Institutional Repository in Medical Sciences of Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
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    Specific features of the facial nerve trunk

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    Introduction: The facial nerve trunk (FNT) is vulnerable to iatrogenic injures in surgery of the retromandibular region, particularly in mastoidectomy. Variation of the FNT number, topography and course increase the risk of its iatrogenic injures. Our goal was to determine the length of the FNT depending on the gender, laterality, cephalometric type, branching pattern and variant of branching. Materials and Methods: The study was conducted on 75 formalized adult hemiheads (59 males and 16 females), dissected at the Department of Anatomy and Clinical Anatomy of Nicolae Testemitanu State University of Medicine and Pharmacy. The length of the FNT was measured from the point of its exit through the stylomastoid foramen until point of its division into primary branches. One-way ANOVA, t-test and χ2 test were used for statistical analysis. Results: In males the mean length of the FNT was 11.3 mm and in females it was 10.4 mm, p = 0.289. Bilaterally the length of the FNT was equal to 11.1 mm, p = 0.981. The mean length of the FNT in mesocephalic type was 10.9 ± 2.87 mm, in brachycephalic type it was 12.3 ± 3.54 mm and in dolichocephalic type it was 10.9 ± 2.54 mm. The intergroup frequency variation (IGFV = 0.755); the degree of freedom (df = 2); p = 0.474. Seven branching patterns of the extracranial portion of the facial nerve were revealed in the current study. Depending on the branching pattern the length of the FNT varied as follows: Type I (12.2 ± 3.33 mm); Type II (11.0 ± 2.54 mm); Type III (11.3 ± 2.93 mm); Type IV (10.3 ± 3.85 mm); Type V (11.5 ± 2.08 mm); Type VI (10.1 ± 2.06 mm); Type NI-atypical (11.5 ± 3.11 mm); IGFV = 0.794; df = 6; p = 0.578. In classic branching patterns the mean length of the FNT was 11.4 mm, while in atypical variants, it was 10.6 mm; p = 0.258. Conclusion: The length on the FNT was variable on four of the examined criteria. The FNT was longer in males, in brachycephalic type, in Type I and in classic variant of branching

    Ultramicroscopic study of the lateral tubule hybridization

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    Introducere. Stratul hibrid reprezintă partea de dentină aflată în contact strâns cu materialul restaurator, demineralizată de acid și infiltrată de rășina adezivă. Fiind un biopolimer tridimensional de colagen-rășină, determină o legătură continuă și stabilă între adeziv și substratul dentinar. Fenomenul de hibridizare tubulară laterală este descris ca formarea unui strat hibrid în pereții ramurilor tubulilor dentinari laterali. Asigurarea hibridizării adecvate și stabilitatea interfeței rășină-dentină sunt o cheie importantă în procesul adeziunii. Scopul lucrării. Studierea ultramicroscopică a fenomenului de hibridizare dentinară tubulară laterală la obturarea cavităților cu compozit prin tehnica de stratificare și injection-molding. Material și metode. Pentru realizarea studiului au fost selectați molari de minte, lipsiți de carie, iar la nivelul acestora au fost preparate cavități mezio-ocluzale. Dinții au fost repartizați în două loturi de cercetare: lotul control cu cavități obturate prin tehnica convențională de stratificare și lotul experimental cu cavități obturate prin tehnica injection-molding. A fost folosit adezivul universal Scotchbond Universal Adhesive, 3M ESPE și compozitul Filtek One Bulk Fill Restorative, 3M ESPE. Dinții obturați au fost secționați pe direcție vestibulo- orală cu ajutorul discurilor de almaz. Șlifurile dentare obținute au fost supuse studiului ultramicroscopic al interfeței adezive prin microscopie electronică scanată (SEM). Rezultate și discuții. În cadrul analizei șlifurilor dentare, fenomenul de hibridizare dentinară tubulară laterală a fost mai des întâlnit în cazul tehnicii injection-molding de obturare cu compozit. Astfel se prezintă retenții adiționale ca supliment al procesului de adeziune, fapt ce este determinat de injectarea unui material compozit cu proprietăți de curgere, care prezintă elemente caracteristice unui proces hidrodinamic, și anume: viscozitatea materialului ghidată de fluiditatea sa, aplicarea sub presiune și distribuția acesteia, viteza curgerii și fricțiunea. Concluzii. Tehnica injection-molding de obturare cu compozit determină apariția la nivelul interfeței adezive a fenomenului de hibridizare dentinară tubulară laterală, care contribuie la retenția suplimentară și etanșeitatea adeziunii prin formarea micro-extensiilor laterale ramificate din tubii dentinari principali.Background. The hybrid layer represents the portion of dentin that is in close contact with the restorative material, demineralized by acid, and infiltrated with adhesive resin. Being a three-dimensional collagen- resin biopolymer, it determines a continuous and stable bond between the adhesive and the dentin substrate. The phenomenon of lateral tubular hybridization is described as the formation of a hybrid layer within the walls of the lateral branches of dentinal tubules. Ensuring proper hybridization and the stability of the resin-dentin interface is a key factor in the adhesion process. Objective of the study. The ultramicroscopic study of the lateral tubule hybridization in cavity filling with composite by using the layering and injection-molding techniques. Material and methods. For the study, free caries third molars were selected, and mesio-occlusal cavities were prepared. The teeth were divided into two research groups: a control group with cavities restored using the conventional layering technique and an experimental group with cavities restored using the injection- molding technique. The Scotchbond Universal adhesive (3M ESPE) and Filtek One Bulk Fill Restorative composite (3M ESPE) were used. The restored teeth were sectioned in the vestibulo-oral direction using diamond discs. The obtained dental samples were subjected to an ultramicroscopic study of the adhesive interface using scanning electron microscopy (SEM). Results and discussions. In the analysis of dental samples, the phenomenon of lateral tubule hybridization was more frequently observed when using the injection-molding composite filling technique. This results in additional retention as a supplement to the adhesion process, which is determined by the injection of a flowable composite material exhibiting characteristics of a hydrodynamic process, namely: the viscosity of the material guided by its fluidity, application under pressure and its distribution, flow rate, and friction. Conclusions. The injection-molding composite filling technique leads to the appearance of the lateral tubule hybridization at the adhesive interface, which contributes to additional retention and adhesion sealing by forming micro-resin-tugs that branch from the main dentinal tubules

    Multifocal transcranial magnetic stimulation in migraine and epilepsy

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    Structura tezei. Lucrarea este expusă pe 88 de pagini de text de bază; include 45 figuri, 6 tabele și 16 anexe; este compusă din introducere, 3 capitole dintre care 2 – conțin material propriu, concluzii generale, recomandări practice, adnotare în limbile română, rusă și engleză și bibliografie cu 297 referințe. Rezultatele cercetării au fost publicate în 18 lucrări ştiinţifice Cuvinte-cheie: Stimulare magnetică transcraniană, stimulare theta burst, migrenă episodică, epilepsie generalizată, prevenție, neuromodulare. Scopul studiului. Aprecierea eficacității stimulării magnetice transcraniene multifocale în profilaxia atacurilor de migrenă la pacienți cu migrenă episodică și a crizelor epileptice la pacienți cu epilepsie generalizată. Obiectivele studiului. (1) Evaluarea efectului stimulării magnetice transcraniene multifocale asupra zilelor cu migrenă, frecvenței și intensității crizelor de migrenă la pacienți cu migrenă episodică; (2) Determinarea impactului TMS multifocal asupra calității vieții la pacienți cu migrenă episodică; (3) Aprecierea efectului stimulării theta burst (TBS) asupra frecvenței și severității crizelor epileptice la pacienți cu epilepsie generalizată; (4) Analiza influenței TBS asupra calității vieții la pacienții cu epilepsie generalizată; (5) Aprecierea profilului de siguranță și tolerabilitate a protocoalelor experimentale de TMS (rTMS și TBS); Originalitatea și noutatea științifică. A fost efectuat un studiu experimental care a debutat paradigma de stimulare magnetică transcraniană multifocală cu examinarea impactului terapeutic al acesteia în tratamentul preventiv al pacienților cu migrenă episodică și epilepsie generalizată. Problema științifică rezolvată în teză constă în identificarea modalităților noi terapeutice de modulare a activității rețelelor cerebrale cortico-subcorticale prin aplicarea stimulării magnetice transcraniene multifocale, ceea ce va contribui la fundamentalizarea paradigmei multifocale de neuromodulare în cercetările științifice ulterioare. Semnificația teoretică și valoarea aplicativă. Prin implementarea unei metode moderne de tratament neuromodulator a pacienților cu migrenă episodică și a celor cu epilepsie generalizată din Republica Moldova, cercetarea efectuată a fundamentalizat viziunea contemporană în algoritmul de evaluare și tratament complex la acești pacienți. Pe lângă aceasta, elaborarea și utilizarea unui protocol multifocal de TMS, inovativ nu doar pe plan național dar și internațional, a permis creșterea cunoștințelor în domeniul metodelor de neuromodulare în tratamentul tulburărilor neurologice paroxismale precum migrena și epilepsia. Impactul practic al prezentului studiu constă în implementarea în cadrul Laboratorului de neurobiologie și genetică medicală, Universității de Stat de Medicină și Farmacie ”Nicolae Testemițanu” și a departamentului de Neurologie, Epileptologie și Boli interne, IMSP IMU a metodei inovative de neuromodulare a activității cerebrale la pacienți cu migrenă episodică și epilepsie generalizată.Структура диссертации. Работа изложена на 88 страницах основного текста; включает 45 фигур, 6 таблиц и 16 приложений; Состоит из введения, 3 глав с общими выводами, практические рекомендации, аннотации на румынском, русском и английском языках и библиографию с 297 ссылками. Результаты исследований опубликованы в 18 научных статьях. Ключевые слова: транскраниальная магнитная стимуляция, тета-стимуляция, эпизодическая мигрень, генерализованная эпилепсия, профилактика, нейромодуляция. Цель исследования. Оценка эффективности мультифокальной транскраниальной магнитной стимуляции в профилактики приступов мигрени у больных с эпизодической мигренью и эпилептических припадков у больных с генерализованной эпилепсией. Задачи исследования: (1) Оценка влияния мультифокальной транскраниальной магнитной стимуляции на количество дней мигрени, частоту и интенсивность приступов мигрени у пациентов с эпизодической мигренью; (2) Определение влияния мультифокальной ТМС на качество жизни пациентов с эпизодической мигренью; (3) Оценка влияния тета-стимуляции (TБС) на частоту и тяжесть эпилептических припадков у пациентов с генерализованной эпилепсией; (4) Анализ влияния ТБС на качество жизни пациентов с генерализованной эпилепсией; (5) Оценка профиля безопасности и переносимости экспериментальных протоколов ТМС (рТМС и TБС); Научная оригинальность и новизна. Проведено экспериментальное исследование, дебютировавшее с парадигмой мультифокальной транскраниальной магнитной стимуляции с изучением ее терапевтического воздействия в профилактическом лечении пациентов с эпизодической мигренью и генерализованной эпилепсией. Научная проблема, решаемая в диссертации, заключается в выявлении новых терапевтических способов модуляции активности корково-подкорковых сетей головного мозга путем применения мультифокальной транскраниальной магнитной стимуляции, что может способствовать обоснованию парадигмы мультифокальной нейромодуляции в дальнейших научных исследованиях. Теоретическая значимость и прикладное значение. Внедряя современный метод нейромодулирующего лечения пациентов с эпизодической мигренью и генерализованной эпилепсией в Республики Молдова, проведенное исследование закрепило современное видение алгоритма комплексного обследования и лечения этих пациентов. Помимо этого, разработка и применение мультифокального протокола ТМС, инновационного не только на национальном, но и на международном уровне, позволили расширить знания в области методов нейромодуляции при лечении пароксизмальных неврологических расстройств, какими являются мигрень и эпилепсия. Практическая значимость настоящего исследования заключается во внедрении в лаборатории нейробиологии и медицинской генетики Государственного медикофармацевтического университета им. Николае Тестемицану и Деапартамента неврологии, эпилептологии и внутренних болезней Института Неотложной Медицины, инновационного метода нейромодуляции у больных с эпизодической мигренью и генерализованной эпилепсией.Structure of the thesis. The thesis is presented on 88 text pages; includes 45 figures, 6 tables and 16 appendices; it is composed of introduction, 3 chapters of which 2 – contain own research data, general conclusions, practical recommendations, annotation in Romanian, Russian and English and 297 bibliographic references. The main results of the research were published in 18 scientific papers. Keywords: Transcranial magnetic stimulation, theta burst stimulation, episodic migraine, generalized epilepsy, prevention, neuromodulation. The aim of study. Assesment of multifocal transcranial magnetic stimulation efficacy in prevention of migraine attacks in patients with episodic migraine and epileptic seizures in patients with generalized epilepsy. Objectives of the study. (1) Assess the effect of multifocal transcranial magnetic stimulation on migraine days, frequency and intensity of migraine attacks in patients with episodic migraine; (2) Determine the impact of multifocal TMS on quality of life in patients with episodic migraine; (3) Assess the effect of theta burst stimulation (TBS) on frequency and severity of epileptic seizures in patients with generalized epilepsy; (4) Analysis of the influence of TBS on quality of life in patients with generalized epilepsy; (5) Safety and tolerability profile assessment of experimental multifocal TMS protocols (rTMS and TBS); Scientific originality and novelty. An experimental study was conducted that debuted the paradigm of multifocal transcranial magnetic stimulation with the examination of its therapeutic impact in preventive treatment of patients with episodic migraine and generalized epilepsy. The scientific problem solved in the thesis consists in identifying new therapeutic ways of modulating the activity of cortico-subcortical brain networks by applying multifocal transcranial magnetic stimulation, which will strengthen the foundation of the multifocal neuromodulation paradigm in further scientific research. Theoretical significance and applicative value. By implementing a modern method of neuromodulatory treatment of patients with episodic migraine and those with generalized epilepsy from the Republic of Moldova, the research conducted has fundamentalized the contemporary vision in the complex evaluation and treatment algorithm for these patients. In addition, the development and use of a multifocal TMS protocol, innovative not only nationally but also internationally, allowed the increase of knowledge in the field of neuromodulation methods in the treatment of paroxysmal neurological disorders such as migraine and epilepsy. The practical impact of the present study consists in the implementation within the Laboratory of Neurobiology and Medical Genetics, State University of Medicine and Pharmacy "Nicolae Testemițanu" and the Department of Neurology, Epileptology and Internal Diseases, Emergency Medicine Institute of the innovative method of neuromodulation of brain activity in patients with episodic migraine and generalized epilepsy

    Current events in liver transplatology

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    Background. Liver transplantation is a surgical procedure that involves removing a diseased liver and replacing it with a healthy liver from another person, called a donor. This procedure is used when the liver is unable to perform its normal functions (liver failure or end-stage liver disease). The types of transplant are from a living donor (the right lobe of the liver is used) and from a deceased donor (the entire liver of the donor is used along with the portal vein). Materials and methods. To carry out the study, the selection and analysis of bibliographic sources published in specialized medical scientific databases between 2018-2024 available online were carried out. Results Liver transplantation techniques are whole liver (from deceased donor), reduced liver (left lobe or segments 2-3 compatible with the pediatric recipient), split liver (two grafts that can be used for either an adult and a child, or for two adults), domino (sequential, where a young patient with a metabolic disorder receives a liver from a deceased donor, and the young patient's liver is harvested for donation to an older patient with end-stage liver disease), dual graft (2 grafts from 2 different donors). For the highest possible success rate of liver transplantation, some basic principles must be followed, such as high genetic compatibility, perfect harvesting and transplantation technique, and careful postoperative care. The most common indications for liver transplantation are end-stage chronic liver diseases, acute liver failure, non-resectable malignant liver diseases, and hereditarymetabolic liver diseases. Conclusions The only hope for long-term survival of a person with liver failure is a liver transplant. Liver transplant patients require clinical, biochemical, and instrumental monitoring to detect early (acute rejection, early and late hepatic artery thrombosis, arterial stenosis, acute Budd Chiari syndrome, anastomotic fistula) and late (chronic rejection, chronic Budd Chiari syndrome, portal vein thrombosis, portal vein stenosis, recurrent sclerosing cholangitis, papillary stenosis, proximal hepatic duct stenosis) complications. To increase the tolerability, safety and adherence of the therapy in the long term, the patient will undergo treatment with immunosuppressants and antivirals

    Bone graft use in internal fixation of proximal and diaphyseal humeral fractures and pseudoarthrosis

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    Introduction: This study explores the use of bone graft in combination with internal fixation for treating fractures and pseudarthrosis of the proximal and diaphyseal humerus. Materials and Methods: We retrospectively analyzed data collected for proximal and diaphyseal humerus fractures between 2020-2024. The analysis focused on cases treated with open reduction and internal fixation (ORIF), with or without bone graft utilization. Results: Out of 584 cases analyzed, 65 (8.9%) were diagnosed with pseudarthrosis. In 12 cases post ORIF treatment with implant stability of diaphyseal segment were applied mononuclear stem cell apheresis (1.6%), and ORIF with T-plates or LCP for Neer 3-4 part fractures in 5 cases (0.6%) and humeral diaphysis fractures in 13 cases (1.8%). Bone graft(alo-auto) was used in 35 (4.8%) pseudarthrosis cases. 349 cases (47.6%) were extremity superior humerus fractures treated with ORIF using T-plates or LCP for Neer 2-parts fractures in 92 cases (12.5%), Neer 3-4 parts fractures in 229 cases (31.2%), and Neer 3-4 parts fractures with diaphyseal extension in 22 cases (3.0%). Bone graft was used in 6 (0.8%) of these cases. 170 cases (23.2%) were diaphysis humerus fractures treated with ORIF using T-plates or LCP in the proximal 1/3 in 5 cases (0.7%), the middle 1/3 in 157 cases (21.4%), and the distal 1/3 in 7 cases (1%). Bone graft was used in 1 (0.1%) of these cases. Conclusions: The use of bone graft is frequent in the treatment of proximal and diaphyseal humerus pseudarthrosis. Internal fixation with plates remains an essential method in managing these fracture types. This has implications for future research in bone healing and fracture management

    Cакрококцигеальная тератома у детей

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    Rezumat. Teratomul sacrococcigian este cel mai des întâlnit neoplasm din perioada neonatală. În articol în baza unui caz clinic se analizează problema recurenței teratomului sacrococcigian și importanța evaluării sechelelor funcționale la diatanță.Summary. The sacrococcygeal teratoma is the most common neoplasm in neonatal period. The article on the basis of a clinical case analyzes the problem of recurrence of the sacrococcygeal teratoma and the importance of evaluation the functional sequelae.Резюме. Cакрококцигеальная тератома является самым часто встречаемым новообразованием в неонатальном периоде. В статье на базе одного клинического случая анализируется проблема рецидива крестцовокопчиковой тератомы и важность исследования функциональных результатов

    Laringita cronică nespecifică: Ghid metodologic pentru studenţi, medici rezidenţi, medici cursanţi otorinolaringologi şi de alte specialităţi

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    Radiographic evaluation of periapical lesions pre- and post-endodontic treatment

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    Introducere. Leziunile periapicale sunt procese inflamatorii cronice de etiologie endodontică, cauzate de infecția pulpară și extinderea microorganismelor în spațiul periapical. Acestea sunt asociate cu distrucția osului alveolar și pot fi evaluate imagistic prin scoruri precum CBCT-PAI, ERI, PESS și CBCT-PAVI. Tomografia computerizată cu fascicul conic (CBCT) permite o evaluare tridimensională detaliată a extinderii și evoluției acestor leziuni. Monitorizarea modificărilor imagistice pre- și post-tratament oferă informații esențiale privind eficiența intervenției endodontice și procesele de vindecare osoasă. Scopul lucrării. Evaluarea rezultatelor tratamentului endodontic prin analiza comparativă a parametrilor imagistici ai leziunilor periapicale înainte și după tratament, utilizând CBCT ca metodă principală de investigare. Material și metode. Studiul a inclus pacienți cu leziuni periapicale diagnosticate imagistic, supuși tratamentului endodontic conform protocoalelor clinice standardizate. Investigațiile imagistice au fost realizate utilizând CBCT înainte și la un interval post-tratament pentru evaluarea modificărilor structurale. Parametrii analizați au cuantificat dimensiunile mezio-distale, buco-linguale și corono-apicale ale leziunilor, precum și modificările breșelor corticale, prin utilizarea scorurilor CBCT-PAI, ERI, PESS și CBCT-PAVI. Analiza statistică s-a realizat utilizând testul Wilcoxon pentru compararea valorilor pre- și post-tratament, cu un prag de semnificație de p<0.05. Rezultate. Datele obținute au evidențiat o reducere semnificativă a dimensiunilor leziunilor periapicale în toate direcțiile analizate (p<0.001), precum și o scădere a scorurilor imagistice CBCT-PAI, ERI, PESS și CBCT-PAVI. Diminuarea volumului leziunilor și a breșelor corticale indică procese de vindecare osoasă activă după tratamentul endodontic. Rezultatele confirmă eficiența tratamentului în reducerea inflamației periapicale și stimularea regenerării tisulare. Concluzii. Studiul confirmă eficiența tratamentului endodontic în reducerea dimensiunilor și severității leziunilor periapicale, evidențiată prin analiza imagistică CBCT. Parametrii CBCT-PAI, ERI, PESS și CBCT-PAVI constituie instrumente obiective utile pentru monitorizarea evoluției post-terapeutice.Background. Periapical lesions are chronic inflammatory processes of endodontic etiology, caused by pulp infection and the spread of microorganisms into the periapical space. They are associated with the destruction of the alveolar bone and can be assessed using imaging scores such as CBCT-PAI, ERI, PESS, and CBCT-PAVI. Cone beam computed tomography (CBCT) allows for a detailed three-dimensional evaluation of the extent and progression of these lesions. Monitoring pre- and post-treatment imaging changes provides essential information regarding the effectiveness of endodontic interventions and bone healing processes. Objective of the study. To assess the results of endodontic treatment through a comparative analysis of the imaging parameters of periapical lesions before and after treatment, using CBCT as the primary investigative method. Material and methods. The study included patients with radiographically diagnosed periapical lesions, who underwent endodontic treatment according to standardized clinical protocols. Imaging investigations were performed using CBCT before and at a post-treatment interval to assess structural changes. The analyzed parameters quantified the mesio-distal, bucco-lingual, and corono-apical dimensions of the lesions, as well as changes in cortical breaches, using the CBCT-PAI, ERI, PESS, and CBCT-PAVI scores. Statistical analysis was performed using the Wilcoxon test to compare pre- and post-treatment values, with a significance threshold of p<0.05. Results. The data obtained demonstrated a significant reduction in the size of periapical lesions in all analyzed directions (p<0.001), as well as a decrease in the CBCT-PAI, ERI, PESS, and CBCT-PAVI imaging scores. The reduction in lesion volume and cortical breaches indicates active bone healing processes following endodontic treatment. The results confirm the effectiveness of the treatment in reducing periapical inflammation and stimulating tissue regeneration. Conclusions. The study confirms the effectiveness of endodontic treatment in reducing the size and severity of periapical lesions, as evidenced by CBCT imaging analysis. The CBCT-PAI, ERI, PESS, and CBCT-PAVI parameters serve as useful objective tools for monitoring post-treatment evolution

    Adipose tissue in chest region and its impact on the condition of various organs

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    Introduction. The presence of the adipose tissue in the chest region might be linked to many pathological conditions meanwhile it can be physiological in many cases. A comprehensive assessment requires a morphological analysis in relation to the anatomical structures of the mediastinum to better understanding of its clinical significance and potential implications. Material and methods. Observation and morphometry of 22 mediastinal complexes from the department's fund were performed. The results of 50 examinations, such as computer tomography, magnetic resonance, angiography, performed before therapeutic treatment and the preoperative period, as well as the operation protocols from the observation sheets, were subjected to the study. The results were processed statistically. Our data were compared with bibliographic data obtained by the same methods. Results: Four cites of fat storage are distinguished: subcutaneous, visceral, special and ectopic cites. There are extrapleural, mediastinal, epicardial, pericardial, and myocardial fat depots in the thoracic cavity. Thoracic adiposity affects the lung function, with distinct gender differences.Visceral and subcutaneous fats are associated with the reduced lung functions. Cardiopulmonary changes might be due to pericardial, epicardial, periaortic, and extracardiac fat. Mediastinal fat-related lesions were also observed, underscoring the importance of distinguishing chest fat from gynecomastia. Additionally, thoracic fat accumulation showed a potential association with non-traumatic vertebral fractures, suggesting broader systemic implications. Conclusion: The visceral fat is more toxic than subcutaneous. Distribution of adipose tissue in the chest region has impact on lung function, cardiopulmonary health, and musculoskeletal integrity. The need for further research to explore clinical significance of thoracic adiposity that will contribute to improve quality of clinical diagnosis, which will be helpful for therapeutic and preventive interventions. and this research may open the gates for the new generation of imaging technique for adipose tissue assessment

    The role of glycation processes in aging

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    Background. Glycation is a non-enzymatic reaction in which reducing sugars react with free amino groups in proteins, lipids, or nucleic acids, leading to the formation of advanced glycation end products (AGEs). AGE accumulation leads to structural and functional alterations in proteins, contributing to aging. Objective of the study. To elucidate the biochemical mechanisms of glycation, its impact on aging, and potential therapeutic strategies to mitigate its effects. Materials and methods. A literature review covering the years 2019–2024 was conducted, analyzing 15 peer-reviewed articles from PubMed, ScienceDirect, Wiley Online Library, and MDPI. Results. The glycation process begins when a reducing sugar, such as glucose or fructose, reacts with the free amino group of lysine or arginine residues in proteins. Over time, these intermediate compounds undergo glycoxidation and dehydration, forming irreversible AGEs such as Nε- (carboxymethyl)lysine, pentosidine, and pyrraline. AGEs interact with the receptor for advanced glycation end products (RAGE), a transmembrane receptor highly expressed in endothelial cells, macrophages, and neurons. AGE-RAGE binding triggers activation of nuclear factor kappa b (NF-κB), a transcription factor that upregulates the expression of pro-inflammatory cytokines such as TNF-α, IL-6, and IL-1β, promoting chronic inflammation and cellular dysfunction. Mitochondrial dysfunction is exacerbated by AGEs through oxidative phosphorylation impairment, increasing reactive oxygen species (ROS) production. This oxidative stress further amplifies AGE formation in a vicious cycle, accelerating cellular senescence via activation of the p53/p21 and p16INK4a pathways. Additionally, glycation disrupts the ubiquitin-proteasome system and autophagy, preventing the clearance of damaged proteins and contributing to intracellular toxicity. Therapeutic strategies to counteract glycation include AGE inhibitors (aminoguanidine, pyridoxamine), RAGE antagonists, and antioxidants (vitamin C, resveratrol, polyphenols), which scavenge ROS and reduce AGE formation. Dietary interventions, such as caloric restriction and a low-glycemic diet, have also been shown to limit AGE accumulation and mitigate aging-related damage. Conclusions. Glycation is a key driver of aging through its impact on protein function, oxidative stress, and chronic inflammation. Understanding the biochemical processes underlying glycation opens avenues for therapeutic interventions aimed at reducing AGE accumulation and mitigating age-related diseases

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