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Figure 6 | Cardiovascular Diabetology

Figure 6

From: The central role of vascular extracellular matrix and basement membrane remodeling in metabolic syndrome and type 2 diabetes: the matrix preloaded

Figure 6

Renal glomerular Remodeling. This image portrays a normal nephron unit on the left transitioning to an abnormal remodeled nephron unit with changes representative of diabetic nephropathy and changes of glomerulosclerosis. Left: Normal renal capillary glomerular and tubulo-interstitial structures. Transitioning to the Center of the image is the mesangial stalk with mesangial cell hyperplasia (yellow) and mesangial expansion with loss of foot processes of the podocyte (also termed visceral epithelium) (blue) and increasing thickness of the glomerular BM (red). Right: Increased capillary glomerular BM thickening (red) with atrophic podocytes and loss of foot processes of the podocyte (blue) to the capillary glomerular endothelial cell. Right: Also depicts tubulo-interstitial fibrosis with expansion of the peritubular (blue) extracellular matrix (fibrosis) with an increased thickening of the tubular BM (red). Just below the efferent (blue) arteriole is depicted hyaline arteriolosclerosis and just above the afferent arteriole (red) is depicted hyperplastic arteriolosclerosis with its characteristic "onion skin" like changes. The thickened BMs, arteriolar changes, and the mesangial expansion all are PAS+, hyaline staining, and contain large amounts of type IV collagen with increased laminin and fibronectin with concurrent decreased amounts of heparin sulfate proteoglycan (perlecan). Continuous with the proximal tubules (green) is the outer parietal epithelial cells (green), which constitutes the outer structure of Bowman's capsule and Bowman's space.

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