Mammalian Diaphanous1 signalling in neurovascular complications of diabetes

Over the past few decades, diabetes gradually has become one of the top non‐communicable disorders, affecting 476.0 million in 2017 and is predicted to reach 570.9 million people in 2025. It is estimated that 70 to 100% of all diabetic patients will develop some if not all, diabetic complications over the course of the disease. Despite different symptoms, mechanisms underlying the development of diabetic complications are similar, likely stemming from deficits in both neuronal and vascular components supplying hyperglycaemia‐susceptible tissues and organs. Diaph1, protein diaphanous homolog 1, although mainly known for its regulatory role in structural modification of actin and related cytoskeleton proteins, in recent years attracted research attention as a cytoplasmic partner of the receptor of advanced glycation end‐products (RAGE) a signal transduction receptor, whose activation triggers an increase in proinflammatory molecules, oxidative stressors and cytokines in diabetes and its related complications. Both Diaph1 and RAGE are also a part of the RhoA signalling cascade, playing a significant role in the development of neurovascular disturbances underlying diabetes‐related complications. In this review, based on the existing knowledge as well as compelling findings from our past and present studies, we address the role of Diaph1 signalling in metabolic stress and neurovascular degeneration in diabetic complications. In light of the most recent developments in biochemical, genomic and transcriptomic research, we describe current theories on the aetiology of diabetes complications, highlighting the function of the Diaph1 signalling system and its role in diabetes pathophysiology. The neurovascular unit emphasizes the fundamental vascular and nervous component interplay in the progression of diabetic complications. Diaph1, protein diaphanous homolog 1, recently attracted attention as a potential contributor to diabetes pathogenesis. Increased presence of Diaph1 was observed in diabetic endothelium, cardiomyocytes, retina and kidneys and decreased in diabetic peripheral nerves. Based on existing data and findings from our own studies we review the role of Diaph1 in diabetic complication pathogenesis in light of recent biochemical, genomic and transcriptomic advances.