Changes in the microcirculatory bed vessels in skin and muscles of patients, suffering ischemic form of the diabetic foot syndrome

Keywords: diabetes mellitus; syndrome of diabetic foot; аngiopathy; basal membranes; hemomicrocirculatory bed

Abstract

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.

Author Biographies

S. М. Didenko, Clinical Hospital «Feofania» of State Directorate for Affairs, Kyiv

Didenko S.N., PhD, vascular surgeon, Center of vascular surgery, Clinical Hospital «Feofaniya».
Address: 21 Zabolotnogo Str., 03143, Kyiv, Ukraina, tel.: +38 (044) 259-65-74
E-mail: hirurgdidenko@gmail.com
ORCID: 0000-0002-3115-7524

V. Yu. Subbotin, Clinical Hospital «Feofania» of State Directorate for Affairs, Kyiv

Subbotin V.U., vascular surgeon, head of the Center of Vascular Surgery, Clinical Hospital «Feofaniya».
Address: 21 Zabolotnogo Str., 03143, Kyiv, Ukraina, tel.: +38 (044) 259-67-70
E-mail: vitaliksub@ukr.net
ORCID: 0000-0002-1538-7004

О. V. Каlenska, Clinical Hospital «Feofania» of State Directorate for Affairs, Kyiv

Kalenska O.V., PhD, head of the pathoanatomical department, Clinical Hospital «Feofaniya».
Address: 21 Zabolotnogo Str., 03143, Kyiv, Ukraina, tel.: +38 (044) 259-67-38
E-mail: ovkalenska@ukr.net
ORCID: 0000-0002-5925-3067

L. V. Каlenska, Clinical Hospital «Feofania» of State Directorate for Affairs, Kyiv

Kalenska L.V., pathologist of the pathoanatomical department, Clinical Hospital «Feofaniya».
Address: 21 Zabolotnogo Str., 03143, Kyiv, Ukraina, tel.: +38 (044) 259-67-38
E-mail: lvkalenska@ukr.net
ORCID:0000-0002-4296-8357

І. М. Savitska, Shalimov National Institute of Surgery and Transplantology, Kyiv

Savytska I.M., Candidate of Medical Science, senior researcher, Department of Experimental Surgery, State Institute «Shalimov’s Nacional Institute of Surgeri and Transplantation» to Nacional Academy of medical Sciences of Ukrainian
30, Geroyev Sevastopolya str., Kyiv, Ukraine, 03680
irinasavitska@ukr.net / 0975100401
ORCID 0000-00020-2749-7825

Yu. М. Hupalo, Scientific-Practical Centre of Prophylactic and Clinical Medicine of State Directorate for Affairs, Kyiv

Hupalo Y.M., PhD, vascular surgeon, leading researcher at the department of minimally invasive surgery, State institution of Science «Research and Practical Center of Preventive and Clinical Medicine»
Address: 5 Verchniay Str., 01014, Kyiv, Ukraina, tel.: +380679367820
ORCID : 0000-0002-4856-1398

О. E. Shved, Scientific-Practical Centre of Prophylactic and Clinical Medicine of State Directorate for Affairs, Kyiv

Shved O.E., PhD, vascular surgeon, senior researcher at the department of minimally invasive surgery, State institution of Science «Research and Practical Center of Preventive and Clinical Medicine»
Address: 5 Verchniay Str., 01014, Kyiv, Ukraina, tel.: +390673216191
E-mail: Lenashved@ukr.net
ORCID ID: 0000-0002-7652-9301

D. U. Shapovalov, Scientific-Practical Centre of Prophylactic and Clinical Medicine of State Directorate for Affairs, Kyiv

Shapovalov D.U., vascular surgeon, junior researcher at the scientific department of minimally invasive surgery, State institution of Science «Research and Practical Center of Preventive and Clinical Medicine»
Address: 5 Verchniay Str., 01014, Kyiv, Ukraina, tel.: +380679900911
E-mail: pandanila.kiev@gmail.com
ORCID ID: 0000-0001-7419-9559

References

1. Udovichenko OV, Tokmakova AJu. Diabeticheskaja mikroangiopatija v geneze sindroma diabeticheskoj stopy Saharnyj diabet. 2001;2:14-8. [In Russian].

2. Gorshunova GN, Valiullin VV. Morfologicheskie izmenenija kozhi pri diabeticheskoj angiopatii. Zhurnal anatomii i gistopatologii. 2012;1(3):44-6. [In Russian].

3. Ametov AS. Saharnyj diabet i serdechno-sosudistye zabolevanija Russkij medicinskij zhurnal. 2014;13:954. [In Russian].

4. Contreras I, Reiser KM, Martinez N. Effects of aspirin or basic amino acids on collagen cross-links and complications in NIDDM Diabetes Care. 1997;20(5):832-5.

5. Banks W, Bale E, White F, Anat J. Morphometric studies of epidermal-dermal junctions in the rat ear: some effects of experimental friction an epidermis and anchorning friction. 1984;139(3):425-35.

6. Balabolkin MI. Rol’ glikirovanija belkov, oksidantnogo stressa v patogeneze sosudistyh oslonenij pri saharnom diabete. Saharnyj diabet. Materialy Vtorogo diabeticheskogo kongressa. 2002;4:8-16. [In Russian].

7. Emel’janov V.V. Metabolicheskie faktory uskorennogo starenija organizma u bol’nyh saharnym diabetom 2 tipa i ih korrekcija: avtoref. dis. ...kand. med. nauk. - Cheljabinsk. 2007; 24 р. [In Russian]

8. Blanpain C, Lowry W, Pasolli H. Canonical notch signaling functions as a commitment switch in the epidermal lineage Genes Dev. 2006;20:3022-35.

9. Baum H, Meurer I, Unteregger G. Ki-67 antigen expression and growth pattern of basal cell carcinomas Arch. Dermatol Res. 1993;285(5):291-5.

10. Prophet EB, Mills B, Arrington JB, Sobin L. Laboratory Methods in Histotechnology. Institute of Pathology. Washington, 1994. 274 p.

11. Petrov SV, Rajhlin NT. Rukovodstvo po immunohimicheskoj diagnostike opuholej cheloveka pod redakciej. 3 izdanie dopolnennoe i pererabotannoe. Kazan’: Izd-vo «Titul»; 2004. 456 р. [In Russian].

12. Avtandilov GG. Medicinskaja morfometrija. Rukovodstvo. Moskva: Medicina; 1990. 384 р. [In Russian].
Published
2018-03-03
How to Cite
DidenkoS. М., Subbotin, V. Y., КаlenskaО. V., КаlenskaL. V., SavitskaІ. М., HupaloY. М., ShvedО. E., & Shapovalov, D. U. (2018). Changes in the microcirculatory bed vessels in skin and muscles of patients, suffering ischemic form of the diabetic foot syndrome. Klinicheskaia Khirurgiia, 85(3), 35-38. https://doi.org/10.26779/2522-1396.2018.03.35
Section
General Problems of Surgery

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