Systemic endothelial inflammation in type 1 diabetic patients with poorly controlled hyperglycemia and macrovascular complications - endothelial biopsy and real-time PCR analysis

Many patients with type 1 diabetes are severely debilitated by vascular complications, such as heart attacks, strokes and bad circulation in their legs. The endothelium, cells that line the blood vessels, plays an important role in vascular inflammation and the development of atherosclerosis, which can cause these vascular complications. Sampling human endothelium at various stages of vascular diseases is thus crucial to the understanding of molecular mechanisms underlying vascular complications.

We plan to use a safe and minimally invasive endothelial biopsy technique and highly sensitive real-time PCR to study venous endothelial inflammation and dysfunction in 36 patients with severe adult-onset diabetes mellitus and poorly controlled blood sugar, and compare them with 33 healthy age-matched volunteers. Samples of cells lining the blood vessels will be obtained from these patients through a small wire and tube placed in an arm vein. The levels of two inflammatory mediators in these cells will be measured by quantitative polymerase chain reaction technique. Comparison will be made between the patients and healthy volunteers and among the patients before and after treatment.