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Ji Y, Qin Y, Tan Q, Qiu Y, Han S, Qi X. Development of a chemiluminescence assay for tissue plasminogen activator inhibitor complex and its applicability to gastric cancer. BMC Biotechnol 2024; 24:30. [PMID: 38720310 PMCID: PMC11080135 DOI: 10.1186/s12896-024-00850-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 04/17/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Venous thromboembolism (VTE), is a noteworthy complication in individuals with gastric cancer, but the current diagnosis and treatment methods lack accuracy. In this study, we developed a t-PAIC chemiluminescence kit and employed chemiluminescence to detect the tissue plasminogen activator inhibitor complex (t-PAIC), thrombin-antithrombin III complex (TAT), plasmin-α2-plasmin inhibitor complex (PIC) and thrombomodulin (TM), combined with D-dimer and fibrin degradation products (FDP), to investigate their diagnostic potential for venous thrombosis in gastric cancer patients. The study assessed variations in six indicators among gastric cancer patients at different stages. RESULTS The t-PAIC reagent showed LOD is 1.2 ng/mL and a linear factor R greater than 0.99. The reagents demonstrated accurate results, with all accuracy deviations being within 5%. The intra-batch and inter-batch CVs for the t-PAIC reagent were both within 8%. The correlation coefficient R between this method and Sysmex was 0.979. Gastric cancer patients exhibited elevated levels of TAT, PIC, TM, D-D, FDP compared to the healthy population, while no significant difference was observed in t-PAIC. In the staging of gastric cancer, patients in III-IV stages exhibit higher levels of the six markers compared to those in I-II stages. The ROC curve indicates an enhancement in sensitivity and specificity of the combined diagnosis of four or six indicators. CONCLUSION Our chemiluminescence assay performs comparably to Sysmex's method and at a reduced cost. The use of multiple markers, including t-PAIC, TM, TAT, PIC, D-D, and FDP, is superior to the use of single markers for diagnosing VTE in patients with malignant tumors. Gastric cancer patients should be screened for the six markers to facilitate proactive prophylaxis, determine the most appropriate treatment timing, ameliorate their prognosis, decrease the occurrence of venous thrombosis and mortality, and extend their survival.
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Affiliation(s)
- Yu Ji
- Department of Pathology, Affiliated Hospital of Jiangnan University, No.1000, Hefeng Road, Wuxi, 214122, Jiangsu, China
- Wuxi Medical College, Jiangnan University, Wuxi, Jiangsu, China
| | - Yan Qin
- Department of Pathology, Affiliated Hospital of Jiangnan University, No.1000, Hefeng Road, Wuxi, 214122, Jiangsu, China
- Wuxi Medical College, Jiangnan University, Wuxi, Jiangsu, China
| | - Qi Tan
- Department of Pathology, Affiliated Hospital of Jiangnan University, No.1000, Hefeng Road, Wuxi, 214122, Jiangsu, China
- Wuxi Medical College, Jiangnan University, Wuxi, Jiangsu, China
| | - Yanru Qiu
- Wuxi Medical College, Jiangnan University, Wuxi, Jiangsu, China
| | - Shuang Han
- Department of Pathology, Affiliated Hospital of Jiangnan University, No.1000, Hefeng Road, Wuxi, 214122, Jiangsu, China.
- Wuxi Medical College, Jiangnan University, Wuxi, Jiangsu, China.
| | - Xiaowei Qi
- Department of Pathology, Affiliated Hospital of Jiangnan University, No.1000, Hefeng Road, Wuxi, 214122, Jiangsu, China.
- Wuxi Medical College, Jiangnan University, Wuxi, Jiangsu, China.
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Neubauer-Geryk J, Wielicka M, Hoffmann M, Myśliwiec M, Bieniaszewski L. The Impact of Disease Duration on Microcirculatory Dysfunction in Young Patients with Uncomplicated Type 1 Diabetes. Biomedicines 2024; 12:1020. [PMID: 38790982 PMCID: PMC11117961 DOI: 10.3390/biomedicines12051020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Revised: 04/27/2024] [Accepted: 05/03/2024] [Indexed: 05/26/2024] Open
Abstract
This study aimed to evaluate the earliest changes in the structure and function of the peripheral microcirculation using capillaroscopy and transcutaneous oxygen pressure measurement in children and adolescents with type 1 diabetes mellitus at baseline and during post-occlusive reactive hyperemia (PORH) in the function of diabetes duration. Sixty-seven patients with type 1 diabetes mellitus (T1D), aged 8 to 18 years, and twenty-eight age- and sex-matched healthy subjects were included in the analysis. Diabetic patients were divided into subgroups based on median disease duration. The subgroups differed in chronological age, lipid levels, and thyroid hormones. Capillaroscopy was performed twice: at baseline and then again after the PORH test. Transcutaneous oxygen pressure also was recorded under baseline conditions during and after the PORH test. Comparison of capillaroscopy and transcutaneous oxygen pressure parameters at rest and after the PORH showed no statistically significant difference between the subgroups. This remained true after adjusting for variables that differentiated the two subgroups. However, in the group of patients with long-standing diabetes, significant negative correlations were observed between the Coverage value after the PORH test and capillary reactivity with TcPO2_zero (biological zero). Significant positive correlations were also found between distance after the PORH test and TcPO2_zero. The results of our study indicate that in patients with a shorter duration of diabetes, the use of multiple tests provides a better characterization of the structure and function of microcirculation because the onset of dysfunction does not occur at the same time in all the tests.
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Affiliation(s)
- Jolanta Neubauer-Geryk
- Clinical Physiology Unit, Medical Simulation Centre, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (M.W.); (L.B.)
| | - Melanie Wielicka
- Clinical Physiology Unit, Medical Simulation Centre, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (M.W.); (L.B.)
| | - Magdalena Hoffmann
- Diabetology Outpatient Clinic, Non-Public Health Care Institution SAFMED, 83-000 Pruszcz Gdański, Poland;
| | - Małgorzata Myśliwiec
- Department of Pediatrics, Diabetology and Endocrinology, Medical University of Gdańsk, 80-211 Gdańsk, Poland;
| | - Leszek Bieniaszewski
- Clinical Physiology Unit, Medical Simulation Centre, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (M.W.); (L.B.)
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Neubauer-Geryk J, Wielicka M, Myśliwiec M, Zorena K, Bieniaszewski L. The Relationship between TNF-a, IL-35, VEGF and Cutaneous Microvascular Dysfunction in Young Patients with Uncomplicated Type 1 Diabetes. Biomedicines 2023; 11:2857. [PMID: 37893230 PMCID: PMC10604652 DOI: 10.3390/biomedicines11102857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 10/15/2023] [Accepted: 10/19/2023] [Indexed: 10/29/2023] Open
Abstract
The aim of this study was to analyze the relationship between immunological markers and the dysfunction of cutaneous microcirculation in young patients with type 1 diabetes. The study group consisted of 46 young patients with type 1 diabetes and no associated complications. Microvascular function was assessed with the use of nail fold capillaroscopy before and after implementing post-occlusive reactive hyperemia. This evaluation was then repeated after 12 months. Patients were divided into two subgroups according to their baseline median coverage (defined as the ratio of capillary surface area to surface area of the image area), which was established during the initial exam (coverageBASE). Additionally, the levels of several serum biomarkers, including VEGF, TNF-a and IL-35, were assessed at the time of the initial examination. HbA1c levels obtained at baseline and after a 12-month interval were also obtained. Mean HbA1c levels obtained during the first two years of the course of the disease were also analyzed. Patients with coverageBASE below 16.85% were found to have higher levels of VEGF and TNF-α, as well as higher levels of HbA1c during the first two years following diabetes diagnosis. Our results support the hypothesis that the development of diabetic complications is strongly influenced by metabolic memory and an imbalance of pro- and anti-inflammatory cytokines, regardless of achieving adequate glycemic control.
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Affiliation(s)
- Jolanta Neubauer-Geryk
- Clinical Physiology Unit, Medical Simulation Centre, Medical University of Gdańsk, 80-210 Gdansk, Poland; (M.W.); (L.B.)
| | - Melanie Wielicka
- Clinical Physiology Unit, Medical Simulation Centre, Medical University of Gdańsk, 80-210 Gdansk, Poland; (M.W.); (L.B.)
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Division of Neonatology, Ann Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL 60611, USA
| | - Małgorzata Myśliwiec
- Department of Pediatrics, Diabetology and Endocrinology, Medical University of Gdansk, 80-211 Gdansk, Poland;
| | - Katarzyna Zorena
- Department of Immunobiology and Environment Microbiology, Medical University of Gdańsk, 80-211 Gdańsk, Poland;
| | - Leszek Bieniaszewski
- Clinical Physiology Unit, Medical Simulation Centre, Medical University of Gdańsk, 80-210 Gdansk, Poland; (M.W.); (L.B.)
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Bogusz-Górna K, Polańska A, Dańczak-Pazdrowska A, Żaba R, Sumińska M, Fichna P, Kędzia A. Non-invasive detection of early microvascular changes in juveniles with type 1 diabetes. Cardiovasc Diabetol 2023; 22:285. [PMID: 37865774 PMCID: PMC10590527 DOI: 10.1186/s12933-023-02031-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 10/12/2023] [Indexed: 10/23/2023] Open
Abstract
AIMS/HYPOTHESIS The study aimed to assess the usefulness of capillaroscopy and photoplethysmography in the search for early vascular anomalies in children with type 1 diabetes. METHODS One hundred sixty children and adolescents aged 6-18, 125 patients with type 1 diabetes, and 35 healthy volunteers were enrolled in the study. We performed a detailed clinical evaluation, anthropometric measurements, nailfold capillaroscopy, and photoplethysmography. RESULTS Patients with diabetes had more often abnormal morphology in capillaroscopy (68.60%, p = 0.019), enlarged capillaries (32.6%, p = 0.006), and more often more over five meandering capillaries (20.90%, p = 0.026) compared to healthy controls. Meandering capillaries correlated with higher parameters of nutritional status. In a photoplethysmography, patients with diagnosed neuropathy had a higher percentage of flow disturbance curves (p < 0.001) with a reduced frequency of normal curves (p = 0.050). CONCLUSIONS Capillaroscopic and photoplethysmographic examinations are non-invasive, painless, fast, and inexpensive. They are devoid of side effects, and there are no limitations in the frequency of their use and repetition. The usefulness of capillaroscopy and photoplethysmography in the study of microcirculation in diabetic patients indicates the vast application possibilities of these methods in clinical practice.
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Affiliation(s)
- Klaudia Bogusz-Górna
- Department of Pediatric Diabetes, Auxology, and Obesity, Poznan University of Medical Sciences, Poznan, Poland.
| | - Adriana Polańska
- Department of Dermatology and Venereology, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Ryszard Żaba
- Department of Dermatology and Venereology, Poznan University of Medical Sciences, Poznan, Poland
| | - Marta Sumińska
- Department of Pediatric Diabetes, Auxology, and Obesity, Poznan University of Medical Sciences, Poznan, Poland
| | - Piotr Fichna
- Department of Pediatric Diabetes, Auxology, and Obesity, Poznan University of Medical Sciences, Poznan, Poland
| | - Andrzej Kędzia
- Department of Pediatric Diabetes, Auxology, and Obesity, Poznan University of Medical Sciences, Poznan, Poland
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Xiao H, Yu W, Li L, Yin X, Zhai Q, Hu D, Zhang X, Wang F. Trimester-specific reference intervals of hemostasis biomarkers for healthy pregnancy. Scand J Clin Lab Invest 2023; 83:379-383. [PMID: 37491076 DOI: 10.1080/00365513.2023.2233903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 07/02/2023] [Accepted: 07/02/2023] [Indexed: 07/27/2023]
Abstract
Physiological changes in hemostasis during pregnancy have been reported by several authors. This study aimed at establishing reference intervals for the hemostasis biomarkers thrombin-antithrombin complex (TAT), α2-plasmininhibitor-plasmin complex (PIC), thrombomodulin (TM) and tissue plasminogen activator-inhibitor complex (tPAI-C), in healthy pregnancies. After excluding outliers, a total of 496 healthy pregnant women (128 first-trimester, 142 second-trimester, 107 third-trimester and 119 pre-labor) and 103 healthy nonpregnant women were enrolled from Shenzhen Bao'an Women's and Children's Hospital. Hemostasis biomarkers, TAT, PIC, TM and tPAI-C, were measured by using a quantitative chemiluminescence enzyme immunoassay performed on HISCL automated analysers. The median and reference intervals (the 2.5th and 97.5th percentiles) were calculated to establish trimester-specific reference intervals for healthy pregnant women. The reference intervals for TAT, PIC, TM and tPAI-C in the first trimester were 0.7-7.6 1 µg/L, 0.2-0.9 mg/L, 2.8-11.0 TU/ml, and 1.2-6.5 1 µg/L, respectively. The reference intervals in the second trimester were 1.7-12.0 1 µg/L, 0.2-1.0 mg/L, 3.7-11.6 TU/ml, and 2.8-8.8 1 µg/L, respectively. The reference intervals in the third trimester were 2.7-16.1 1 µg/L, 0.1-1.4 mg/L, 2.9-12.9 TU/ml, and 1.9-8.0 1 µg/L, respectively. At pre-labor, the reference intervals were 4.8-32.9 1 µg/L, 0.2-1.9 mg/L, 4.2-12.6 TU/ml, and 2.8-15.4 1 µg/L, respectively. Gestational reference intervals for TAT, PIC, TM and tPAI-C in healthy pregnancies are provided, but only for TAT with increasing concentrations throughout pregnancy, the reference intervals for non-pregnant were not applicable.
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Affiliation(s)
- Haijun Xiao
- Shenzhen Baoan Women's and Children's Hospital, Guangdong, P.R. China
| | - Weijian Yu
- Shenzhen Baoan Women's and Children's Hospital, Guangdong, P.R. China
| | - Lihua Li
- Shenzhen Baoan Women's and Children's Hospital, Guangdong, P.R. China
| | - Xiaoqin Yin
- Shenzhen Longhua New District People's Hospital, P.R. China
| | - Qingna Zhai
- Shenzhen Baoan Women's and Children's Hospital, Guangdong, P.R. China
| | - Die Hu
- Shenzhen Baoan Women's and Children's Hospital, Guangdong, P.R. China
| | - Xiufa Zhang
- Shenzhen Baoan Women's and Children's Hospital, Guangdong, P.R. China
| | - Feng Wang
- Shenzhen Baoan Women's and Children's Hospital, Guangdong, P.R. China
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Ding R, Zhu S, Zhao X, Yue R. Vascular endothelial growth factor levels in diabetic peripheral neuropathy: a systematic review and meta-analysis. Front Endocrinol (Lausanne) 2023; 14:1169405. [PMID: 37251664 PMCID: PMC10213658 DOI: 10.3389/fendo.2023.1169405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 04/28/2023] [Indexed: 05/31/2023] Open
Abstract
Objective Vascular endothelial growth factors (VEGFs, including VEGF-A, VEGF-B, VEGF-C, VEGF-D and PLGF) have important roles in the development and function of the peripheral nervous system. Studies have confirmed that VEGFs, especially VEGF-A (so called VEGF) may be associated with the diabetic peripheral neuropathy (DPN) process. However, different studies have shown inconsistent levels of VEGFs in DPN patients. Therefore, we conducted this meta-analysis to evaluate the relationship between cycling levels of VEGFs and DPN. Methods This study searched 7 databases, including PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), VIP Database, WanFang Database, and Chinese Biomedical Literature (CBM), to find the target researches. The random effects model was used to calculate the overall effect. Results 14 studies with 1983 participants were included, among which 13 studies were about VEGF and 1 was VEGF-B, so only the effects of VEGF were pooled. The result showed that there were obviously increased VEGF levels in DPN patients compared with diabetic patients without DPN (SMD:2.12[1.34, 2.90], p<0.00001) and healthy people (SMD:3.50[2.24, 4.75], p<0.00001). In addition, increased circulating VEGF levels were not associated with an increased risk of DPN (OR:1.02[0.99, 1.05], p<0.00001). Conclusion Compared with healthy people and diabetic patients without DPN, VEGF content in the peripheral blood of DPN patients is increased, but current evidence does not support the correlation between VEGF levels and the risk of DPN. This suggests that VEGF may play a role in the pathogenesis and repairment of DPN.
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Affiliation(s)
- Rui Ding
- Department of Endocrinology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Shicong Zhu
- Department of Respiratory, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiaoyan Zhao
- Department of Endocrinology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Rensong Yue
- Department of Endocrinology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Zhang Y, Li G, Xiao F, Wang B, Li J, Jia X, Sun Y, Chen H. Relationship between serum fibroblast growth factor 19 and vascular endothelial growth factor and soluble klotho protein in type 1 diabetic children. BMC Pediatr 2023; 23:120. [PMID: 36927328 PMCID: PMC10018886 DOI: 10.1186/s12887-023-03938-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 03/01/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND Fibroblast growth factor 19 (FGF19) takes part in maintaining the balance of glycolipids and may be involved in complications of type 1 diabetes(T1D) in children. This study aimed at at evaluating the relationship among the levels of serum FGF19 and vascular endothelial growth factor(VEGF)and soluble klotho protein(sklotho) in type 1 diabetic children. METHODS In a cross-section single center study samples were obtained from 96 subjects: 66 T1D and 30 healthy children.Serum FGF19 and VEGF and sklotho concentrations were measured by ELISA. And 66 type 1 diabetes participants were divided into two groups according to T1D duration or three groups according to HbA1c.Furthermore,we compared the serum levels of FGF19 and VEGF and sklotho in different groups. RESULTS The concentration of FGF19 was lower in T1D than in the controls(226.52 ± 20.86pg/mu vs.240.08 ± 23.53 pg/L, p = 0.03),while sklotho was also lower in T1D than in the controls (2448.67 ± 791.92pg/mL vs. 3083.55 ± 1113.47pg/mL, p = 0.011). In contrast, VEGF levels were higher in diabetic patients than in controls (227.95 ± 48.65pg/mL vs. 205.92 ± 28.27 pg/mL, p = 0.016). In T1D, FGF19 and VEGF and sklotho was not correlated with the duration of diabetes. FGF19 and VEGF and sklotho were correlated with HbA1c (r=-0.349, p = 0.004 and r = 0.302, p = 0.014 and r=-0.342, p = 0.005, respectively), but not with blood glucose and lipid. Among subjects in the T1D group, concentrations of FGF19,VEGF and sklotho protein were different between different groups according to the degree of HbA1c(P < 0.005).Furthermore, there was a positive correlation between the serum FGF19 concentration and sklotho levels (r = 0.247,p = 0.045), and a negative correlation between the serum FGF19 concentration and VEGF level(r=-0.335,P = 0.006). CONCLUSIONS The serum FGF19 levels have a close relation with serum VEGF levels and sklotho levels among T1D subjects. FGF19 may be involved in the development of complications in children with type 1 diabetes through interaction with VEGF and sklotho.
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Affiliation(s)
- Yanjun Zhang
- Department of Pediatric Endocrinology, Shandong Provincial Hospital, Shandong University, 9677 Jingshi Road, Lixia Area, 250021, Jinan, Shandong, China
- Department of Pediatrics, Bin Zhou Medical University Hospital, 661 Huangheer Road, 256603, Bin cheng Area, Bin Zhou, Shandong, China
| | - Guimei Li
- Department of Pediatric Endocrinology, Shandong Provincial Hospital, Shandong University, 9677 Jingshi Road, Lixia Area, 250021, Jinan, Shandong, China.
- Department of Pediatric Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 9677 Jingshi Road, Lixia Area, 250021, Jinan, Shandong, China.
| | - Feifei Xiao
- Department of Pediatrics, Bin Zhou Medical University Hospital, 661 Huangheer Road, 256603, Bin cheng Area, Bin Zhou, Shandong, China
| | - Bang Wang
- Department of Pediatrics, Bin Zhou Medical University Hospital, 661 Huangheer Road, 256603, Bin cheng Area, Bin Zhou, Shandong, China
| | - Jianchang Li
- Department of Pediatrics, Bin Zhou Medical University Hospital, 661 Huangheer Road, 256603, Bin cheng Area, Bin Zhou, Shandong, China
| | - Xiuhong Jia
- Department of Pediatrics, Bin Zhou Medical University Hospital, 661 Huangheer Road, 256603, Bin cheng Area, Bin Zhou, Shandong, China
| | - Yan Sun
- Department of Pediatric Endocrinology, Shandong Provincial Hospital, Shandong University, 9677 Jingshi Road, Lixia Area, 250021, Jinan, Shandong, China
- Department of Pediatric Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 9677 Jingshi Road, Lixia Area, 250021, Jinan, Shandong, China
| | - Hongye Chen
- Department of Pediatrics, Bin Zhou Medical University Hospital, 661 Huangheer Road, 256603, Bin cheng Area, Bin Zhou, Shandong, China
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Maldonado G, Chacko A, Lichtenberg R, Ionescu M, Rios C. Nailfold capillaroscopy in diabetes mellitus: a case of neo-angiogenesis after achieving normoglycemia. Oxf Med Case Reports 2022; 2022:omac088. [PMID: 36176947 PMCID: PMC9514106 DOI: 10.1093/omcr/omac088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 06/25/2022] [Accepted: 07/12/2022] [Indexed: 11/12/2022] Open
Abstract
Diabetes mellitus (DM) is a disease process characterized by a chronic hyperglycemic milieu that leads to micro and macrovascular complications, including diabetic retinopathy, diabetic nephropathy and diabetic neuropathy. During the last decade, researchers have used nail-fold capillaroscopy to study the microvascular alterations in rheumatologic diseases; however, the technology is gaining momentum in other disease processes that alter microvascular architecture. We observed a drastic improvement in the nail-fold capillary architecture in a patient with uncontrolled DM. After achieving excellent glycemic control 6 months after diagnosis, increased capillary density and evident rearrangement of the capillaries replaced the avascular areas and giant capillaries found at the time of diagnosis.
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Affiliation(s)
| | - Amala Chacko
- MacNeal Hospital Internal Medicine Department, , Berwyn, IL, USA
| | | | | | - Carlos Rios
- Universidad Espiritu Santo Rheumatology Department, , Samborondón, Ecuador
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R-spondin 3 Inhibits High Glucose-Induced Endothelial Activation Through Leucine-Rich G Protein-Coupled Receptor 4/Wnt/β-catenin Pathway. J Cardiovasc Pharmacol 2022; 80:70-81. [PMID: 35767713 DOI: 10.1097/fjc.0000000000001295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 04/22/2022] [Indexed: 11/26/2022]
Abstract
ABSTRACT High glucose-induced endothelial activation plays critical roles in the development of diabetic vascular complications. R-spondin 3 could inhibit inflammatory damage, and diabetic vascular inflammation is secondary to endothelial activation. In this article, we identify R-spondin 3 as a novel regulator of high glucose-induced endothelial activation. We found that the serum levels of R-spondin 3 were significantly reduced in type 2 diabetic patients and db/db mice. We observed that the increased expressions of vascular cell adhesion molecule-1, intercellular cell adhesion molecule-1, and monocyte chemoattractant protein-1 (endothelial activation makers) in high glucose-stimulated human umbilical vein endothelial cell lines (HUVECs) could be inhibited by overexpressing R-spondin 3 or human R-spondin 3 recombinant protein. Subsequently, high glucose-induced adhesion and migration of human myeloid leukemia mononuclear cells (THP-1 cells) to HUVECs were markedly suppressed by the overexpression of R-spondin 3 in HUVECs. Moreover, the inhibitory effect of R-spondin 3 on the expressions of vascular cell adhesion molecule-1, intercellular cell adhesion molecule-1, and monocyte chemoattractant protein-1 in high glucose-treated HUVECs could be blocked by knockdown of leucine-rich G protein-coupled receptor 4 (R-spondin 3 receptor) or the specific inhibitor of Wnt/β-catenin pathway. Taken together, R-spondin 3 could suppress high glucose-induced endothelial activation through leucine-rich G protein-coupled receptor 4/Wnt/β-catenin pathway.
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Yilmaz U, Ayan A, Uyar S, Inci A, Ozer H, Yilmaz FT, Demirtas G, Kok M, Tokuc A. Capillaroscopic appearance of nailfold vasculature of diabetic nephropathy patients. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2022; 66:2359-3997000000475. [PMID: 35551680 PMCID: PMC9832852 DOI: 10.20945/2359-3997000000475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 03/02/2022] [Indexed: 11/23/2022]
Abstract
Objective Diabetic nephropathy is a microvascular complication of diabetes and the most common cause of end-stage renal failure throughout the world. Videocapillaroscopy is a simple and noninvasive method that can display capillaries in the nail bed at the micron level. A few studies have been conducted on detecting retinopathy, another important diabetic microvascular complication, with videocapillaroscopy; however, no comprehensive study has been performed on diabetic nephropathy. We aimed to determine the relationship between nephropathy and capillaroscopic changes. Methods Capillaroscopic findings of 144 patients with type 2 diabetes and 88 healthy controls were assessed prospectively by nailfold videocapillaroscopy. Twelve capillaroscopic findings were evaluated in all subjects. Results Patients with albuminuria had more capillary aneurysms (15.5%), more microhemorrhages (15.5%), greater tortuosity (76.3%), more neoformations (29.9%), more bizarre capillaries (49.5%) and more bushy capillaries (20.6%) than the control group. In logistic regression analysis, tortuosity was significantly correlated with albuminuria (OR: 2.451, p = 0.048). Conclusion Our findings show that the application of nailfold videocapillaroscopy can detect microvascular abnormalities in the nail bed that occur in diabetes mellitus patients compared to healthy people. Although there was no difference in the microvascular changes among the stages of diabetic nephropathy, a relationship between tortuosity and albuminuria was identified by logistic regression analysis. Nailfold videocapillaroscopy may be a new application that can be used to screen the microvascular changes that occur in diabetes mellitus.
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Affiliation(s)
- Ustun Yilmaz
- Department of Nephrology, SBU Antalya Training and Research Hospital, Antalya, Turkey,
| | - Ayse Ayan
- Department of Rheumatology, SBU Antalya Training and Research Hospital, Antalya, Turkey
| | - Seyit Uyar
- Department of Internal Medicine, SBU Antalya Training and Research Hospital, Antalya, Turkey
| | - Ayca Inci
- Department of Nephrology, SBU Antalya Training and Research Hospital, Antalya, Turkey
| | - Hakan Ozer
- Department of Internal Medicine, SBU Antalya Training and Research Hospital, Antalya, Turkey
| | - Fikriye Tuter Yilmaz
- Department of Neurology, SBU Antalya Training and Research Hospital, Antalya, Turkey
| | - Gulay Demirtas
- Department of Nephrology, SBU Antalya Training and Research Hospital, Antalya, Turkey
| | - Mehmet Kok
- Department of Internal Medicine, SBU Antalya Training and Research Hospital, Antalya, Turkey
| | - Abdullah Tokuc
- Department of Internal Medicine, SBU Antalya Training and Research Hospital, Antalya, Turkey
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11
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Animal Models of Systemic Sclerosis: Using Nailfold Capillaroscopy as a Potential Tool to Evaluate Microcirculation and Microangiopathy: A Narrative Review. Life (Basel) 2022; 12:life12050703. [PMID: 35629370 PMCID: PMC9147447 DOI: 10.3390/life12050703] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 05/05/2022] [Accepted: 05/06/2022] [Indexed: 11/18/2022] Open
Abstract
Systemic sclerosis (SSc) is an autoimmune disease with three pathogenic hallmarks, i.e., inflammation, vasculopathy, and fibrosis. A wide plethora of animal models have been developed to address the complex pathophysiology and for the development of possible anti-fibrotic treatments. However, no current model comprises all three pathological mechanisms of the disease. To highlight the lack of a complete model, a review of some of the most widely used animal models for SSc was performed. In addition, to date, no model has accomplished the recreation of primary or secondary Raynaud’s phenomenon, a key feature in SSc. In humans, nailfold capillaroscopy (NFC) has been used to evaluate secondary Raynaud’s phenomenon and microvasculature changes in SSc. Being a non-invasive technique, it is widely used both in clinical studies and as a tool for clinical evaluation. Because of this, its potential use in animal models has been neglected. We evaluated NFC in guinea pigs to investigate the possibility of applying this technique to study microcirculation in the nailfold of animal models and in the future, development of an animal model for Raynaud’s phenomenon. The applications are not only to elucidate the pathophysiological mechanisms of vasculopathy but can also be used in the development of novel treatment options.
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12
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Li Y, Li B, Wang B, Liu M, Zhang X, Li A, Zhang J, Zhang H, Xiu R. Integrated pancreatic microcirculatory profiles of streptozotocin-induced and insulin-administrated type 1 diabetes mellitus. Microcirculation 2021; 28:e12691. [PMID: 33655585 PMCID: PMC8365673 DOI: 10.1111/micc.12691] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 02/17/2021] [Accepted: 02/24/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE As an integrated system, pancreatic microcirculatory disturbance plays a vital role in the pathogenesis of type 1 diabetes mellitus (T1DM), which involves changes in microcirculatory oxygen and microhemodynamics. Therefore, we aimed to release type 1 diabetic and insulin-administrated microcirculatory profiles of the pancreas. METHODS BALB/c mice were assigned to control, T1DM, and insulin-administrated groups randomly. T1DM was induced by intraperitoneal injection of streptozotocin (STZ). 1.5 IU insulin was administrated subcutaneously to keep the blood glucose within the normal range. After anesthetizing by isoflurane, the raw data set of pancreatic microcirculation was collected by the multimodal device- and computer algorithm-based microcirculatory evaluating system. After adjusting outliers and normalization, pancreatic microcirculatory oxygen and microhemodynamic data sets were imported into the three-dimensional module and compared. RESULTS Microcirculatory profiles of the pancreas in T1DM exhibited a loss of microhemodynamic coherence (significantly decreased microvascular blood perfusion) accompanied by an impaired oxygen balance (significantly decreased PO2 , SO2 , and rHb). More importantly, with insulin administration, the pathological microcirculatory profiles were partially restored. Meanwhile, there were correlations between pancreatic microcirculatory blood perfusion and PO2 levels. CONCLUSIONS Our findings establish the first integrated three-dimensional pancreatic microcirculatory profiles of STZ-induced and insulin-administrated T1DM.
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Affiliation(s)
- Yuan Li
- Institute of Microcirculation, Key Laboratory of Microcirculation, Ministry of Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Bingwei Li
- Institute of Microcirculation, Key Laboratory of Microcirculation, Ministry of Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Bing Wang
- Institute of Microcirculation, Key Laboratory of Microcirculation, Ministry of Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Mingming Liu
- Institute of Microcirculation, Key Laboratory of Microcirculation, Ministry of Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.,Diabetes Research Center, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xiaoyan Zhang
- Institute of Microcirculation, Key Laboratory of Microcirculation, Ministry of Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Ailing Li
- Institute of Microcirculation, Key Laboratory of Microcirculation, Ministry of Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jian Zhang
- Institute of Microcirculation, Key Laboratory of Microcirculation, Ministry of Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.,Diabetes Research Center, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Honggang Zhang
- Institute of Microcirculation, Key Laboratory of Microcirculation, Ministry of Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Ruijuan Xiu
- Institute of Microcirculation, Key Laboratory of Microcirculation, Ministry of Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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13
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Nowroozpoor A, Gutterman D, Safdar B. Is microvascular dysfunction a systemic disorder with common biomarkers found in the heart, brain, and kidneys? - A scoping review. Microvasc Res 2020; 134:104123. [PMID: 33333140 DOI: 10.1016/j.mvr.2020.104123] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 12/09/2020] [Accepted: 12/12/2020] [Indexed: 02/07/2023]
Abstract
Although microvascular dysfunction (MVD) has been well characterized in individual organs as different disease entities, clinical evidence is mounting in support of an underlying systemic process. To address this hypothesis, we systematically searched PubMed and Medline for studies in adults published between 2014 and 2019 that measured blood biomarkers of MVD in three vital organs i.e. brain, heart, and the kidney. Of the 9706 unique articles 321 met the criteria, reporting 49 biomarkers of which 16 were common to the three organs. Endothelial dysfunction, inflammation including reactive oxidation, immune activation, and coagulation were the commonly recognized pathways. Triglyceride, C-reactive protein, Cystatin C, homocysteine, uric acid, IL-6, NT-proBNP, thrombomodulin, von Willebrand Factor, and uric acid were increased in MVD of all three organs. In contrast, vitamin D was decreased. Adiponectin, asymmetric dimethylarginine, total cholesterol, high-density and low-density cholesterol were found to be variably increased or decreased in studies. We review the pathways underlying MVD in the three organs and summarize evidence supporting its systemic nature. This scoping review informs clinicians and researchers in the multi-system manifestation of MVD. Future work should focus on longitudinal investigations to evaluate the multi-system involvement of this disease.
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Affiliation(s)
- Armin Nowroozpoor
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, United States
| | - David Gutterman
- Department of Internal Medicine, Section of Cardiology, Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Basmah Safdar
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, United States.
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14
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Ciaffi J, Ajasllari N, Mancarella L, Brusi V, Meliconi R, Ursini F. Nailfold capillaroscopy in common non-rheumatic conditions: A systematic review and applications for clinical practice. Microvasc Res 2020; 131:104036. [PMID: 32603698 DOI: 10.1016/j.mvr.2020.104036] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 06/24/2020] [Accepted: 06/25/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The role of nailfold capillaroscopy (NC) in common non-rheumatic conditions has not been systematically reported. The aim of this review is to outline NC features observed in frequent non-rheumatic conditions, providing a practical tool to support rheumatologists for the interpretation of capillaroscopic abnormalities in patients with no established connective tissue disease (CTD). METHODS We undertook a systematic search in PubMed and Web of Science databases. Studies reporting adults or children with common non-rheumatic diseases or conditions in which quantitative and/or qualitative assessment of morphological nailbed capillary findings was obtained, were included. The presence of a control group composed by subjects not affected by the studied condition and direct comparison of findings between groups were needed. RESULTS We included 25 articles. Diabetes mellitus (11 studies), glaucoma (7 studies) and essential hypertension (3 studies) were the most represented diseases. Reduced capillary density, tortuosity, dilated capillaries, microhaemorrhages, ramified capillaries and avascular areas can be observed in diabetic patients. Association was reported between poor glycaemic control or longer duration of diabetes, or presence of microvascular complications as retinopathy and neuropathy, and more severe capillaroscopic abnormalities. Decreased capillary density, tortuosity, microhaemorrhages, dilated capillaries, avascular areas and ramifications might also be present in glaucoma, while in essential hypertension a reduced capillary density might be expected. CONCLUSION Abnormal capillaroscopic findings are not uncommon even in individuals with no CTD. Therefore, presence of comorbidities known to potentially affect the microvascular array should always be investigated in patients undergoing NC and the interpretation of findings might be weighted accordingly.
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Affiliation(s)
- Jacopo Ciaffi
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, via Pupilli 1, 40136 Bologna, Italy.
| | - Nerenxa Ajasllari
- Department of Rheumatology, UHC Mother Teresa, Rruga e Dibrës 372, Tirana, AL, 1000, Albania.
| | - Luana Mancarella
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, via Pupilli 1, 40136 Bologna, Italy.
| | - Veronica Brusi
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, via Pupilli 1, 40136 Bologna, Italy.
| | - Riccardo Meliconi
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, via Pupilli 1, 40136 Bologna, Italy; Department of Biomedical and Neuromotor Sciences (DIBINEM), Section of Rheumatology, IRCCS Istituto Ortopedico Rizzoli, via Pupilli 1, 40136 Bologna, Italy.
| | - Francesco Ursini
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, via Pupilli 1, 40136 Bologna, Italy; Department of Biomedical and Neuromotor Sciences (DIBINEM), Section of Rheumatology, IRCCS Istituto Ortopedico Rizzoli, via Pupilli 1, 40136 Bologna, Italy.
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15
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Zhou K, Zhang J, Zheng ZR, Zhou YZ, Zhou X, Wang LD, Suo B, Jiang XF, Liu PJ, Wang DH. Diagnostic and Prognostic Value of TAT, PIC, TM, and t-PAIC in Malignant Tumor Patients With Venous Thrombosis. Clin Appl Thromb Hemost 2020; 26:1076029620971041. [PMID: 33141604 PMCID: PMC7649926 DOI: 10.1177/1076029620971041] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 10/05/2020] [Accepted: 10/13/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Venous thromboembolism (VTE) is an important complication in patients with malignant tumors. Its exact diagnosis and treatment are still lacking. We used a high-sensitive chemiluminescence method to detect thrombin-antithrombin III complex (TAT), plasmin-α2-plasmininhibitor complex (PIC), thrombomodulin (TM), and tissue plasminogen activator-inhibitor complex(t-PAIC) in combination with D-dimer and fibrin degradation product (FDP) to analyze their diagnostic and prognostic value in patients with malignant tumors. METHODS In total, 870 patients with confirmed malignant tumors were included, 82 of whom had diagnosed VTE; 200 healthy individuals were classified as the control group. The TAT, PIC, TM, and t-PAIC were detected using Sysmex HISCL5000 automated analyzers, whereas FDP and D-dimer were detected using Sysmex CS5100 coagulation analyzer. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic efficiency. Survival probabilities were determined using Kaplan-Meier analysis, and multivariate analyses were performed using a Cox regression model. RESULTS Compared with healthy controls, patients with malignant tumors showed significantly elevated TAT, PIC, TM, t-PAIC, D-dimer, and FDP. Similarly, compared with patients in the non-thrombosis group, those in the thrombosis group showed significantly elevated levels of the above mentioned markers. Logistic regression analysis showed that TAT, PIC, TM, t-PAIC, D-Dimer, and FDP were all associated with VTE. ROC analysis showed that "TAT+PIC+TM+t-PAIC+D-dimer+FDP"showed the highest sensitivity and specificity. Patients with elevated TAT, PIC, TM, and t-PAIC had a significantly shorter survival. Multivariate Cox survival analysis showed that TM and t-PAIC were significantly associated with poor prognosis. In addition, the incidence of VTE was significantly lower in patients with malignant tumors who were treated with low-molecular-weight heparin (LMWH), and their survival period was significantly longer than that of patients with malignant tumors who were not treated with LMWH. CONCLUSION TAT, PIC, TM, and t-PAIC combined with D-dimer and FDP were better than the application of a single marker in the diagnosis of VTE in patients with malignant tumors. TAT and PIC can be used as sensitive markers in the diagnosis of VTE but not as prognostic markers. TM and t-PAIC might be independent prognostic indicators in patients with malignant tumors, regardless of the state of thrombus.
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Affiliation(s)
- Kun Zhou
- Department of Clinical Laboratory, General Hospital of Heilongjiang Province Land Reclamation Bureau, Harbin, Heilongjiang, People’s Republic of China
- Kun Zhou, Department of Clinical Laboratory, General Hospital of Heilongjiang Province Land Reclamation Bureau, 235 Hashuang Road, Nangang District, Harbin, Heilongjiang 150088, People’s Republic of China.
| | - Jun Zhang
- Rehabilitation Department, General Hospital of Heilongjiang Province Land Reclamation Bureau, Harbin, Heilongjiang, People’s Republic of China
| | - Zun-Rong Zheng
- Department of Clinical Laboratory, General Hospital of Heilongjiang Province Land Reclamation Bureau, Harbin, Heilongjiang, People’s Republic of China
| | - Yu-Zhen Zhou
- Department of Clinical Laboratory, General Hospital of Heilongjiang Province Land Reclamation Bureau, Harbin, Heilongjiang, People’s Republic of China
| | - Xun Zhou
- Department of Clinical Laboratory, General Hospital of Heilongjiang Province Land Reclamation Bureau, Harbin, Heilongjiang, People’s Republic of China
| | - Li-Da Wang
- Department of Medical Record, General Hospital of Heilongjiang Province Land Reclamation Bureau, Harbin, Heilongjiang, People’s Republic of China
| | - Bing Suo
- Department of Medical Record, General Hospital of Heilongjiang Province Land Reclamation Bureau, Harbin, Heilongjiang, People’s Republic of China
| | - Xiao-Feng Jiang
- Department of Molecular Diagnosis Laboratory, The 4th Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, People’s Republic of China
| | - Pei-Jia Liu
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, People’s Republic of China
| | - Dong-Hua Wang
- Department of Gastrointestinal Surgery, General Hospital of Heilongjiang Province Land Reclamation Bureau, Harbin, Heilongjiang, People’s Republic of China
- Dong-Hua Wang, Department of Gastrointestinal Surgery, General Hospital of Heilongjiang Province Land Reclamation Bureau, 235 Hashuang Road, Nangang District, Harbin, Heilongjiang 150088, People’s Republic of China.
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16
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Sugimoto K, Murakami H, Deguchi T, Arimura A, Daimon M, Suzuki S, Shimbo T, Yagihashi S. Cutaneous microangiopathy in patients with type 2 diabetes: Impaired vascular endothelial growth factor expression and its correlation with neuropathy, retinopathy and nephropathy. J Diabetes Investig 2019; 10:1318-1331. [PMID: 30719863 PMCID: PMC6717820 DOI: 10.1111/jdi.13020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 01/21/2019] [Accepted: 01/31/2019] [Indexed: 12/14/2022] Open
Abstract
AIMS/INTRODUCTION To examine the three-dimensional morphology and vascular endothelial growth factor (VEGF) expression of skin microvasculature in patients with type 2 diabetes in relation to neuropathy, retinopathy and nephropathy. MATERIALS AND METHODS The present study enrolled 17 individuals with type 2 diabetes and 16 without. Skin sections were double-immunostained for type IV collagen and VEGF-A or protein gene product 9.5. Projected images from confocal microscopy served to quantify the occupancy rate of subepidermal type IV collagen-immunoreactive microvascular basement membrane area (OR-T4MBM), subepidermal VEGF-A-immunoreactive area and the VEGF/T4MBM ratio, as well as the protein gene product 9.5-immunoreactive intraepidermal nerve fiber density. Reduced intraepidermal nerve fiber density was applied for the diagnosis of neuropathy, fundic ophthalmoscopy and fluorescein angiography for retinopathy, and microalbuminuria or persistent proteinuria for nephropathy. RESULTS A total of 12 patients with diabetes had neuropathy, 10 had retinopathy and eight had nephropathy. Regardless of the presence or absence of neuropathy, retinopathy or nephropathy, OR-T4MBM was significantly increased in patients with diabetes compared with individuals without diabetes. In contrast, VEGF/T4MBM ratio was significantly decreased in those with neuropathy and retinopathy, as well as in those with and without nephropathy, whereas a trend toward a decreased VEGF/T4MBM ratio was seen in patients without retinopathy, as compared with individuals without diabetes. CONCLUSIONS The present study is the first report to show that cutaneous microangiopathy, as indicated by subepidermal microvascular proliferation and impaired VEGF expression, appears to occur before the development of overt clinical neuropathy, retinopathy or nephropathy in patients with type 2 diabetes.
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Affiliation(s)
| | - Hiroshi Murakami
- Department of Endocrinology and MetabolismHirosaki University Graduate School of MedicineHirosakiJapan
| | - Takahisa Deguchi
- Department of Diabetes and Endocrine MedicineKagoshima University Graduate School of Medical and Dental SciencesKagoshimaJapan
| | - Aiko Arimura
- Department of Diabetes and Endocrine MedicineKagoshima University Graduate School of Medical and Dental SciencesKagoshimaJapan
| | - Makoto Daimon
- Department of Endocrinology and MetabolismHirosaki University Graduate School of MedicineHirosakiJapan
| | - Susumu Suzuki
- Diabetes CenterOhta Nishinouchi HospitalKoriyamaJapan
| | - Takuro Shimbo
- Department of Internal MedicineOhta Nishinouchi HospitalKoriyamaJapan
| | - Soroku Yagihashi
- Department of Pathology and Molecular MedicineHirosaki University Graduate School of MedicineHirosakiJapan
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17
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Gujjar AR. Diabetes and Stroke: More than just accelerated atherosclerosis? Sultan Qaboos Univ Med J 2018; 18:e261-e263. [PMID: 30607264 PMCID: PMC6307639 DOI: 10.18295/squmj.2018.18.03.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 11/18/2018] [Accepted: 11/19/2018] [Indexed: 01/02/2023] Open
Abstract
Editorial
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Affiliation(s)
- Arunodaya R Gujjar
- Department of Medicine, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
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