Extramural Coronary Artery Disease in Type I Diabetes Mellitus: A Quantative Autopsy Study

Author Institution: Departments of Pathology and Internal Medicine, College of Medicine, University of CincinnatiExtramural coronary arteries of 17 type I diabetics and 22 control patients were examined at necropsy following a detailed methodology plan. There was a greater extent of luminal narrowing in the extramural coronary arteries in the diabetic patients than in the controls. While it is known that in patients with the advanced stage of type I diabetes mellitus significant coronary atherosclerosis is likely to be present, it is new information that they have a propensity for obstructive atherosclerosis, not just in the 3 major coronary arteries but also in the branches. Young type I diabetics with atherosclerosis of proximal portions of the coronary vasculature are likely to have equally severe atherosclerosis in the distal portions and branches as well. Atherosclerosis was less severe in the diabetic patients who did receive hemodialysis and/or a renal transplant than those who did not

The Role of Plasma Extracellular Vesicles in Remote Ischemic Conditioning and Exercise-Induced Ischemic Tolerance

Ischemic conditioning and exercise have been suggested for protecting against brain ischemia-reperfusion injury. However, the endogenous protective mechanisms stimulated by these interventions remain unclear. Here, in a comprehensive translational study, we investigated the protective role of extracellular vesicles (EVs) released after remote ischemic conditioning (RIC), blood flow restricted resistance exercise (BFRRE), or high-load resistance exercise (HLRE). Blood samples were collected from human participants before and at serial time points after intervention. RIC and BFRRE plasma EVs released early after stimulation improved viability of endothelial cells subjected to oxygen-glucose deprivation. Furthermore, post-RIC EVs accumulated in the ischemic area of a stroke mouse model, and a mean decrease in infarct volume was observed for post-RIC EVs, although not reaching statistical significance. Thus, circulating EVs induced by RIC and BFRRE can mediate protection, but the in vivo and translational effects of conditioned EVs require further experimental verification