In the View of Endothelial Microparticles: Novel Perspectives for Diagnostic and Pharmacological Management of Cardiovascular Risk during Diabetes Distress

Acute or chronic exposure to diabetes-related stressors triggers a specific psychological and behavior stress syndrome called diabetes distress, which underlies depressive symptoms in most diabetic patients. Distressed and/or depressive diabetic adults exhibit higher rates of cardiovascular mortality and morbidity, which have been correlated to macrovascular complications evoked by diabetic behavior stress. Recent experimental findings clearly point out that oxidative stress accounts for the vascular dysfunction initiated by the exposure to life stressors in diabetic conditions. Moreover, oxidative stress has been described as the main autocrine and paracrine mechanism of cardiovascular damage induced by endothelial microparticles (anuclear ectosomal microvesicles released from injured endothelial cells) in diabetic subjects. Such robust relationship between oxidative stress and cardiovascular diseases strongly suggests a critical role for endothelial microparticles as the primer messengers of the redox-dependent vascular dysfunction underlying diabetes distress. Here, we provide novel perspectives opened in the view of endothelial microparticles as promising diagnostic and pharmacotherapeutic biomarkers of cardiovascular risk in distressed diabetic patients.