New research to find out what damage diabetes does to the smallest blood vessels of the heart in order to develop new therapies

Blood vessels under a microscope.
Directly imaging the tiniest blood vessels of the beating heart will provide important insights into how diabetes damages them.

Dr Neena Kalia, Reader and Director of Intravital Imaging at the Institute of Cardiovascular Sciences (ICVS), University of Birmingham, has been awarded a three-year British Heart Foundation (BHF) research grant to find out what damage diabetes does to the smallest blood vessels of the heart.

Following a heart attack, patients with type 2 diabetes are more likely to suffer from adverse outcomes including heart failure, arrhythmia and death. This may be linked to poor blood flow to the heart muscle following damage to the coronary microvessels. However, it is not possible for cardiologists to see the smallest blood vessels of the heart with current clinical tools such as angiography.

Researchers within the Microcirculation Research Group have developed a state-of-the-art imaging technique which allows them to look in detail at the microvessels of beating hearts. Using this technique, it will be possible to directly see for the first time how diabetes, induced by a high fat diet, damages the coronary microvessels before and after a heart attack. Ongoing work by the group has identified a protein called IL-36 as being critical in mediating microvascular damage in older hearts compared to young hearts. However, its role in diabetes is unknown so this will be investigated alongside its potential as a therapeutic target.  

In response to receiving the award, Dr Kalia said: “Although the prognosis of patients after a heart attack has improved significantly, this has not been matched by similar improvements in outcomes for heart attack patients with diabetes. This poses a significant clinical problem as 25-30% of patients presenting with a heart attack have type 2 diabetes in developed countries and it is estimated that 10% of the world population will have diabetes by 2035.   

"We believe therapies that protect the coronary microvessels are critical in delivering better outcomes but we firstly need to know what damage high blood sugar levels actually inflicts on the coronary microcirculation – only then can we develop novel approaches to protect them.”

The project combines the internationally recognised diabetes, microvascular imaging and IL-36 expertise of Professor David Hodson, Dr Dean Kavanagh and Dr Martin Stacey (University of Leeds). 

Dr Kalia has recently been promoted to Reader following her significant contributions to translational research and teaching excellence. She would like to pay special thanks to members of the Microcirculation Research Group, past and present, for the part they have played in getting her work recognised.

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