Dysfunctional vasa vasorum in diabetic peripheral artery obstructive disease with critical lower limb ischaemia.
Eur J Vasc Endovasc Surg
; 40(3): 365-74, 2010 Sep.
Article
em En
| MEDLINE
| ID: mdl-20570185
ABSTRACT
OBJECTIVES AND DESIGN:
To establish whether in diabetic patients with peripheral artery obstructive disease (PAOD) vasa vasorum (vv) neoangiogenesis is altered with increased arterial damage. MATERIALS Thirty-three patients with PAOD and critical lower limb ischaemia, 22 with type II diabetes.METHODS:
Immunohistochemistry for endothelial cell markers (CD34 and von Willebrand Factor); real-time reverse transcription polymerase chain reaction (RT-PCR) to quantify arterial wall expression of vascular endothelial growth factor (VEGF); enzyme-linked immunosorbent assay (ELISA) to assess blood VEGF; flow cytometry to detect circulating endothelial cells (CECs).RESULTS:
Patients with PAOD and diabetes have a higher frequency (60% vs. 45%) of advanced atherosclerotic lesions and a significant reduction (p = 0.0003) in CD34(+) capillaries in the arterial media. Adventitial neoangiogenesis was increased equally (CD34(+) and vWF(+)) in all patients. Likewise, all patients have increased CEC and VEGF concentration in the blood as well as in-situ VEGF transcript expression.CONCLUSIONS:
Patients with PAOD have remarkable arterial damage despite increased in-situ and circulating expression of the pro-angiogenic VEGF; a dysfunctional vv angiogenesis was seen in diabetics which also showed a higher frequency of parietal damage; it is suggested that in diabetic arterial wall, injury is worsened by vv inability to finalise an effective VEGF-driven arterial wall neoangiogenesis.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Arteriopatias Oclusivas
/
Vasa Vasorum
/
Neovascularização Fisiológica
/
Extremidade Inferior
/
Angiopatias Diabéticas
/
Isquemia
Tipo de estudo:
Observational_studies
Limite:
Aged80
País/Região como assunto:
Europa
Idioma:
En
Revista:
Eur J Vasc Endovasc Surg
Assunto da revista:
ANGIOLOGIA
Ano de publicação:
2010
Tipo de documento:
Article
País de afiliação:
Itália