Morphological characteristics of dermal diabetic microangiopathy

Yasuda, Hitoshi; Taniguchi, Yuki; Yamashita, Makio; Kobayashi, Nobuyuki; Sonobe, Masanobu; Hatanaka, I; Kikkawa, Ryuichi; Shigeta, Yukio

doi:10.1016/0168-8227(90)90111-6

Cited by 7 publications

(4 citation statements)

References 22 publications

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“…Among these, the thickening of the basement membrane is a general phenomenon encountered in both vascular (Fischer and Gaertner, 1983;Yasuda et al, 1990) and nonvascular tissues (Johnson, 1981). When related to cells not belonging to the vascular wall, this hypertrophy does not seem to play a clinically significant role.…”

Section: Discussionmentioning

confidence: 99%

Alterations of the Rat Mesentery Vasculature in Experimental Diabetes

Arshi

Bendayan

Ghitescu

2000

Laboratory Investigation

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SUMMARY:The alteration induced by diabetes on vascular permeability to serum albumin was investigated in the mesentery of streptozotocin-induced hyperglycemic rats. Double-tagged ( 125 I and dinitrophenol-haptenated) heterologous albumin was intravenously administered in normal and hyperglycemic animals, and the extravasation of the tracer was evaluated by radioactivity measurements and by morphometry at the ultrastructural level using quantitative protein A-colloidal gold immunocytochemistry. The results demonstrate that diabetes induces a significant increase in the permeability of the mesentery vessels to albumin. This increase is due to a more efficient transport of macromolecules by endothelial plasmalemmal vesicles and not to leakier interendothelial junctions. Passage across the endothelial basement membranes did not appear to be restricted in either the control or diabetic condition. However, in diabetes, the mesothelial basement membrane appeared to become modified and to restrain the passage of albumin toward the peritoneal cavity. After 3 months of diabetes, the rats presented a net increase in the average diameter of the blood vessels localized in the mesentery arcada (macrovascular hyperplasy) and a notable angiogenesis, manifested at the level of the microvasculature in the mesenteric windows. (Lab Invest 2000, 80:1171-1184.T he association of diabetes with vascular dysfunctions gradually evolving toward incapacitating or life-threatening vascular pathologies is undisputed. Extensive clinical observations and studies on animal models have amply documented that hyperglycemia accelerates and worsens atherosclerosis in large arteries (Colwell et al, 1988;Shantaram, 1999;Steiner 1997) and affects, although in different ways, the microvessels of selected vascular beds, such as those of the retina (Bazan et al, 1997;Cunha-Vaz, 1983;Porta, 1996;Ruggiero et al, 1997), kidney (Flyvbjerg, 1997;Mauer et al, 1984;Nyengaard and Bendtsen, 1993;Vlassara et al, 1994), and nerves (Cameron and Cotter, 1997;Malik et al, 1993; Tesfay et al, 1994). Particular attention has been directed to the study of diabetes-induced retinopathies and nephropathies, because of their obvious clinical implications. On the other hand, the impact of diabetes on other vascular beds has been generally overlooked. Therefore, it is not known whether diabetic microangiopathy concerns all blood vessels, creating a sort of "dysfunctional background" exacerbated in particular tissues by local factors to a full blown vascular pathology, or the vasculature of many organs is simply spared by the deleterious effects of hyperglycemia/ hypoinsulinemia. The latter hypothesis would fall in line with the ever-growing body of evidence pointing to important physiological and biochemical dissimilarities between various vascular segments (Boegehold, 1998;Rajotte et al, 1998;Thorin and Shreeve, 1998).Several morphologic features and physiologic parameters appear as leit motifs of diabetic microangiopathies. Among these, the thickening of the basement membran...

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Section: Discussionmentioning

confidence: 99%

Alterations of the Rat Mesentery Vasculature in Experimental Diabetes

Arshi

Bendayan

Ghitescu

2000

Laboratory Investigation

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“…The total protein flux (J s ) is dependent on the rate of fluid filtration (J v , the product of L p and ΔP) the reflection coefficient (σ), the Peclet number (Pe), which describes the contribution of convective protein flux relative to that occurring via diffusion, P d , the diffusive permeability for albumin, A, the surface area available for solute exchange, and C p and C t the plasma and interstitial protein concentrations, respectively. By taking into account the increased L p in response to elevated glucose, our data suggest that the P a measured by Yuan et al following elevated glucose treatment may be an over estimation of the solute permeability, where P a values of 3.17 and 6.45 × 10 − 6 cm · s − 1 were calculated for 5 mM and 20 mM glucose, respectively [49]. Using Equation , the increased total protein flux (J s ) resulting from the observed increase in L p from this study (2.13‐fold) can be calculated.…”

Section: Discussionmentioning

confidence: 94%

“…With increasing duration of diabetes structural adaptive changes occur, the most marked of which is basement membrane thickening. A ubiquitous finding, basement membrane thickening has been demonstrated in microvessels of the eye [6], kidney [32], muscle [26], and the skin [49]. A reduced compliance of diabetic vessels has been reported, which is thought to be a result of the thickening of the basement membrane [5].…”

Section: Compliancementioning

confidence: 99%

Hyperglycemia Stimulates a Sustained Increase in Hydraulic Conductivity In Vivo without Any Change in Reflection Coefficient

et al. 2007

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These data suggest that hyperglycemia induced increased apparent protein permeability may be secondary to a glucose-mediated change in macromolecular convective flux rather than any change in protein permeability per se. The authors speculate that the increased microvascular permeability to water in vivo is mediated by direct interaction of glucose with the endothelial cells (perhaps with the glycocalyx).

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“…Conversely, the number of branches increased in the epidermal/SVP layer. These highly detailed and 3D layer-specific insights into the unperturbed skin environment in vivo may help explain apparently contradictory observations in the literature, typically based on histological ex vivo findings, with reports ranging from microvascular density increases, thickening of the microvascular basement membrane and hyperplasia occurring with diabetes progression 9 , 37 , 40 – 43 , to observations of no change 9 , 10 or a decrease 43 , 44 in microvascular diameter.…”

Section: Discussionmentioning

confidence: 99%

Dermal features derived from optoacoustic tomograms via machine learning correlate microangiopathy phenotypes with diabetes stage

Karlas,

Katsouli,

Fasoula

et al. 2023

Nat. Biomed. Eng

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Skin microangiopathy has been associated with diabetes. Here we show that skin-microangiopathy phenotypes in humans can be correlated with diabetes stage via morphophysiological cutaneous features extracted from raster-scan optoacoustic mesoscopy (RSOM) images of skin on the leg. We obtained 199 RSOM images from 115 participants (40 healthy and 75 with diabetes), and used machine learning to segment skin layers and microvasculature to identify clinically explainable features pertaining to different depths and scales of detail that provided the highest predictive power. Features in the dermal layer at the scale of detail of 0.1–1 mm (such as the number of junction-to-junction branches) were highly sensitive to diabetes stage. A ‘microangiopathy score’ compiling the 32 most-relevant features predicted the presence of diabetes with an area under the receiver operating characteristic curve of 0.84. The analysis of morphophysiological cutaneous features via RSOM may allow for the discovery of diabetes biomarkers in the skin and for the monitoring of diabetes status.

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Morphological characteristics of dermal diabetic microangiopathy

Cited by 7 publications

References 22 publications

Alterations of the Rat Mesentery Vasculature in Experimental Diabetes

Alterations of the Rat Mesentery Vasculature in Experimental Diabetes

Hyperglycemia Stimulates a Sustained Increase in Hydraulic Conductivity In Vivo without Any Change in Reflection Coefficient

Dermal features derived from optoacoustic tomograms via machine learning correlate microangiopathy phenotypes with diabetes stage

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