Literature DB >> 20570185

Dysfunctional vasa vasorum in diabetic peripheral artery obstructive disease with critical lower limb ischaemia.

C Orrico1, G Pasquinelli, L Foroni, D Muscarà, P L Tazzari, F Ricci, M Buzzi, E Baldi, N Muccini, M Gargiulo, A Stella.   

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. Copyright 2010 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

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Year:  2010        PMID: 20570185     DOI: 10.1016/j.ejvs.2010.04.011

Source DB:  PubMed          Journal:  Eur J Vasc Endovasc Surg        ISSN: 1078-5884            Impact factor:   7.069


  10 in total

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