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Research explores impact of red blood cell damage in type 2 diabetes

Researchers in Sweden have investigated how red blood cells change in type 2 diabetes and how this affects the risk of cardiovascular complications.
The underlying causes of cardiovascular complications in people with diabetes are partly known but research is uncovering new findings each year. The latest study suggests that in type 2 diabetes red blood cells suffer damage which causes them to release harmful substances.
In a more upbeat discovery, the Karolinska Institutet research team also identified a treatment that inhibited abnormal blood cell function. They hypothesise that the treatment could be developed to potentially prevent harmful cardiovascular effects in humans with type 2 diabetes.
The researchers looked at two studies focusing on red blood cells in people and mice with type 2 diabetes, and explored whether they contributed to poor cardiovascular outcomes.
They observed that red blood cells carrying oxygen to tissues were more likely to stick to the vessel wall in people with type 2 diabetes compared to those without the condition. Previous research has also indicated that sugary blood (glycated blood) presents a greater risk of heart problems occurring.
Professor John Pernow, who worked on both studies, stated that within the mouse study: “We found that healthy blood vessels exposed to red blood cells from patients with type 2 diabetes suffer damage to their innermost cell layers, the endothelial cells.
“This phenomeno, which is called endothelial dysfunction, appears early on in the development of diabetes-related vessel injury and greatly reduces the ability of the vessels to dilate while aggravating the inflammation.”
The study team discovered that these harmful effects were linked to elevated activity of the enzyme arginase, which increased the formation of harmful oxygen-derived free radicals in the blood vessels.
Prof Pernow explained that his team may have discovered a way to counter these effects. He said: “We also found that treatment that targeted arginase or oxygen-derived free radicals normalised red blood cell function, which meant that their harmful effect on cardiovascular function could be prevented.
“Our hope is that this knowledge will give rise to new treatments, specifically targeted at red blood cells that prevent vascular injury and protect the heart in the event of heart attack in patients with type 2 diabetes.”
One of the research papers was published in the Journal of the American College of Cardiology and the other was featured in the JACC: Basic to Translational Science journal.

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