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Titolo:
VON-WILLEBRAND-FACTOR IN DIABETIC ANGIOPATHY
Autore:
KESSLER L; WIESEL ML; ATTALI P; MOSSARD JM; CAZENAVE JP; PINGET M;
Indirizzi:
HOP CENT,SERV ENDOCRINOL & MALAD METAB,1 PL HOP F-67091 STRASBOURG FRANCE HOP UNIV STRASBOURG,SERV ENDOCRINOL F-67091 STRASBOURG FRANCE HOP UNIV STRASBOURG,ESTAB TRANSFUS SANGUINE F-67091 STRASBOURG FRANCE HOP UNIV STRASBOURG,SERV CARDIOL F-67091 STRASBOURG FRANCE
Titolo Testata:
DIABETES & METABOLISM
fascicolo: 4, volume: 24, anno: 1998,
pagine: 327 - 336
SICI:
0338-1684(1998)24:4<327:VIDA>2.0.ZU;2-W
Fonte:
ISI
Lingua:
ENG
Soggetto:
URINARY ALBUMIN EXCRETION; ENDOTHELIAL-CELL DAMAGE; VONWILLEBRAND-FACTOR; VASCULAR-DISEASE; FACTOR-VIII; CARDIOVASCULAR-DISEASE; INSULIN-RESISTANCE; FACTOR ANTIGEN; MELLITUS; DYSFUNCTION;
Keywords:
VON WILLEBRAND FACTOR; DIABETES; ANGIOPATHY; ENDOTHELIAL DYSFUNCTION;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
60
Recensione:
Indirizzi per estratti:
Citazione:
L. Kessler et al., "VON-WILLEBRAND-FACTOR IN DIABETIC ANGIOPATHY", DIABETES & METABOLISM, 24(4), 1998, pp. 327-336

Abstract

Diabetes mellitus is a complex disease characterised by chronic hyperglycaemia responsible for complications affecting the kidneys, eyes, peripheral nerves and micro- and macrovascular systems. Van Willebrand factor (vWf), a multimeric glycoprotein mainly synthesised by endothelial cells, is involved in platelet adhesion and aggregation and acts as the carrier of coagulation factor VIII in plasma. Increased levels of vWf, reflecting activation of or damage to endothelial cells, have been described in association with atherosclerosis and diabetes. vWf appears to be a predictive marker of diabetic nephropathy and neuropathy, although not of retinopathy, which suggests that endothelial dysfunction precedes the onset of diabetic microangiopathy. This dysfunction could he especially involved in the pathogenesis of renal abnormalities of diabetes. vWf is not a predictive marker of macroangiopathy when diabetes is associated with atherosclerotic risk factors. In the presence of chronic diabetic complications, vWf levels are not associated with any grade of retinopathy but increase with the severity of nephropathy and would appear to be a risk factor for macrovascular mortality in these patients. The endothelial dysfunction of diabetes can generate atherosclerotic lesions responsible for damage to the arterial wall,atheroma and formation of platelet microaggregates. Concomitant with high vWf levels, other possible mechanisms of endothelial damage include reduced synthesis or release of nitric oxide, hyperglycaemic pseudohypoxia and protein kinase-C activation, increased synthesis of proteins bearing advanced glycosylation end-products or transforming growth factor-beta (TGF-beta) activation of coagulation and inhibition of fibrinolysis. At present, it is not known whether high vWf levels are inherent to the physiopathology of diabetes, nor whether diabetes inducesendothelial dysfunction through other pathways, However, since angiopathy resulting from endothelial dysfunction is the main cause of morbidity and mortality in diabetic patients, appropriate therapy is necessary to reduce these complications. Glycaemic control seems to he insufficient to normalise plasma vWf, whereas a decrease can be obtained byingestion of diets rich in oleic acid or by treatment with statins. Inhibition of the binding of vWf to the GP1ba receptor by synthetic peptides, aurin tricarboxylic acid or monoclonal antibodies has been proposed to prevent the thrombosis induced by high levels of plasma vWf. Thus, vWf probably represents an interesting target for the inhibition of thrombosis in diabetes.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 25/11/20 alle ore 04:48:47