| Effect of sulodexide on endothelial glycocalyx and vascular permeability in patients with type 2 diabetes mellitus. | |
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MedLine Citation:
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PMID: 20865240 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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AIMS/HYPOTHESIS: Endothelial glycocalyx perturbation contributes to increased vascular permeability. In the present study we set out to evaluate whether: (1) glycocalyx is perturbed in individuals with type 2 diabetes mellitus, and (2) oral glycocalyx precursor treatment improves glycocalyx properties. METHODS: Male participants with type 2 diabetes (n = 10) and controls (n = 10) were evaluated before and after 2 months of sulodexide administration (200 mg/day). The glycocalyx dimension was estimated in two different vascular beds using sidestream dark field imaging and combined fluorescein/indocyanine green angiography for sublingual and retinal vessels, respectively. Transcapillary escape rate of albumin (TER(alb)) and hyaluronan catabolism were assessed as measures of vascular permeability. RESULTS: Both sublingual dimensions (0.64 [0.57-0.75] μm vs 0.78 [0.71-0.85] μm, p < 0.05, medians [interquartile range]) and retinal glycocalyx dimensions (5.38 [4.88-6.59] μm vs 8.89 [4.74-11.84] μm, p < 0.05) were reduced in the type 2 diabetes group compared with the controls whereas TER(alb) was increased (5.6 ± 2.3% vs 3.7 ± 1.7% in the controls, p < 0.05). In line with these findings, markers of hyaluronan catabolism were increased with diabetes (hyaluronan 137 ± 29 vs 81 ± 8 ng/ml and hyaluronidase 78 ± 4 vs 67 ± 2 U/ml, both p < 0.05). Sulodexide increased both the sublingual and retinal glycocalyx dimensions in participants with diabetes (to 0.93 [0.83-0.99] μm and to 5.88 [5.33-6.26] μm, respectively, p < 0.05). In line, a trend towards TER(alb) normalisation (to 4.0 ± 2.3%) and decreases in plasma hyaluronidase (to 72 ± 2 U/ml, p < 0.05) were observed in the diabetes group. CONCLUSION/INTERPRETATION: Type 2 diabetes is associated with glycocalyx perturbation and increased vascular permeability, which are partially restored following sulodexide administration. Further studies are warranted to determine whether long-term treatment with sulodexide has a beneficial effect on cardiovascular risk. TRIAL REGISTRATION: www.trialregister.nl NTR780/ http://isrctn.org ISRCTN82695186 FUNDING: An unrestricted Novartis Foundation for Cardiovascular Excellence grant (2006) to M. Nieuwdorp/E. S. G. Stroes, Dutch Heart Foundation (grant number 2005T037). |
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Authors:
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L N Broekhuizen; B A Lemkes; H L Mooij; M C Meuwese; H Verberne; F Holleman; R O Schlingemann; M Nieuwdorp; E S G Stroes; H Vink |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2010-09-25 |
Journal Detail:
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Title: Diabetologia Volume: 53 ISSN: 1432-0428 ISO Abbreviation: Diabetologia Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-11-08 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0006777 Medline TA: Diabetologia Country: Germany |
Other Details:
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Languages: eng Pagination: 2646-55 Citation Subset: IM |
Affiliation:
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Department of Vascular Medicine, Academic Medical Centre, Room F4.211, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands. |
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Bank Name/Acc. No.:
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ISRCTN/ISRCTN82695186 |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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