Pathogenetic aspects of vascular endothelial dysfunction and the role of L-arginine in the therapy and prevention of vascular complications in patients with diabetes mellitus

At the present stage of development of medical and biological science, it is considered relevant to study the role of oxidative stress and vascular endothelial dysfunction as pathogenetic links in the development of vascular complications and in the justification of methods for correcting indicators of pathological processes. The aim of this review is to analyze current literature data on the pathogenetic mechanisms underlying the formation of vascular endothelial dysfunction, its role in the development of functional disorders in diabetes mellitus, and the use of L-arginine to correct the identified alterations in these parameters. Materials and methods. The methodological approaches used to achieve this aim in the present review are based on the analysis of a sufficient number of sources from Russian and international scientific literature indexed in PubMed, Scopus, Web of Science, and eLibrary using the following keywords: diabetes mellitus, lipid peroxidation, nitric oxide, endothelial dysfunction, cardiorenal system pathology, periodontitis, L-arginine. Results. The mechanisms of oxidative stress development and vascular endothelial dysfunction, as well as their role in the formation of functional manifestations of cardiorenal system pathology and periodontitis in patients with diabetes mellitus, were considered, along with the role of L-arginine in their correction. Discussion. The analysis performed made it possible to identify the mechanisms underlying impairment of cardiorenal system function and the development of periodontitis, including the formation of vascular endothelial dysfunction, and to substantiate the use of L-arginine for their correction. Conclusion. It is noted that in both Russia and worldwide, the study of mechanisms involved in the development of vascular complications, as well as the improvement of the effectiveness of therapeutic and preventive strategies aimed at the terminal manifestations of these diseases, remains highly relevant.