Methylglyoxl and osteoprotegerin down-regulation in patients with uncontrolled diabetes mellitus: A possible therapeutic approach to diminish lower extremity amputations

Recent research has elucidated additional mechanisms underlying the connection between microvascular complications and uncontrolled diabetes mellitus (DM). Amongst such mechanisms is the aberrant regulation of the body's immune response. Employing a qualitative meta-analysis, the research from several studies was analyzed to reveal underlying connections, namely methylglyoxl (MG) and osteoprotegerin (OPG), between the innate immune response and microvascular complications seen in uncontrolled DM. By analyzing the information from multiple studies, and presenting it in a synergistic manner, it is the hope of this study to not only elucidate previously opaque mechanisms, but to also draw attention to another area of therapeutic research. Targeting the regulation of MG and OPG could alleviate the exacerbating inflammatory effects of proinflammatory cytokines such as TNF-α. Such targeted therapies would diminish the progression of myointimal hyperplasia, found to be one of many etiologies leading to ischemia in the lower extremities and consequential necrosis.