Increased erythrocyte- and platelet-derived microvesicles in newly diagnosed type 2 diabetes mellitus

Gkaliagkousi, Εugenia; Nikolaidou, Barbara; Lazaridis, Αntonios; Yiannaki, E.; Anyfanti, Panagiota; Zografou, Ioanna; Markala, Dimitra; Δούμα, Στέλλα

doi:10.1177/1479164119844691

Cited by 44 publications

(39 citation statements)

References 47 publications

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“…Activated platelets with an increased mean volume [mean platelet volume (MPV)] secrete microparticles (MPs) and soluble adhesion molecules (e.g., sP-selectin and sCD40L) that in turn activate endothelial and immune cells ( 67 – 69 ). Higher levels of platelet-derived MPs, which correlate positively with fasting blood sugar and glycated hemoglobin, have been shown in newly diagnosed T2DM patients compared to healthy individuals ( 70 ).…”

Section: Effects Of T2dm On the Circulatory Systemmentioning

confidence: 99%

The Effects of Type 2 Diabetes Mellitus on Organ Metabolism and the Immune System

et al. 2020

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Metabolic abnormalities such as dyslipidemia, hyperinsulinemia, or insulin resistance and obesity play key roles in the induction and progression of type 2 diabetes mellitus (T2DM). The field of immunometabolism implies a bidirectional link between the immune system and metabolism, in which inflammation plays an essential role in the promotion of metabolic abnormalities (e.g., obesity and T2DM), and metabolic factors, in turn, regulate immune cell functions. Obesity as the main inducer of a systemic low-level inflammation is a main susceptibility factor for T2DM. Obesity-related immune cell infiltration, inflammation, and increased oxidative stress promote metabolic impairments in the insulin-sensitive tissues and finally, insulin resistance, organ failure, and premature aging occur. Hyperglycemia and the subsequent inflammation are the main causes of micro-and macroangiopathies in the circulatory system. They also promote the gut microbiota dysbiosis, increased intestinal permeability, and fatty liver disease. The impaired immune system together with metabolic imbalance also increases the susceptibility of patients to several pathogenic agents such as the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Thus, the need for a proper immunization protocol among such patients is granted. The focus of the current review is to explore metabolic and immunological abnormalities affecting several organs of T2DM patients and explain the mechanisms, whereby diabetic patients become more susceptible to infectious diseases.

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Section: Effects Of T2dm On the Circulatory Systemmentioning

confidence: 99%

The Effects of Type 2 Diabetes Mellitus on Organ Metabolism and the Immune System

et al. 2020

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“…Among them, endothelial MVs are characterized by significant biological properties implicating them in several pathophysiological pathways, including the pathogenesis of CV diseases. Elevated endothelial MVs have been reported in patients with a variety of CV comorbidities, including diabetes, hypertension, acute coronary syndromes, and chronic ischemic heart disease [11,12,33]. Not only do they represent markers of endothelial dysfunction, but are also considered conveyors of biological messages between cells, which are implicated in the evolvement of vascular damage.…”

Section: Discussionmentioning

confidence: 99%

“…Several markers have been suggested for assessment of vascular injury [10]. Microvesicles (MVs) have also been recently acknowledged as potential markers in patients with high CV risk [11,12].…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, platelet microvesicles (PMVs) participate in several homeostatic responses and pathogenic processes including inflammation, atherosclerosis, immunity, and cancer [16]. Recently, erythrocyte MVs have also been implicated in patients with increased CV risk [12], with emerging evidence from basic research that suggests a potent thrombo-inflammatory role [17]. Such novel markers also aim to better characterize the substantial residual CV risk in high-risk patients, which is not effectively treated with current therapeutic options [18,19].…”

Section: Introductionmentioning

confidence: 99%

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Assessment of Endothelial Injury and Pro-Coagulant Activity Using Circulating Microvesicles in Survivors of Allogeneic Hematopoietic Cell Transplantation

Gavriilaki

Sakellari

Anyfanti

et al. 2020

IJMS

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(1) Background: survivors of allogeneic hematopoietic cell transplantation (alloHCT) suffer from morbidity and mortality due to cardiovascular events. We hypothesized that vascular injury and pro-coagulant activity are evident in alloHCT survivors without existing alloHCT complications or relapse. (2) Methods: we enrolled consecutive adult alloHCT survivors without established cardiovascular disease and control individuals matched for traditional cardiovascular risk factors (January–December 2019). Circulating microvesicles (MVs) of different cellular origins (platelet, erythrocyte, and endothelial) were measured by a standardized flow cytometry protocol as novel markers of vascular injury and pro-coagulant activity. (3) Results: we recruited 45 survivors after a median of 2.3 (range 1.1–13.2) years from alloHCT, and 45 controls. The majority of patients suffered from acute (44%) and/or chronic (66%) graft-versus-host disease (GVHD). Although the two groups were matched for traditional cardiovascular risk factors, alloHCT survivors showed significantly increased platelet and erythrocyte MVs compared to controls. Within alloHCT survivors, erythrocyte MVs were significantly increased in patients with a previous history of thrombotic microangiopathy. Interestingly, endothelial MVs were significantly increased only in alloHCT recipients of a myeloablative conditioning. Furthermore, MVs of different origins showed a positive association with each other. (4) Conclusions: endothelial dysfunction and increased thrombotic risk are evident in alloHCT recipients long after alloHCT, independently of traditional cardiovascular risk factors. An apparent synergism of these pathophysiological processes may be strongly involved in the subsequent establishment of cardiovascular disease.

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“…Accelerated atherosclerosis in DM is multifactorial, involving endothelial dysfunction, platelet activation, thrombin generation and inflammation (Figure 1(a)). Platelet activation can be detected already in impaired glucose tolerance and newly diagnosed T2DM, 8,9 also in animal models. 10 Altered platelet generation reported in DM appears to be characterised by megakaryocyte aneuploidy, 11 increased platelet mass, 12 altered platelet count versus volume ratio 8,12 and increased young and hyperreactive platelets.…”

Section: Platelet Activationmentioning

confidence: 99%

Antithrombotic therapy and revascularisation strategies in people with diabetes and coronary artery disease

Rocca¹,

Rubboli

Zaccardi³

2019

Eur J Prev Cardiolog

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Background Diabetes mellitus, largely type 2, affects nearly 10% of the global adult population according to the World Health Organization. Diabetes is an independent risk factor for atherosclerotic cardiovascular diseases, including coronary artery disease. Diabetes patients experience a two to three-fold increased incidence of coronary artery disease, despite improved metabolic control and management of other cardiovascular risk factors. Discussion Platelet abnormalities and activation as well as reduced antiplatelet drug responsiveness characterise diabetes mellitus. Mechanisms linking diabetes to platelet and vascular abnormalities, atherogenesis and atherosclerotic cardiovascular disease are still only partially known, highlighting the unique complexity of the pro-atherogenic clinical scenario and its treatment. Consistently, a higher residual cardiovascular risk characterises patients with diabetes compared with those without, in spite of improved antiplatelet and antithrombotic treatment combinations. Randomised clinical trials aimed at optimising antiplatelet treatment specifically in patients with diabetes are lacking, both in acute and chronic coronary artery disease settings. Thus, patients with diabetes are treated with regimens validated in studies including only variable proportions of diabetes patients. Myocardial revascularisation appears to confer a comparable relative benefit between diabetes patients and patients without diabetes, and generally coronary artery bypass grafting has a better outcome in diabetes mellitus versus peripheral coronary intervention. New glucose-lowering drugs have been shown to reduce the incidence of major cardiovascular events in secondary prevention. Type 1 diabetes mellitus remains less explored than type 2 in this context. Conclusion Diabetes-tailored antithrombotic strategies in acute and chronic coronary artery disease remain an unmet clinical need, requiring ad-hoc trials and precision pharmacological strategies.

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Increased erythrocyte- and platelet-derived microvesicles in newly diagnosed type 2 diabetes mellitus

Cited by 44 publications

References 47 publications

The Effects of Type 2 Diabetes Mellitus on Organ Metabolism and the Immune System

The Effects of Type 2 Diabetes Mellitus on Organ Metabolism and the Immune System

Assessment of Endothelial Injury and Pro-Coagulant Activity Using Circulating Microvesicles in Survivors of Allogeneic Hematopoietic Cell Transplantation

Antithrombotic therapy and revascularisation strategies in people with diabetes and coronary artery disease

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