Inflammatory Mechanisms of Diabetes and Its Vascular Complications

Abstract

The main cause of death in patients with type 2 DM is cardiovascular complications resulting from the progression of atherosclerosis. The pathophysiology of the association between diabetes and its vascular complications is complex and multifactorial and closely related to the toxic effects of hyperglycemia that causes increased generation of reactive oxygen species and promotes the secretion of pro-inflammatory cytokines. Subsequent oxidative stress and inflammation are major factors of the progression of type 2 DM and its vascular complications. Data on the pathogenesis of the development of type 2 DM and associated cardiovascular diseases, in particular atherosclerosis, open up broad prospects for the further development of new diagnostic and therapeutic approaches.

Anti-inflammatory role of SGLT2 inhibitors as part of their anti-atherosclerotic activity: Data from basic science and clinical trials

“…As described before, inflammation is a significant factor in vascular cell dysfunction, causing the development and progression of atherosclerosis in diabetes ( 45 ).…”

Atheroprotective Effects of Glycyrrhiza glabra L.

“…It is generally accepted that inflammatory mechanisms play a key role in the development of atherosclerosis [ 23 , 24 , 25 ]. Pathophysiologically, the inflammatory process at an early stage of atherogenesis includes the following stages: inflammatory activation of endothelial cells, recruitment of monocytes and other leukocytes to the intima of the vessel, the transition of monocytes to tissue macrophages, the uptake of multiple modified atherogenic LDL by macrophages with the formation of foam cells, their secretion of inflammatory cytokines, reactive oxygen species (ROS) and other mediators, which subsequently leads to the death of foam cells (for example, as a result of apoptosis) and the formation of atherosclerotic plaque [ 26 , 27 , 28 ]. Bioactive components of G. glabra may influence the above stages of inflammation associated with atherogenesis, thus exerting an anti-atherosclerotic effect [ 9 ].…”

Potential Roles of Anti-Inflammatory Plant-Derived Bioactive Compounds Targeting Inflammation in Microvascular Complications of Diabetes

“…Inflammation plays a crucial role in metabolic dysregulation. The inhibition of inflammation is considered as a metabolically protective process that decreases the development of T2DM and insulin resistance [ 50 ]. The insulin resistance of skeletal muscles, adipose tissues, and the liver, induces insulin secretion from the pancreas, which further maintains a normal blood sugar level [ 51 , 52 , 53 ].…”

“…Interestingly, these target tissues have their own specialized macrophages to keep tissue integrity and support crucial physiological activities. In addition, at each stage of the development of T2DM, the number of macrophages in these tissues goes through alteration [ 50 , 54 , 55 ].…”

“…In obesity, continuous metabolic pressure can disturb important ER activities, which can further cause metabolic collapse, inflammation, and weakened cellular health [ 56 ]. Furthermore, hyperglycemia can significantly induce reactive oxygen species (ROS), which can further lead to an elevated level of activation of inflammatory signaling pathways [ 50 ]. T2DM and T2DM-linked cardiovascular complications, including macrophages/monocytes and atherosclerosis, have significant contributions in regulating inflammation.…”