Diabetic foot cellular hypoxia may be due to capillary shunting - A novel hypothesis

Medical Hypotheses

Volumn 82, Issue 1, 2014, Pages 57-59

  Gabbay, Itay E ^a   Gabbay, Merav ^b   Gabbay, Uri ^c  

^a TECHNION ISRAEL INSTITUTE OF TECHNOLOGY   (Israel)

^b CLALIT HEALTH SERVICES   (Israel)

^c TEL AVIV UNIVERSITY   (Israel)

Author keywords

[No Author keywords available]

Indexed keywords

ARTERIAL OXYGEN TENSION; ARTICLE; BLOOD FLOW; CAPILLARY FLOW; CELL HYPOXIA; DIABETIC FOOT; GAS EXCHANGE; HUMAN; INFECTION; ISCHEMIA; MICROCIRCULATION; NEUROPATHY; OXYGEN SATURATION; TISSUE BLOOD FLOW;

CAPILLARIES; CELL HYPOXIA; DIABETIC FOOT; HUMANS; MODELS, BIOLOGICAL; OXYGEN CONSUMPTION; REGIONAL BLOOD FLOW;

EID: 84890887128     PISSN: 03069877     EISSN: 15322777     Source Type: Journal    
DOI: 10.1016/j.mehy.2013.11.005     Document Type: Article

References (26)

1. Hafner J., Schaad I., Schneider E., et al. Leg ulcers in peripheral arterial disease (arterial leg ulcers): impaired wound healing above the threshold of chronic critical limb ischemia. J Am Acad Dermatol 2000, 43:1001-1008.
2. Hsu S.R., Su H.M., Hsieh M.C., et al. Risk factors of accelerated progression of peripheral artery disease in hemodialysis. Kaohsiung J Med Sci 2013, 29:82-87.
3. LaRosa J.C. Atherosclerotic risk factors in cardiovascular disease. J Reprod Med 1986, 31(Suppl. 9):906-912.
4. Diabetic Foot: lower extremities arteries disease and limb salvage. 2nd ed. In: Sidway AN, editor. Lippincott Williams & Wilkins. 2005.
5. Shaw J.E., Boulton A.J. The pathogenesis of diabetic foot problems: an overview. Diabetes 1997, 46(Suppl. 2):58-61.
6. Chao C.Y., Cheing G.L. Microvascular dysfunction in diabetic foot disease and ulceration. Diabetes Metab Res Rev 2009, 25:604-614.
7. Greenman R.L., Panasyk S., Wang X., et al. Early changes in the skin microcirculation and muscle metabolism of the diabetic foot. Lancet 2005, 366:1711-1717.
8. Lepäntalo M, Apelqvist J, Setacci C, et al. Diabetic foot. Eur J Vasc Endovasc Surg. 2011;42 (Suppl. 2):S60-S74 chapter 5.
9. Jeffcoate W.J., Harding K.G. Diabetic foot ulcers. Lancet 2003, 361:1545-1551.
10. Hunt J.A. Foot infections in diabetes are rarely due to a single microorganism. Diabet Med 1992, 9:749-752.
11. Flynn M.D., Tooke J.E. Aetiology of diabetic foot ulceration: a role for the microcirculation?. Diabet Med 1992, 9:320-329.
12. Flynn M.D., Edmonds M.E., Tooke J.E., Watkins P.J. Direct measurement of capillary blood flow in the diabetic neuropathic foot. Diabetologia 1988, 31:652-656.
13. Fagrell B., Jörneskog G., Intaglietta M. Disturbed microvascular reactivity and shunting - a major cause for diabetic complications. Vasc Med 1999, 4:125-127.
14. Boulton A.J., Scarpello J.H., Ward J.D. Venous oxygenation in the diabetic neuropathic foot: evidence of arteriovenous shunting. Diabetologia 1982, 22:6-8.
15. Schramm J.C., Dinh T., Veves A. Microvascular changes in the diabetic foot. Int J Low Extrem Wounds 2006, 5:149-159.
16. Veves A, Giurini JM, LoGerfo FW, editors. The Diabetic Foot: medical and surgical management. 3rd ed. New York: Humana Press, Springer; 2012.
17. Newrick P.G., Cochrane T., Betts R.P., Ward J.D., Boulton A.J. Reduced hyperaemic response under the diabetic neuropathic foot. Diabet Med 1988, 5:570-573.
18. Comerford J.A., Broe P.J., Wilson I.A., Bouchier-Hayes D.J. Digital ischaemia and palpable pedal pulses. Br J Surg 1987, 74:493-495.
19. Netten P.M., Wollersheim H., Thien T., Lutterman J.A. Skin microcirculation of the foot in diabetic neuropathy. Clin Sci (Lond) 1996, 91:559-565.
20. Zweifach B.W. Microcirculation. Ann Rev Physiol 1973, 35:117-150.
21. Baez S., Feldman S.M., Gootman P.M. Central neural influence on precapillary microvessels and sphincter. Am J Physiol 1977, 233:H141-H147.
22. Peng H., Matchkov V., Ivarsen A., Aalkjaer C., Nilsson H. Hypothesis for the initiation of vasomotion. Circ Res 2001, 88:810-815.
23. Aalkjær C., Boedtkjer D., Matchkov V. Vasomotion - what is currently thought?. Acta Physiol (Oxf) 2011, 202:253-269.
24. Fagrell B., Jörneskog G., Intaglietta M. Disturbed microvascular reactivity and shunting - a major cause for diabetic complications. 9Editorial). Vasc Med 1999, 4:125-127.
25. De Backer D., Donadello K., Taccone F.S., et al. Microcirculatory alterations: potential mechanisms and implications for therapy. Ann Intensive Care 2011, 1:27.
26. Gabbay U, Bobrovsky BZ. A novel paradigm comprehensively explains shock, heart failure and aerobic exhaustion through an assumed central physiological control of the momentary cardiovascular performance reserve. Submitted to Medical Hypotheses.