Abstract
Diabetes mellitus is characterized by a lack of insulin causing elevated blood glucose, often with associated insulin resistance. Over time, especially in genetically susceptible individuals, such chronic hyperglycemia can cause tissue injury. One pathological response to tissue injury is the development of fibrosis, which involves predominant extracellular matrix (ECM) accumulation. The main factors that regulate ECM in diabetes are thought to be pro-sclerotic cytokines and protease/anti-protease systems. This review will examine the key markers and regulators of tissue fibrosis in diabetes and whether their levels in biological fluids may have clinical utility.
Keywords:
diabetic complications; extracellular matrix; markers.
MeSH terms
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Animals
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Basement Membrane / pathology
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Biomarkers / blood
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Biomarkers / metabolism*
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Biomarkers / urine
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Cardiomyopathies / metabolism
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Cardiomyopathies / pathology
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Connective Tissue Growth Factor
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Diabetes Complications / blood
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Diabetes Complications / metabolism*
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Diabetes Complications / pathology*
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Diabetes Complications / urine
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Diabetic Angiopathies / metabolism
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Diabetic Angiopathies / pathology
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Diabetic Nephropathies / metabolism
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Diabetic Nephropathies / pathology
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Diabetic Retinopathy / metabolism
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Diabetic Retinopathy / pathology
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Endothelium, Vascular / pathology
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Extracellular Matrix / metabolism
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Extracellular Matrix / pathology
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Fatty Liver / pathology
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Fibrosis
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Glycation End Products, Advanced / metabolism
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Heart Diseases / metabolism
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Heart Diseases / pathology
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Heart Failure / metabolism
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Heart Failure / pathology
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Humans
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Hyperglycemia / metabolism
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Hyperglycemia / pathology
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Immediate-Early Proteins / metabolism
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Insulin Resistance
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Intercellular Signaling Peptides and Proteins / metabolism
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Liver Cirrhosis / metabolism
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Metalloproteases / metabolism
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Peptide Fragments / blood
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Procollagen / blood
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Renin-Angiotensin System / physiology
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Transforming Growth Factor beta / metabolism
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Tunica Intima / pathology
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Up-Regulation / physiology
Substances
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Biomarkers
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CCN2 protein, human
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Glycation End Products, Advanced
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Immediate-Early Proteins
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Intercellular Signaling Peptides and Proteins
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Peptide Fragments
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Procollagen
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Transforming Growth Factor beta
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procollagen Type III-N-terminal peptide
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Connective Tissue Growth Factor
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Metalloproteases