Maladaptive Endothelial Plasticity as a Target in Diabetic Vascular Disease
Medicine · Diabetes
This review reframes diabetic vascular disease as a disorder of maladaptive endothelial plasticity, where endothelial cells undergo pathological transitions across angiogenic, inflammatory, metabolic, and fibrotic axes. By integrating single-cell data from diabetic mouse models and human patient samples, the authors demonstrate that restoring adaptive plasticity requires coordinated multi-dimensional interventions tailored to disease stage and vascular bed. For a clinician leading diabetic foot care and managing systemic complications in India, this framework provides a mechanistic basis for understanding how metabolic therapies (GLP-1 agonists, SGLT2 inhibitors) combined with anti-inflammatory or anti-fibrotic agents could prevent irreversible vascular damage and progression to amputation.
Novelty: 94%
Rigor: 92%
Significance: 96%
Validity: 90%
Clarity: 95%
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