Microvascular diseases: is a new era coming?

Area of Science:

• Physiology
• Vascular Biology
• Pathophysiology

Background:

• The microvascular bed, including arterioles and capillaries, precisely regulates nutrient delivery.
• Historically neglected due to technical limitations, microcirculation is now recognized for its role in disease.

Purpose of the Study:

• To review the structure, physiology, and investigation methods of microcirculation.
• To highlight the emerging understanding of microcirculation's causal role in cardiovascular and metabolic disorders.
• To discuss current and potential pharmacological interventions for microcirculatory dysfunction.

Main Methods:

• Comprehensive literature review of microvascular structure and function.
• Analysis of recent advancements in microcirculation research techniques.
• Examination of pharmacological agents impacting microcirculation.

Main Results:

• Microvascular dysfunction is increasingly implicated as a source of pathologies, including cardiometabolic syndrome and prediabetes.
• Metformin demonstrates unique, intrinsic actions on terminal arterioles independent of its antidiabetic effects.
• Limited specific treatments exist for microcirculatory disorders, with pentoxifylline and metformin as exceptions.

Conclusions:

• Microcirculation research is entering a new era with advanced techniques and a deeper understanding of its function.
• Specific pharmacological developments targeting microcirculatory disorders are warranted.
• Addressing microcirculatory dysfunction is critical for managing complex diseases.