Changes in the microcirculatory bed vessels in skin and muscles of patients, suffering ischemic form of the diabetic foot syndrome
Objective. To reveal characteristic changes in the blood vessels of skin and muscles, аs well as in basal membranes of epidermis and vessels in patients, suffering diabetic foot syndrome (DFS) and to conduct morphometric estimation for determination of the key criteria of the diabetes mellitus various stages.
Маterials and methods. There were investigated 24 examples of skin and muscles in the lower extremities (LE) of patients, suffering ischemic form of DFS on background of stenotic-occlusion affection of the LE arteries. Morphological, іmmunohistochemical investigation for determination of the proliferative activity marker Кі-67 and marker of vascular process and the basal membranes Type IV collagen were conducted. The epidermis basal membranes and the blood vessels thickness, the hemomicrocirculatory bed (HMCB) diameter in skin and muscles were measured and compared, as well as the percent of expressed basal keratinocytes.
Results. Changes in the skeletal muscles HMCB were more severe, than in the skin HMCB, witnessed by results of the PAS-positive compounds of the Type IV collagen in basal membranes of epidermis and walls of the blood vessels.
Conclusion. On background of diabetic angiopathy the keratinocytes proliferation level in the patients’ skin have lowered down to 25.8%.
Increase of the Type IV collagen marker expression was accompanied by the basal epidermis membrane thickening in 2.7 and blood vessels - in 3.1 times.
Accumulation of the Type IV collagen and glycosylated compounds have brought to narrowing of lumen in all vessels, particularly in the HMCB vessels. Internal diameter of the HMCB vessels in skin have reduced: arteriols - by 39%, venules - by 28%, capillaries - by 49%. Internal diameter of the HMCB vessels in muscles have reduced also: arteriols - by 45%, venules - by 38%, capillaries - by 51%.
In skeletal muscles the vessels’ lumen narrowing in HMCB was more pronounced, than in skin, and was accompanied by more significant pathological signs in these tissues.
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