Vascular Basement Membrane Thickening in Diabetic Retinopathy

Abstract

Vascular basement membrane (BM) thickening is a fundamental structural alteration of small blood vessels in diabetes. Over two decades of research has established hyperglycemia as the primary causal factor mediating this alteration. Various high glucose-induced mechanisms have been investigated and excess synthesis of BM components has been identified as a major contributing factor to BM thickening. Although BM thickening has been long hailed as the histological hallmark of diabetic microangiopathy, the consequences of BM thickening on the functionality of target organs of diabetes remain elusive even today. This review presents an overview of our current understanding of the BM structure and function, and focuses on how capillary BM thickening develops, its effect on retinal vascular function, and potential strategies for preventing the development of BM thickening in diabetic retinopathy.

KEYWORDS::

• Basement membrane
• Basement membrane thickening
• Diabetic retinopathy
• Microangiopathy
• Vascular lesions

ACKNOWLEDGMENTS

Work on basement membrane gene regulation was supported in part by grants from the American Diabetes Association, NEI, National Institutes of Health (EY 014702), and Massachusetts Lions Eye Research Foundation, Inc.

Declaration of interest: The authors report no conficts of interest. The authors alone are responsible for the content and writing of the paper.