[Cutaneous vasodilation induced by local pressure application: modifications in diabetes].
Prolonged external pressure can cause pressure sores. We examined the link between mechanical sensitivity and cutaneous vasodilation, and its possible alteration in patients at high risk of pressure sores. Clinical and experimental studies have shown that this link, which is not dependent on inflammation or pain, involves capsaicin-sensitive nerve fibers. Receptors for calcitonin gene-related peptide, vasoactive intestinal peptide and pituitary adenylate cyclase-activating polypeptide are also involved, contrary to neurokinin receptors. Endothelial nitric oxide is crucialfor pressure-induced vasodilation. This link is altered in diabetes, even prior to the onset of nervous complications. Restoration of pressure-induced vasodilation might prevent the onset of pressure sores and plantar ulcers in diabetic patients.
Saumet
Jean Louis
JL
UMR CNRS 6188, Circulations Régionales et Micro Circulation, Faculté de médecine, 49045 Angers. jeanlouis.saumet@univ-angers.fr
D000818:Animals; D003920:Diabetes Mellitus / Q000503:physiopathology*; D017719:Diabetic Foot / Q000503:physiopathology; D006801:Humans; D011312:Pressure; D003668:Pressure Ulcer / Q000503:physiopathology; D051381:Rats; D012867:Skin / Q000098:blood supply*; D014664:Vasodilation / Q000502:physiology*