551
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Recent advances in the applications of metabolomics in eye research. Anal Chim Acta 2018; 1037:28-40. [PMID: 30292303 DOI: 10.1016/j.aca.2018.01.060] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 01/26/2018] [Accepted: 01/29/2018] [Indexed: 11/21/2022]
Abstract
Metabolomics, the identification and quantitation of metabolites in a system, have been applied to identify new biomarkers or elucidate disease mechanism. In this review, we discussed the application of metabolomics in several ocular diseases and recent developments in metabolomics regarding tear fluids analysis, data acquisition and processing.
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552
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Czakó C, Sándor GL, Ecsedy M, Szepessy Z, Borbándy Á, Resch M, Papp A, Récsán Z, Horváth H, Nagy ZZ, Kovács I. Diabeteses kisér-károsodás vizsgálata optikai koherencia tomográfián alapuló angiográfiával. Orv Hetil 2018; 159:320-326. [DOI: 10.1556/650.2018.30962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Abstract: Introduction: Optical coherence tomography angiography is a non-invasive imaging technique that is able to visualize the different retinal vascular layers using motion contrast to detect blood flow without intravenous dye injection. This method might help to assess microangiopathy in diabetic retinopathy during screening and follow-up. Aim: To quantify retinal microvasculature alterations in both eyes of diabetic patients in relation to systemic risk factors using optical coherence tomography angiography. Method: Both eyes of 36 diabetic patients and 45 individuals without diabetes were examined. Duration of diabetes, insulin therapy, blood pressure, HbA1c, dyslipidemia, axial length and the presence of diabetic retinopathy were recorded. Retinal vessel density was measured by optical coherence tomography angiography. The effect of risk factors on vessel density and between-eye asymmetry was assessed using multivariable regression analysis. Results: Vessel density was significantly lower and between-eye difference was significantly higher in diabetic patients compared to controls (p<0.05). Both vessel density and between-eye asymmetry significantly correlated with diabetes duration (p<0.05) after controlling for the effect of risk factors. The between-eye asymmetry in vessel density was significantly higher in patients without clinically detectable diabetic retinopathy compared to control subjects (p<0.001). Conclusions: There is a decrease in retinal vessel density and an increase in between-eye asymmetry in patients with diabetes compared to healthy subjects. By using optical coherence tomography angiography, the detection of these microvascular alterations is possible before clinically detectable diabetic retinopathy and might serve as a useful tool in both screening and timing of treatment. Orv Hetil. 2018; 159(8): 320–326.
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Affiliation(s)
- Cecília Czakó
- Szemészeti Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Üllői út 26., 1085
| | - Gábor László Sándor
- Szemészeti Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Üllői út 26., 1085
| | - Mónika Ecsedy
- Szemészeti Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Üllői út 26., 1085
| | - Zsuzsanna Szepessy
- Szemészeti Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Üllői út 26., 1085
| | - Ágnes Borbándy
- Szemészeti Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Üllői út 26., 1085
| | - Miklós Resch
- Szemészeti Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Üllői út 26., 1085
| | - András Papp
- Szemészeti Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Üllői út 26., 1085
| | - Zsuzsa Récsán
- Szemészeti Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Üllői út 26., 1085
| | - Hajnalka Horváth
- Szemészeti Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Üllői út 26., 1085
| | - Zoltán Zsolt Nagy
- Szemészeti Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Üllői út 26., 1085
| | - Illés Kovács
- Szemészeti Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Üllői út 26., 1085
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553
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Pang B, Zhou H, Kuang H. The potential benefits of glucagon-like peptide-1 receptor agonists for diabetic retinopathy. Peptides 2018; 100:123-126. [PMID: 28807775 DOI: 10.1016/j.peptides.2017.08.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 08/01/2017] [Accepted: 08/08/2017] [Indexed: 01/13/2023]
Abstract
For a long time, diabetic retinopathy (DR) has been one of the most severe complications of diabetes. The early treatment of DR is not clearly recognized. The additional benefit of hypoglycemic agents for DR has become a new research field. Glucagon-like peptide-1 receptor (GLP-1R) has been shown to be widely expressed in tissues including retina. Glucagon-like peptide-1 receptor agonists (GLP-1RA) have been generally used in the treatment of diabetic patients. Studies shows that GLP-1RA could inhibit nerve damage by decrease apoptosis of nerve cells and activation of glial cells. In addition, GLP-1RA plays a protective role for tight junction (TJ) and cells of blood retinal barrier (BRB). It also protects retina from BRB damage. In this review, we discuss the potential protective mechanisms of GLP-1RA for DR beyond the hypoglycemic effects.
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Affiliation(s)
- Baoying Pang
- Department of Endocrinology, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Huanran Zhou
- Department of Endocrinology, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Hongyu Kuang
- Department of Endocrinology, The First Affiliated Hospital of Harbin Medical University, Harbin, China.
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554
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Li W, Webster KA, LeBlanc ME, Tian H. Secretogranin III: a diabetic retinopathy-selective angiogenic factor. Cell Mol Life Sci 2018; 75:635-647. [PMID: 28856381 PMCID: PMC5771826 DOI: 10.1007/s00018-017-2635-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 08/25/2017] [Accepted: 08/28/2017] [Indexed: 12/13/2022]
Abstract
Secretogranin III (Scg3) is a member of the granin protein family that regulates the biogenesis of secretory granules. Scg3 was recently discovered as an angiogenic factor, expanding its functional role to extrinsic regulation. Unlike many other known angiogenic factors, the pro-angiogenic actions of Scg3 are restricted to pathological conditions. Among thousands of quantified endothelial ligands, Scg3 has the highest binding activity ratio to diabetic vs. healthy mouse retinas and lowest background binding to normal vessels. In contrast, vascular endothelial growth factor binds to and stimulates angiogenesis of both diabetic and control vasculature. Consistent with its role in pathological angiogenesis, Scg3-neutralizing antibodies alleviate retinal vascular leakage in mouse models of diabetic retinopathy and retinal neovascularization in oxygen-induced retinopathy mice. This review summarizes our current knowledge of Scg3 as a regulatory protein of secretory granules, highlights its new role as a highly disease-selective angiogenic factor, and envisions Scg3 inhibitors as "selective angiogenesis blockers" for targeted therapy.
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Affiliation(s)
- Wei Li
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, FL, 33136, USA.
- Vascular Biology Institute, University of Miami School of Medicine, Miami, FL, 33136, USA.
| | - Keith A Webster
- Vascular Biology Institute, University of Miami School of Medicine, Miami, FL, 33136, USA
- Department Pharmacology, University of Miami School of Medicine, Miami, FL, 33136, USA
| | - Michelle E LeBlanc
- Schepens Eye Research Institute, Harvard Medical School, Boston, MA, 02114, USA
| | - Hong Tian
- Everglades Biopharma, Miami, FL, 33156, USA
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555
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O-Linked β- N-acetylglucosamine (O-GlcNAc) modification: a new pathway to decode pathogenesis of diabetic retinopathy. Clin Sci (Lond) 2018; 132:185-198. [PMID: 29352075 DOI: 10.1042/cs20171454] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 12/13/2017] [Accepted: 12/18/2017] [Indexed: 01/08/2023]
Abstract
The incidence of diabetes continues to rise among all ages and ethnic groups worldwide. Diabetic retinopathy (DR) is a complication of diabetes that affects the retinal neurovasculature causing serious vision problems, including blindness. Its pathogenesis and severity is directly linked to the chronic exposure to high glucose conditions. No treatments are currently available to stop the development and progression of DR. To develop new and effective therapeutic approaches, it is critical to better understand how hyperglycemia contributes to the pathogenesis of DR at the cellular and molecular levels. We propose alterations in O-GlcNAc modification of target proteins during diabetes contribute to the development and progression of DR. The O-GlcNAc modification is regulated through hexosamine biosynthetic pathway. We showed this pathway is differentially activated in various retinal vascular cells under high glucose conditions perhaps due to their selective metabolic activity. O-GlcNAc modification can alter protein stability, activity, interactions, and localization. By targeting the same amino acid residues (serine and threonine) as phosphorylation, O-GlcNAc modification can either compete or cooperate with phosphorylation. Here we will summarize the effects of hyperglycemia-induced O-GlcNAc modification on the retinal neurovasculature in a cell-specific manner, providing new insight into the role of O-GlcNAc modification in early loss of retinal pericytes and the pathogenesis of DR.
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556
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Mishra S, Yogi P, Sagdeo PR, Kumar R. Mesoporous Nickel Oxide (NiO) Nanopetals for Ultrasensitive Glucose Sensing. NANOSCALE RESEARCH LETTERS 2018; 13:16. [PMID: 29327092 PMCID: PMC5764908 DOI: 10.1186/s11671-018-2435-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 01/04/2018] [Indexed: 06/07/2023]
Abstract
Glucose sensing properties of mesoporous well-aligned, dense nickel oxide (NiO) nanostructures (NSs) in nanopetals (NPs) shape grown hydrothermally on the FTO-coated glass substrate has been demonstrated. The structural study based investigations of NiO-NPs has been carried out by X-ray diffraction (XRD), electron and atomic force microscopies, energy dispersive X-ray (EDX), and X-ray photospectroscopy (XPS). Brunauer-Emmett-Teller (BET) measurements, employed for surface analysis, suggest NiO's suitability for surface activity based glucose sensing applications. The glucose sensor, which immobilized glucose on NiO-NPs@FTO electrode, shows detection of wide range of glucose concentrations with good linearity and high sensitivity of 3.9 μA/μM/cm2 at 0.5 V operating potential. Detection limit of as low as 1 μΜ and a fast response time of less than 1 s was observed. The glucose sensor electrode possesses good anti-interference ability, stability, repeatability & reproducibility and shows inert behavior toward ascorbic acid (AA), uric acid (UA) and dopamine acid (DA) making it a perfect non-enzymatic glucose sensor.
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Affiliation(s)
- Suryakant Mishra
- Material Research Laboratory, Discipline of Physics & MEMS, Indian Institute of Technology Indore, Simrol, Indore, 453552, India
| | - Priyanka Yogi
- Material Research Laboratory, Discipline of Physics & MEMS, Indian Institute of Technology Indore, Simrol, Indore, 453552, India
| | - P R Sagdeo
- Material Research Laboratory, Discipline of Physics & MEMS, Indian Institute of Technology Indore, Simrol, Indore, 453552, India
| | - Rajesh Kumar
- Material Research Laboratory, Discipline of Physics & MEMS, Indian Institute of Technology Indore, Simrol, Indore, 453552, India.
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557
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Wong MYZ, Man REK, Fenwick EK, Gupta P, Li LJ, van Dam RM, Chong MF, Lamoureux EL. Dietary intake and diabetic retinopathy: A systematic review. PLoS One 2018; 13:e0186582. [PMID: 29324740 PMCID: PMC5764236 DOI: 10.1371/journal.pone.0186582] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 10/03/2017] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION The evidence linking dietary intake with diabetic retinopathy (DR) is growing but unclear. We conducted a systematic review of the association between dietary intake and DR. METHODS We systematically searched PubMed, Embase, Medline, and the Cochrane Central register of controlled trials, for publications between January 1967 and January 2017 using standardized criteria for diet and DR. Interventional and observational studies investigating micro- and macro-nutrient intakes; food and beverage consumptions; and dietary patterns were included. Study quality was evaluated using a modified Newcastle-Ottawa scale for observational studies, and the Cochrane collaboration tool for interventional studies. RESULTS Of 4265 titles initially identified, 31 studies (3 interventional, 28 Observational) were retained. Higher intakes of dietary fibre, oily fish, and greater adherence to a Mediterranean diet were protective of DR. Conversely, high total caloric intake was associated with higher risk of DR. No significant associations of carbohydrate, vitamin D, and sodium intake with DR were found. Associations of antioxidants, fatty acids, proteins and alcohol with DR remain equivocal. CONCLUSIONS Dietary fibre, oily fish, a Mediterranean diet and a reduced caloric intake are associated with lower risk of DR. Longitudinal data and interventional models are warranted to confirm our findings and better inform clinical guidelines.
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Affiliation(s)
- Mark Y. Z. Wong
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore
| | - Ryan E. K. Man
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore
| | - Eva K. Fenwick
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore
- Duke-NUS Medical School, Office of Clinical Sciences, Singapore
| | - Preeti Gupta
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore
| | - Ling-Jun Li
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore
- Duke-NUS Medical School, Office of Clinical Sciences, Singapore
| | - Rob M. van Dam
- Singapore Institute for Clinical Sciences, A*STAR, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Mary F. Chong
- Singapore Institute for Clinical Sciences, A*STAR, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Ecosse L. Lamoureux
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore
- Duke-NUS Medical School, Office of Clinical Sciences, Singapore
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558
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Lalit PS, Thangal Y, Fayi Y, Takhellambam SD. Potentials of Gene Therapy for Diabetic Retinopathy: The Use of Nucleic Acid Constructs Containing a TXNIP Promoter. OPEN ACCESS JOURNAL OF OPHTHALMOLOGY 2018; 3. [PMID: 31106306 DOI: 10.23880/oajo-16000147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Diabetic retinopathy (DR) is considered as a chronic eye disease leading to blindness. DR is associated with hyperglycemia-induced oxidative stress, chronic low-grade inflammation and premature cell death. DR affects retinal capillaries, neuroretina and the retinal pigment epithelium. Recently, the thioredoxin-interacting protein TXNIP has been shown as a pro-oxidative stress, pro-inflammatory and pro-apoptotic protein, highly induced by diabetes and high glucose in all cells examined including the retina. TXNIP's actions involve binding to and inhibition of anti-oxidant and thiol-reducing capacities of thioredoxins (Trx) causing cellular oxidative stress and apoptosis. Trx1 is found in the cytosol and nucleus while Trx2 is the mitochondrial isoform. Several studies provided evidence that knockdown of TXNIP by siRNA or chemical blockade ameliorates early abnormalities of DR including endothelial dysfunction, pericyte apoptosis, Müller cell gliosis and neurodegeneration. Therefore, TXNIP is considered a potential target for preventing or slowing down the progression of DR. We recently proposed that nucleic acid constructs containing a proximal TXNIP promoter linked to a redox gene or shRNA that reduces oxidative stress and inflammation may be used to treat DR. The TXNIP promoter is sensitive to hyperglycemia therefore can drive expression of the linked gene or shRNA under high glucose environment such as seen in diabetes while remaining unresponsive at physiological glucose levels. Such a TXNIP-promoter linked gene or shRNA construct can be delivered to the retina by using adeno-associated viral vectors including AAV2 and AAV2/8 or an appropriate carrier via the intravitreal or sub retinal delivery for long-term gene therapies in DR.
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Affiliation(s)
- P S Lalit
- Department of Anatomy and Cell Biology, Wayne State University School of Medicine, USA.,Department of Ophthalmology, Wayne State University School of Medicine, USA
| | - Y Thangal
- Department of Anatomy and Cell Biology, Wayne State University School of Medicine, USA
| | - Y Fayi
- Department of Anatomy and Cell Biology, Wayne State University School of Medicine, USA
| | - S D Takhellambam
- Department of Anatomy and Cell Biology, Wayne State University School of Medicine, USA
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559
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Singh LP. Gene and Tissue Engineering For the Treatment of Diabetes and Its Retinal Complications: The Use of Nucleic Acid Constructs Bearing A TXNIP Gene Promoter. CURRENT TRENDS IN BIOMEDICAL ENGINEERING & BIOSCIENCES 2018; 13. [PMID: 31355358 PMCID: PMC6660148 DOI: 10.19080/ctbeb.2018.13.555869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Diabetes is a chronic disease in which insulin production is deficient (Type 1) or resistant (Type 2) leading to organ complications including the heart, kidney, retina, and peripheral nerves. About 10% of diabetics are Type 1 while ~90 percent are Type 2 associated with life style changes and obesity. Whether it is Type 1 or Type 2, chronic hyperglycemia prevails and associated oxidative stress and low grade inflammation are considered to play critical roles in diabetes and its complications including diabetic retinopathy (DR). Thioredoxin-Interacting Protein, TXNIP, is strongly induced by diabetes and high glucose in all tissues examined including the pancreatic beta cells and the retina. TXNIP binds to and inhibits the anti-oxidant and thiol reducing capacity of thioredoxins and causes cellular oxidative stress, inflammation and premature cell death. TXNIP is induced strongly by high glucose and its metabolites with minutes and remains elevated as long as hyperglycemia persists. Therefore, the TXNIP gene promoter linked with insulin or a gene of interest may be used to induce gene expression or suppression and in tissue engineering for adipose or tissue-derived autologous stem cells producing insulin for the treatment of diabetes and its complications such as DR as well as age-related neurodegenerative diseases.
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Affiliation(s)
- Lalit P Singh
- Department of Anatomy and Cell Biology, Wayne State University School of Medicine, USA.,Department of Ophthalmology, Wayne State University School of Medicine, USA
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560
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Song G, Lin D, Bao L, Jiang Q, Zhang Y, Zheng H, Gao Q. Effects of High Glucose on the Expression of LAMA1 and Biological Behavior of Choroid Retinal Endothelial Cells. J Diabetes Res 2018; 2018:7504614. [PMID: 29967796 PMCID: PMC6008893 DOI: 10.1155/2018/7504614] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 05/05/2018] [Accepted: 05/12/2018] [Indexed: 12/05/2022] Open
Abstract
Hyperglycemia is one of the main causes of proliferative diabetic retinopathy (PDR) characterized by thickening of the vascular basement membrane. Laminin alpha 1 (LAMA1) is a primary component of laminin, a major protein constituent of the basement membrane. In this study, we investigated the role of LAMA1 in the development of PDR. Retinal choroidal vascular endothelial cells (RF/6A line) were exposed to glucose at different concentrations (5 mM, 15 mM, 25 mM, and 35 mM) and analyzed for cell growth, migration, proliferation, and adhesion. LAMA1 expression was examined 24 and 48 h following glucose treatment using Western blotting, RT-PCR, and immunofluorescence. The results showed that the proliferation, migration, and adhesion of RF/6A cells were increased by high glucose, whereas LAMA1 expression was slightly higher at 15 mM but decreased at 25 mM and 35 mM glucose compared to control. Thus, the changes in the biological behavior of high glucose-exposed retinal vascular endothelial cells correspond to variations in LAMA1 expression, indicating a possibility for LAMA1 involvement in PDR development. Our findings suggest that LAMA1 may play a role in PDR and, thus, may serve as a potential target for DR diagnosis and/or treatment.
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Affiliation(s)
- Guangwei Song
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China
- The Second School of Medicine, Wenzhou Medical University, Wenzhou 325027, China
| | - Da Lin
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China
- The Second School of Medicine, Wenzhou Medical University, Wenzhou 325027, China
| | - Licheng Bao
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China
- The Second School of Medicine, Wenzhou Medical University, Wenzhou 325027, China
| | - Qi Jiang
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China
- The Second School of Medicine, Wenzhou Medical University, Wenzhou 325027, China
| | - Yinan Zhang
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China
- The Second School of Medicine, Wenzhou Medical University, Wenzhou 325027, China
| | - Haihua Zheng
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China
- The Second School of Medicine, Wenzhou Medical University, Wenzhou 325027, China
| | - Qianying Gao
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China
- The Second School of Medicine, Wenzhou Medical University, Wenzhou 325027, China
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561
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Ischemic Retinopathies: Oxidative Stress and Inflammation. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2017; 2017:3940241. [PMID: 29410732 PMCID: PMC5749295 DOI: 10.1155/2017/3940241] [Citation(s) in RCA: 99] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Accepted: 11/20/2017] [Indexed: 12/15/2022]
Abstract
Ischemic retinopathies (IRs), such as retinopathy of prematurity (ROP), diabetic retinopathy (DR), and (in many cases) age-related macular degeneration (AMD), are ocular disorders characterized by an initial phase of microvascular changes that results in ischemia, followed by a second phase of abnormal neovascularization that may culminate into retinal detachment and blindness. IRs are complex retinal conditions in which several factors play a key role during the development of the different pathological stages of the disease. Increasing evidence reveals that oxidative stress and inflammatory processes are important contributors to the pathogenesis of IRs. Despite the beneficial effects of the photocoagulation and anti-VEGF therapy during neovascularization phase, the need to identify novel targets to prevent initial phases of these ocular pathologies is still needed. In this review, we provide an update on the involvement of oxidative stress and inflammation in the progression of IRs and address some therapeutic interventions by using antioxidants and anti-inflammatory agents.
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562
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Yeste J, García-Ramírez M, Illa X, Guimerà A, Hernández C, Simó R, Villa R. A compartmentalized microfluidic chip with crisscross microgrooves and electrophysiological electrodes for modeling the blood-retinal barrier. LAB ON A CHIP 2017; 18:95-105. [PMID: 29168876 DOI: 10.1039/c7lc00795g] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The interconnection of different tissue-tissue interfaces may extend organ-on-chips to a new generation of sophisticated models capable of recapitulating more complex organ-level functions. Single interfaces are largely recreated in organ-on-chips by culturing the cells on opposite sides of a porous membrane that splits a chamber in two or by connecting the cells of two adjacent compartments through microchannels. However, it is difficult to interconnect more than one interface using these approaches. To address this challenge, we present a novel microfluidic device where cells are arranged in parallel compartments and are highly interconnected through a grid of microgrooves, which facilitates paracrine signaling and heterotypic cell-cell contact between multiple tissues. In addition, the device includes electrodes on the substrate for the measurement of transepithelial electrical resistance (TEER). Unlike conventional methods for measuring the TEER where electrodes are on each side of the cell barrier, a method with only electrodes on the substrate has been validated. As a proof-of-concept, we have used the device to mimic the structure of the blood-retinal barrier by co-culturing primary human retinal endothelial cells (HREC), a human neuroblastoma cell line (SH-SY5Y), and a human retinal pigment epithelial cell line (ARPE-19). Cell barrier formations were assessed by a permeability assay, TEER measurements, and ZO-1 expression. These results validate the proposed microfluidic device with microgrooves as a promising in vitro tool for the compartmentalization and monitoring of barrier tissues.
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Affiliation(s)
- Jose Yeste
- Institut de Microelectrònica de Barcelona, IMB-CNM (CSIC), 08193, Bellaterra, Barcelona, Spain.
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563
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Dai W, Tham YC, Cheung N, Yasuda M, Tan NYQ, Cheung CY, Wang JJ, Mitchell P, Sabanayagam C, Wong TY, Cheng CY. Macular thickness profile and diabetic retinopathy: the Singapore Epidemiology of Eye Diseases Study. Br J Ophthalmol 2017; 102:1072-1076. [PMID: 29175970 DOI: 10.1136/bjophthalmol-2017-310959] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Revised: 09/25/2017] [Accepted: 11/04/2017] [Indexed: 01/08/2023]
Abstract
BACKGROUND To evaluate retinal thickness profiles in eyes with and without diabetic retinopathy (DR) using spectral-domain optical coherence tomography (SD-OCT) among individuals with diabetes. METHODS Participants were recruited from the Singapore Epidemiology of Eye Diseases Study, a population-based study among Chinese, Malays and Indians aged 40 years or older residing in Singapore. All participants underwent standardised systemic and ophthalmic examinations. Average thickness of the macula, ganglion cell-inner plexiform layer and outer retina layer (from the outer plexiform layer to the retinal pigment epithelium layer) were measured using SD-OCT. DR status and severity were graded based on fundus photographs using the modified Airlie House classification system. Participants with macular oedema were excluded. RESULTS 2240 eyes from 1280 participants were included. Of these, 1764 (78.7%) eyes had no DR, 351 (15.7%) eyes had minimal or mild DR and 125 (5.6%) eyes had moderate or worse DR. After adjusting for age, gender, ethnicity, axial length, hypertension, glycated haemoglobin, body mass index, total cholesterol and diabetes duration, eyes with DR had thicker macula (245.44 µm vs 243.04 µm, P=0.03) and outer retina (124.26 µm vs 123.08 µm, P=0.01) than eyes without DR. When stratified by DR severity, thicker macula (250.24 µm vs 242.88 µm, P=0.011) and outer retina (126.4 µm vs 123.0 μm, P=0.006) were observed in eyes with moderate or worse, but not minimal or mild DR, compared with eyes without DR. CONCLUSIONS Even in the absence of macular oedema, eyes with DR, particularly those with more severe DR, had thicker macular and outer retinal layers than eyes without DR.
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Affiliation(s)
- Wei Dai
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Yih Chung Tham
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Ning Cheung
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Duke-NUS Medical School, National University of Singapore, Singapore
| | - Masayuki Yasuda
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Nicholas Y Q Tan
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Department of Ophthalmology, National University Hospital, Singapore
| | - Carol Y Cheung
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Jie Jin Wang
- Duke-NUS Medical School, National University of Singapore, Singapore
| | - Paul Mitchell
- Centre for Vision Research, University of Sydney, Sydney, Australia
| | - Charumathi Sabanayagam
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Duke-NUS Medical School, National University of Singapore, Singapore
| | - Tien-Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Duke-NUS Medical School, National University of Singapore, Singapore.,Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Duke-NUS Medical School, National University of Singapore, Singapore.,Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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564
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Singh LP, Devi TS, Yumnamcha T. The Role of Txnip in Mitophagy Dysregulation and Inflammasome Activation in Diabetic Retinopathy: A New Perspective. ACTA ACUST UNITED AC 2017; 4. [PMID: 29376145 PMCID: PMC5786434 DOI: 10.19080/jojo.2017.04.555643] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Mitochondria are responsible for bioenergetics, metabolism and apoptosis signals in health and disease. The retina being a part of the central nervous system consumes large amounts of glucose and oxygen to generate ATP via the mitochondrial oxidative phosphorylation for its phototransduction and visual function. During ATP generation, electrons leak from the mitochondrial electron transport chain, which is captured by molecular oxygen to produce reactive oxygen species (ROS). These mtROS damage mitochondrial proteins, mtDNA, and membrane lipids and release them in the cytosol. Mitochondrial components are recognized as danger-associated molecular patterns (DAMPS) by cytosolic pattern recognition receptors such as NOD-like receptors, NLRP3 inflammasomes. They process pro-caspase-1 to active caspase-1, which cleaves pro-inflammatory IL-1β o mature IL-1β causing inflammation and cell death by pyroptosis. To counter the damaging action of mtROS and inflammasomes in fully differentiated cells in the retina, the removal of the damaged and dysfunctional mitochondria by a double-membrane autophagic process via lysosomal degradation called mitophagy is critical for mitochondrial homeostasis and cell survival. Nonetheless, under chronic diseases including diabetic retinopathy (DR), mitophagy dysregulation and NLRP3 inflammasome activation exist, which cause premature cell death and disease progression. Recently, the thioredoxin-interacting protein TXNIP, which is strongly induced by diabetes and inhibits anti-oxidant function of thioredoxin, has been implicated in mitochondrial dysfunction, mitophagic dysregulation and NLRP3 inflammasome activation in DR. Therefore, TXNIP silencing or pharmacological inhibition may normalize mitophagic flux and NLRP3 inflammasome activation, which will prevent or slow down the progression of DR.
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Affiliation(s)
- Lalit P Singh
- Department of Anatomy and Cell Biology, Wayne State University School of Medicine, USA.,Department of Ophthalmology, Wayne State University School of Medicine, USA
| | - Takhellambam S Devi
- Department of Anatomy and Cell Biology, Wayne State University School of Medicine, USA
| | - Thangal Yumnamcha
- Department of Anatomy and Cell Biology, Wayne State University School of Medicine, USA
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565
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Cheung CYL, Sabanayagam C, Law AKP, Kumari N, Ting DSW, Tan G, Mitchell P, Cheng CY, Wong TY. Retinal vascular geometry and 6 year incidence and progression of diabetic retinopathy. Diabetologia 2017. [PMID: 28623387 DOI: 10.1007/s00125-017-4333-0] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
AIMS/HYPOTHESIS We aimed to examine prospectively the association between a range of retinal vascular geometric variables measured from retinal photographs and the 6 year incidence and progression of diabetic retinopathy. METHODS We conducted a prospective, population-based cohort study of Asian Malay individuals aged 40-80 years at baseline (n = 3280) who returned for a 6 year follow-up. Retinal vascular geometric variables (tortuosity, branching, fractal dimension, calibre) were measured from baseline retinal photographs using a computer-assisted program (Singapore I Vessel Assessment). Diabetic retinopathy was graded from baseline and follow-up photographs using the modified Airlie House classification system. Incidence of diabetic retinopathy was defined as a severity of ≥15 at follow-up among those without diabetic retinopathy at baseline. Incidence of referable diabetic retinopathy was defined as moderate or severe non-proliferative diabetic retinopathy, proliferative diabetic retinopathy or diabetic macular oedema at follow-up in participants who had had no or mild non-proliferative diabetic retinopathy at baseline. Progression of diabetic retinopathy was defined as an increase in severity of ≥2 steps at follow-up. Log-binomial models with an expectation-maximisation algorithm were used to estimate RR adjusting for age, sex, diabetes duration, HbA1c level, BP, BMI, estimated GFR and total and HDL-cholesterol at baseline. RESULTS A total of 427 individuals with diabetes participated in the baseline and 6 year follow-up examinations. Of these, 19.2%, 7.57% and 19.2% developed incidence of diabetic retinopathy, incidence of referable diabetic retinopathy and diabetic retinopathy progression, respectively. After multivariate adjustment, greater arteriolar simple tortuosity (mean RR [95% CI], 1.34 [1.04, 1.74]), larger venular branching angle (RR 1.26 [1.00, 1.59]) and larger venular branching coefficient (RR 1.26 [1.03, 1.56]) were associated with incidence of diabetic retinopathy. Greater arteriolar simple tortuosity (RR 1.82 [1.32, 2.52]), larger venular branching coefficient (RR 1.46 [1.03, 2.07]), higher arteriolar fractal dimension (RR 1.59 [1.08, 2.36]) and larger arteriolar calibre (RR 1.83 [1.15, 2.90]) were associated with incidence of referable diabetic retinopathy. Greater arteriolar simple tortuosity (RR 1.34 [1.12, 1.61]) was associated with diabetic retinopathy progression. Addition of retinal vascular variables improved discrimination (C-statistic 0.796 vs 0.733, p = 0.031) and overall reclassification (net reclassification improvement 18.8%, p = 0.025) of any diabetic retinopathy risk beyond established risk factors. CONCLUSIONS/INTERPRETATION Retinal vascular geometry measured from fundus photographs predicted the incidence and progression of diabetic retinopathy in adults with diabetes, beyond established risk factors.
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Affiliation(s)
- Carol Yim-Lui Cheung
- Singapore Eye Research Institute, Singapore National Eye Centre, 11 Third Hospital Avenue, 168751, Singapore, Republic of Singapore
- Department of Ophthalmology and Visual Sciences, Chinese University of Hong Kong, Hong Kong, Special Administrative Region, People's Republic of China
| | - Charumathi Sabanayagam
- Singapore Eye Research Institute, Singapore National Eye Centre, 11 Third Hospital Avenue, 168751, Singapore, Republic of Singapore
- Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Republic of Singapore
| | - Antony Kwan-Pui Law
- Department of Ophthalmology and Visual Sciences, Chinese University of Hong Kong, Hong Kong, Special Administrative Region, People's Republic of China
| | - Neelam Kumari
- Singapore Eye Research Institute, Singapore National Eye Centre, 11 Third Hospital Avenue, 168751, Singapore, Republic of Singapore
| | - Daniel Shu-Wei Ting
- Singapore Eye Research Institute, Singapore National Eye Centre, 11 Third Hospital Avenue, 168751, Singapore, Republic of Singapore
| | - Gavin Tan
- Singapore Eye Research Institute, Singapore National Eye Centre, 11 Third Hospital Avenue, 168751, Singapore, Republic of Singapore
| | - Paul Mitchell
- Centre for Vision Research, University of Sydney, Sydney, NSW, Australia
| | - Ching Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, 11 Third Hospital Avenue, 168751, Singapore, Republic of Singapore
- Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Republic of Singapore
- Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS Medical School, National University of Singapore, Singapore, Republic of Singapore
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, 11 Third Hospital Avenue, 168751, Singapore, Republic of Singapore.
- Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Republic of Singapore.
- Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS Medical School, National University of Singapore, Singapore, Republic of Singapore.
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566
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Leti F, DiStefano JK. Long Noncoding RNAs as Diagnostic and Therapeutic Targets in Type 2 Diabetes and Related Complications. Genes (Basel) 2017; 8:genes8080207. [PMID: 28829354 PMCID: PMC5575670 DOI: 10.3390/genes8080207] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 08/16/2017] [Accepted: 08/16/2017] [Indexed: 01/20/2023] Open
Abstract
Protein-coding genes represent only a small fraction of the human genome. In the past, the majority of the genomic sequence has been considered transcriptionally silent, but recent large-scale studies have uncovered an array of functionally significant elements, including non-protein-coding transcripts, within these noncoding regions of the human genome. Long noncoding RNAs (lncRNAs), a class of noncoding transcripts with lengths >200 nucleotides, are pervasively transcribed in the genome and function as signals, decoys, guides, or scaffolds to regulate gene expression. More than 200 diseases have been associated with dysregulated or dysfunctional lncRNAs, and new associations continue to accumulate in the literature. The role of lncRNAs in the pathogenesis of type 2 diabetes mellitus and related complications has only recently been recognized, but there is already evidence for their involvement in many of the pathophysiological mechanisms underlying the disease. In this review, we summarize the current knowledge of the functions and underlying mechanisms of lncRNA activity with a focus on type 2 diabetes mellitus and related renal and retinal complications of the disease. We also discuss the potential of lncRNAs to serve as therapeutic targets for drug development and diagnostic markers for clinical applications in the management of diabetes.
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Affiliation(s)
- Fatjon Leti
- Department of Biomedical Research, National Jewish Health, Denver, CO 80210, USA.
| | - Johanna K DiStefano
- Department of Biomedical Research, National Jewish Health, Denver, CO 80210, USA.
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567
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Fondi K, Wozniak PA, Howorka K, Bata AM, Aschinger GC, Popa-Cherecheanu A, Witkowska KJ, Hommer A, Schmidl D, Werkmeister RM, Garhöfer G, Schmetterer L. Retinal oxygen extraction in individuals with type 1 diabetes with no or mild diabetic retinopathy. Diabetologia 2017; 60:1534-1540. [PMID: 28547132 PMCID: PMC5491565 DOI: 10.1007/s00125-017-4309-0] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 04/20/2017] [Indexed: 12/25/2022]
Abstract
AIMS/HYPOTHESIS The aim of this study was to compare retinal oxygen extraction in individuals with diabetes with no or mild non-proliferative diabetic retinopathy and healthy age- and sex-matched volunteers. METHODS A total of 24 participants with type 1 diabetes and 24 healthy age- and sex-matched volunteers were included in this cross-sectional study. Retinal oxygen extraction was measured by combining total retinal blood flow measurements using a custom-built bi-directional Doppler optical coherence tomography system with measurements of oxygen saturation using spectroscopic reflectometry. Based on previously published mathematical modelling, the oxygen content in retinal vessels and total retinal oxygen extraction were calculated. RESULTS Total retinal blood flow was higher in diabetic participants (46.4 ± 7.4 μl/min) than in healthy volunteers (40.4 ± 5.3 μl/min, p = 0.002 between groups). Oxygen content in retinal arteries was comparable between the two groups, but oxygen content in retinal veins was higher in participants with diabetes (0.15 ± 0.02 ml O2/ml) compared with healthy control participants (0.13 ± 0.02 ml O2/ml, p < 0.001). As such, the arteriovenous oxygen difference and total retinal oxygen extraction were reduced in participants with diabetes compared with healthy volunteers (total retinal oxygen extraction 1.40 ± 0.44 vs 1.70 ± 0.47 μl O2/min, respectively, p = 0.03). CONCLUSIONS/INTERPRETATION Our data indicate early retinal hypoxia in individuals with type 1 diabetes with no or mild diabetic retinopathy as compared with healthy control individuals. Further studies are required to fully understand the potential of the technique in risk stratification and treatment monitoring. TRIAL REGISTRATION ClinicalTrials.gov NCT01843114.
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Affiliation(s)
- Klemens Fondi
- Department of Clinical Pharmacology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Piotr A Wozniak
- Department of Clinical Pharmacology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
- Department of Ophthalmology, Medical University of Warsaw, Warsaw, Poland
| | - Kinga Howorka
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Ahmed M Bata
- Department of Clinical Pharmacology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Gerold C Aschinger
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Alina Popa-Cherecheanu
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Department of Ophthalmology, Emergency University Hospital, Bucharest, Romania
| | - Katarzyna J Witkowska
- Department of Clinical Pharmacology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Anton Hommer
- Department of Clinical Pharmacology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
- Department of Ophthalmology, Sanatorium Hera, Vienna, Austria
| | - Doreen Schmidl
- Department of Clinical Pharmacology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - René M Werkmeister
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Gerhard Garhöfer
- Department of Clinical Pharmacology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Leopold Schmetterer
- Department of Clinical Pharmacology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria.
- Singapore Eye Research Institute, Singapore, Republic of Singapore.
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Republic of Singapore.
- Imperial College, London, UK.
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568
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Fenwick EK, Xie J, Man REK, Sabanayagam C, Lim L, Rees G, Wong TY, Lamoureux EL. Combined poor diabetes control indicators are associated with higher risks of diabetic retinopathy and macular edema than poor glycemic control alone. PLoS One 2017; 12:e0180252. [PMID: 28662119 PMCID: PMC5491170 DOI: 10.1371/journal.pone.0180252] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 06/13/2017] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To examine the association of individual and combined indicators of diabetes control with diabetic retinopathy and diabetic macular edema. MATERIALS AND METHODS In this clinical, cross-sectional study, 613 adults with type 2 diabetes (372 any diabetic retinopathy; 183 any diabetic macular edema) were examined. Diabetic retinopathy was assessed from fundus photographs; diabetic macular edema from Ocular Coherence Tomography scans; and HbA1c and serum lipid values from fasting blood samples. Poor glucose control was defined as HbA1c≥7%; poor blood pressure control as SBP≥130/DBP≥80; and poor lipid control as total cholesterol:HDL ratio≥4.0. The association of poor glucose control, poor blood pressure control and poor lipid control alone and in combination (poor glucose & blood pressure control; poor glucose & lipid control; poor blood pressure & lipid control; and poor glucose, blood pressure & lipid control) with diabetic retinopathy/diabetic macular edema was examined using multiple logistic regression models. RESULTS Patients' mean±standard deviation age was 64.9±11.6 years (57% male). In adjusted models, compared to those with good control of all indicators (n = 99, 18.3%), the odds ratio (95% Confidence Interval) of having any diabetic retinopathy was 2.44 (1.34-4.46), 3.75 (1.75-8.07), 4.64 (2.13-10.12) and 2.28 (1.01-5.16) for poor glucose control only; poor glucose & blood pressure control; poor glucose & lipid control; and poor glucose, blood pressure & lipid control, respectively. Correspondingly for diabetic macular edema, they were 3.19 (1.55-6.59); 3.60 (1.58-8.22); 2.76 (1.18-6.44); and 3.01 (1.18-7.67), respectively. Odds were not significantly increased for other indicators. DISCUSSION Compared to individual indicators of poor diabetes control, risk of diabetic retinopathy and diabetic macular edema increased three to fourfold with a combination of these indicators. Targeting combined diabetes control indicators is important to reduce risk of diabetic retinopathy/diabetic macular edema.
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Affiliation(s)
- Eva K. Fenwick
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, Melbourne, Australia
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Duke NUS Medical School, National University of Singapore, Singapore, Singapore
| | - Jing Xie
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, Melbourne, Australia
| | - Ryan E. K. Man
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Charumathi Sabanayagam
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Duke NUS Medical School, National University of Singapore, Singapore, Singapore
| | - Lyndell Lim
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, Melbourne, Australia
| | - Gwyn Rees
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, Melbourne, Australia
| | - Tien Y. Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Duke NUS Medical School, National University of Singapore, Singapore, Singapore
| | - Ecosse L. Lamoureux
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, Melbourne, Australia
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Duke NUS Medical School, National University of Singapore, Singapore, Singapore
- * E-mail:
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569
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Prasad T, Roksnoer LCW, Zhu P, Verma A, Li Y, Batenburg WW, de Vries R, Danser AHJ, Li Q. Beneficial Effects of Combined AT1 Receptor/Neprilysin Inhibition (ARNI) Versus AT1 Receptor Blockade Alone in the Diabetic Eye. Invest Ophthalmol Vis Sci 2017; 57:6722-6730. [PMID: 27951594 PMCID: PMC5156511 DOI: 10.1167/iovs.16-20289] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Purpose Dysfunction of the renin-angiotensin system (RAS) contributes to pathogenesis of diabetic retinopathy (DR). Yet RAS blockers have only limited beneficial effects on progression of DR in clinical trials. The natriuretic peptide system offsets RAS, so that enhancing the activity of this system on top of RAS blockade might be beneficial. Neprilysin has an important role in the degradation of natriuretic peptides. Therefore, we hypothesize that dual angiotensin receptor-neprilysin inhibition (ARNI) may outperform angiotensin receptor blocker (ARB) in protection against DR. We tested this hypothesis in streptozotocin-induced diabetic transgenic (mRen2)27 rats. Methods Adult male diabetic (mRen2)27 rats were followed for 5 or 12 weeks. Treatment with vehicle, irbesartan (ARB), or ARB combined with the neprilysin inhibitor thiorphan (irbesartan+thiorphan [ARNI]) occurred during the final 3 weeks. Retinal cell death, gliosis, and capillary loss were evaluated. Real-time polymerase chain reaction (RT-PCR) analyses were performed to quantify the retinal level of inflammatory cell markers. Results Both ARB- and ARNI-treated groups showed similarly reduced retinal apoptotic cell death, gliosis, and capillary loss compared to the vehicle-treated group in the 5-week study. Treatment with ARNI reduced the expression of inflammatory markers more than ARB treatment in the 5-week study. In the 12-week study, ARNI treatment showed significantly more reduction in apoptotic cell death (51% vs. 25% reduction), and capillary loss (68% vs. 43% reduction) than ARB treatment. Conclusions Treatment with ARNI provides better protection against DR in diabetic (mRen2)27 transgenic rats, compared to ARB alone. This approach may be a promising treatment option for patients with DR.
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Affiliation(s)
- Tuhina Prasad
- Department of Ophthalmology, College of Medicine, University of Florida, Gainesville, Florida, United States
| | - Lodi C W Roksnoer
- Division of Pharmacology and Vascular Medicine, Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Ping Zhu
- Department of Ophthalmology, College of Medicine, University of Florida, Gainesville, Florida, United States
| | - Amrisha Verma
- Department of Ophthalmology, College of Medicine, University of Florida, Gainesville, Florida, United States
| | - Yiming Li
- Department of Ophthalmology, College of Medicine, University of Florida, Gainesville, Florida, United States
| | - Wendy W Batenburg
- Division of Pharmacology and Vascular Medicine, Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - René de Vries
- Division of Pharmacology and Vascular Medicine, Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - A H Jan Danser
- Division of Pharmacology and Vascular Medicine, Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Qiuhong Li
- Department of Ophthalmology, College of Medicine, University of Florida, Gainesville, Florida, United States
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570
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Update on Diagnosis and Treatment of Diabetic Retinopathy: A Consensus Guideline of the Working Group of Ocular Health (Spanish Society of Diabetes and Spanish Vitreous and Retina Society). J Ophthalmol 2017; 2017:8234186. [PMID: 28695003 PMCID: PMC5488240 DOI: 10.1155/2017/8234186] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Revised: 04/20/2017] [Accepted: 05/23/2017] [Indexed: 02/07/2023] Open
Abstract
A group of members of the Spanish Retina and Vitreous Society (SERV) and of the Working Group of Ocular Health of the Spanish Society of Diabetes (SED) updated knowledge regarding the diagnosis and treatment of diabetic retinopathy (DR) based on recent evidence reported in the literature. A synthesis of this consensus forms the basis of the present review, which is intended to inform clinicians on current advances in the field of DR and their clinical applicability to patients with this disease. Aspects presented in this article include screening procedures of DR, new technologies in the early diagnosis of DR, control of risk factors in the different stages of the disease, indications of panretinal laser photocoagulation, efficacy of intravitreal antiangiogenic agents and steroids, and surgical options for treating DR-related complications. Practical information regarding periodicity of screening procedures in patients with type 1 and type 2 diabetes, ophthalmological controls according to the stage of retinopathy and complications, and criteria and degree of urgency for referral of a DR patient to the ophthalmologist are also presented.
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571
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Determinants of Quantitative Optical Coherence Tomography Angiography Metrics in Patients with Diabetes. Sci Rep 2017; 7:2575. [PMID: 28566760 PMCID: PMC5451475 DOI: 10.1038/s41598-017-02767-0] [Citation(s) in RCA: 120] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 04/18/2017] [Indexed: 11/08/2022] Open
Abstract
Early microvascular damage in diabetes (e.g. capillary nonperfusion and ischemia) can now be assessed and quantified with optical coherence tomography-angiography (OCT-A). The morphology of vascular tissue is indeed affected by different factors; however, there is a paucity of data examining whether OCT-A metrics are influenced by ocular, systemic and demographic variables in subjects with diabetes. We conducted an observational cross-sectional study and included 434 eyes from 286 patients with diabetes. Foveal avascular zone (FAZ) area, FAZ circularity, total and parafoveal vessel density (VD), fractal dimension (FD), and vessel diameter index (VDI) from the superficial capillary plexus OCT-angiogram were measured by a customized automated image analysis program. We found that diabetic retinopathy (DR) severity was associated with increased FAZ area, decreased FAZ circularity, lower VD, lower FD, and increased VDI. Enlarged FAZ area was correlated with shorter axial length and thinner central subfield macular thickness. Decreased FAZ circularity was correlated with a reduction in visual function. Decreased VD was correlated with thinner macular ganglion-cell inner plexiform layer. Increased VDI was correlated with higher fasting glucose level. We concluded that the effects of ocular and systemic factors in diabetics should be taken into consideration when assessing microvascular alterations via OCT-A.
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572
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Prada-Medina CA, Fukutani KF, Pavan Kumar N, Gil-Santana L, Babu S, Lichtenstein F, West K, Sivakumar S, Menon PA, Viswanathan V, Andrade BB, Nakaya HI, Kornfeld H. Systems Immunology of Diabetes-Tuberculosis Comorbidity Reveals Signatures of Disease Complications. Sci Rep 2017; 7:1999. [PMID: 28515464 PMCID: PMC5435727 DOI: 10.1038/s41598-017-01767-4] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 04/10/2017] [Indexed: 12/13/2022] Open
Abstract
Comorbid diabetes mellitus (DM) increases tuberculosis (TB) risk and adverse outcomes but the pathological interactions between DM and TB remain incompletely understood. We performed an integrative analysis of whole blood gene expression and plasma analytes, comparing South Indian TB patients with and without DM to diabetic and non-diabetic controls without TB. Luminex assay of plasma cytokines and growth factors delineated a distinct biosignature in comorbid TBDM in this cohort. Transcriptional profiling revealed elements in common with published TB signatures from cohorts that excluded DM. Neutrophil count correlated with the molecular degree of perturbation, especially in TBDM patients. Body mass index and HDL cholesterol were negatively correlated with molecular degree of perturbation. Diabetic complication pathways including several pathways linked to epigenetic reprogramming were activated in TBDM above levels observed with DM alone. Our data provide a rationale for trials of host-directed therapies in TBDM, targeting neutrophilic inflammation and diabetic complication pathways to address the greater morbidity and mortality associated with this increasingly prevalent dual burden of communicable and non-communicable diseases.
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Affiliation(s)
- Cesar A Prada-Medina
- Department of Pathophysiology and Toxicology, School of Pharmaceutical Sciences, University of São Paulo, 05508, São Paulo, Brazil
| | - Kiyoshi F Fukutani
- Laboratório de Imunoparasitologia, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
| | - Nathella Pavan Kumar
- National Institutes of Health- NIRT - International Center for Excellence in Research, Chennai, India
| | - Leonardo Gil-Santana
- Unidade de Medicina Investigativa, Laboratório Integrado de Microbiologia e Imunorregulação, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
- Multinational Organization Network Sponsoring Translational and Epidemiological Research, Instituto Brasileiro para a Investigação da Tuberculose, Fundação José Silveira, Salvador, Brazil
- Curso de Medicina, Faculdade de Tecnologia e Ciências, Salvador, Brazil
| | - Subash Babu
- National Institutes of Health- NIRT - International Center for Excellence in Research, Chennai, India
| | - Flávio Lichtenstein
- Department of Pathophysiology and Toxicology, School of Pharmaceutical Sciences, University of São Paulo, 05508, São Paulo, Brazil
| | - Kim West
- Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America
| | | | - Pradeep A Menon
- National Institute for Research in Tuberculosis, Chennai, India
| | | | - Bruno B Andrade
- Unidade de Medicina Investigativa, Laboratório Integrado de Microbiologia e Imunorregulação, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
- Multinational Organization Network Sponsoring Translational and Epidemiological Research, Instituto Brasileiro para a Investigação da Tuberculose, Fundação José Silveira, Salvador, Brazil
- Curso de Medicina, Faculdade de Tecnologia e Ciências, Salvador, Brazil
- Universidade Salvador (UNIFACS), Laureate Universities, Salvador, Brazil
- Division of Infectious Diseases, Department of Medicine, Vanderbilt University School of Medicine, Nashville, USA
| | - Helder I Nakaya
- Department of Pathophysiology and Toxicology, School of Pharmaceutical Sciences, University of São Paulo, 05508, São Paulo, Brazil.
| | - Hardy Kornfeld
- Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America.
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573
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Oxidative stress and diabetic retinopathy: development and treatment. Eye (Lond) 2017; 31:1122-1130. [PMID: 28452994 DOI: 10.1038/eye.2017.64] [Citation(s) in RCA: 141] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 03/14/2017] [Indexed: 02/07/2023] Open
Abstract
Diabetic retinopathy (DR) is the most common microvascular complication in diabetic patients and one of the main causes of acquired blindness in the world. From the 90s until date, the incidence of this complication has increased. Reactive oxygen species (ROS) is a free radical with impaired electron that usually participates in the redox mechanisms of some body molecules such as enzymes, proteins, and so on. In normal biological conditions, ROS is maintained in equilibrium, however its overproduction can lead to biological process called oxidative stress and this is considered the main pathogenesis of DR. The retina is susceptible to ROS because of high-energy demands and exposure to light. When the balance is broken, ROS produces retinal cell injury by interacting with the cellular components. This article describes the possible role of oxidative stress in the development of DR and proposes some treatment options based on its stages. The review of the topic shows that blindness caused by DR can be avoided by early detection and timely treatment.
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574
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Cehofski LJ, Honoré B, Vorum H. A Review: Proteomics in Retinal Artery Occlusion, Retinal Vein Occlusion, Diabetic Retinopathy and Acquired Macular Disorders. Int J Mol Sci 2017; 18:ijms18050907. [PMID: 28452939 PMCID: PMC5454820 DOI: 10.3390/ijms18050907] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 03/08/2017] [Accepted: 04/05/2017] [Indexed: 01/26/2023] Open
Abstract
Retinal artery occlusion (RAO), retinal vein occlusion (RVO), diabetic retinopathy (DR) and age-related macular degeneration (AMD) are frequent ocular diseases with potentially sight-threatening outcomes. In the present review we discuss major findings of proteomic studies of RAO, RVO, DR and AMD, including an overview of ocular proteome changes associated with anti-vascular endothelial growth factor (VEGF) treatments. Despite the severe outcomes of RAO, the proteome of the disease remains largely unstudied. There is also limited knowledge about the proteome of RVO, but proteomic studies suggest that RVO is associated with remodeling of the extracellular matrix and adhesion processes. Proteomic studies of DR have resulted in the identification of potential therapeutic targets such as carbonic anhydrase-I. Proliferative diabetic retinopathy is the most intensively studied stage of DR. Proteomic studies have established VEGF, pigment epithelium-derived factor (PEDF) and complement components as key factors associated with AMD. The aim of this review is to highlight the major milestones in proteomics in RAO, RVO, DR and AMD. Through large-scale protein analyses, proteomics is bringing new important insights into these complex pathological conditions.
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Affiliation(s)
- Lasse Jørgensen Cehofski
- Department of Ophthalmology, Aalborg University Hospital, Hobrovej 18-22, 9000 Aalborg, Denmark.
- Department of Clinical Medicine, Aalborg University, Søndre Skovvej 15, 9000 Aalborg, Denmark.
| | - Bent Honoré
- Department of Clinical Medicine, Aalborg University, Søndre Skovvej 15, 9000 Aalborg, Denmark.
- Department of Biomedicine, Aarhus University, Ole Worms Allé 3, Building 1182, 024, 8000 Aarhus C, Denmark.
| | - Henrik Vorum
- Department of Ophthalmology, Aalborg University Hospital, Hobrovej 18-22, 9000 Aalborg, Denmark.
- Department of Clinical Medicine, Aalborg University, Søndre Skovvej 15, 9000 Aalborg, Denmark.
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575
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Wang JH, Ling D, Tu L, van Wijngaarden P, Dusting GJ, Liu GS. Gene therapy for diabetic retinopathy: Are we ready to make the leap from bench to bedside? Pharmacol Ther 2017; 173:1-18. [PMID: 28132907 DOI: 10.1016/j.pharmthera.2017.01.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Diabetic retinopathy (DR), a chronic and progressive complication of diabetes mellitus, is a sight-threatening disease characterized in the early stages by neuronal and vascular dysfunction in the retina, and later by neovascularization that further damages vision. A major contributor to the pathology is excess production of vascular endothelial growth factor (VEGF), a growth factor that induces formation of new blood vessels and increases permeability of existing vessels. Despite the recent availability of effective treatments for the disease, including laser photocoagulation and therapeutic VEGF antibodies, DR remains a significant cause of vision loss worldwide. Existing anti-VEGF agents, though generally effective, are limited by their short therapeutic half-lives, necessitating frequent intravitreal injections and the risk of attendant adverse events. Management of DR with gene therapies has been proposed for several years, and pre-clinical studies have yielded enticing findings. Gene therapy holds several advantages over conventional treatments for DR, such as a longer duration of therapeutic effect, simpler administration, the ability to intervene at an earlier stage of the disease, and potentially fewer side-effects. In this review, we summarize the current understanding of the pathophysiology of DR and provide an overview of research into DR gene therapies. We also examine current barriers to the clinical application of gene therapy for DR and evaluate future prospects for this approach.
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Affiliation(s)
- Jiang-Hui Wang
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia; Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia
| | - Damien Ling
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia; Discipline of Ophthalmology, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Leilei Tu
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia; Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Peter van Wijngaarden
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia; Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia
| | - Gregory J Dusting
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia; Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia
| | - Guei-Sheung Liu
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia; Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia; Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia.
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576
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Kang MK, Park SH, Kim YH, Lee EJ, Antika LD, Kim DY, Choi YJ, Kang YH. Dietary Compound Chrysin Inhibits Retinal Neovascularization with Abnormal Capillaries in db/db Mice. Nutrients 2016; 8:nu8120782. [PMID: 27918469 PMCID: PMC5188437 DOI: 10.3390/nu8120782] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 11/23/2016] [Accepted: 11/28/2016] [Indexed: 12/13/2022] Open
Abstract
Diabetic retinopathy (DR) develops in a significant proportion of patients with chronic diabetes, characterized by retinal macular edema and abnormal retinal vessel outgrowth leading to vision loss. Chrysin, a naturally-occurring flavonoid found in herb and honeycomb, has anti-inflammatory, antioxidant, and anti-cancer properties. This study sought to determine the protective effects of chrysin on retinal neovascularization with abnormal vessels and blood-retinal barrier (BRB) breakdown in 33 mM glucose-exposed human retinal endothelial cells and in db/db mouse eyes. High glucose caused retinal endothelial apoptotic injury, which was inhibited by submicromolar chrysin. This compound diminished the enhanced induction of HIF-1α, vascular endothelial growth factor (VEGF), and VEGF receptor-2 (VEGFR2) in high glucose-exposed retinal endothelial cells. Consistently, oral administration of 10 mg/kg chrysin reduced the induction of these proteins in db/db mouse eye tissues. In addition, chrysin restored the decrement of VE-cadherin and ZO-1 junction proteins and PECAM-1 in hyperglycemia-stimulated retinal endothelial cells and diabetic mouse retina, possibly maintaining tight cell-cell interactions of endothelial cells and pericytes. Anti-apoptotic chrysin reduced the up-regulation of Ang-1, Ang-2, and Tie-2 crucial to retinal capillary occlusion and BRB permeability. Furthermore, orally treating chrysin inhibited acellular capillary formation, neovascularization, and vascular leakage observed in diabetic retinas. These observations demonstrate, for the first time, that chrysin had a capability to encumber diabetes-associated retinal neovascularization with microvascular abnormalities and BRB breakdown.
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Affiliation(s)
- Min-Kyung Kang
- Department of Food Science and Nutrition, Hallym University, Chuncheon 24252, Korea.
| | - Sin-Hye Park
- Department of Food Science and Nutrition, Hallym University, Chuncheon 24252, Korea.
| | - Yun-Ho Kim
- Department of Food Science and Nutrition, Hallym University, Chuncheon 24252, Korea.
| | - Eun-Jung Lee
- Department of Food Science and Nutrition, Hallym University, Chuncheon 24252, Korea.
| | - Lucia Dwi Antika
- Department of Food Science and Nutrition, Hallym University, Chuncheon 24252, Korea.
| | - Dong Yeon Kim
- Department of Food Science and Nutrition, Hallym University, Chuncheon 24252, Korea.
| | - Yean-Jung Choi
- Department of Food Science and Nutrition, Hallym University, Chuncheon 24252, Korea.
| | - Young-Hee Kang
- Department of Food Science and Nutrition, Hallym University, Chuncheon 24252, Korea.
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577
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Factors Influencing Intention to Receive Examination of Diabetes Complications. Asian Nurs Res (Korean Soc Nurs Sci) 2016; 10:289-294. [DOI: 10.1016/j.anr.2016.10.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Revised: 09/16/2016] [Accepted: 10/09/2016] [Indexed: 11/18/2022] Open
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578
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579
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Hu JX, Thomas CE, Brunak S. Network biology concepts in complex disease comorbidities. Nat Rev Genet 2016; 17:615-29. [PMID: 27498692 DOI: 10.1038/nrg.2016.87] [Citation(s) in RCA: 201] [Impact Index Per Article: 25.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The co-occurrence of diseases can inform the underlying network biology of shared and multifunctional genes and pathways. In addition, comorbidities help to elucidate the effects of external exposures, such as diet, lifestyle and patient care. With worldwide health transaction data now often being collected electronically, disease co-occurrences are starting to be quantitatively characterized. Linking network dynamics to the real-life, non-ideal patient in whom diseases co-occur and interact provides a valuable basis for generating hypotheses on molecular disease mechanisms, and provides knowledge that can facilitate drug repurposing and the development of targeted therapeutic strategies.
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Affiliation(s)
- Jessica Xin Hu
- Novo Nordisk Foundation Center for Protein Research, University of Copenhagen, Copenhagen DK-2200, Denmark
| | - Cecilia Engel Thomas
- Novo Nordisk Foundation Center for Protein Research, University of Copenhagen, Copenhagen DK-2200, Denmark
| | - Søren Brunak
- Novo Nordisk Foundation Center for Protein Research, University of Copenhagen, Copenhagen DK-2200, Denmark.,Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, Copenhagen DK-2100, Denmark
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