New insights into hyperglycemia-induced molecular changes in microvascular cells.
Hyperglycemia is the most prevalent characteristic of diabetes and plays a central role in mediating adverse effects on vascular cells during the progression of diabetic vascular complications. In diabetic microangiopathy, hyperglycemia induces biochemical and molecular changes in microvascular cells that ultimately progress to retinal, renal, and neural complications and extends to other complications, including advanced periodontal disease. In this review, we describe changes involving basement membrane thickening, tissue remodeling, gap junctions, inflammation, cytokines, and transcription factors, and their effects on the pathogenesis of diabetic microvascular complications. The majority of the changes described relate to retinal microangiopathy, since ultrastructural, structural, and biochemical alterations have been well-characterized in this tissue.
Roy
S
S
Departments of Medicine and Ophthalmology, Boston University School of Medicine, MA 02118, USA. sayon@bu.edu
Trudeau
K
K
Roy
S
S
Behl
Y
Y
Dhar
S
S
Chronopoulos
A
A
D000818:Animals; D017209:Apoptosis / Q000187:drug effects / Q000502:physiology; D001485:Basement Membrane / Q000473:pathology; D018031:Connexin 43 / Q000235:genetics / Q000378:metabolism; D016207:Cytokines / Q000096:biosynthesis; D003930:Diabetic Retinopathy / Q000235:genetics / Q000473:pathology / Q000503:physiopathology*; D016326:Extracellular Matrix Proteins / Q000378:metabolism; D051858:Forkhead Transcription Factors / Q000502:physiology; D017629:Gap Junctions / Q000473:pathology; D006801:Humans; D006943:Hyperglycemia / Q000473:pathology / Q000503:physiopathology*; D007328:Insulin / Q000494:pharmacology; D020782:Matrix Metalloproteinases / Q000378:metabolism; D055806:Microvessels / Q000378:metabolism / Q000473:pathology*; D009389:Neovascularization, Pathologic / Q000473:pathology; D010518:Periodontitis / Q000378:metabolism
D018031:Connexin 43; D016207:Cytokines; D016326:Extracellular Matrix Proteins; D051858:Forkhead Transcription Factors; D007328:Insulin; D020782:Matrix Metalloproteinases