Seminar - Microcirculation and Wound Healing in Diabetes
Date: March 5, 2010
Time: 4:00 PM
Location: Matheson Hall, Room: 109
Aristidis Veves, MD, DSc
Research Director, Microcirculation Lab and
Joslin-Beth Israel Deaconess Foot Center
Associate Professor, Harvard Medical School
Diabetic foot ulceration is one of the most common and serious complications of diabetes, both type 1 and 2, that affects 15% of all diabetic patients leading to 82,000 amputations per year in the U.S. Initially it was thought that large vessel peripheral vascular disease and neuropathy were the main two reasons not only for the development of foot ulceration, but also the reasons of failure to heal the ulcer. However, over the last decade it has been realized that additional factors contribute both to the development and failure to heal the DFU. These factors include reduced resistance to infection, functional changes in the microcirculation and abnormalities in the expression and activity of growth factors and cytokines that are involved in the healing process. Recent studies in our unit have shown that systemic factors are present long before the development of DFU. Neuropathy and vascular function factors are related to the development of DFU and aberrant cytokine and growth factor levels to the failure to heal it. Furthermore, the data indicate that the skin of diabetic patients who are at risk of developing foot ulceration contains fewer mast cells while intense inflammation is present in patients who developed foot ulcers that failed to heal and this may explain the lack of appropriate healing. Diabetic patients, especially neuropathic patients, have tended to have lower expression of SP and, CRF, CRF-1R and NK-1R. Studies in the rabbit ear model and diabetic or non diabetic wild type or knock out mice have provided similar results and have indicated possible involved mechanisms, including mast cell dysfunction, aberrant growth factor and cytokine expression and increased expression and activity of tyrosine phosphatase 1B (PTP1B). Understanding these mechanisms can lead to the development of new therapeutic approaches for the management of diabetic foot problems.
Dr. Aristidis Veves is the Research Director of the Joslin-Beth Israel Deaconess Foot Center and of the Microcirculation Lab, and Associate Professor at Harvard Medical School. He received his M.D. from the Medical School, Aristotelion / University of Thessaloniki (Greece), his M.Sc. from the Faculty of Medicine, University of Manchester (U.K.), and his D.Sc. from Athens Medical School (Greece). Dr. Veves did his internship in General Medicine at Athens Naval Hospital (Greece), and completed his residency in General Medicine at Tsaggari General District Hospital (Athens, Greece). He then served as Hon. Senior House Officer in the University Department of Medicine, Diabetes and Endocrinology at Manchester Royal Infirmary (U.K.). Most recently, he was a Research Fellow at Deaconess – Joslin Foot Center, Deaconess Hospital (Boston, MA).
Dr. Veves’ main academic interest is the role of neuropathy and vascular disease in the development of diabetic foot problems. Dr. Veves is also involved with evaluating the endothelial function of the brachial artery, as well as other studies involving endothelial function. In summary, the main effort of Dr. Veves’ research is to develop techniques which will identify patients at risk of developing diabetic foot problems at the early stages and to develop therapeutic strategies which will prevent or slow the progression of this condition. In addition, Dr. Veves is also interested in the etiology of diabetic foot problems and the pathophysiology of wound healing in diabetes.
Dr. Veves’ areas of expertise include diabetic neuropathy, diabetic foot problems, and vascular reactivity.
Matheson Hall is located at 32nd and Market Streets.