Diabetic capillary angiopathy in human skeletal muscles

Bencosme, Sergio A.; West, Roxroy O.; Kerr, John; Wilson, D.Laurence

doi:10.1016/0002-9343(66)90188-4

Cited by 49 publications

(8 citation statements)

References 22 publications

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“…(For studies of vessel pathFrom the Department of Medicine, Aalborg Municipal Hospital, Aalborg, Denmark. ology of the peripheral nerves see Fagerberg 1 ; heart, Blumenthal et al 2 ; skin and muscles, Goldenberg et al, 3 Aagenaes and Moe, 4 Pedersen and Olsen, 5 Handelsman et al, 6 Zacks et al, 7 McMillan et al, 8 Bencosme et al, 9 Siperstein et al 10 ; bulbar conjunctiva, Funahaski and Fink, 11 Pieri and Scarpelli 12 ; inner ear, J0rgen-sen 13 ; mucosa of the stomach, Angervall et al 14 ; pancreas, Lazarus and Volk 15 ; gingiva, Stahl et al 16 ; placenta, Burstein et al 17 ; retina, Ashton, 18 Bloodworth 19 ; kidney, Thornsen. 20 ) During the past few years, it has been possible with electron microscopy to detect nonspecific structural changes very early during the disease and possibly even before the onset of clinically detectable diabetes.…”

Section: Discussionmentioning

confidence: 99%

Functional Microangiopathy in Diabetes Mellitus

Ditzel

1968

Diabetes

100

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The present knowledge of the state of the microvasculature in diabetic subjects early during the course of the disease and prior to any clinical signs of retinopathy and nephropathy is reviewed. Functional changes in the peripheral vascular bed have been demonstrated by various methods in the retina, the skin and the conjunctiva. The common features of these functional changes appear to be a loss of normal vascular tone and increased permeability. There is also evidence of a functional disorder of the glomerular capillaries in young diabetics early during their disease, as indicated by increased glomerular filtration rates. Based on the presence of a functional microangiopathy, a dynamic concept of the development of clinical microangiopathy is presented. It is suggested that the functional changes may occur very early and might in some instances come before the degenerative vascular changes. Thus they might participate in the mechanism of the development of the long-term diabetic syndrome.

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Section: Discussionmentioning

confidence: 99%

Functional Microangiopathy in Diabetes Mellitus

Ditzel

1968

Diabetes

100

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“…This suggestion was strongly supported by the electron microscopic observations of Bergstrand and Bucht (5), and of Farquhar, Hopper, and Moon (6), each of whom independently provided evidence that an accumulation of basement membrane or of basement membrane-like material in the capillaries of the glomerulus may represent the earliest and perhaps the underlying vascular abnormality of diabetic renal disease. In subsequent years, hypertrophy of the capillary basement membranes has also been observed in a number of other diabetic tissues, including retina (7), skin (8,9), nerve (10), muscle (7,(11)(12)(13)(14), and placenta (15). On the basis of these observations several investigators have raised the possibility that widespread thickening of the capillary basement membranes may in fact represent the single lesion responsible for all of the vascular complications of diabetes (7,11,15).…”

mentioning

confidence: 99%

Studies of muscle capillary basement membranes in normal subjects, diabetic, and prediabetic patients

Siperstein¹,

Unger²,

Madison³

1968

J. Clin. Invest.

586

237

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A B S T R A C T A technique is described for the measurement of muscle capillary basement membranes by electron microscopic examination of needle biopsies of the quadriceps muscle. With this procedure it has been possible to obtain an objective evaluation of the significance of capillary basement membrane hypertrophy in diabetic mi- than genetic diabetes only infrequently show basement membrane hypertrophy. These results indicate that thickening of the muscle capillary basement membranes is a characteristic of genetic diabetes mellitus, and further, that the hyperglycemia of diabetes is probably not the factor responsible for the microangiopathy characteristic of diabetes mellitus. Finally, the discovery of thickened capillary basement membranes in prediabetic patients suggests that basement membrane hypertrophy is a relatively early lesion of the diabetic syndrome and provides further support for the conclusion that this vascular defect is independent of carbohydrate derangements of diabetes mellitus.

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“…COGAN et al (1961) and ASHTON (1963) noted that these nonfunctioning capillaries were devoid of cellular nuclei and appeared to be hollow tubular structures. Electron microscopy identified capillary basement membrane thickening in retina, glomerulus, (BLOODWORTH, 1962(BLOODWORTH, , 1963) muscle (ZACKS et al, 1962, SlPERSTEIN et al, 1968, BEACOSME et al, 1969, YODIAKEN et al, 1969and WILLIAMSON et al, 1971) and dermal tissues (BANSON et al, 1964). Although recognition of these diffuse capillary abnormalities lends credence to the concept of a generalized microangiopathy in diabetes mellitus, it does not offer an explanation for the ischemia responsible for cytoid body formation.…”

Section: Discussionmentioning

confidence: 99%

The pathogenesis of the cotton wool spot in diabetic retinopathy

Madson

Chester

1974

Doc Ophthalmol

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The clinical and pathological findings of 58 patients with diabetes mellitus were reviewed. Sixteen patients who did not have diabetes served as controls. Attention was directed towards the presence of cytoid bodies in the nerve fiber layer of the retina (the pathological equivalent of the cotton wool spot).In paraffin embedded tissue of the diabetic group, cytoid bodies, without demonstrable vascular occlusion, was observed in 35 patients. In contrast, lipid stains of trypsin digested retina demonstrated lipid occlusion of arterioles, precapillary arterioles and/or capillaries in 29 of the 35. In 17 of the 29, lipid occlusion was also noted in gelatin embedded whole retina. Particularly striking was the observation that 10 of the 17 disclosed the presence of cytoid bodies at the same site as the lipid occluded blood vessel.This data indicates that lipid occlusion plays an important role in the production of the cotton wool spot in diabetic retinopathy.

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Diabetic capillary angiopathy in human skeletal muscles

Cited by 49 publications

References 22 publications

Functional Microangiopathy in Diabetes Mellitus

Functional Microangiopathy in Diabetes Mellitus

Studies of muscle capillary basement membranes in normal subjects, diabetic, and prediabetic patients

The pathogenesis of the cotton wool spot in diabetic retinopathy

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