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A molecular change in red blood cells may predict vascular damage in people with type 2 diabetes. morgan23/Getty Images

  • MicroRNA-210, which is present in healthy red blood cells, helps regulate vascular function.
  • A new study shows that there is a lower level of microRNA-210 in the red blood cells of people with type 2 diabetes.
  • Replenishing levels of microRNA-210 may one day prevent vascular injury associated with this type of diabetes.

Among the many complications of type 2 diabetes, the development of cardiovascular disease and poorer clinical outcomes following cardiovascular events, especially heart attacks, may be of particular concern.

A recent study published in the journal Diabetes suggests that a lack of a specific molecule in red blood cells may be the root of type 2 diabetes-induced vascular complications.

In recent years, research has shown that these specialized cells undergo several changes and can become dysfunctional in people with this form of diabetes.

Red blood cells carry oxygen from the lungs to the rest of the body. They also transport carbon dioxide back to the lungs for exhalation. In a lesser-known but equally crucial role, red blood cells have an influence on maintaining cardiovascular equilibrium, or homeostasis. This is partly achieved through the production of nitric oxide.

The body uses nitric oxide to widen blood vessels. And researchers have noted that red blood cells in people with type 2 diabetes have a reduced ability to produce nitric oxide. This can lead to the constriction of coronary arteries.

Type 2 diabetes can also affect the release of adenosine triphosphate by red blood cells. This is the primary molecule for storing and transferring energy within the body.

Another change in the red blood cells of people with diabetes is an increased formation of reactive oxygen species. The presence of these molecules can lead to more plaque formation on the interior walls of arteries, a health problem called atherosclerosis.

In the new study, researchers at the Karolinska Institutet, in Sweden, investigated which molecular changes within red blood cells could explain these dysfunctions. The team recruited 36 participants with type 2 diabetes and 32 healthy participants who did not take medication and had normal fasting glucose levels and no history of cardiovascular disease.

The researchers found that the red blood cells of those with type 2 diabetes had much less microRNA-210 than those of the healthy participants. MicroRNA molecules occur naturally and regulate cellular functions, including vascular activity.

The study showed that the reduction in microRNA-210 caused changes in specific vascular protein levels. These alterations contributed to the development of endothelial dysfunction. The endothelium is the thin membrane that lines the heart and blood vessels.

The researchers also found that atherosclerotic plaques taken from participants with type 2 diabetes had lower levels of microRNA-210 than those from the healthy participants.

In addition, glycemic control through medication appeared to have no major influence on the detrimental effects of the changes to red blood cells in participants with type 2 diabetes.

Dr. Swapnil Khare, an assistant professor of clinical medicine and medical director of inpatient diabetes at Indiana University School of Medicine, shared her thoughts on the study with Medical News Today. She was not involved in the research.

“They showed in a part of the study that if they replace the microRNA, the endothelial dysfunction did improve,” Dr. Khare explained. “I would say this isn’t a surprising study, but definitely exciting.”

The direct relationship between microRNAs and red blood cells has yet to be completely understood. The study authors acknowledge that clarifying the signaling pathways between these biostructures will require further research.

In an interview with MNT, Dr. Zhichao Zhou, a researcher at Karolinska Institutet and the first author of the study, said:

“Given [that] microRNAs are very stable in circulation in general, and [that] we observed that red blood cell microRNA-210 levels are decreased in type 2 diabetes, microRNA-210 may become a potential diagnostic marker to predict possible vascular complications.”

In the conclusion to the study paper, the researchers write that increasing red blood cell microRNA-210 levels has the potential to be an effective treatment for endothelial dysfunction and help prevent vascular injury in people with type 2 diabetes.