Changes in Morphometric Indicators of Blood Vessels of Masticatory Muscles in Simulation of Diabetic Angiopathy in Rats

Summary. Relevance. Diabetic joint damage is common in the clinic. The blood vessels of the masticatory muscles that affect the morphogenesis of diabetic arthropathy of the temporomandibular joint remain poorly studied in this pathology. Objective: to study the features of remodeling of blood vessels of the masticatory muscles of the temporomandibular joint in experimental hyperglycemia by quantitative morphological methods. Materials and Methods. The study material was 45 laboratory mature white male rats, which were divided into 3 groups. The 1st group consisted of 15 intact apparently healthy animals, the 2nd included 15 rats with one-month diabetic angiopathy, and the 3rd had 15 rats with two-month specified pathology. Diabetes mellitus was simulated by a single intraperitoneal injection of streptozotocin from Sigma at a dose of 50 mg/kg. Euthanasia of animals was performed by bloodletting under thiopental anesthesia one and two months after the start of the experiment. The blood glucose concentration was determined. Histological micropreparations were made from the temporomandibular joint and the temporal and external pterygoid muscles. Morphometric measurements of small caliber arteries (outer diameter 26-50 μm), veins and microvessels of the hemomicrocirculatory tract were performed on muscle micropreparations; relative volumes of damaged synoviocytes and chondrocytes were determined on micropreparations of joints. Quantitative indicators were processed statistically. Results and Conclusions. It was revealed that the gleam of arteries considerably decreases, their wall thickens, and endotheliocytes are damaged in the studied muscles with the modeled pathology. Venous vessels are dilated, full-blooded with a reduced wall thickness. The most pronounced changes in these experimental conditions are the structure of microvessels, which is characterized by narrowing of arterioles, precapillary arterioles and hemocapillaries, pronounced expansion of postcapillary venules and venules. Plethora, stasis, thrombosis, irregularity of the lumen, sacculation, and varicose expansions were noted in venous microvessels. Venous fullness led to hypoxia, disorders of trophism and metabolism, dystrophy, necrobiosis of muscle fibers and stromal structures, foci of infiltration and sclerosis. It was revealed that morphological changes in the vascular bed of the masticatory muscles affect the morphogenesis of diabetic arthropathy of the temporomandibular joint.

Progression of initial diabetic angiopathy: association with carbohydrate disorders

Background. Recognizing the early stages of diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM) and predicting their progression is important and is an urgent challenge of modern ophthalmology. The study aimed at investigating the peculiarities of occurrence and progression of DR initial studies and establishing its relationship with the severity of carbohydrate metabolism disorders in patients with T2DM. Materials and methods. We examined 91 patients (182 eyes) with T2DM. Based on the ETDRS system of clinical signs Airlie House, there were determined the microaneurysms (MA), microhemorrhages (MH), intraretinal microvascular anomalies (IRMA), retinal venous anomalies, retina nonperfusion, and their relationship with the severity of carbohydrate dysmetabolism in T2DM patients. Results. Most patients (72.5 %) had no retinopathy at the start of the study (ETDRS level was 0–10 in both eyes). The rest (27.5 %) had the ETDRS level 10 in one eye, while the other showed single changes in the caliber of blood vessels, dilatation, and tortuosity of the veins, IRMA or MH, which corresponded to the ETDRS level 14/15. In these patients, the duration of T2DM was longer (on average by 3 years), and the carbohydrate disorders were more pronounced. During one year of observation, eye changes progressed in different ways: in the absence of DR at the beginning of the study, progression was noted in 50.0 % of cases, while in their presence — in 92.0 %. The patients with progression had a longer history of diabetes and worse indicators of carbohydrate metabolism. Conclusions. It has been established that diabetic changes in the retina begin from a single vascular injury. With its presence within one year, DR develops in most cases.

Salvia Miltiorrhiza in Anti-diabetic Angiopathy

Background:: Salvia miltiorrhiza, a traditional Chinese medicine, also named as Danshen in China, is widely used for treatment of cardiovascular disease. It demonstrates multiple biological functions, such as anti-oxidative stress, anti-inflammation and anti-thrombosis. Diabetic angiopathy is one of the diabetic complications with macro- and microangiopathy. The macroangiopathy mainly occurs to arteries, while the microangiopathy mainly includes diabetic retinopathy and nephropathy. Many factors associated with diabetes, such as metabolic abnormalities and oxidative stress, can induce vascular lesions. These factors promote the accumulation of lipids as well as inflammatory cytokines, increase production of extracellular cell matrix, and impair endothelium functions, thereby leading to vascular dysfunction. Conclusion:: This review attempts to summarize the progress of the studies of Salvia miltiorrhiza on diabetic angiopathy, including improving endothelial function, anti-oxidative stress, reducing the risk of vascular blockage, inhibiting inflammation as well as regulating lipid metabolism. We also summarize the pharmacological activity of bioactive components in Salvia miltiorrhiza and the delivery systems. We made the conclusion that Salvia miltiorrhiza can be used as a potential auxiliary drug for treatment of diabetic angiopathy.

Combined physical therapy for diabetic angiopathy

Background. The problem of diabetic angiopathy is characteristic of countries even with a high level of development of medicine. The high frequency of complications of diabetes with high biological and social significance determines the need for their correction. The purpose of the work was to increase the effectiveness of rehabilitation treatment for patients with diabetic angiopathy through the combined use of therapeutic exercises and functional electrical stimulation of the lower extremities. Methods. A prospective cohort study was conducted, in which 90 patients (63 men and 27 women) with an established diagnosis of type 2 diabetes took part. Results. It was found that the use of therapeutic gymnastics and training walking on a treadmill and functional neuroelectrostimulation of the lower extremities increase the motor capabilities of patients due to the analgesic effect, improved neurogenic control of vasoconstriction of arteriovenous anastomoses and increased capillary blood flow. Conclusion. Functional electrical stimulation method can be effectively used in physical therapy programs for patients with diabetic lower limb angiopathies at the inpatient and outpatient stages.

Effect of a-tocopherol on the development of diabetic angiopathy, platelet aggregation, and prostacyclin-thromboxan system of rats with streptozotocin-induced diabetes

Under study were effects of intravenous infusions of a new emulsion, -tocopherol, on the development of diabetic microangiopathy, platelet -tocopherol level, ADP-induced platelet aggregation level, exogenic (from 14C-arachidonic acid) thromboxan (TxA2) biosynthesis in suspension of washed platelets and of prostacyclin (Pgb) one in isolated aortic rings of rats with streptozotocin-induced diabetes. Six-week injections of -tocopherol in a dose 100 mg/100 g b. w. with 48 h intervals immediately after development of streptozotocin-induced diabetes prevented the development of diabetic angiopathy but did not normalize platelet functional activity and Pgl2/TxA2 balance in vessels and platelets. Similar injections of -tocopherol in the presence of developed angiopathy resulted in its regressive development and normalization of the before-said prostanoid balance and platelet characteristics.

The Correlation between Secretory Phospholipase A2 Type IIA Levels and Mean Platelet Volume among Type 2 Diabetes Mellitus Patients

Background: Platelet activity plays a role in the occurrence of diabetic angiopathy with an increase in mean platelet volume (MPV) as a marker of platelet activity. Platelet activity is influenced by phospholipase A2 type IIA (sPLA2 type IIA), which is a lipid-mediating enzyme that connects the pathogenesis of Diabetes Mellitus (DM) with complications of diabetic angiopathy. This study aimed to examine the relationship between levels of type IIA sPLA2 and MPV among type II DM patients. Subjects and Method: This was a cross-sectional study. A total of 63 patients with type II DM was selected for this study. The inclusion criteria for the study subjects were type 2 diabetes mellitus patients who did not experience an infectious disease, acute inflammation, trauma, surgery or malignancy, anemia, taking antiplatelet drugs, having abnormal platelet counts, and smoking. The dependent variable was levels of type IIA sPLA2. The independent variable was MPV. The data were obtained from the medical records of Prof. Dr. Soerojo Mental Hospital, Magelang. The data were analyzed using Spearman correlation test. Results: The study showed the median level of sPLA2 type IIA was 3841.50 ng / dL and the average MPV value was 7.36 fl. The results of the Spearman correlation analysis showed that there was no relationship between sPLA2 type IIA and MPV (p = 0.551), but there was a tendency for an increase in type IIA sPLA2 followed by an increase in MPV value (r = 0.077). There was a difference in the average MPV value in the subject group with DM ≤ 10 years and> 10 years (p = 0.009), and it was statistically significant. Conclusion: There is a tendency for an increase in type IIA sPLA2 followed by an increase in the MPV value among type II DM patients. Keywords: type II diabetes melitus, type IIA sPLA2 enzyme, mean platelet volume Correspondence: Woro Ayu Sekararum. Faculty of Medicine, Universitas Pembangunan Nasional ‘Veteran’ Jakarta. Jl, Rumah Sakit Fatmawati, Pondok Labu, South Jakarta, Indonesia. E-mail: [email protected]. Mobile: 0811975511 DOI: https://doi.org/10.26911/the7thicph.01.09

Pathophysiological model of indirect revascularization in rats with microangiopathy of limbs caused by experimental streptozocin diabetes

Despite the large number of publications, the model of experimental diabetes after the introduction of streptozotocin remains a subject of lively scientific debate. The purpose of this study was to develop a pathophysiological model of indirect revascularization in rats with microangiopathy of limbs caused by experimental streptozotocin diabetes. Experimental studies were carried out in a chronic experiment on 100 sexually mature Wistar rats weighing 180-250 g. The streptozotocin diabetes model used. After culling animals from increased resistance to pancreatotropic toxicity by the criterion of the absence of hyperglycemia, three experimental groups were formed: Group I (control) – rats with streptozotocin-induced angiopathy without treatment (n=10); II group – rats with streptozotocin-induced angiopathy treated with pentoxifylline (100 mg/kg IP for 10 days) for therapeutic purposes (n=25); III group – rats with streptozotocin-induced angiopathy, which together with the treatment were injected with platelet-rich plasma (in the right hind limb, once, with a volume of 0.2 ml, linearly, retrogradely, from two points) and pentoxifylline (100 mg/kg IP for 10 days) (n=25). The duration of the experiment was 110 days. We studied the level of glycemia, the state of microcirculation, and the degree of pathomorphological changes in the various study groups. Statistical processing was performed by non-parametric methods using software Statistica 10.0. The developed pathophysiological model of indirect revascularization with the introduction of pentoxifylline and plasma enriched with platelets in diabetic angiopathy is adequate to the needs of clinical physiology. It has been shown that the isolated administration of pentoxifylline is inferior to combined therapy by revascularizing activity. The results of the work may be an experimental justification for the feasibility of clinical application of the combination of pentoxifylline and platelets rich plasma in the treatment of diabetic angiopathy, as well as its use in prophylactic purposes in patients with diabetes mellitus.