Elevated circulating P-selectin in insulin dependent diabetes mellitus

Area of Science:

• Endocrinology and Metabolism
• Vascular Biology
• Immunology

Background:

• Increased P-selectin expression is observed on platelets and choroidal microvessels in patients with insulin dependent diabetes mellitus (IDDM).
• This suggests a potential role for P-selectin in the pathophysiology of IDDM-related vascular issues.

Purpose of the Study:

• To investigate whether plasma concentrations of circulating P-selectin (cP-selectin) are elevated in patients with IDDM.
• To compare cP-selectin levels between non-smoking IDDM patients on intensified insulin therapy and healthy controls.

Main Methods:

• Prospective, cross-sectional, analyst-blinded study design.
• Plasma levels of cP-selectin and von Willebrand antigen (vWF-Ag) were measured using enzyme-linked immunoassays.
• Subjects were individually matched for sex, age, and body mass index, with 42 pairs analyzed.

Main Results:

• Median plasma cP-selectin levels were 21% higher in IDDM patients (285 ng/ml) compared to controls (236 ng/ml; p = 0.004).
• Median plasma vWF-Ag levels were 10% higher in IDDM patients (96 U/dl) than in controls (87 U/dl; p = 0.025).
• No significant correlation was found between plasma cP-selectin and vWF-Ag levels in either group.

Conclusions:

• Elevated plasma cP-selectin levels in IDDM patients align with increased P-selectin expression on platelets and microvessels.
• These findings provide a rationale for targeting P-selectin with small molecule inhibitors.
• Targeting P-selectin may help treat or prevent micro- and macrovascular complications associated with IDDM.