Investigating The Aetiology And Pathophysiology Of Renal Microvascular Complications

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There have been a number of manuscripts reporting on the association of complications in type 2 diabetes with high glucose blood levels, high levels of C-Peptide, high advanced glycation end products (AGEs) and vascular cell adhesion molecule-1 (VCAM-1) and oxidative stress. In order to further investigate the aetiology and pathophysiology of renal microvascular complications in type 2 diabetes, papers were reviewed through 2000 using the NIH PubMed Literature Search System. Inclusion criteria were that manuscripts 1) be primary peer-review research article; 2) concisely explained, or investigated, the pathophysiology of renal microvascular complications in type 2 diabetes; 3) be published in English. High blood glucose levels and…show more content…
Enhanced oxidative stress and changes in antioxidant capacity, found in both clinical and experimental diabetes, are thought to be the main cause of chronic diabetic complications, in particular at a microvascular level (Moussa 2008). Excessively high levels of free radicals cause damage to vital cellular components such as proteins, membrane lipids, and nucleic acids, and finally lead to cell death (Maritim, Sanders & Watkins 2003). The formation of advanced glycation end products (AGEs), is another factor to be considered in diabetes type 2 microvascular nephropathy (Motawi et al., 2013). Interaction of AGEs with their cellular receptors (RAGE) has an important role in the pathogenesis of diabetic complications via enhanced expression of adhesion molecules, including vascular cell adhesion molecule-1 (VCAM-1), and intercellular adhesion molecule-1 (ICAM-1), both markers of vascular injury (Motawi et al., 2013). Motawi et al. (2013) advanced the hypothesis that tight glycemic control may restore plasma levels of sRAGE, VCAM-1 and oxidative stress parameters near the normal level in type 2 diabetic patients, reported as a decoy receptor for AGEs. Motawi et al. (2003) demonstrated that poor glycemic control decreases plasma sRAGE and increases VCAM-1 levels while good glycemic control improves these abnormalities which provides benefit to diabetic patients. Many other studies (Nakamura et al., 2008;
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