RESUMEN
Diabetes is constantly increasing at a rate that outpaces genetic variation and approaches to pandemic magnitude. Skin cells physiology and the cutaneous healing response are progressively undermined in diabetes which predisposes to lower limb ulceration, recidivism, and subsequent lower extremities amputation as a frightened complication. The molecular operators whereby diabetes reduces tissues resilience and hampers the repair mechanisms remain elusive. We have accrued the notion that diabetic environment embraces preconditioning factors that definitively propel premature cellular senescence, and that ulcer cells senescence impair the healing response. Hyperglycemia/oxidative stress/mitochondrial and DNA damage may act as major drivers sculpturing the senescent phenotype. We review here historical and recent evidences that substantiate the hypothesis that diabetic foot ulcers healing trajectory, is definitively impinged by a self-expanding and self-perpetuative senescent cells society that drives wound chronicity. This society may be fostered by a diabetic archetypal secretome that induces replicative senescence in dermal fibroblasts, endothelial cells, and keratinocytes. Mesenchymal stem cells are also susceptible to major diabetic senescence drivers, which accounts for the inability of these cells to appropriately assist in diabetics wound healing. Thus, the use of autologous stem cells has not translated in significant clinical outcomes. Novel and multifaceted therapeutic approaches are required to pharmacologically mitigate the diabetic cellular senescence operators and reduce the secondary multi-organs complications. The senescent cells society and its adjunctive secretome could be an ideal local target to manipulate diabetic ulcers and prevent wound chronification and acute recidivism. This futuristic goal demands harnessing the diabetic wound chronicity epigenomic signature.
Asunto(s)
Senescencia Celular/fisiología , Pie Diabético/fisiopatología , Cicatrización de Heridas/fisiología , Daño del ADN , Humanos , Células Madre Mesenquimatosas/fisiología , Estrés OxidativoRESUMEN
The Mongolian gerbil has been widely used as a global brain ischemia model because of its incomplete cerebral circle of Willis. However, the inter-individual anatomic variability of this vascular structure interferes with the reliability of the model. The aim of this work was to introduce modifications to the protocol of global brain ischemia experiments in Mongolian gerbils in an attempt to increase the reliability and usefulness of this model. Our study focused on the assessment of the level of anastomosis of the cerebral circle of Willis in order to evaluate its contribution to clinicopathological outcomes in this model. Sham-operated, Ischemic, and Ischemic + Hypothermia animals were subjected to a 15-minute occlusion of the common carotid arteries. Transcardiac perfusion with bromophenol blue / gelatin solution was performed 72 hours after ischemia. Brains were processed for anatomopathological analysis. Tissue damage was observed in the hippocampus, caudate-putamen nucleus, neocortex, and thalamic nuclei of animals from the Ischemic group. The circles of Willis of the Sham-operated animals showed bilateral (38 percent), unilateral (48 percent) or no posterior communicating arteries (14 percent). A negative correlation between infarct volume and the level of anastomosis was revealed for the Ischemic, but not for the Ischemic + Hypothermia group. Additionally, Analysis of covariance (ANCOVA) was performed to assess the contribution of the level of anastomosis to the clinicopathological outcomes. It was confirmed that the infarct volume decreased in the Ischemic + Hypothermia group when compared to the Ischemic group. Since the level of anastomosis cannot be predicted, this variable should necessarily be considered when analyzing the results of global brain ischemia in Mongolian gerbils.