment of diabetic foot and to present the results of a case series on the application of this form in patients with trophic ulcers receiving standard treatment, as well as to compare the obtained results with current data on the molecular mechanisms of taxifolin action.

Methods. A prospective observational study (case series, n = 15) in patients with severe diabetic foot receiving standard therapy supplemented with aqueous dihydroquercetin per os and topically as a gel. The dynamics of ulcer healing (area, depth, granulation), laboratory markers of inflammation and oxidative stress (including malondialdehyde levels), and quality of life according to the SF-36 questionnaire were evaluated. Additionally, to compare the clinical results obtained with global practice, a targeted analysis of publications in PubMed, Scopus, and eLIBRARY databases for 2019–2024 was conducted on the pathogenesis of diabetic foot and the use of taxifolin/dihydroquercetin.

Results. Complete ulcer healing within 6–10 weeks was achieved in 13 out of 15 patients (86.7%), while 2 patients (13.3%) showed a significant reduction in ulcer area (~75%) without complete closure by the end of the observation period. The mean reduction in ulcer area was 68  ±  18%, accompanied by decreased levels of C-reactive protein, malondialdehyde, leptin, and insulin, as well as improved quality of life scores on the SF-36 questionnaire. No adverse events related to the intake of aqueous solution of dihydroquercetin (taxifolin) and topical application of gel formulations based on it were registered. The obtained data are consistent with the concept of the key role of oxidative stress and microangiopathy in the pathogenesis of diabetic foot and indicate the potential of dihydroquercetin as an adjuvant component of comprehensive therapy in comorbid patients.

Conclusion. Based on the presented case series, the integration of aqueous solution of dihydroquercetin (taxifolin) into personalized comprehensive therapy for diabetic foot in comorbid patients appears promising, accelerating ulcer healing with satisfactory tolerability according to observational data; the obtained results are consistent with available experimental and clinical data from global literature, but require confirmation in randomized controlled trials.

About the authors

Pavel V. Seliverstov

Federal State Budgetary Educational Institution of Higher Education “S.M. Kirov Military Medical Academy” of the Ministry of Health of the Russian Federation

Author for correspondence.
Email: seliverstovpv@yandex.ru
ORCID iD: 0000-0001-5623-4226
SPIN-code: 6166-7005

Candidate of Medical Sciences, Associate Professor, 2nd Department (Advanced Medical Therapy), Responsible for Coordinating Scientific Work at the Department

Russian Federation, Lebedeva St., 6, Saint Petersburg, 194044

Victor V. Zakrevsky

Federal State Budgetary Educational Institution of Higher Education “S.M. Kirov Military Medical Academy” of the Ministry of Health of the Russian Federation

Email: vzakr@list.ru
ORCID iD: 0000-0002-4355-2986
SPIN-code: 4606-3139

Doctor of Medical Sciences, Professor, Associate Professor, 2nd Department of Advanced Therapy for Physicians

Russian Federation, Lebedeva St., 6, Saint Petersburg, 194044

Artem S. Ivaniuk

Federal State Budgetary Educational Institution of Higher Education “S.M. Kirov Military Medical Academy” of the Ministry of Health of the Russian Federation

Email: oper_hir@mail.ru
ORCID iD: 0009-0005-8622-3655
SPIN-code: 2960-8188

Candidate of Medical Sciences, Lecturer at the Department of Hospital Surgery

Russian Federation, Lebedeva St., 6, Saint Petersburg, 194044

Aida M. Kerimova

Federal State Budgetary Educational Institution of Higher Education «Astrakhan State Medical University» of the Ministry of Healthcare of the Russian Federation

Email: aika.kerimova02@mail.ru
ORCID iD: 0009-0001-2314-036X

6th Year Student, Medical Degree

Russian Federation, Bakinskaya St., 121, Astrakhan, Astrakhan Region, Southern Federal District, 414000

Stanislav E. Maltsev

Orenburg State Medical University (OrSMU)

Email: pankeev2002@gmail.com
ORCID iD: 0009-0001-2432-7257

6th Year Student

Russian Federation, Sovetskaya Street, 6, Orenburg, Orenburg Region, 460014

Kirill M. Tokarev

Federal State Budgetary Educational Institution of Higher Education “Academician I.P. Pavlov First Saint-Petersburg State Medical University” of the Ministry of Healthcare of Russian Federation

Email: kir.tokarev@mail.ru
ORCID iD: 0009-0005-4505-8841

6th Year Student

Russian Federation, L’va Tolstogo str., 6–8, Saint-Petersburg, 197022

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