Subendothelial matrix as the playground for “diabetic milieu” factors in development of angiopathy

Abstract

Despite a few decades of intensive researches, the coherent view on the effector mechanisms causing development of diabetic angiopathy remains in demand. At the level of the whole organism, stable or intermittent hyperglycemia along with the altered levels of insulin, glycosylated proteins and lipoproteins, accompanied by modulation of intracellular metabolic pathways are considered as the main causative factors of diabetic micro- and macroangiopathy. At the tissue level, the general manifestation of vascular damage in diabetes appears as the basal membrane thickening. Here, based on the available literature and own experimental data, the changes in local microenvironment are considered as an important intermediate step in the realization of the effects of “diabetic milieu” factors on vessel wall cells. Special attention is paid to the carbohydrate determinants and deposition of von Willebrand factor in subendothelial matrix produced by endothelial cells in vitro.