Microstructural Characterisation of Resistance Artery Remodelling in Diabetes Mellitus

Abstract

Introduction: Microvascular remodelling is a symptom of cardiovascular disease. Despite the mechanical environment being recognised as a major contributor to the remodelling process, it is currently only understood in a rudimentary way. Objective: Amorphological and mechanicalevaluation of the resistance vasculature in health and diabetes mellitus.Methods: The cells and extracellular matrix of human subcutaneous resistance arteriesfrom abdominal fat biopsieswere imagedusing two-photon fluorescence and second harmonic generationat varying transmural pressure.The results informed a two-layer mechanical model.Results: Diabetic resistance arteries reducedin wall area as pressure was increased. This was attributed to the presence of thick, straight collagen fibre bundles that bracedthe outer wall.The abnormal mechanical environment caused theinternal elastic lamina and endothelial and vascular smooth muscle cellarrangementsto twist. Conclusions: Our resultssuggest diabetic microvascular remodelling is likely to be stress-driven, comprisingat least two stages: 1. Laying down of adventitial bracing fibres that limit outward distension, and 2. Deposition of additional collagen in the media, likely due to the significantly altered mechanical environment. This work represents a step towards elucidating the local stress environment of cells, which iscrucial to build accurate models of mechanotransduction in disease.