الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Glycemic variability (GV) is fluctuation between high and low glucose levels. Clinical studies showed that GV might be important for the pathogenesis of atherosclerosis and cardiovascular complications in patients with diabetes. Acute GV refers to within or between-day fluctuations in an individual and is usually measured by continuous glucose monitoring system. On the other hand chronic GV refers to glycemic fluctuations over months to years. A certain degree of GV variability is observed in people with normal glucose tolerance showed significant increases in with aging . Endothelial progenitor cells (EPCs) are a subtypes of stem cells with high proliferative and differentiating potentiality. They mainly derived from bone marrow (BM) and peripheral blood (PB) . EPCs are mobilized from BM into PB then homed to the sites of vascular injury and differentiate into mature endothelial cells, participating in angiogenesis and vascular repair. Impairments in mobilization and function of the BM-derived EPCs have been reported in studies of diabetes. Granulocyte-colony stimulating factor (G-CSF), a cytokine known to promote the mobilization of bone marrow-derived hematopoietic stem cells into the circulation has been shown to play a neuroprotective role in ischemic stroke through mobilizing bone marrow (BM)-derived endothelial progenitor cells (EPCs), inducing angiogenesis, inhibiting apoptosis, accelerating wound healing, and reducing fibrosis . The objectives of the present work are to compare between the effect of acute blood glucose fluctuation and constant hyperglycemia on aorta by different histological and biochemical studies and to evaluate the role of G-CSF as a novel therapy. This study was carried out at the Faculty of Medicine, Assuit University. The experiment duration 11 days. A total of 30 male albino rats (each rat was about 180 ± 5 gram) were allocated in five cages (6 rats/cage) and divided into five groups (6 rats per each group) as the followings: group I (G1); Control group: They received 1ml saline by intraperitoneal injection for four days. group II (G2); Constant high glucose group [CHG]: They received 50% glucose 1 ml by intraperitoneal injection every two hours for four days. group III (G 3); Acute glucose fluctuation group [AFG]: They received 50% glucose 1 ml intraperitoneal injection every four hours for four days. group IV (G 4); Recovery group: They received 50% glucose 1 ml by intraperitoneal injection every four hours for four days followed by one week not received nothing then sacrificed. group V (G 5): Treated group by Filgrastim: They received 50% glucose 1 ml by intraperitoneal injection every four hours for four days then the group injected with 1.4 ml of diluted granulocyte colony stimulating factor (Neupogen®) subcutaneously at a dose of 200 microgram / kg / day for five days then left for two days without treatment (Elbana et al., 2015). The following morphometric indices were measured: Tunica Intima Thickness (the distance between the lumen and the first elastic lamina) Tunica media thickness (the distance between the end of the first elastic lamina and the final elastic lamina at media-adventitia border )(Guce et al 2011) Area% of collagen Area % of elastic fiber Caspase 3 optical density VEGF optical density Plasma insulin, glucose level and c-peptide were compared between groups Conclusion In summary, our results indicate that acute fluctuation hyperglycemia induces more severe endothelial damage and may be more harmful to the cardiovascular system as compared to persistent hyperglycemia. Fluctuation hyperglycemia may significantly increase oxidative stress, apoptosis and dysfunction in endothelial cells. Therefore, not only lowering blood glucose level, but also reducing glucose fluctuation is very important in clinic. Based on our results, granulocyte colony stimulating factor may provide a promising therapy for ameliorating fluctuation hyperglycemia-induced cardiovascular diseases. More study of the effect of glucose fluctuations on beta cell of pancreas. Research more on the effect of chronic fluctuations on aorta. More trials on the effect of granulocyte colony stimulating factor on different organs.S