Potential pathogenic inflammatory mechanisms of endothelial dysfunction induced by type 2 diabetes mellitus.
Insulin resistance and the vascular complications of diabetes include activation of the inflammation cascade, endothelial dysfunction, and oxidative stress. The comorbidities of diabetes, namely obesity, insulin resistance, hyperglycemia, hypertension and dyslipidemia collectively aggravate these processes while antihyperglycemic interventions tend to correct them. Increased C-reactive protein, interleukin 6, tumor necrosis factor alpha and especially interstitial cellular adhesion molecule-1, vascular cellular adhesion molecule-1, and E-selectin are associated with cardiovascular and non-cardiovascular complications of both type 1 and type 2 diabetes. We sought to review the clinical implications of the inflammation theory, including the relevance of inflammation markers as predictors of type 2 diabetes in clinical studies, and the potential treatments of diabetes, inferred from the pathophysiology.
1st Cardiology Unit, Hippokration Hospital, Athens University Medical School, Athens, Greece. kampoliannamaria@yahoo.gr
Anna-Maria
AM
Kampoli
Dimitris
D
Tousoulis
Alexandros
A
Briasoulis
George
G
Latsios
Nikolaos
N
Papageorgiou
Christodoulos
C
Stefanadis
D000818:Animals; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000276:immunology / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000209:etiology / Q000276:immunology / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000276:immunology / Q000378:metabolism; D004730:Endothelium, Vascular / Q000276:immunology / Q000378:metabolism; D006801:Humans; D007249:Inflammation / Q000209:etiology* / Q000276:immunology / Q000378:metabolism; D018836:Inflammation Mediators / Q000276:immunology; D007333:Insulin Resistance / Q000276:immunology; D008055:Lipids / Q000097:blood / Q000276:immunology; D008928:Mitochondria / Q000276:immunology / Q000378:metabolism; D009569:Nitric Oxide / Q000096:biosynthesis / Q000276:immunology; D018384:Oxidative Stress / Q000276:immunology; D017382:Reactive Oxygen Species / Q000276:immunology / Q000378:metabolism
D015415:Biomarkers; D001786:Blood Glucose; D018836:Inflammation Mediators; D008055:Lipids; D017382:Reactive Oxygen Species; D009569:Nitric Oxide