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Quantitative evaluation of retinal vascular morphology based on the human visual bionic mechanism for the evaluation of diabetic retinopathy onset 基于人眼视觉仿生机制的视网膜血管形态定量评价对糖尿病视网膜病变发病的评价
IF 2.7 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2026-01-06 DOI: 10.1016/j.mvr.2026.104901
Yi Xu , Yuting Wu , Saiguang Ling , Zhou Dong , Xin Ke , Lina Lu , Zheng Ye , Jianling Song , Haidong Zou

Background and aims

A limited amount of diabetic retinopathy (DR) development can be explained by traditional risk factors. This study aimed to determine the association of artificial intelligence (AI)-assisted retinal vasculature measurement parameters with DR onset in adults with type 2 diabetes.

Methods

This observational cohort study was conducted in 556 patients with type 2 diabetes without DR who underwent general and ophthalmological examinations. Their blood pressure, body mass index (BMI), fasting blood glucose (FBG), and glycosylated hemoglobin levels were measured. An AI-based fundus image analysis system was used to assess vessel tortuosity, fractal dimension, and retinal arteriolar/venular diameters in different regions.

Results

At the end of the observation period, 299 patients remained free of DR (control group), whereas 257 developed DR (progression group). The retinal arteriolar caliber, venular caliber, arteriolar tortuosity, and venular tortuosity did not differ significantly between the groups at baseline (P > 0.05). However, DR onset was significantly correlated with retinal arteriolar caliber, fractal dimensions, and retinal venular tortuosity (P < 0.05). The widening of the retinal arteriolar diameter within the 1.5–2.0 PD region of the optical disc center was the strongest predictor of DR development. It also improved the performance of the DR onset prediction model compared with those using traditional risk factors alone.

Conclusions

AI-assisted retinal vasculature measurements were associated with DR onset and progression. In addition to increased retinal venular tortuosity and fractal dimension, retinal arteriolar caliber within the 1.5–2.0 PD may serve as a valuable biomarker of early vascular dysfunction and increased DR risk.
背景与目的:传统的危险因素可以解释少量糖尿病视网膜病变(DR)的发生。本研究旨在确定人工智能(AI)辅助视网膜血管测量参数与成人2型糖尿病患者DR发病的关系。方法对556例无DR的2型糖尿病患者进行了观察性队列研究。测量他们的血压、体重指数(BMI)、空腹血糖(FBG)和糖化血红蛋白水平。采用基于人工智能的眼底图像分析系统对不同区域的血管弯曲度、分形维数和视网膜小静脉直径进行评估。结果观察结束时,299例患者未发生DR(对照组),257例患者发生DR(进展组)。各组视网膜小动脉口径、静脉口径、小动脉迂曲度和静脉迂曲度在基线时无显著差异(P > 0.05)。然而,DR的发病与视网膜小动脉直径、分形维数和视网膜小静脉弯曲度有显著相关(P < 0.05)。在光盘中心1.5-2.0 PD区域内视网膜小动脉直径的扩大是DR发展的最强预测因子。与仅使用传统危险因素的预测模型相比,该方法还提高了DR发病预测模型的性能。结论人工智能辅助视网膜血管测量与DR的发生和进展有关。除了视网膜静脉曲度和分形维数增加外,1.5-2.0 PD内的视网膜小动脉直径可能是早期血管功能障碍和DR风险增加的有价值的生物标志物。
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引用次数: 0
Erythrocyte rheology under anesthesia: Insights from glycated and non-glycated red blood cells 麻醉下的红细胞流变学:糖化和非糖化红细胞的观察。
IF 2.7 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2025-12-22 DOI: 10.1016/j.mvr.2025.104900
Marcus V. Batista da Silva , Horacio V. Castellini , Nicolás A. Alet , Bibiana D. Riquelme , Analía I. Alet
Hemorheological alterations in diabetes mellitus complicate surgical outcomes. This study investigated the rheological effects of commonly used anesthetic drugs (propofol, remifentanil, vecuronium, and their combinations) on healthy human erythrocytes and on glycated erythrocytes in vitro to simulate diabetic hyperglycemia. Experiments were performed using an erythrocyte rheometer, an optical aggregometer, and digital image analysis. The results demonstrate that these anesthetic drugs increase erythrocyte aggregation. Propofol and its combinations showed a possible synergistic effect, resulting in the formation of larger aggregates. Viscoelasticity analysis of non-glycated erythrocytes showed that propofol alone increased the elastic modulus. Conversely, the combination of propofol, remifentanil, and vecuronium decreased the erythrocyte stationary storage modulus, suggesting possible interactions with the cytoskeleton and lipid bilayer. In glycated erythrocytes, the same drug combinations did not significantly affect viscoelastic parameters. These findings indicate that these drugs, when evaluated at clinically relevant concentrations, affect hemorheological parameters differently in non-glycated and glycated erythrocytes. These results provide information that could help in understanding microvascular complications in diabetic patients during and after surgical procedures.
糖尿病患者的血液流变学改变使手术结果复杂化。本研究研究了常用麻醉药物(异丙酚、瑞芬太尼、维库溴铵及其联合用药)对体外模拟糖尿病高血糖的健康人红细胞和糖化红细胞的流变学影响。实验使用红细胞流变仪、光学聚集仪和数字图像分析进行。结果表明,这些麻醉药物增加红细胞聚集。异丙酚及其组合可能表现出协同效应,导致形成更大的聚集体。非糖化红细胞的粘弹性分析表明,单独使用异丙酚可增加红细胞的弹性模量。相反,异丙酚、瑞芬太尼和维库溴铵联合使用会降低红细胞固定储存模量,提示可能与细胞骨架和脂质双分子层相互作用。在糖化红细胞中,相同的药物组合对粘弹性参数没有显著影响。这些发现表明,在临床相关浓度下,这些药物对非糖化红细胞和糖化红细胞的血液流变学参数的影响不同。这些结果提供了有助于了解糖尿病患者手术期间和手术后微血管并发症的信息。
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引用次数: 0
Comparative analysis of retinal and choroidal microvascular characteristics by gender in myopic children: A SS-OCTA study 近视儿童视网膜和脉络膜微血管特征的性别比较分析:SS-OCTA研究。
IF 2.7 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2025-12-20 DOI: 10.1016/j.mvr.2025.104899
Ting Guo , Mingli He , Fangyuan Zhou , Ruoyu Zhang , Yishuang Xu , Zhen Chen , Dihao Hua

Purpose

To investigate gender differences in retinal and choroidal thickness and vascular density (VD) among myopic children using swept-source OCT angiography (SS-OCTA).

Methods

This cross-sectional study included 673 Chinese myopic children (8–16 years; 305 males, 368 females). Macular and optic disc regions were imaged. Parameters were compared using ANCOVA adjusted for age and refractive error, with supplementary partial correlation analyses.

Results

Females showed significantly lower foveal and parafoveal superficial vascular complex (SVC) and macular choriocapillaris (CC) VD (all P < 0.05). Axial length (AL) correlated positively with foveal and parafoveal thickness and VD, and negatively in the perifovea (all P < 0.05).It also positively correlated with RNFL and GCC thickness, SVC, and RPC VD in temporal optic-disc sectors (r = 0.11 to 0.19, P < 0.01), and negatively in nasal sectors (r = −0.11 to −0.23, P < 0.01). In males, correlations between AL and foveal SVC VD (Z = −2.53, P < 0.05), AL and parafoveal deep vascular complex VD (Z = −2.34, P < 0.05), and SE and perifoveal CC VD (Z = −2.82, P < 0.01) were significantly stronger.

Conclusions

Females exhibited reduced SVC and CC VD. Both genders showed significant associations between refractive parameters and vascular parameters, with partially stronger correlations observed in males. These gender differences in ocular blood flow suggest that gender may influence vascular alterations associated with myopia, warranting further research. Recognition of gender-based differences in ocular vasculature and structure may inform individualized myopia-control strategies and improve treatment efficacy across genders.
目的:应用扫描源OCT血管造影(SS-OCTA)研究近视儿童视网膜、脉络膜厚度和血管密度(VD)的性别差异。方法:对673名中国近视儿童(8-16岁 )进行横断面研究,其中男性305名,女性368名。黄斑和视盘区域成像。采用年龄和屈光不正校正后的ANCOVA进行参数比较,并辅以偏相关分析。结果:女性表现出较低的中央凹和中央凹旁浅血管复合(SVC)和黄斑绒毛膜毛细血管(CC) VD(均P )。两性的屈光参数和血管参数之间都有显著的相关性,其中男性的相关性更强。这些眼血流量的性别差异表明,性别可能影响与近视相关的血管改变,值得进一步研究。认识到基于性别的眼部血管和结构的差异,可以为个性化的近视控制策略提供信息,并提高性别间的治疗效果。
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引用次数: 0
Impact of the menstrual cycle phase on microvascular function at high altitude 高海拔地区月经周期阶段对微血管功能的影响。
IF 2.7 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2025-12-13 DOI: 10.1016/j.mvr.2025.104898
Guia Tagliapietra , Giorgio Manferdelli , Tom Citherlet , Antoine Raberin , Benjamin J. Narang , Tadej Debevec , Grégoire P. Millet
Ovarian hormones may modulate key physiological functions that play a crucial role in the acute response to hypoxia. Women remain underrepresented in high-altitude physiology research. This exploratory study aimed to investigate the impact of menstrual cycle (MC) phases on resting skeletal muscle oxygen consumption and post-occlusive microvascular reactive hyperemia in the lower limbs during acute high-altitude exposure in eumenorrheic women. Microvascular function was assessed via vascular occlusion test in combination with near-infrared spectroscopy on the vastus lateralis muscle. Measurements were conducted at low altitude (1224 m) and after one night at 3375 m (inspired O2 pressure: 96 ± 1 mmHg) during both the early follicular (EF) and mid-luteal (ML) phases. At high altitude, baseline tissue saturation index (TSI) (65.0 ± 4.8 vs. 66.1 ± 2.7 %; p = 0.559), desaturation rate (−0.086 ± 0.061 vs. −0.080 ± 0.039 %·s−1; p = 0.920), normalized reperfusion slope (0.013 ± 0.010 vs. 0.014 ± 0.005 %·s−1; p = 0.100) and minimum TSI (52.9 ± 6.8 vs. 53.9 ± 3.9 %; p = 0.647) did not differ significantly between EF and ML. Reperfusion rate decreased significantly from low (0.894 ± 0.320) to high altitude during both EF (0.661 ± 0.424; p = 0.027) and ML (0.722 ± 0.253; p = 0.027). These findings suggest that microvascular function is not significantly modulated by the MC at 3375 m. This study adds further evidence suggesting that no specific recommendation regarding the optimal menstrual cycle phase for acute high-altitude exposure is warranted.
卵巢激素可能调节在缺氧急性反应中起关键作用的关键生理功能。女性在高海拔生理学研究中的代表性仍然不足。本探索性研究旨在探讨月经周期(MC)阶段对急性高海拔暴露绝经期女性下肢静息骨骼肌耗氧量和闭塞后微血管反应性充血的影响。通过血管闭塞试验结合近红外光谱对股外侧肌进行微血管功能评估。在低海拔(1224 m)和3375 m(吸气O2压:96 ± 1 mmHg)一晚后,在卵泡早期(EF)和黄体中期(ML)阶段进行测量。在高海拔,基线组织饱和指数(TSI)(65.0 ±  4.8和66.1±2.7  %;p = 0.559),稀释率(-0.086 ±  0.061和-0.080±0.039  %·s - 1; p = 0.920),归一化再灌注斜率( 0.013±0.010 vs 0.014  ±0.005  %·s - 1; p = 0.100)和最小TSI( 52.9±6.8 vs 53.9  ±3.9  %;p = 0.647)EF和毫升之间没有显著差异。再灌注率显著降低从低(0.894 ±0.320 )在EF(高海拔0.661 ± 0.424;p = 0.027)和ML(0.722±0.253;p = 0.027)。这些发现表明,在3375 m处,微血管功能不受MC的显著调节。这项研究提供了进一步的证据,表明没有关于急性高海拔暴露的最佳月经周期的具体建议是必要的。
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引用次数: 0
Vascular diameter and responsiveness to soluble guanylate cyclase modulators: A systematic review of preclinical and clinical evidence 血管直径和对可溶性鸟苷酸环化酶调节剂的反应性:临床前和临床证据的系统回顾。
IF 2.7 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2025-12-07 DOI: 10.1016/j.mvr.2025.104896
M.S. Josef

Background

Vessel diameter has been proposed as a determinant of responsiveness to soluble guanylate cyclase (sGC) modulators, but available evidence remains heterogeneous across species and experimental settings. Understanding these relationships is important for improving translational interpretation and therapeutic use of sGC stimulators and activators.

Methods

A systematic review was performed according to PRISMA principles, identifying in vitro, in vivo, and clinical studies that examined vascular or signaling responses to sGC stimulators or activators in vessels of defined diameter. Data were extracted on vessel type, size, species, disease model, compound class, and measured outcomes such as vasorelaxation or cyclic guanosine monophosphate (cGMP) production. Methodological quality and risk of bias were assessed using SYRCLE, Cochrane RoB 2.0, and ROBINS-I tools. Additional relevant studies identified after the main search were summarized as supporting evidence.

Results

Fifty-three studies met inclusion criteria (thirty-eight preclinical, fifteen clinical). In general, smaller vessels showed stronger relaxation and higher cGMP responses to sGC activators, while the evidence for sGC stimulators was more heterogeneous and less consistently diameter-dependent. The magnitude of this relationship varied with species, vascular bed, and oxidative or pathological conditions. Human tissue studies often lacked information on pre-analytical factors such as ischemia time or donor characteristics. Across study designs, risk-of-bias assessment indicated predominantly moderate or high risk, largely due to incomplete methodological reporting and limited control for confounding.

Conclusions

Current evidence supports a size-dependent pattern of vascular responsiveness to sGC modulators, but inference strength is constrained by heterogeneous methodologies and inconsistent reporting. Future work should implement standardized vessel classification, rigorous biospecimen handling, and transparent methodological documentation to clarify the clinical significance of vessel diameter in sGC-based therapy.
背景:血管直径被认为是对可溶性鸟苷酸环化酶(sGC)调节剂的反应性的决定因素,但现有的证据在物种和实验环境中仍然存在差异。了解这些关系对于改善sGC刺激剂和激活剂的翻译解释和治疗使用是重要的。方法:根据PRISMA原则进行系统综述,确定体外、体内和临床研究,检查血管或信号对sGC刺激剂或激活剂在规定直径的血管中的反应。提取有关血管类型、大小、种类、疾病模型、化合物类别和测量结果(如血管松弛或环鸟苷单磷酸(cGMP)产生)的数据。采用sycle、Cochrane RoB 2.0和ROBINS-I工具评估方法学质量和偏倚风险。在主要检索后发现的其他相关研究被总结为支持证据。结果:53项研究符合纳入标准(38项临床前研究,15项临床研究)。一般来说,较小的血管对sGC激活剂表现出更强的舒张和更高的cGMP反应,而sGC刺激剂的证据则更加不均匀,并且不太一致地依赖于直径。这种关系的大小随物种、血管床、氧化或病理条件而变化。人体组织研究通常缺乏诸如缺血时间或供体特征等分析前因素的信息。在整个研究设计中,偏倚风险评估显示主要是中度或高风险,主要是由于方法学报告不完整和混淆控制有限。结论:目前的证据支持血管对sGC调节剂反应的大小依赖模式,但推断强度受到不同方法和不一致报道的限制。未来的工作应该实施标准化的血管分类、严格的生物标本处理和透明的方法学文件,以阐明血管直径在sgc治疗中的临床意义。
{"title":"Vascular diameter and responsiveness to soluble guanylate cyclase modulators: A systematic review of preclinical and clinical evidence","authors":"M.S. Josef","doi":"10.1016/j.mvr.2025.104896","DOIUrl":"10.1016/j.mvr.2025.104896","url":null,"abstract":"<div><h3>Background</h3><div>Vessel diameter has been proposed as a determinant of responsiveness to soluble guanylate cyclase (sGC) modulators, but available evidence remains heterogeneous across species and experimental settings. Understanding these relationships is important for improving translational interpretation and therapeutic use of sGC stimulators and activators.</div></div><div><h3>Methods</h3><div>A systematic review was performed according to PRISMA principles, identifying in vitro, in vivo, and clinical studies that examined vascular or signaling responses to sGC stimulators or activators in vessels of defined diameter. Data were extracted on vessel type, size, species, disease model, compound class, and measured outcomes such as vasorelaxation or cyclic guanosine monophosphate (cGMP) production. Methodological quality and risk of bias were assessed using SYRCLE, Cochrane RoB 2.0, and ROBINS-I tools. Additional relevant studies identified after the main search were summarized as supporting evidence.</div></div><div><h3>Results</h3><div>Fifty-three studies met inclusion criteria (thirty-eight preclinical, fifteen clinical). In general, smaller vessels showed stronger relaxation and higher cGMP responses to sGC activators, while the evidence for sGC stimulators was more heterogeneous and less consistently diameter-dependent. The magnitude of this relationship varied with species, vascular bed, and oxidative or pathological conditions. Human tissue studies often lacked information on pre-analytical factors such as ischemia time or donor characteristics. Across study designs, risk-of-bias assessment indicated predominantly moderate or high risk, largely due to incomplete methodological reporting and limited control for confounding.</div></div><div><h3>Conclusions</h3><div>Current evidence supports a size-dependent pattern of vascular responsiveness to sGC modulators, but inference strength is constrained by heterogeneous methodologies and inconsistent reporting. Future work should implement standardized vessel classification, rigorous biospecimen handling, and transparent methodological documentation to clarify the clinical significance of vessel diameter in sGC-based therapy.</div></div>","PeriodicalId":18534,"journal":{"name":"Microvascular research","volume":"164 ","pages":"Article 104896"},"PeriodicalIF":2.7,"publicationDate":"2025-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145715045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Fifteen-minute walk improves microcirculation in people with diabetes mellitus 15分钟步行可改善糖尿病患者的微循环。
IF 2.7 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2025-12-06 DOI: 10.1016/j.mvr.2025.104897
Laura Palacios-Abril , Aroa Tardáguila-García , Francisco Javier Álvaro-Afonso , Sol Tejeda-Ramírez , Mateo López-Moral , José Luis Lázaro-Martínez

Introduction

Skin perfusion is a key marker for detecting microcirculatory disorders in the lower extremity and predicting complications in patients with diabetes mellitus. This study aimed to evaluate microcirculation before and after an external stimulus—characterised by tissue hypoxia, increased temperature, and pressure—to assess its effect on tissue perfusion.

Material and methods

A pre–post analytical study was conducted in 30 participants. Baseline measurements included skin perfusion pressure, digital, ankle, and toe pressures, and transcutaneous oxygen pressure, obtained using a combined sphygmomanometry and laser Doppler flowmetry system. Sensors were placed on the dorsum of the foot, pads of both great toes, and the third finger of the hand, with pneumatic cuffs on the upper arm, ankles, and toes. Ankle–brachial and toe–brachial indices were calculated. Participants then completed a supervised 15-minute treadmill walk at 2.5 km/h, after which all measurements were repeated. Notable changes in participants with compromised vascular status prompted an exploratory subgroup analysis. Risk of ulceration was defined according to the International Working Group on the Diabetic Foot classification, based on loss of protective sensation, peripheral arterial disease, foot deformity, and any prior ulceration or amputation. Ischaemia was classified using the Wound, Ischaemia and Foot Infection system, which grades severity according to ankle–brachial index, toe pressure, and transcutaneous oxygen pressure. Stratification using these internationally recognised classifications provided a standardised framework to interpret the responses in a clinically meaningful context. Effects across subgroups were analysed using one-factor analysis of variance, evaluating both absolute and relative changes to account for baseline heterogeneity.

Results

Overall, microvascular parameters, particularly skin perfusion pressure, increased significantly by 15 % (p = 0.035, d = −0.412) after the intervention, whereas macrovascular parameters remained unchanged. Subgroup analyses revealed no statistically significant differences, but potentially relevant increases of up to 33 % in tissue perfusion were observed, especially in participants with compromised vascular status.

Conclusion

This simple, non-pharmacological stimulus may effectively enhance tissue perfusion in patients with diabetes mellitus, particularly in those at high risk of ulceration or with moderate to severe ischaemia, offering clinically feasible intervention.
导读:皮肤灌注是检测糖尿病患者下肢微循环障碍和预测并发症的关键指标。本研究旨在评估以组织缺氧、温度和压力升高为特征的外部刺激前后的微循环,以评估其对组织灌注的影响。材料和方法:对30名参与者进行了前后分析研究。基线测量包括皮肤灌注压、指压、踝压和趾压,以及经皮氧压,使用联合血压计和激光多普勒血流测量系统获得。传感器被放置在脚背、两个大脚趾的脚垫和第三个手指上,上臂、脚踝和脚趾上有气动袖口。计算踝肱指数和趾肱指数。然后,参与者以2.5 公里/小时的速度在跑步机上完成了15分钟的监督步行,之后所有的测量都重复进行。血管状况受损的参与者的显著变化促使探索性亚组分析。溃疡风险根据国际糖尿病足分类工作组定义,基于保护性感觉丧失、外周动脉疾病、足部畸形和任何先前的溃疡或截肢。使用伤口、缺血和足部感染系统对缺血进行分类,该系统根据踝肱指数、脚趾压力和经皮氧压对严重程度进行分级。使用这些国际公认的分类进行分层提供了一个标准化的框架来解释临床有意义的情况下的反应。使用单因素方差分析分析亚组间的影响,评估绝对和相对变化以解释基线异质性。结果:总体而言,干预后微血管参数,特别是皮肤灌注压显著增加了15 % (p = 0.035,d = -0.412),而大血管参数保持不变。亚组分析显示没有统计学上的显著差异,但观察到组织灌注的潜在相关增加高达33 %,特别是在血管状况受损的参与者中。结论:这种简单的非药物刺激可有效增强糖尿病患者的组织灌注,特别是对溃疡高风险或中重度缺血患者,是临床可行的干预措施。
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引用次数: 0
Pericytes at the crossroads of sepsis: Mechanisms and therapeutic opportunities in vascular barrier dysfunction 脓毒症的十字路口周细胞:血管屏障功能障碍的机制和治疗机会
IF 2.7 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2025-12-03 DOI: 10.1016/j.mvr.2025.104895
Changhong Miao , Lu Xiao , Xinyi Xu , Jingchao Miao , Jiajin Liu , Haobo Zhao
This review highlights the crucial role of pericytes in sepsis-induced vascular barrier dysfunction and proposes pericytes as a potential therapeutic target. Research shows that the loss of pericytes is closely associated with increased microvascular permeability, abnormal microcirculation, and multi-organ dysfunction in sepsis. Interventions such as activation of the Ang/Tie2 pathway, VEGF inhibition, PDGF-B signaling modulation, and MSC-derived exosomes may effectively restore microvascular stability and alleviate organ damage related to sepsis. The article further explores the integration of cutting-edge technologies such as single-cell genomics and proteomics to precisely identify pericyte function and therapeutic targets, providing new directions and innovative strategies for sepsis treatment.

Background

Pericytes are mural cells embedded in the vascular basement membrane and form an integral part of the microvascular structure. Through close interactions with endothelial cells, they participate in vascular remodeling, maintenance of barrier integrity, regulation of capillary blood flow, and protection of the central nervous system. Relevant studies have increasingly emphasized the role of pericytes in sepsis-associated microcirculatory dysfunction, suggesting new directions for therapeutic intervention. This review outlines the biological features of pericytes and their contribution to sepsis-related vascular pathology, with particular attention to mechanisms by which pericytes mediate organ injury. By highlighting key signaling pathways and processes involved in pericyte-driven vascular barrier disruption, we suggest that targeting pericytes may offer a potential strategy for the treatment of sepsis.
这篇综述强调了周细胞在脓毒症诱导的血管屏障功能障碍中的重要作用,并提出周细胞是一个潜在的治疗靶点。研究表明,脓毒症中周细胞的丢失与微血管通透性增高、微循环异常、多器官功能障碍密切相关。激活Ang/Tie2通路、抑制VEGF、PDGF-B信号调节和msc衍生外泌体等干预措施可有效恢复微血管稳定性,减轻败血症相关器官损伤。本文进一步探讨了单细胞基因组学和蛋白质组学等前沿技术的融合,以精确识别周细胞功能和治疗靶点,为脓毒症的治疗提供新的方向和创新策略。周细胞是嵌入血管基底膜的壁细胞,是微血管结构的组成部分。它们通过与内皮细胞的密切相互作用,参与血管重塑,维持屏障完整性,调节毛细血管血流,保护中枢神经系统。相关研究越来越强调周细胞在脓毒症相关微循环功能障碍中的作用,为治疗干预提供了新的方向。本文概述了周细胞的生物学特征及其在脓毒症相关血管病理学中的作用,并特别关注周细胞介导器官损伤的机制。通过强调周细胞驱动的血管屏障破坏的关键信号通路和过程,我们建议靶向周细胞可能为脓毒症的治疗提供一种潜在的策略。
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引用次数: 0
The underdiagnosed risk of Coronary microvascular dysfunction in post CABG/angioplasty patients a call for myocardial perfusion mapping of blood flow dynamics 冠脉搭桥/血管成形术后患者冠状动脉微血管功能障碍未被诊断的风险呼吁对血流动力学进行心肌灌注测绘。
IF 2.7 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2025-11-26 DOI: 10.1016/j.mvr.2025.104886
B. Gayathri , K. Sreekanth , G. Aparna , C. Chandana , N. Radhakrishnan , E.K. Radhakrishnan
Angioplasty and coronary artery bypass grafting (CABG) are common interventions for the management of coronary artery disease aiming to address atherosclerotic plaques in the epicardial coronary arteries. However, many patients experience recurrent angina and other complications such as low cardiac output and even mortality due to other undiagnosed pathologies. Coronary microvascular dysfunction (CMD), which causes impaired blood flow in the microvascular network is a critically overlooked factor in this regard. Such microvascular dysfunction occurs due to the endothelial abnormalities leading to vascular remodelling, and increased resistance to blood flow. The mobilization of unstable plaques during operative procedures such as stenting, angioplasty, and bypass surgery can also contribute to the microcirculatory obstruction, potentially resulting in fatal coronary embolization. Also, such plaque rupture release emboli that can migrate and obstruct the distal arterioles, resulting in low cardiac output, recurrent angina, and ischemia. These microvascular blocks resulting from preexisting dysfunction or iatrogenic embolization are mostly undiagnosed after a CABG or angioplasty. Diagnosis of CMD is challenging, as conventional imaging techniques only focus on macrovascular assessment, neglecting the importance of microvascular hemodynamics. Current diagnostic protocols need a re-evaluation to include methods to assess microvascular perfusion dynamics in postoperative patients.
血管成形术和冠状动脉旁路移植术(CABG)是治疗冠状动脉疾病的常见干预措施,旨在解决心外膜冠状动脉粥样硬化斑块。然而,许多患者会经历复发性心绞痛和其他并发症,如低心输出量,甚至由于其他未确诊的病理而死亡。冠状动脉微血管功能障碍(CMD)会导致微血管网络中的血流受损,这是一个被严重忽视的因素。这种微血管功能障碍的发生是由于内皮异常导致血管重构,血流阻力增加。在支架置入术、血管成形术和搭桥手术等手术过程中,不稳定斑块的动员也可能导致微循环阻塞,可能导致致命的冠状动脉栓塞。此外,斑块破裂释放出栓塞,栓塞可迁移并阻塞远端小动脉,导致心排血量低、心绞痛复发和缺血。这些由先前存在的功能障碍或医源性栓塞引起的微血管阻塞在冠脉搭桥或血管成形术后大多无法诊断。CMD的诊断具有挑战性,因为传统的成像技术只关注大血管的评估,而忽视了微血管血流动力学的重要性。目前的诊断方案需要重新评估,包括评估术后患者微血管灌注动力学的方法。
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引用次数: 0
Chronic nicotine exposure drives dose-dependent pulmonary hypertension and cardiopulmonary remodeling: Preclinical and clinical validation 慢性尼古丁暴露驱动剂量依赖性肺动脉高压和心肺重塑:临床前和临床验证。
IF 2.7 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2025-11-14 DOI: 10.1016/j.mvr.2025.104884
Jin Zhou , Xiaomin Hou , Zhifa Zheng , Tingting Quan , Xin Meng , Yi Xu , Liangyuan Zhao , Xiaoxia Ren , Lingbo Yang , Yiwei Shi , Xiaojiang Qin
Pulmonary hypertension (PH) is a severe and life-threatening pulmonary vascular disease. Cigarette smoking is a significant environmental risk factor for PH, and nicotine, a primary toxic component of cigarettes, is closely associated with the development and progression of PH. This study aimed to elucidate the pathological progression of PH induced by chronic nicotine exposure and its dose-dependent effects. We established a murine model of PH by intranasal nicotine instillation in C57BL/6 J mice, coupled with a clinical cohort study of smokers. Using high-resolution echocardiography, right heart catheterization, microvascular tension measurement, and histopathological techniques, we systematically assessed nicotine's dose-dependent effects on pulmonary hemodynamics, vascular function, and cardiac structure and function. Results demonstrated right ventricular systolic pressure (RVSP)—a surrogate for pulmonary arterial (PA) systolic pressure without pulmonary valve stenosis—increased from 18.09 ± 0.28 mmHg (Control) to 31.99 ± 0.21 mmHg (High-dose, P < 0.01). RV hypertrophy and dilation were accompanied by dose-dependent impairment in tricuspid annular plane systolic excursion (TAPSE), declining from 1.83 ± 0.05 mm to 1.15 ± 0.03 mm (P < 0.01). PA abnormalities included shortened acceleration time (PAT), reduced PAT/ejection time ratio, increased PA diameter (PAD), vascular wall thickening, and inflammatory infiltration. Microvascular tension studies confirmed functional impairment. Clinical validation mirrored core findings: in PH patients, smoking index correlated positively with PAD (R2 = 0.8553, P < 0.01) and negatively with TAPSE (R2 = 0.7523, P < 0.01), strongly corroborating animal data and underscoring nicotine's clinical hazards. Our research demonstrates chronic nicotine exposure induces dose-dependent PH through elevated PA pressure, pulmonary vascular remodeling, and RV dysfunction, providing mechanistic insights for smoking-related PH prevention and treatment.
肺动脉高压(Pulmonary hypertension, PH)是一种严重的危及生命的肺血管疾病。吸烟是PH的重要环境危险因素,尼古丁作为香烟的主要毒性成分,与PH的发生发展密切相关。本研究旨在阐明慢性尼古丁暴露诱导PH的病理进展及其剂量依赖性效应。我们建立了C57BL/6 J小鼠鼻腔内滴入尼古丁的小鼠PH模型,并结合吸烟者的临床队列研究。通过高分辨率超声心动图、右心导管、微血管张力测量和组织病理学技术,我们系统地评估了尼古丁对肺血流动力学、血管功能和心脏结构和功能的剂量依赖性影响。结果证明右心室收缩压(RVSP)——代理为肺动脉(PA)收缩压无肺动脉瓣stenosis-increased 的18.09±0.28  31.99毫米汞柱(控制) ±0.21  毫米汞柱(大剂量P 2 = 0.8553,P 2 = 0.7523,P
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引用次数: 0
PAI-1 promotes thromboangiitis obliterans progression through NF-κB-NLRP3 pathway activation via HIF-1α-dependent signaling PAI-1通过hif -1α依赖性信号通路激活NF-κB-NLRP3通路促进血栓闭塞性脉管炎进展。
IF 2.7 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2025-11-13 DOI: 10.1016/j.mvr.2025.104885
Xiao Xu , Xiaohu Ge , Hongbo Ci , Maitiseyiti Abulaihaiti , JianPing Yang , YangYang Li , Feng Zhu

Background

Thromboangiitis obliterans (TAO, Buerger's disease) is a chronic inflammatory disorder that affects small and medium-sized vessels in the limbs. Although the pathogenesis of TAO remains incompletely understood, elevated levels of plasminogen activator inhibitor-1 (PAI-1) have been associated with cardiovascular diseases. This study investigates the mechanism by which PAI-1 activates the NF-κB/NLRP3 inflammatory pathway in vascular endothelial cells through hypoxia-inducible factor-1α (HIF-1α), contributing to the progression of TAO.

Methods

Proteomic analysis was performed on plasma samples from 5 TAO patients and 5 healthy controls to identify differentially expressed proteins (DEPs). In vitro, human umbilical vein endothelial cells (HUVECs) were subjected to 1 % hypoxia to mimic TAO conditions. Interventions included PAI-1 knockdown using lentiviral vectors and treatment with the HIF-1α agonist dimethyloxalylglycine (DMOG). Cell viability was assessed using the CCK-8 assay, apoptosis was measured by flow cytometry, and inflammatory factor levels were detected by enzyme-linked immunosorbent assay (ELISA). Protein expression was analyzed by Western blotting. In vivo, a TAO rat model was established by sodium laurate injection. The severity of limb ischemia was evaluated using gross lesion grading and infrared thermography, while pathological changes were assessed by hematoxylin and eosin (H&E) staining and Masson's trichrome staining.

Results

Elevated levels of PAI-1, HIF-1α, and key molecules in the NLRP3/NF-κB pathway were observed in both TAO rats and hypoxic HUVECs. PAI-1 knockdown significantly improved limb ischemia and suppressed the NLRP3/NF-κB pathway in TAO rats. Compared with the DMOG intervention group, combined treatment with PAI-1 knockdown and DMOG effectively alleviated ischemic symptoms, increased body weight, and reduced the expression of HIF-1α and inflammatory pathway molecules in TAO rats.

Conclusion

PAI-1 promotes the progression of TAO by activating the NF-κB pathway via HIF-1α. Targeted inhibition of PAI-1 represents a potential therapeutic strategy for TAO.
背景:血栓闭塞性脉管炎(TAO,伯格氏病)是一种影响四肢中小血管的慢性炎症性疾病。虽然TAO的发病机制尚不完全清楚,但纤溶酶原激活物抑制剂-1 (PAI-1)水平升高与心血管疾病有关。本研究探讨PAI-1通过缺氧诱导因子1α (hypoxia-inducible factor-1α, HIF-1α)激活血管内皮细胞NF-κB/NLRP3炎症通路,促进TAO进展的机制。方法:对5例TAO患者和5例健康对照者的血浆样本进行蛋白质组学分析,鉴定差异表达蛋白(DEPs)。体外,将人脐静脉内皮细胞(HUVECs)置于1 %的缺氧条件下模拟TAO条件。干预措施包括使用慢病毒载体敲除PAI-1和使用HIF-1α激动剂二甲基氧基酰甘氨酸(DMOG)治疗。采用CCK-8法评估细胞活力,流式细胞术检测细胞凋亡,酶联免疫吸附试验(ELISA)检测炎症因子水平。Western blotting分析蛋白表达。采用月桂酸钠注射液建立TAO大鼠体内模型。采用肉眼病变分级和红外热像仪评估肢体缺血严重程度,采用苏木精伊红(H&E)染色和马松三色染色评估病理变化。结果:TAO大鼠和缺氧HUVECs中PAI-1、HIF-1α及NLRP3/NF-κB通路关键分子水平均升高。PAI-1敲低可显著改善TAO大鼠肢体缺血,抑制NLRP3/NF-κB通路。与DMOG干预组相比,PAI-1敲低和DMOG联合治疗能有效缓解TAO大鼠的缺血症状,增加体重,降低HIF-1α和炎症途径分子的表达。结论:PAI-1通过HIF-1α激活NF-κB通路,促进TAO的进展。靶向抑制PAI-1是一种潜在的治疗TAO的策略。
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引用次数: 0
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Microvascular research
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