Diabetic vascular diseases: molecular mechanisms and therapeutic strategies
Abstract Vascular complications of diabetes pose a severe threat to human health. Prevention and treatment protocols based on a single vascular complication are no longer suitable for the long-term management of patients with diabetes. Diabetic panvascular disease (DPD) is a clinical syndrome in whi...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Nature Publishing Group
2023-04-01
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| Series: | Signal Transduction and Targeted Therapy |
| Online Access: | https://doi.org/10.1038/s41392-023-01400-z |
| _version_ | 1797845724812017664 |
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| author | Yiwen Li Yanfei Liu Shiwei Liu Mengqi Gao Wenting Wang Keji Chen Luqi Huang Yue Liu |
| author_facet | Yiwen Li Yanfei Liu Shiwei Liu Mengqi Gao Wenting Wang Keji Chen Luqi Huang Yue Liu |
| author_sort | Yiwen Li |
| collection | DOAJ |
| description | Abstract Vascular complications of diabetes pose a severe threat to human health. Prevention and treatment protocols based on a single vascular complication are no longer suitable for the long-term management of patients with diabetes. Diabetic panvascular disease (DPD) is a clinical syndrome in which vessels of various sizes, including macrovessels and microvessels in the cardiac, cerebral, renal, ophthalmic, and peripheral systems of patients with diabetes, develop atherosclerosis as a common pathology. Pathological manifestations of DPDs usually manifest macrovascular atherosclerosis, as well as microvascular endothelial function impairment, basement membrane thickening, and microthrombosis. Cardiac, cerebral, and peripheral microangiopathy coexist with microangiopathy, while renal and retinal are predominantly microangiopathic. The following associations exist between DPDs: numerous similar molecular mechanisms, and risk-predictive relationships between diseases. Aggressive glycemic control combined with early comprehensive vascular intervention is the key to prevention and treatment. In addition to the widely recommended metformin, glucagon-like peptide-1 agonist, and sodium-glucose cotransporter-2 inhibitors, for the latest molecular mechanisms, aldose reductase inhibitors, peroxisome proliferator-activated receptor-γ agonizts, glucokinases agonizts, mitochondrial energy modulators, etc. are under active development. DPDs are proposed for patients to obtain more systematic clinical care requires a comprehensive diabetes care center focusing on panvascular diseases. This would leverage the advantages of a cross-disciplinary approach to achieve better integration of the pathogenesis and therapeutic evidence. Such a strategy would confer more clinical benefits to patients and promote the comprehensive development of DPD as a discipline. |
| first_indexed | 2024-04-09T17:43:35Z |
| format | Article |
| id | doaj.art-2246be3ad1904f9bb9d9fce4614e8a58 |
| institution | Directory Open Access Journal |
| issn | 2059-3635 |
| language | English |
| last_indexed | 2024-04-09T17:43:35Z |
| publishDate | 2023-04-01 |
| publisher | Nature Publishing Group |
| record_format | Article |
| series | Signal Transduction and Targeted Therapy |
| spelling | doaj.art-2246be3ad1904f9bb9d9fce4614e8a582023-04-16T11:26:26ZengNature Publishing GroupSignal Transduction and Targeted Therapy2059-36352023-04-018112910.1038/s41392-023-01400-zDiabetic vascular diseases: molecular mechanisms and therapeutic strategiesYiwen Li0Yanfei Liu1Shiwei Liu2Mengqi Gao3Wenting Wang4Keji Chen5Luqi Huang6Yue Liu7National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical SciencesNational Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical SciencesDepartment of Nephrology and Endocrinology, Wangjing Hospital, China Academy of Chinese Medical SciencesDepartment of Nephrology and Endocrinology, Wangjing Hospital, China Academy of Chinese Medical SciencesNational Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical SciencesNational Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical SciencesChina Center for Evidence-based Medicine of TCM, China Academy of Chinese Medical SciencesNational Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical SciencesAbstract Vascular complications of diabetes pose a severe threat to human health. Prevention and treatment protocols based on a single vascular complication are no longer suitable for the long-term management of patients with diabetes. Diabetic panvascular disease (DPD) is a clinical syndrome in which vessels of various sizes, including macrovessels and microvessels in the cardiac, cerebral, renal, ophthalmic, and peripheral systems of patients with diabetes, develop atherosclerosis as a common pathology. Pathological manifestations of DPDs usually manifest macrovascular atherosclerosis, as well as microvascular endothelial function impairment, basement membrane thickening, and microthrombosis. Cardiac, cerebral, and peripheral microangiopathy coexist with microangiopathy, while renal and retinal are predominantly microangiopathic. The following associations exist between DPDs: numerous similar molecular mechanisms, and risk-predictive relationships between diseases. Aggressive glycemic control combined with early comprehensive vascular intervention is the key to prevention and treatment. In addition to the widely recommended metformin, glucagon-like peptide-1 agonist, and sodium-glucose cotransporter-2 inhibitors, for the latest molecular mechanisms, aldose reductase inhibitors, peroxisome proliferator-activated receptor-γ agonizts, glucokinases agonizts, mitochondrial energy modulators, etc. are under active development. DPDs are proposed for patients to obtain more systematic clinical care requires a comprehensive diabetes care center focusing on panvascular diseases. This would leverage the advantages of a cross-disciplinary approach to achieve better integration of the pathogenesis and therapeutic evidence. Such a strategy would confer more clinical benefits to patients and promote the comprehensive development of DPD as a discipline.https://doi.org/10.1038/s41392-023-01400-z |
| spellingShingle | Yiwen Li Yanfei Liu Shiwei Liu Mengqi Gao Wenting Wang Keji Chen Luqi Huang Yue Liu Diabetic vascular diseases: molecular mechanisms and therapeutic strategies Signal Transduction and Targeted Therapy |
| title | Diabetic vascular diseases: molecular mechanisms and therapeutic strategies |
| title_full | Diabetic vascular diseases: molecular mechanisms and therapeutic strategies |
| title_fullStr | Diabetic vascular diseases: molecular mechanisms and therapeutic strategies |
| title_full_unstemmed | Diabetic vascular diseases: molecular mechanisms and therapeutic strategies |
| title_short | Diabetic vascular diseases: molecular mechanisms and therapeutic strategies |
| title_sort | diabetic vascular diseases molecular mechanisms and therapeutic strategies |
| url | https://doi.org/10.1038/s41392-023-01400-z |
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