Department of Specialistic Surgical and Anaestesiological Sciences, S. Orsola-Malpighi Hospital - University of Bologna, Via Massarenti, 9 Bld 5, 40126 Bologna, Italy.
Eur J Vasc Endovasc Surg. 2010 Sep;40(3):365-74. doi: 10.1016/j.ejvs.2010.04.011. Epub 2010 Jun 1.
To establish whether in diabetic patients with peripheral artery obstructive disease (PAOD) vasa vasorum (vv) neoangiogenesis is altered with increased arterial damage.
Thirty-three patients with PAOD and critical lower limb ischaemia, 22 with type II diabetes.
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).
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.
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.
研究在患有外周动脉阻塞性疾病（PAOD）的糖尿病患者中，血管新生是否因动脉损伤增加而发生改变。
33 名患有 PAOD 和严重下肢缺血的患者，22 名患有 2 型糖尿病。
免疫组织化学检测内皮细胞标志物（CD34 和血管性血友病因子）；实时逆转录聚合酶链反应（RT-PCR）定量评估血管内皮生长因子（VEGF）在动脉壁中的表达；酶联免疫吸附试验（ELISA）评估血液 VEGF 浓度；流式细胞术检测循环内皮细胞（CECs）。
PAOD 合并糖尿病患者的动脉粥样硬化晚期病变发生率更高（60% vs. 45%），动脉中层 CD34(+)毛细血管数量显著减少（p = 0.0003）。所有患者的外膜新生血管生成（CD34(+)和 vWF(+)）均同等增加。同样，所有患者的血液 CEC 和 VEGF 浓度以及原位 VEGF 转录表达均增加。
尽管存在促血管生成 VEGF 的原位和循环表达增加，但 PAOD 患者仍存在明显的动脉损伤；糖尿病患者的 vv 血管生成功能失调，且更容易发生壁损伤；提示在糖尿病患者的动脉壁中，vv 无法完成有效的 VEGF 驱动的动脉壁新生血管生成，从而加重了损伤。
