Understanding the damage diabetes causes to the bone marrow

Unravelling mechanisms of stem cell depletion for preservation of regenerative fitness in patients with diabetes

People with diabetes have a higher chance of developing heart failure, dementia, and suffering heart attacks and strokes, compared to people without diabetes. The exact reasons for this are unknown, but researchers know that circulatory problems are common in people with diabetes. This is partly because high glucose levels circulating in the blood can damage blood vessels. Professors Paolo Madeddu and Costanza Emanueli at the Bristol Heart Institute are experts in this field. Their previous work identified that blood vessel damage in diabetes also affects the bone marrow, deep inside bones. Bone marrow is responsible for producing blood cells and stem cells, the latter have the ability to develop into a range of different cell types. Bone marrow is therefore necessary to maintaining healthy tissue repair and turnover of blood cells in the circulatory system. The researchers found that diabetes impairs the blood supply to bone marrow, which reduces stem-cell production and activity because they do not receive enough nutrients or oxygen. Moreover, high glucose levels in the bloodstream also damage the stem cells, reducing the body’s ability to repair itself. The researchers have been awarded over £700,000 over five years to build on this knowledge. They will investigate the circulatory system of the bone marrow in around 150 people with diabetes, focusing in particular on the blood flow around bone marrow. They will use powerful microscopes and scanning machines to look at the behaviour of cells in the bone marrow circulation. They hope to find out new ways to protect cells in the bone marrow from the damage caused by diabetes. Being able to maintain healthy vessels through maintaining bone marrow function in people with diabetes will be important to preserving a healthy circulation and helping to prevent heart or circulatory disease in these people.