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Preservation of pancreatic endocrine and peri-islet exocrine capillary networks in type 2 diabetes
Alex M. Tollefson, Frank R. Marsico, Manami Hara
Alex M. Tollefson, Frank R. Marsico, Manami Hara
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Research Article Endocrinology Vascular biology

Preservation of pancreatic endocrine and peri-islet exocrine capillary networks in type 2 diabetes

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Abstract

Chronic hyperglycemia induces microvascular complications in patients with type 2 diabetes (T2D), particularly diabetic retinopathy, nephropathy, and neuropathy. We revisited the pancreatic vasculature to reexamine such damage in 3D. Using thick pancreatic tissue slices, we analyzed volumetric intraislet capillary density (vICD) and peri-islet volumetric exocrine capillary density (vECD) as well as interface capillary counts along the islet periphery to quantify vascular integration between the islets and surrounding acinar cells. Contrary to the previous reports, vICD was not homogeneous but highly heterogeneous across the five species studied (human, monkey, pig, ferret, and mouse), especially in smaller islets. vICD became less variable with increasing islet size, converging at approximately 20%. With this foundation of islet vascularization, pancreatic tissues from non-diabetic and T2D subjects consisting of 8 age- and sex-matched pairs (age range of 35–65 years with various duration: 0–15 years) were examined. Strikingly, no significant differences in microvascular density were found; mean vICD and mean vECD were nearly equivalent between the groups. Capillary integration with respect to islet size was comparable. These findings suggest that integrated pancreatic blood flow with robust crosstalk between the endocrine and exocrine pancreas may facilitate microvascular preservation in T2D via local distribution of insulin.

Authors

Alex M. Tollefson, Frank R. Marsico, Manami Hara

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Figure 5

Comparison of peri-islet vECD and interface capillary counts between ND and T2D human subjects.

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Comparison of peri-islet vECD and interface capillary counts between ND ...
(A) Approach to volumetric exocrine capillary density (vECD). Identification of exocrine regions in the immediate periphery of islets based on distance between voxels. Purple indicates close proximity to islets. Scale bar: 200 μm. (B) Exocrine regions (transparent) 25 μm thick rendered in 3D immediately outside the islets (opaque blue). Capillaries are in red. This thickness was set so that exocrine region diameter would occupy a diameter range similar to that of islets. (C) Binary fluorescence for exocrine capillaries (red), exocrine regions (purple), and islets (cyan). (D) vICD values and intraislet capillaries in white, vECD values and exocrine capillaries in red. (E) Plots of vECD against islet effective diameter in human subjects with and without T2D. Mean peri-islet vECD values were significantly different (P < 0.001), but effect size (0.23) indicated minimal practical significance. (F) Approach to quantifying the number of individual capillaries at the islet periphery. Capillary fluorescence inside and 25 μm outside of rendered islets. Scale bar: 100 μm. (G) Rendered capillary segments. (H) Highlighted segments at the periphery of islets, intersecting their margins. (I) Isolation of highlighted segments for quantification. (J) Plots of islet surface area against the number of capillaries at the islet periphery in human subjects with and without T2D. Mean islet surface area to segment ratios (μm2/segment) were significantly different (P < 0.01), but effect size (0.11) indicated minimal practical significance.

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