Role of nitric oxide in pathogenesis of tumor growth and its possible application in cancer treatment.

In this review, the role of nitric oxide (NO) in the pathogenesis of the tumor growth and possibilities of its application in the treatment of cancer patients are analyzed. NO is one of the most important mediators of physiological processes being involved in the regulation of practically all body functions in health and disease. The role of NO in the development of many pathological conditions has been extensively studied and debated in recent years. Today it is clear that NO in relation to malignant tumors may exhibit a dual activity - can stimulate tumor growth and cause an opposite antitumor effect. Effects of NO are mostly dependent on its concentration. At low concentrations, NO could inhibit apoptosis and cause mutations that potentially lead to the formation of malignant growth loci. However, a high concentration of NO appears to be detrimental to malignant cells, in particular under conditions of simultaneous exposure to ionizing radiation. In humans, the inducible NO synthase (iNOS, type II) is the most powerful form of NO synthases (NOS) and has the ability to synthesize large amounts of NO for a long time and exert a protective function. iNOS is expressed in macrophages, monocytes, neutrophils, fibroblasts, hepatocytes, and other cell types. In tissue of malignant tumors, the macrophagal iNOS is the main form. Experimental data provide an evidence that activated macrophages and leukocytes, which are the part of peritumorous inflammatory infiltrate, can provide radiosensitization of tumors by direct synthesis of NO and indirectly - through the secretion of cytokines stimulating iNOS activity in cancer cells. Such approach could be useful for the development of new schemes and methods of anticancer therapy based on the activation of endogenous NO biosynthesis pathways.

[Cytophlavin inclusion in complex treatment of diabetic foot syndrome with signs of lower limb blood vessels medicalcinosis]. / Vkliuchenie Tsitoflavina v komleksnom lechenii sindroma diabeticheskoi stopy s priznakami mediakal'tsinoza sosudov nizhnikh konechnostei.

The aim of this study was to evaluate the effect of cytoflavin inclusion in therapy regimens of patients with diabetic foot syndrome and medicalcinosis on the microcirculation of the lower limb blood vessels. For this purpose, 64 patients with type II diabetes mellitus (subcompensated form), diabetic foot syndrome and signs of medicalcinosis foot blood vessels of various severity were examined. All patients were divided into 2 groups depending on the therapy scheme: patients of group I (33 people) received insulin, antibiotics, disaggregants, statins, anti-inflammatory drugs, painkillers, detoxification therapy. Patients of group II (31 patients) in addition to the main therapy received cytoflavin according to the scheme: 10 ml per 0.9 ml NaCl 200 ml intravenously, drip at a rate of 60 cap/min, 10 days course, then 2 tablets 2 times a day for 1 month. The severity of the microangiopathy of the lower extremities was assessed considering transcutaneous oximetry data in dynamics (before treatment, on the 10th and 40th day of therapy) gained using TCM-2 device (RADIOMETER, Denmark) with has heating oxygen electrode type Clarc. Before the treatment subcompensated level of metabolic disorders corresponding to the II degree of microcirculatory disorders was registered in all patients. Against the backdrop of cytoflavin inclusion in the complex therapy, there was an improvement in the metabolic rate (up to compensated) with a decrease in the degree of microcirculation disorders up to I degree. Positive dynamics of metabolic disorders significantly reduced frequency and extent of surgical interventions. The results obtained suggest that cytoflavin should be included in the treatment regimens of patients with this pathology.