Microvascular abnormalities in capillaroscopy correlate with higher serum IL-18 and sE-selectin levels in patients with type 1 diabetes complicated by microangiopathy

Abstract

Microvascular abnormalities are one of the most important causes of persistent diabetic complications. The aim of this study was to compare microvascular changes examined by nailfold capillaroscopy with serum concentrations of soluble E-selectin (sE-selectin) and IL-18 in type 1 diabetic patients with and without microangiopathy. Serum levels of sE-selectin and IL-18 were determined by an enzyme-linked immunosorbent assay in 106 patients with type 1 diabetes and in 40 healthy controls. All diabetic patients were evaluated by extensive clinical, laboratory and capillaroscopic studies. Morphological changes were observed by nailfold capillaroscopy in 86 out of 106 (81%) diabetic patients. Severe capillaroscopic changes were seen in 32 out of 54 (59%) patients with microangiopathy, but in only seven out of 52 (13%) patients without microangiopathy. Higher serum levels of sE-selectin (p < 0.001) and IL-18 (p < 0.05) were demonstrated in diabetic patients compared to controls. Significant differences of sE-selectin (p < 0.001) and IL-18 (p < 0.01) serum concentrations were observed between diabetic patients with microangiopathy and controls. Moreover, comparison between patients with and without microangiopathic complications showed a significantly higher capillaroscopic score and sE-selectin serum concentration in the group with microangiopathy (p < 0.001). Furthermore, diabetic patients with severe microvascular changes in capillaroscopy showed significantly higher IL-18 (p < 0.001) and sE-selectin (p < 0.05) serum levels than subgroups without changes or with mild abnormalities. Our findings suggest that abnormalities in nailfold capillaroscopy may reflect the extent of microvascular involvement and are associated with higher sE-selectin and IL-18 serum levels, as well as with microangiopathic complications in diabetic patients.

Nailfold Capillaroscopy Findings in Diabetic Patients (A Pilot Cross-Sectional Study)

“…In consistence to other investigations [3] [17], we saw a high frequency of capillary changes especially increased tortuosity of vascular loops and angiogenesis in diabetic patients. Kaminska-Winciorek et al also showed an increased frequency of twisted capillaries in patients with diabetes type 1 and 2 [4].…”

“…Vascular damage, finally leads to eventual capillary obliteration. Morphological and functional changes in capillary microscopy have been reported in relation to vascular reactivity after induced ischemia [1]- [3].…”

“…Despite all these findings, little data exist on the relationship between microvascular changes in capillaroscopy and type 1, 2 diabetes features. Earlier diagnosis of vascular pathology with Capillaroscopy as a reliable method could be crucial for the therapy of diabetic patients [3]. Therefore the aim of this work was a quantitative and qualitative nailfold capillaroscopic assessment to describe the morphological and structural changes in capillary of a large series of type 1, 2 diabetic subjects.…”

“…Nailfold capillaroscopy (NC) is a non-invasive, easy to perform, painless, and sensitive technique for evaluating microvascular involvement, mainly in Raynaud's phenomenon (RP), systemic sclerosis and connective tissue patients [3]- [5]. Moreover, capillaroscopy is now applied to predict the risk of development of future visceral complications and digital ulcers in patients with systemic disease [6].…”

Immunotherapeutic Approach for Better Management of Cancer - Role of IL-18

“…Higher serum levels of sE-selectin and IL-18 were demonstrated in diabetic patients compared to controls. Significant differences of sE-selectin and IL-18 serum concentrations were observed between diabetic patients with microangiopathy and controls suggest that abnormalities in nailfold capillaroscopy may reflect the extent of microvascular involvement and are associated with higher sE-selectin and IL-18 serum levels, as well as with microangiopathic complications in diabetic patients (Kuryliszyn et al, 2011). Hyper glycaemia increases inflammatory cytokine concentration in the blood.…”