Clinical and laboratory evaluation of the effectiveness of аntioxidant therapy in correcting age-associated disorders of detrusor adaptive reactivity

Introduction. This article is dedicated to the clinico-pathogenetic aspects of antioxidant therapy in the correction of age-related bladder dysfunction. Current data indicate a correlation between aging and chronic inflammation and oxidative stress, described by the theory of «inflam-maging». Despite the proven effectiveness of antioxidants in experimental models, their clinical significance in geriatric and urological practice requires further study. The work focuses on the need for further research to optimize therapeutic strategies, which is relevant for improving care for patients with age-related bladder dysfunction. Aims. To evaluate the clinical and laboratory efficacy of antioxidant therapy with alpha-lipoic acid (α-LA) in combination with coenzyme Q10 (CoQ10) in correcting the pathogenetic factors of age-related bladder dysfunction in elderly patients. Materials and Methods. A placebo-controlled, randomized, single-blind study was conducted. Included were 98 patients over 60 years old with moderate to severe symptoms of lower urinary tract. Markers of low-level age-associated inflammation (TNF-α, IL-6, IL1RA), endothelial dysfunction (ET-1, IL-1β, ESM1), pro-fibrotic status (TGF beta 1 and CTGF), and free radical oxidation (8-isoprostane, malondialde-hyde, diene conjugates, catalase) were determined. The study was conducted over a 12-month therapy period with a subsequent observation period (12 months). Results. The analysis of the data demonstrates that the combination therapy of CoQ10 and α-LA has a statistically significant positive impact on the dynamics of both serological markers of inflammaging and clinical symptomatology. A significant reduction in levels of inflammation markers, endothelial dysfunction, lipid peroxidation, and pro-fibrotic cytokines was observed after 6 months of antioxidant therapy, indicating the effectiveness of this combination in correcting markers of low-level age-associated inflammation. The positive impact of antioxidants on clinical and laboratory parameters confirms their role in managing age-associated changes in the urinary system, which may justify their broader application in geriatric and urological practice. Conclusion. The combination of alpha-lipoic acid and coenzyme Q10 effectively corrects the pathogenetic factors of senile bladder, demonstrating a reduction in age-associated inflammation markers and improvement in symptomatology, confirming the potential of these agents as urogeroprotectors.