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La micro-angiopatia diabetica

Contributo allo studio delle lesioni dei capillari del glomerulo renale, del muscolo striato e della gengiva

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Riassunto

Gli AA. riferiscono i risultati di alcune indagini morfologiche intorno alla micro-angiopatia diabetica, condotte con l'ausilio della microscopia ottica e di quella elettronica su 92 frammenti bioptici (58 di rene, 25 di muscolo e 9 di gengiva). Essi confermano il carattere ubiquitario delle lesioni capillari, ma riferiscono di aver rilevato alcune differenze circa la sede dell'apposizione di sostanze elettrondense sulla membrana basale dei capillari (versante interno nei capillari glomerulari; versante esterno nei capillari del muscolo e della gengiva). Gli AA. ritengono che l'evoluzione delle lesioni iniziali della nefroangiopatia diabetica proceda secondo le seguenti tappe: proliferazioni delle cellule mesangiali con produzione di sostanza simil-membrana od apposizione sul suo versante endoteliale di sostanze elettrondense; comparsa di fibrille collagene.

Resume

Les AA. portent les résultats obtenus avec des recherches morphologiques sur la micro-angiopathie diabétique, conduites avec l'aide de la microscopie optique et électronique sur 92 fragments bioptiques (58 rénales, 25 musculaires, 9 gencivales). Ils confirment le caractère ubiquitaire des lesions capillaires, mais ils référent d'avoir relevé certaines differences sur le siège de l'apposition de substances électrondenses sur la membrane basale des capillaires (côté interne dans les capillaires glomerulaires; côté externe dans les capillaires du muscle et de la gencive). Les. AA. pensent que l'évolution des lesions initiales de la néphroangiopathie diabétique procéde suivant des étapes: prolifération des cellules mesangiales avec production d'une substance semblable la membrane basale; épaissement authentique de la membrane basale glomerulaire ou apposition sur sa côté endothéliale de substances électrondenses; apparition de fibrilles collagènes.

Resumen

Los AA. refieren los resultados de algunas investigaciones morfológicas sobre la micro-angiopatía diabética, hechas con auxilio de la microscopía óptica y electrónica, en 92 fragmentos para biopsia (58 de riñon, 25 de músculo y 9 de encía). Ellos confirman el carácter ubiquitario de las lesiones capilares, pero refieren haber notado algunas diferencias por lo que respecta a la localización de la aposición de substancias electrón-densas sobre la membrana basal de los capilares (superficie interna en los capilares glomerulares; superficie externa en los capilares del músculo y de encía). Los AA. piensan que la evolución de las lesiones iniciales en la nefro-angiopatía diabética proceda a las siguientes etapas: proliferaciones de la células mesangiales con producción de substancia similmembrana basal; espesamiento auténtico de la membrana basal glomerular o aposición en su superficie endotelial de substancias electrón-densas; aparición de fibrilas colágenas.

Zusammenfassung

Die AA. berichten ueber die Resultate einiger morphologischer Untersuchungen bei der diabetischen Mikro-Angiopathie, die mittels der optischen und Elektronenmikroskopie an 92 Biopsien (58 von der Niere, 25 von Muskeln, 9 vom Zahnfleisch) durchgefuehrt wurden. Sie bestaetigen den ubiquitaeren Charakter der Kapillarschaeden, teilen aber mit, einige Unterschiede festgestellt zu haben, was den Appositionssitz von elektronendichten Substanzen an der Basalmembran der Kapillaren anbetrifft (Innenseite der Glomerulum-Kapillaren; Aussenseite der Muskel- und Zahnfleischkapillaren). Die AA. glauben, dass die Entwicklung der Anfangsschaeden der diabetischen Nephroangiopathie laut folgenden Etappen fortschreitet: Proliferationen der mesangialen Zellen und Produktion von Basalmembran-aehnlicher Substanz; authentische Verdickung der glomerularen Basalmembran oder Apposition von elektronendichten Substanzen an ihrer Innenseite; Auftreten von kollagenen Fibrillen.

Summary

The results of some morphological researches about diabetic micro-angiopathy performed by means of light and electronic microscopy on 92 bioptical small pieces (58 from kidney, 25 from muscle and 9 from gum) are referred by the AA. The ubiquitous character of the capillary damage is confirmed but some differences are also noticed concerning the seat where electron-dense material is present in the capillary basement membrane (inside the glomerular capillaries, outside the muscle and gum capillaries). According to the AA. opinion, the initial damage of diabetic nephroangiopathy has an evolution with the following steps: mesangial cell proliferation with production of a basement-membran-like material; true thickening of glomerular basement membrane or affixing on its endothelial side of electron-dense material; appearance of collagenous fibrils.

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Bibliografia

  1. Aagenaes O., Hagens E. N.: Tilfaelde of Diabetisk Artropati -Ugeskr. Loeg121 572, 1959.

    CAS  Google Scholar 

  2. Aagenaes O., Moe H.: Light and Electron Microscopy Study of Skin Capillaries of Diabetics -Diabetes10 253, 1961.

    Article  CAS  PubMed  Google Scholar 

  3. Angervall L., Säve Söderbergh J.: Microangiopathy in the Digestive Tract in Subjects with Diabetes of Early Onset and Long Duration - Diabetologia2 117, 1966.

    Article  CAS  PubMed  Google Scholar 

  4. Ashton N.: Diabetic Microangiopathy - Adv. Ophth.8 1, 1958.

    Google Scholar 

  5. Bergstrand A., Bucht H.: The Glomerular Lesions of Diabetes Mellitus and their Electron Microscope Appearances - J. Path. Bact.77 231, 1959.

    Article  CAS  PubMed  Google Scholar 

  6. Berns A. W., Owens A. B., Cecelia T., Blumenthal H. T.: A Histo- and Immunopathologic Study of the Vessels and Islets of Langerhans of the Pancreas in Diabetes Mellitus - J. Geront.19 179, 1964.

    Article  CAS  PubMed  Google Scholar 

  7. Bloodworth J. M. B.: Diabetic Microangiopathy - Diabetes12 99, 1963.

    Article  PubMed  Google Scholar 

  8. Bloodworth J. M. B.: Histochemistry and Electron Microscopy of Diabetic Retinopathy. In: Small Blood Vessel Involvement in Diabetes Mellitus - Siperstein, Colwell, Meyer, Washington D.C. 1964, pag. 81.

    Google Scholar 

  9. Bloodworth J. M. B., Madison M. D.: Experimental Diabetic Glomerulosclerosis - Arch. Path.79 113, 1965.

    PubMed  Google Scholar 

  10. Blumenthal H. T., Alex M., Goldenberg S.: A Study of Lesions of the Intramural Coronary Artery Branches in Diabetes Mellitus - Arch. Path.701 13, 1960.

    Google Scholar 

  11. Camerini-Davalos R. A., Rees S. B., Caulfield J. B., Lozano-Castaneda O., Marble A.: Vascular Changes in Prediabetes. In: Small Blood Vessel Involvement in Diabetes Mellitus -Siperstein, Colwell, Meyer, Washington D.C. 1964, pag. 107.

    Google Scholar 

  12. Campanacci L., Maschio G., Poli D., Mioni G., Bazzato G., Rizzo A.: L'ago-biopsia muscolare. Reperti nel soggetto normale - G. Clin. Med.48 777, 1967.

    CAS  PubMed  Google Scholar 

  13. Cogan D. G., Kuwabara T.: Capillary Shunts in the Pathogenesis of Diabetic Retinopathy -Diabetes12 293, 1963.

    Article  CAS  PubMed  Google Scholar 

  14. Costanzi G., Mancini A., Zampa G. A., Kelescian G.: Recenti studi ed acquisizioni sulle lesioni microvascolari in corso di diabete mellito - Recenti Progr. Med.11 89, 1966.

    Google Scholar 

  15. Dachs S., Churg J., Mautner W., Grishman E.: Diabetic Nefropathy - Amer. J. Path.44 155, 1964.

    CAS  PubMed  PubMed Central  Google Scholar 

  16. Daysog A., Dobson H. L., Brennan J. C.: Renal Glomerular and Vascular Lesions in Prediabetes and in Diabetes Mellitus: a Study Based on Renal Biopsies - Ann. intern. Med.54 672, 1961.

    Article  CAS  Google Scholar 

  17. Emanueli A., Aufiero V., Bertolini A. M.: Gingival Capillaries in Diabetic and non-Diabetic Subjects - Geront. clin. (Basel)9 123, 1967.

    Article  CAS  Google Scholar 

  18. Fagerberg S. E.: Diabetic Neuropathy. A Clinical and Histological Study on the Significance of Vascular Affections - Acta med. scand. (suppl. 345) 1, 1959.

    Google Scholar 

  19. Farquhar M. G., Hopper J., Moon H. D.: Diabetic Glomerulosclerosis: Electron and Light-Microscopic Studies - Amer. J. Path.35 721, 1959.

    CAS  PubMed  PubMed Central  Google Scholar 

  20. Fiaschi E., Scuro L. A., Naccarato R., Monti G., Sirigu F.: Intorno alle prime alterazioni morfologiche del rene nel diabete giovanile recente - Minerva nefrol.10 95, 1963.

    CAS  PubMed  Google Scholar 

  21. Friederici H. H. R., Tucker W. R., Schawartz T. B.: Observations on Small Blood Vessels of Skin in the Normal and in Diabetic Patients - Diabetes15 233, 1966.

    Article  CAS  PubMed  Google Scholar 

  22. Gellman D. D.: The Correlation between the Pathological and Clinical Manifestations of Diabetic Renal Disease. In: Small Blood Vessel Involvement in Diabetes Mellitus - Siperstein, Colwell, Meyer, Washington D.C. 1964, pag. 13.

    Google Scholar 

  23. Goldenberg S., Alex M., Joshi R. A., Blumenthal H. T.: Non Atheromatous Peripheral Vascular Disease of the Lower Extremity in Diabetes Mellitus - Diabetes8 261, 1959.

    Article  CAS  PubMed  Google Scholar 

  24. Jamashita T., Becker B.: The Basement Membrane in the Human Diabetic Eye - Diabetes10 167, 1961.

    Article  Google Scholar 

  25. Kimmelstiel P., Kim O. J., Beres J.: Studies on Renal Biopsies Specimens with the Aid of the Electron Microscope - Amer. J. clin. Path.38 270, 1962.

    Article  CAS  Google Scholar 

  26. Kimmelstiel P., Osawa G., Beres J.: Glomerular Basement Membrane in Diabetics - Amer. J. clin. Path.45 21, 1966.

    Article  CAS  Google Scholar 

  27. Kimmelstiel P., Wilson C.: Intercapillary Lesions in the Glomeruli of Kidney - Amer. J. Path.12 83, 1963.

    Google Scholar 

  28. Latta H.: Renal Lesions and Extrarenal Microangiopathy - Ann. intern. Med.68 638, 1968.

    Google Scholar 

  29. Le Compte P.: Glomerular Lesions in Diabetes: Light Microscopy and Histochemistry. In: Small Blood Vessel Involvement in Diabetes Mellitus - Siperstein, Colwell, Meyer, Washington D.C., 1964, pag. 1.

    Google Scholar 

  30. Marble A., Rees S. B.: La fisiopatologia della microangiopatia nel diabete - Triangolo7 47, 1965.

    Google Scholar 

  31. Otto H., Themann H., Wagner H.: Qualitative und quantitative elektronenmikroskopische Untersuchungen an Hauptcapillaren jugendlicher Diabetiker - Klin. Wschr.45 299, 1967.

    Article  CAS  PubMed  Google Scholar 

  32. Pieri A., Scarpelli P. T., Rizzo M.: Small Blood Vessel Involvement in Diabetes Mellitus: Light Microscope Study of Specimens Obtained by Earlobe Biopsy - Diabetologia1 109, 1965.

    Article  Google Scholar 

  33. Rhodin J.: Discussion in:Vernier R. L. 38, pag. 74.

  34. Salomon M. I.: Diabetic Nephropathy: Clinicopathologic Correlation; a Study Based on Renal Biopsies - Metabolism12 687, 1963.

    CAS  PubMed  Google Scholar 

  35. Scapellato L.: La glomerulosclerosi nodulare intercapillare (o glomerulo-jalinosi nodulare intercapillare o glomerulosclerosi nodulare diabetica). Morfologia, morfogenesi, patogenesi e specificità - Atti I° Simp. Nazionale Diabete, Catania 1956, pag. 333.

    Google Scholar 

  36. Siperstein M. D., Norton W., Unger R. H., Madison L. L.: Muscle Capillary Basement Membrane width in Normal, Diabetic and Prediabetic Patients - Trans. Ass. Amer. Phycns79 330, 1966.

    CAS  Google Scholar 

  37. Spiro R. G.: Glycoproteins and Diabetes - Diabetes12 223, 1963.

    Article  CAS  PubMed  Google Scholar 

  38. Vernier R. L.: Electron Microscopic Studies of the Normal Basement Membrane. In: Small Blood Vessel Involvement in Diabetes Mellitus - Siperstein, Colwell, Meyer, Washington D.C., 1964, pag. 57.

    Google Scholar 

  39. Vernier R. L.: Discussion inVernier R. L. 38, pag. 73.

  40. Zacks S. I., Pegues J. J., Elliott F. A.: Interstitial Muscle Capillaries in Patients with Diabetes Mellitus: a Light and Electron Microscopic Study - Metabolism11 381, 1962.

    CAS  PubMed  Google Scholar 

  41. Zrůstová M., Roštlapil J.: Pathohistologie der diabetischen Mikroangiopathie und Besprechung ihrer moeglichen klinischen Manifestationen - Acta diabet. lat.3 451, 1966.

    Article  Google Scholar 

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  1. Istituto di Patologia Speciale Medica e Metodologia Clinica, dell'Università di Padova, Via Giustiniani, 35100, Padova, Italy

    Ernico Fiaschi, Remo Naccarato, Ludovico A. Scuro, Alberto Rizzo, Guido Previato & Umberto Fagiolo

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  1. Ernico Fiaschi
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  3. Ludovico A. Scuro
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Fiaschi, E., Naccarato, R., Scuro, L.A. et al. La micro-angiopatia diabetica. Acta diabet. lat 6, 87–120 (1969). https://doi.org/10.1007/BF01548041

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