Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 1.736
5-Year Impact Factor – 2.135
Index Copernicus  – 168.52
MEiN – 70 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

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Advances in Clinical and Experimental Medicine

2011, vol. 20, nr 3, May-June, p. 243–248

Publication type: editorial article

Language: English

Angiogenesis in Diabetic Foot Syndrome

Angiogeneza w zespole stopy cukrzycowej

Ewelina Drela1,, Barbara Ruszkowska1,, Arleta Kulwas1,, Beata Małecka1,, Danuta Rość1,

1 Department of Pathophysiology Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Poland

Abstract

Postnatal new blood vessel formation occurs via the process of angiogenesis. Under normal conditions, angiogenesis takes part in placenta development, the reproductive cycle, embryo implantation, muscle remodeling after exercise-induced training or wound healing. Angiogenesis is a multi-step process controlled by many cytokines such as VEGF, TGF, FGF or trombospondin. A disturbing balance between cytokines regulates this process or creates new, different, pathological conditions which lead to incorrect angiogenesis or its impairment. Abnormal angiogenesis is observed in patients with diabetic foot syndrome. Impairment of new blood vessel development contributes to the delay of tissue granulation. Incorrect circulation leads to tissues ischemia. The consequence of this long-lasting state is necrosis, leading to amputation. About twenty-five percent of patients with diabetic foot have an amputation. The following fact shows a dire prognosis: about seventy-five percent of patients live no longer than five rears after onset. Angiogenesis and angiogenic factor studies, especially those of vascular endothelial growth, are creating new therapeutic targets. Growth factor treatment is bringing new hope and concerns to the medical world. That is the direction of knowledge about angiogenic factors and angiogenesis that needs to be intensified.

Streszczenie

Powstawanie naczyń krwionośnych postnatalnie zachodzi najczęściej na drodze angiogenezy. W prawidłowych warunkach następuje podczas tworzenia łożyska, implantacji zarodka, remodelingu mięśni lub gojenia ran. Angiogeneza jest wieloetapowym procesem regulowanym przez wiele cytokin, do których należą: VEGF, TGF, FGF, trombospondyna. Naruszenie równowagi między czynnikami inicjującymi i hamującymi proces tworzenia naczyń prowadzi do nieprawidłowej angiogenezy. Zaburzoną angiogenezę obserwuje się u chorych leczonych diabetologicznie z zespołem stopy cukrzycowej. Nieprawidłowe tworzenie nowych naczyń opóźnia proces ziarninowania rany. Wadliwe krążenie przedłuża stan niedokrwienia, a następstwem długotrwałego niedotlenienia jest martwica prowadząca do amputacji. Amputację przeprowadza się u prawie 25% pacjentów z zespołem stopy cukrzycowej. Wykonanie amputacji kończyny dolnej jest obarczone złym rokowaniem: aż 75% pacjentów nie przeżywa kolejnych 5 lat. Badania nad angiogenezą i czynnikami ją kontrolującymi, zwłaszcza vascular endothelial growth factor, stwarzają nowe możliwości terapeutyczne. Zastosowanie czynników wzrostowych w leczeniu stopy cukrzycowej niesie ze sobą wielkie nadzieje, ale też obawy. Zasadne jest więc przeprowadzanie badań i zgłębianie wiedzy na temat angiogenezy w zespole stopy cukrzycowej.

Key words

angiogenesis, diabetic foot syndrome, vascular endothelial growth factor

Słowa kluczowe

angiogeneza, zespół stopy cukrzycowej, naczyniowo-śródbłonkowy czynnik wzrostu

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