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Sheemar A, Goel P, Thakur PS, Takkar B, Kaur I, Rani PK, Tyagi M, Basu S, Venkatesh P. Diabetes, Diabetic Retinopathy, and Inflammatory Disorders. Ocul Immunol Inflamm 2024; 32:1155-1168. [PMID: 37159104 DOI: 10.1080/09273948.2023.2203742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 04/11/2023] [Accepted: 04/12/2023] [Indexed: 05/10/2023]
Abstract
This review summarizes the impact of systemic and ocular inflammatory disorders on diabetes mellitus (DM) and diabetic retinopathy (DR). Local inflammation is a key pathology in diabetic retinopathy (DR) and is also an evolving target for clinical therapy. The legacy effects of local inflammation at the intracellular level make DR a persistent self-driven vicious process. Ocular inflammation is accompanied as well as incited by systemic inflammation due to diabetes mellitus (DM) itself. Over the years, a multitude of studies have evaluated the impact of systemic inflammatory disorders (SIDs, like rheumatoid arthritis, lupus, psoriasis, etc.) and anti-inflammatory drugs prescribed for managing them on manifestations of DM. Recent studies have indicated increased insulin resistance to be a result of chronic inflammation, and the anti-inflammatory drugs to have a protective effect towards DM. Very few studies have evaluated the impact of SIDs on DR. Furthermore, the evidence from these studies is conflicting, and while local anti-inflammatory therapy has shown a lot of clinical potential for use in DR, the results of systemic anti-inflammatory therapies have been inconsistent. The impact of local ocular inflammation due to uveitis on DR is a crucial aspect that has not been evaluated well at present. Initial pre-clinical studies and small-sized clinical reports have shown a strong and positive relationship between the presence of uveitis and the severity of DR as well as its progression, while larger cross-sectional patient surveys have refuted the same. The long term impact of ocular inflammation due to uveitis on DR needs to be studied while adjusting for confounders.
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Affiliation(s)
- Abhishek Sheemar
- Department of Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Pallavi Goel
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India
| | | | - Brijesh Takkar
- Anant Bajaj Retina Institute, L V Prasad Eye Institute, Hyderabad, India
- Indian Health Outcomes, Public Health, and Economics Research (IHOPE) Centre, L V Prasad Eye Institute, Hyderabad, India
| | - Inderjeet Kaur
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India
| | - Padmaja K Rani
- Anant Bajaj Retina Institute, L V Prasad Eye Institute, Hyderabad, India
| | - Mudit Tyagi
- Uveitis Services, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, India
| | - Soumyava Basu
- Uveitis Services, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, India
| | - Pradeep Venkatesh
- Dr. RP Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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Hu Y, Li Z, Li H, Xu Q, Xu C, Lin W, Ma X, Hao M, Kuang H. Severe hypoglycaemia-induced microglial inflammation damages microvascular endothelial cells, leading to retinal destruction. Diab Vasc Dis Res 2024; 21:14791641241278506. [PMID: 39187253 PMCID: PMC11348349 DOI: 10.1177/14791641241278506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/28/2024] Open
Abstract
Human microglia (HMC) are stress-induced inflammatory cells of the retina. It is unknown whether severe hypoglycaemia causes inflammation in microglia, affects the permeability of human retinal microvascular endothelial cells (HRMECs), and causes retinal damage. This study aimed to explore the effects of severe hypoglycaemia on retinal microglial inflammation and endothelial cell permeability and evaluate the damage caused by hypoglycaemia to the retina. The CCK-8 assay was used to measure cell viability. Western blotting was used to detect IL-1β, IL-6, TNF- α, claudin-1, and occludin expression. ELISA was used to detect IL-1β, IL-6, and TNF- α. Transmission electron microscopy (TEM) and haematoxylin and eosin staining were used to observe the retinal structure. Immunohistochemistry and immunofluorescence staining assays were also used to detect IL-1β, IL-6, TNF- α, claudin-1, and occludin expression. Severe hypoglycaemia promoted inflammation in HMC3 cells. Inflammation caused by hypoglycaemia leads to the decreased expression of tight junction proteins. In vivo, severe hypoglycaemia induced structural damage to the retina, increased the expression of inflammatory factors, and decreased the expression of tight junction proteins. Our results suggest that severe hypoglycaemia leads to acute retinal inflammation, affecting the permeability of HRMECs and causing retinal damage.
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Affiliation(s)
- Yuxin Hu
- The Department of Endocrinology, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Zhen Li
- The Department of Endocrinology, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Hongxue Li
- The Department of Endocrinology, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Qian Xu
- The Department of Endocrinology, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Chengye Xu
- The Department of Endocrinology, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Wenjian Lin
- The Department of Endocrinology, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xuefei Ma
- The Department of Endocrinology, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Ming Hao
- The Department of Endocrinology, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Hongyu Kuang
- The Department of Endocrinology, The First Affiliated Hospital of Harbin Medical University, Harbin, China
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Florido Neto AR, Agostini L, Silva LPD, Nunes MT. Therapeutical Potential of T3 as Adjuvant Therapy in Male Alloxan-induced Diabetic Rats. Endocrinology 2024; 165:bqae066. [PMID: 38862394 DOI: 10.1210/endocr/bqae066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 06/03/2024] [Accepted: 06/06/2024] [Indexed: 06/13/2024]
Abstract
Alloxan-induced diabetic rats present with hypothyroidism. When treated with triiodothyronine (T3), glycemia and proinflammatory cytokine expression are downregulated, improving insulin sensitivity. The effectiveness of associating T3 with insulin (replacement dose [6 U] and [3 U]) in controlling glycemia was investigated in this experimental model. Male Wistar rats were made diabetic by alloxan injection and sorted into groups treated or not with insulin (3 or 6 U) associated or not with T3 (1.5 µg 100 g-1 BW) for 28 days. Nondiabetic rats constituted the control group. Fasting glycemia, glucose decay rate, and thyrotropin (TSH) were measured in the blood/serum of all animals. Immunoblotting was used to assess total GLUT4 expression in skeletal muscles and epididymal white adipose tissue. Cytokine and nuclear factor-κB (NF-κB) expression were measured in these tissues and liver. Diabetic rats presented with increased fasting glycemia, inflammatory cytokines, and NF-κB expression, TSH levels, and insulin resistance. In diabetic rats treated with T3 and/or insulin, these parameters were decreased, whereas GLUT4 and anti-inflammatory cytokine expression were increased. T3 combined with 3-U insulin restored the parameters to values of the control group and was more effective at controlling glycemia than 6-U insulin. Thus, a combination of T3 and insulin might represent a promising strategy for diabetes management since it reduces the insulin requirement by half and improves glycemic control of diabetic rats, which could postpone insulin resistance that develops with chronic insulin administration. These findings open a perspective for using thyroid analogues that provide tissue-specific effects, which might result in a potentially more effective treatment of diabetes.
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Affiliation(s)
- Armando Ribeiro Florido Neto
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of São Paulo, 05508-000, São Paulo, SP, Brazil
| | - Lucas Agostini
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of São Paulo, 05508-000, São Paulo, SP, Brazil
| | - Luciano Pedro da Silva
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of São Paulo, 05508-000, São Paulo, SP, Brazil
| | - Maria Tereza Nunes
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of São Paulo, 05508-000, São Paulo, SP, Brazil
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Reis M, Teixeira A, Cardoso J, Borges T, Caldas Afonso A, Correia-Costa L. Association between proinflammatory cytokines and arterial stiffness in type 1 diabetic adolescents. J Pediatr Endocrinol Metab 2024; 37:405-412. [PMID: 38592062 DOI: 10.1515/jpem-2023-0530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 03/03/2024] [Indexed: 04/10/2024]
Abstract
OBJECTIVES Type 1 diabetes mellitus is considered a state of chronic low-grade inflammation and activation of the innate immune system, which is regulated by several proinflammatory cytokines and other acute-phase reactants. Arterial stiffness, a dynamic property of the vessels evaluated by the determination of pulse wave velocity (PWV), is increased in diabetic patients and is associated with microvascular and macrovascular complications of diabetes and higher cardiovascular risk. In the present study, we aimed to compare the proinflammatory state and arterial stiffness in diabetic and non-diabetic adolescents, and to characterize the association between these two parameters. METHODS Twenty-three type 1 diabetic patients, aged 12-16 years, followed at a tertiary center, and 23 adolescents nonoverweighted healthy controls, from a Portuguese birth-cohort, were included in the present analysis. Anthropometry, blood pressure, glycemic control data, and lipid parameters were collected. Arterial stiffness was evaluated by carotid-femoral pulse wave velocity. Proinflammatory cytokines' concentrations (TNF-α, IL-1β, IL-6, IL-10, IFN-γ, and GM-CSF) were quantified by multiplex immunoassays using a Luminex 200 analyzer. RESULTS There were no statistically significant differences between the proinflammatory cytokines' concentrations in the two groups. PWV [6.63 (6.23-7.07) vs. 6.07 (5.15-6.65) m/s, p=0.015] was significantly higher in the diabetic group. PWV was negatively correlated with GM-CSF (ρ=-0.437, p=0.037) in the diabetic group. A linear association was found between diabetes duration and PWV (with PWV increasing by 0.094 m/s (95 % confidence interval, 0.019 to 0.169) per month of disease duration). In the diabetic group, HbA1c was negatively correlated with IL-10 (ρ=-0.473, p=0.026). Negative correlations were also found between IL-10 and total, HDL, and LDL cholesterol only in the diabetic group. CONCLUSIONS Diabetic adolescent patients present higher PWV, when compared to their healthy counterparts, even though we could not find differences in the levels of several proinflammatory cytokines between the two groups. The negative correlation found between IL-10 and HbA1c might translate a protective counterbalance effect of this anti-inflammatory cytokine, which might also explain the negative correlations found with blood lipids. Further studies are needed to better clarify the association between arterial stiffness and the proinflammatory milieu of diabetes.
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Affiliation(s)
- Mónica Reis
- Instituto de Ciências Biomédicas Abel Salazar, 89239 Universidade do Porto , Porto, Portugal
- 522166 Centro Hospitalar Universitário de Santo António , Porto, Portugal
| | - Ana Teixeira
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Division of Pediatric Nephrology, Centro Materno-Infantil do Norte, 522166 Centro Hospitalar Universitário do Porto , Porto, Portugal
| | - Juliana Cardoso
- Division of Pediatrics, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - Teresa Borges
- Instituto de Ciências Biomédicas Abel Salazar, 89239 Universidade do Porto , Porto, Portugal
- Division of Pediatric Endocrinology, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - Alberto Caldas Afonso
- Instituto de Ciências Biomédicas Abel Salazar, 89239 Universidade do Porto , Porto, Portugal
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Division of Pediatric Nephrology, Centro Materno-Infantil do Norte, 522166 Centro Hospitalar Universitário do Porto , Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Porto, Portugal
- CAC ICBAS-CHP - Centro Académico Clínico Instituto de Ciências Biomédicas Abel Salazar - Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - Liane Correia-Costa
- Instituto de Ciências Biomédicas Abel Salazar, 89239 Universidade do Porto , Porto, Portugal
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Division of Pediatric Nephrology, Centro Materno-Infantil do Norte, 522166 Centro Hospitalar Universitário do Porto , Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Porto, Portugal
- CAC ICBAS-CHP - Centro Académico Clínico Instituto de Ciências Biomédicas Abel Salazar - Centro Hospitalar Universitário de Santo António, Porto, Portugal
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Chen S, Xiao Y, Cui L, Qin X, An Q, Yuan T, Wu Y, Lin Q, Qian Y, Yang C, Zou H. Three-Year Follow-Up Study Investigating Changes in Retinal Vascular Morphology and the Relationship with Diabetic Retinopathy in Children with Type 1 Diabetes Mellitus. Ophthalmic Res 2024; 67:330-339. [PMID: 38679002 DOI: 10.1159/000538797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 04/01/2024] [Indexed: 05/01/2024]
Abstract
INTRODUCTION This study aimed to investigate changes in retinal microvascular morphology and associated factors, and their relationship with diabetic retinopathy (DR) in children with type 1 diabetes mellitus (T1DM). METHODS Thirty-eight children enrolled in this 3-year follow-up study underwent complete ophthalmic examinations including fundus photography. Retinal vascular parameters were measured automatically and compared between baseline and follow-up. Multiple linear regression was used to investigate factors affecting changes in vascular parameters. Binary logistic regression was used to analyze the relationship between retinal microvascular morphology and DR. RESULTS The caliber of all retinal vessels (within 1-1.5 papillary diameter [PD] from the center of the optic disc, p = 0.030; 1.5-2 PD, p = 0.003), arterioles, and venules (1.5-2 PD, p = 0.001) was narrower in nearly all regions in the follow-up group compared with the baseline group. Vascular tortuosity increased in the central part of the retina and decreased in the periphery. The density (1-1.5 PD, p = 0.030) and fractal dimension (p = 0.037) of retinal vessels were increased at the end of the follow-up compared with baseline. Retinal vascular caliber was independently correlated with DR (odds ratio 0.793 [95% confidence interval 0.633-0.993]; p = 0.044). CONCLUSION Retinal microvascular morphology in children with T1DM varied with the disease course. Narrower retinal vessels may be an independent risk factor for DR. Results of this study emphasized the importance of regular follow-up of fundus vascular morphology for the detection of early DR in children with T1DM.
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Affiliation(s)
- Shuli Chen
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China,
| | - Ying Xiao
- Department of Ophthalmology, Children's Hospital of Fudan University, Shanghai, China
| | - Lipu Cui
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xinran Qin
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qingyu An
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tianyi Yuan
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yiwei Wu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiurong Lin
- Shanghai Eye Diseases Prevention & Treatment Center, Shanghai Eye Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Yu Qian
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chenhao Yang
- Department of Ophthalmology, Children's Hospital of Fudan University, Shanghai, China
| | - Haidong Zou
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Eye Diseases Prevention & Treatment Center, Shanghai Eye Hospital, School of Medicine, Tongji University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
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Kugathasan L, Sridhar VS, Tommerdahl KL, Xu C, Bjornstad P, Advani A, Cherney DZI. Minireview: Understanding and targeting inflammatory, hemodynamic and injury markers for cardiorenal protection in type 1 diabetes. Metabolism 2024; 153:155785. [PMID: 38215965 DOI: 10.1016/j.metabol.2024.155785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/16/2023] [Accepted: 01/03/2024] [Indexed: 01/14/2024]
Abstract
The coexistence of cardiovascular disease (CVD) and diabetic kidney disease (DKD) is common in people with type 1 diabetes (T1D) and is strongly associated with an increased risk of morbidity and mortality. Hence, it is imperative to explore robust tools that can accurately reflect the development and progression of cardiorenal complications. Several cardiovascular and kidney biomarkers have been identified to detect at-risk individuals with T1D. The primary aim of this review is to highlight biomarkers of injury, inflammation, or renal hemodynamic changes that may influence T1D susceptibility to CVD and DKD. We will also examine the impact of approved pharmacotherapies for type 2 diabetes, including renin-angiotensin-aldosterone system (RAAS) inhibitors, sodium-glucose cotransporter-2 (SGLT2) inhibitors and glucagon-like peptide-1 receptor agonists (GLP-1RAs) on candidate biomarkers for cardiorenal complications in people with T1D and discuss how these changes may potentially mediate kidney and cardiovascular protection. Identifying predictive and prognostic biomarkers for DKD and CVD may highlight potential drug targets to attenuate cardiorenal disease progression, implement novel risk stratification measures in clinical trials, and improve the assessment, diagnosis, and treatment of at-risk individuals with T1D.
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Affiliation(s)
- Luxcia Kugathasan
- Department of Medicine, Division of Nephrology, University Health Network, Toronto, Ontario, Canada; Department of Physiology, University of Toronto, Toronto, Ontario, Canada; Cardiovascular Sciences Collaborative Specialization, University of Toronto, Toronto, Canada
| | - Vikas S Sridhar
- Department of Medicine, Division of Nephrology, University Health Network, Toronto, Ontario, Canada; Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Kalie L Tommerdahl
- Section of Endocrinology, Department of Pediatrics, University of Colorado, Aurora, CO, USA; Barbara Davis Center for Diabetes, Aurora, CO, USA
| | - Cheng Xu
- Department of Medicine, Division of Nephrology, University Health Network, Toronto, Ontario, Canada
| | - Petter Bjornstad
- Section of Endocrinology, Department of Pediatrics, University of Colorado, Aurora, CO, USA; Division of Nephrology, Department of Medicine, University of Colorado, Aurora, CO, USA
| | - Andrew Advani
- Keenan Research Centre for Biomedical Science and Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - David Z I Cherney
- Department of Medicine, Division of Nephrology, University Health Network, Toronto, Ontario, Canada; Department of Physiology, University of Toronto, Toronto, Ontario, Canada; Cardiovascular Sciences Collaborative Specialization, University of Toronto, Toronto, Canada; Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
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Beatty C, Richardson KP, Tran PMH, Satter KB, Hopkins D, Gardiner M, Sharma A, Purohit S. Multiplex analysis of inflammatory proteins associated with risk of coronary artery disease in type-1 diabetes patients. Clin Cardiol 2024; 47:e24143. [PMID: 37822049 PMCID: PMC10768730 DOI: 10.1002/clc.24143] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/17/2023] [Accepted: 08/21/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Chronic uncontrolled hyperglycemia, a precursor to chronic low-grade inflammation, is a leading cause of coronary artery disease (CAD) due to plaque buildup in type-1 diabetes (T1D) patients. We evaluated levels of 22 inflammatory markers in cross-sectional serum samples from 1222 subjects to evaluate their potential as risk factors for CAD in T1D patients. HYPOTHESIS Circulating levels of markers of inflammation may be the risk factors for incident CAD. METHODS The T1D subjects were divided into two groups: those without CAD (n = 1107) and with CAD (n = 115). Serum levels of proteins were assayed using multiplex immunoassays on a Luminex Platform. Differences between the two groups were made by univariate analysis. Multivariate logistic regression was used to ascertain the potential of proteins as risk factors for CAD. Influence of age, duration of diabetes, sex, hypertension, and dyslipidemia was determined in a stepwise manner. Serum levels of 22 proteins were combined into a composite score using Ridge regression for risk-based stratification. RESULTS Mean levels of CRP, IGFBP1, IGFBP2, insulin-like growth factors binding protein-6 (IGFBP6), MMP1, SAA, sTNFRI, and sTNFRII were elevated in CAD patients (n = 115) compared to T1D patients without CAD (nCAD, n = 1107). After adjusting for age, duration of diabetes, sex, hypertension, and dyslipidemia, higher levels of sTNFRI (odds ratio [OR] = 2.18, 1.1 × 10-3 ), sTNFRII (OR = 1.52, 1 × 10-2 ), and IGFBP6 (OR = 3.62, 1.8 × 10-3 ) were significantly associated with CAD. The composite score based on Ridge regression, was able to stratify CAD patients into low, medium, and high-risk groups. CONCLUSIONS The results show activation of the TNF pathway in CAD patients. Evaluating these markers in serum can be a potential tool for identifying high-risk T1D patients for intensive anti-inflammatory therapeutic interventions.
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Affiliation(s)
- Carol Beatty
- School of MedicineMedical College of GeorgiaAugustaGeorgiaUSA
| | - Katherine P. Richardson
- School of MedicineCenter for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta UniversityAugustaGeorgiaUSA
| | - Paul M. H. Tran
- School of MedicineCenter for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta UniversityAugustaGeorgiaUSA
- Department of Internal MedicineYale School of MedicineNew HavenConnecticutUSA
| | - Khaled B. Satter
- School of MedicineCenter for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta UniversityAugustaGeorgiaUSA
- Department of PathologyNational Institutes of HealthBethesdaMarylandUSA
| | - Diane Hopkins
- School of MedicineCenter for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta UniversityAugustaGeorgiaUSA
| | - Melissa Gardiner
- School of MedicineCenter for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta UniversityAugustaGeorgiaUSA
| | - Ashok Sharma
- School of MedicineCenter for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta UniversityAugustaGeorgiaUSA
| | - Sharad Purohit
- School of MedicineCenter for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta UniversityAugustaGeorgiaUSA
- Department of Obstetrics and GynecologyMedical College of Georgia, Augusta UniversityAugustaGeorgiaUSA
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Bellini S, Guarrera S, Matullo G, Schalkwijk C, Stehouwer CD, Chaturvedi N, Soedamah-Muthu SS, Barutta F, Gruden G. Serum MicroRNA-191-5p Levels in Vascular Complications of Type 1 Diabetes: The EURODIAB Prospective Complications Study. J Clin Endocrinol Metab 2023; 109:e163-e174. [PMID: 37552780 PMCID: PMC10735284 DOI: 10.1210/clinem/dgad468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 08/02/2023] [Accepted: 08/04/2023] [Indexed: 08/10/2023]
Abstract
CONTEXT MicroRNA-191-5p regulates key cellular processes involved in the pathogenesis of diabetic complications such as angiogenesis, extracellular matrix deposition, and inflammation. However, no data on circulating microRNA-191-5p in the chronic complications of diabetes are available. OBJECTIVE To assess whether serum levels of microRNA-191-5p were associated with micro- and macrovascular disease in a large cohort of subjects with type 1 diabetes mellitus (DM1) from the EURODIAB Prospective Complication Study. DESIGN AND SETTING Levels of microRNA-191-5p were measured by quantitative PCR in 420 patients with DM1 recruited as part of the cross-sectional analysis of the EURODIAB Prospective Complication Study. Cases (n = 277) were subjects with nephropathy and/or retinopathy and/or cardiovascular disease (CVD). Controls (n = 143) were patients without complications. Logistic regression analysis was performed to evaluate the potential independent association of microRNA-191-5p levels with chronic complications of diabetes. RESULTS Levels of microRNA-191-5p were significantly reduced (P < .001) in cases compared with controls even after adjustment for age, sex, and diabetes duration. Logistic regression analysis revealed that microRNA-191-5p was negatively associated with a 58% reduced odds ratio (OR) of chronic diabetes complications, specifically CVD, micro-macroalbuminuria, and retinopathy (OR, 0.42; 95% CI, 0.23-0.77), independent of age, sex, physical activity, educational levels, diabetes duration, glycated hemoglobin, total insulin dose, hypertension, smoking, total cholesterol, albumin excretion rate, estimated glomerular filtration rate, serum vascular cell adhesion molecule-1, and tumor necrosis factor-α. Analyses performed separately for each complication demonstrated a significant independent association with albuminuria (OR, 0.36; 95% CI, (0.18-0.75) and CVD (OR, 0.34; 95% CI, 0.16-0.70). CONCLUSIONS In DM1 subjects, microRNA-191-5p is inversely associated with vascular chronic complications of diabetes.
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Affiliation(s)
- Stefania Bellini
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy
| | - Simonetta Guarrera
- Italian Institute for Genomic Medicine, IIGM, 10060 Candiolo, Italy
- Candiolo Cancer Institute, FPO-IRCCS, 10060 Candiolo, Italy
| | - Giuseppe Matullo
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy
- Medical Genetics Unit, AOU Città della Salute e della Scienza, 10126 Turin, Italy
| | - Casper Schalkwijk
- Department of Internal Medicine and Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, 6221 Maastricht, the Netherlands
| | - Coen D Stehouwer
- Department of Internal Medicine and Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, 6221 Maastricht, the Netherlands
| | - Nish Chaturvedi
- Institute of Cardiovascular Science, University College London, London WC1E 6BT, UK
| | - Sabita S Soedamah-Muthu
- Center of Research on Psychology in Somatic Diseases (CORPS), Department of Medical and Clinical Psychology, Tilburg University, 5048 Tilburg, the Netherland
- Institute for Food, Nutrition and Health, University of Reading Reading RG6 6UR, UK
| | - Federica Barutta
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy
| | - Gabriella Gruden
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy
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Liang Y, Fan T, Bai M, Tang M, Cui N, Chen Y, Chen J, Wang J, Guan Y. A Knowledge Map of the Relationship between Diabetes and Stroke: A Bibliometric Analysis Study. Cerebrovasc Dis 2023; 53:270-287. [PMID: 37722359 DOI: 10.1159/000533383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 07/31/2023] [Indexed: 09/20/2023] Open
Abstract
INTRODUCTION The correlation between diabetes and stroke has been studied extensively in epidemiological research. Here, we used bibliometric software to visualize and analyze the literature related to diabetic stroke to provide an overview of the current state of research, hotspots, and future trends in the field. METHODS Based on the Web of Science Core Collection (WoSCC) database, we collected studies related to diabetic stroke from 2007 to December 2022. We used CiteSpace (version 6.1.R5), VOSviewer, and Scimago Graphica to create knowledge maps and conduct visual analyses on authors, countries, institutions, cited references, and keywords, and Origin for statistical analysis. RESULTS We included a total of 5,171 papers on diabetic stroke from the WoSCC database. Overall, there was a steady increase in the number of publications, with a high number of emerging scientists. The USA was the most productive and influential country, which dominated national collaborations. The most common subject category was "neurology." In total, 12 major clusters were generated from the cited references. Keyword analysis showed that keywords related to poststroke injury and treatment are those with the highest burst intensity and latest burst time. CONCLUSIONS Individual disease treatment remains a hot topic, and how to balance acute stroke treatment and glycemic control is currently a difficult clinical problem. At the same time, the mechanism of their interaction and the prevention and treatment of related causative factors remain a hot topic of current and future research.
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Affiliation(s)
- Yitong Liang
- Department of Pharmacy, Xijing Hospital, Fourth Military Medical University, Xi'an, China,
| | - Tingting Fan
- Department of Pharmacy, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Min Bai
- Department of Pharmacy, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Meng Tang
- Department of Pharmacy, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Na Cui
- Department of Pharmacy, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Yue Chen
- Department of Pharmacy, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Jinyi Chen
- Department of Pharmacy, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Jingwen Wang
- Department of Pharmacy, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Yue Guan
- Department of Pharmacy, Xijing Hospital, Fourth Military Medical University, Xi'an, China
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10
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Fickweiler W, Mitzner M, Jacoba CMP, Sun JK. Circulatory Biomarkers and Diabetic Retinopathy in Racial and Ethnic Populations. Semin Ophthalmol 2023:1-11. [PMID: 36710371 DOI: 10.1080/08820538.2023.2168488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Clinical staging systems for diagnosis and treatment of diabetic retinopathy (DR) must closely relate to endpoints that are both relevant for patients and feasible for physicians to implement. Current DR staging systems for clinical eye care and research provide detailed phenotypic characterization to predict patient outcomes in diabetes but have limitations. Biochemical biomarkers provide a rich pool of potential candidates for new DR staging systems that can be readily measured in accessible fluids. Circulating biomarkers that are specific to the retina and relate to angiogenesis and inflammation have been suggested as relevant for DR. Although there is a lack of multi-ethnic studies evaluating circulatory biomarkers in DR, variability in circulatory biomarkers have been reported in people from different ethnic and racial backgrounds. Therefore, there is a need for future studies to evaluate individual or combinations of biomarkers in diverse populations with DR from different ethnic and racial backgrounds.
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Affiliation(s)
- Ward Fickweiler
- Research Division, Joslin Diabetes Center, Boston, MA, USA.,Beetham Eye Institute, Joslin Diabetes Center, Boston, MA, USA.,Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Margalit Mitzner
- Research Division, Joslin Diabetes Center, Boston, MA, USA.,Beetham Eye Institute, Joslin Diabetes Center, Boston, MA, USA
| | - Cris Martin P Jacoba
- Beetham Eye Institute, Joslin Diabetes Center, Boston, MA, USA.,Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Jennifer K Sun
- Research Division, Joslin Diabetes Center, Boston, MA, USA.,Beetham Eye Institute, Joslin Diabetes Center, Boston, MA, USA.,Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
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11
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Zhao S, Liu Y, Zhou C, Chen Z, Cai Z, Han J, Xiao J, Xiao Q. Prediction model of delayed graft function based on clinical characteristics combined with serum IL-2 levels. BMC Nephrol 2022; 23:284. [PMID: 35971094 PMCID: PMC9377118 DOI: 10.1186/s12882-022-02908-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 08/04/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Kidney transplantation is an effective treatment for end-stage renal disease (ESRD). Delayed graft function (DGF) is a common complication after kidney transplantation and exerts substantial effects on graft function and long-term graft survival. Therefore, the construction of an effective model to predict the occurrence of DGF is particularly important. METHODS Seventy-one patients receiving their first kidney transplant at the First Affiliated Hospital of Nanchang University from October 2020 to October 2021 were enrolled in the discovery cohort. Based on clinical characteristics and serum markers, a logistic regression model was used to simulate the risk of DGF in the discovery cohort. The DGF prediction model was named the prediction system and was composed of risk factors related to DGF. Thirty-two patients receiving a kidney transplant at the First Affiliated Hospital of Nanchang University from October 2021 to February 2022 were enrolled in the validation cohort. The validation cohort was used to verify the accuracy and reliability of the prediction model. RESULTS Cold ischemia time (CIT), donor history of diabetes mellitus, donor interleukin-2 (IL-2) level and donor terminal creatinine level constitute the prediction system. In the validation test, the area under the receiver operating characteristic curve (AUC) was 0.867 for the prediction system, and good calibration of the model was confirmed in the validation cohort. CONCLUSIONS This study constructed a reliable and highly accurate prediction model that provides a practical tool for predicting DGF. Additionally, IL-2 participates in the kidney injury process and may be a potential marker of kidney injury.
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Affiliation(s)
- Shitao Zhao
- Department of Transplantation, The First Affiliated Hospital of Nanchang University, 17 Yongwai Zhengjie Street, Nanchang, 330006, Jiangxi, China
| | - Yuan Liu
- Department of Transplantation, The First Affiliated Hospital of Nanchang University, 17 Yongwai Zhengjie Street, Nanchang, 330006, Jiangxi, China
| | - Chen Zhou
- Department of Transplantation, The First Affiliated Hospital of Nanchang University, 17 Yongwai Zhengjie Street, Nanchang, 330006, Jiangxi, China
| | - Zide Chen
- Department of Transplantation, The First Affiliated Hospital of Nanchang University, 17 Yongwai Zhengjie Street, Nanchang, 330006, Jiangxi, China
| | - Zeyu Cai
- Department of Transplantation, The First Affiliated Hospital of Nanchang University, 17 Yongwai Zhengjie Street, Nanchang, 330006, Jiangxi, China
| | - JiaLiang Han
- Department of Transplantation, The First Affiliated Hospital of Nanchang University, 17 Yongwai Zhengjie Street, Nanchang, 330006, Jiangxi, China
| | - Jiansheng Xiao
- Department of Transplantation, The First Affiliated Hospital of Nanchang University, 17 Yongwai Zhengjie Street, Nanchang, 330006, Jiangxi, China.
| | - Qi Xiao
- Department of Transplantation, The First Affiliated Hospital of Nanchang University, 17 Yongwai Zhengjie Street, Nanchang, 330006, Jiangxi, China.
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12
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Barutta F, Bellini S, Guarrera S, Matullo G, Schalkwijk C, Stehouwer CD, Chaturvedi N, Soedamah-Muthu SS, Durazzo M, Gruden G. Association of serum MicroRNA-145-5p levels with microvascular complications of type 1 Diabetes: The EURODIAB prospective complications study. Diabetes Res Clin Pract 2022; 190:109987. [PMID: 35820565 DOI: 10.1016/j.diabres.2022.109987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 06/30/2022] [Accepted: 07/06/2022] [Indexed: 11/25/2022]
Abstract
AIMS To investigate whether serum miR-145-5p levels were associated with micro-macrovascular chronic complications in patients with type 1 diabetes (DM1). METHODS A nested case-control study from the EURODIAB Prospective Complications Study was performed. Cases (n = 289) had one or more complications of diabetes, whereas controls (n = 153) did not have any complication. We measured miR-145-5p levels by qPCR and investigated the association with diabetes complications. RESULTS Mean miR-145-5p levels were significantly lower in cases with microangiopathy [2.12 (0.86-4.94)] compared to controls [3.15 (1.21-7.36), P < 0.05] even after adjustment for age, gender, and diabetes duration. In logistic regression analysis, miR-145-5p levels in the lowest tertile were associated with an over three-fold increased odds ratio (OR) of albuminuria [3.22 (1.17-8.81)], independently of both demographic and diabetes-related factors. In addition, mir145-5p levels in the lowest tertile were independently and inversely associated with arterial hypertension [1.96 (1.08-3.56)] and hypertension was the mediator of the relationship between miR-145-5p and albuminuria. CONCLUSIONS In this large cohort of DM1 patients, we found an inverse association between miR-145-5p and albuminuria that was mediated by systemic hypertension.
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Affiliation(s)
| | | | - Simonetta Guarrera
- Italian Institute for Genomic Medicine, IIGM, Candiolo, Italy; Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
| | - Giuseppe Matullo
- Department of Medical Sciences, University of Turin, Italy; Medical Genetics Unit, AOU Città della Salute e della Scienza, Turin, Italy
| | - Casper Schalkwijk
- Department of Internal Medicine and Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands
| | - Coen D Stehouwer
- Department of Internal Medicine and Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands
| | - Nish Chaturvedi
- Institute of Cardiovascular Science, University College London, London, UK
| | - Sabita S Soedamah-Muthu
- Center of Research on Psychology in Somatic Diseases (CORPS), Department of Medical and Clinical Psychology, Tilburg University, the Netherlands; Institute for Food, Nutrition and Health, University of Reading, Reading, UK
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13
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Cave EM, Bhola S, Crowther NJ, Padoa CJ. The association of vitamin D binding protein levels and genotypes with type 1 diabetes in the black South African population. BMC Endocr Disord 2022; 22:182. [PMID: 35843941 PMCID: PMC9290305 DOI: 10.1186/s12902-022-01097-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 07/04/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Vitamin D deficiency and the vitamin D pathway have previously been associated with type 1 diabetes (T1D). The majority of vitamin D is transported through the blood bound to the vitamin D binding protein (VDBP). Two polymorphisms in the VDBP gene (rs4588 and rs7041) result in different VDBP variants and have been associated with T1D, however the results are not consistent. The association of VDBP levels and its polymorphisms with T1D have not been investigated in the black South African population. Therefore, this study aimed to determine whether rs4588, rs7041 or serum VDBP levels were associated with T1D in this population. METHODS Participants with type 1 diabetes and controls were recruited from the greater Johannesburg area, South Africa. Participants were genotyped for rs4588 and rs7041 using PCR-RFLP and serum VDBP levels were determined by ELISA. RESULTS There was no difference in VDBP allelic or genotypic frequencies between participants with T1D and controls (rs4588 C allele frequency 0.92 vs. 0.94; p = 0.390 and rs7041 T allele frequency 0.95 vs. 0.95; p = 0.890). In univariate analysis, the rs4588 CC genotype was associated with increased serum VDBP levels, however, this association was lost with multivariate analysis. The VDBP genotypes were not associated with any other study variables. In logistic regression analysis, higher VBDP levels were associated with T1D (OR: (95% CI): 6.58 (1.45-29.9); p = 0.015), and within a linear regression analysis, T1D disease status was found to be associated with 0.044 mg/ml higher VDBP levels (p = 0.028). CONCLUSIONS These data suggest that serum VDBP levels are positively associated with the presence of T1D in the African population. Whether VDBP lies in the causal pathway or its elevation is an effect of T1D is uncertain and requires further investigation.
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Affiliation(s)
- Eleanor M Cave
- Department of Chemical Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Sureka Bhola
- Department of Chemical Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Department of Chemical Pathology, National Health Laboratory Service, Johannesburg, South Africa
| | - Nigel J Crowther
- Department of Chemical Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Department of Chemical Pathology, National Health Laboratory Service, Johannesburg, South Africa
| | - Carolyn J Padoa
- Department of Chemical Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
- Department of Chemical Pathology, National Health Laboratory Service, Johannesburg, South Africa.
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14
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Frudd K, Sivaprasad S, Raman R, Krishnakumar S, Revathy YR, Turowski P. Diagnostic circulating biomarkers to detect vision-threatening diabetic retinopathy: Potential screening tool of the future? Acta Ophthalmol 2022; 100:e648-e668. [PMID: 34269526 DOI: 10.1111/aos.14954] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 06/02/2021] [Accepted: 06/17/2021] [Indexed: 12/12/2022]
Abstract
With the increasing prevalence of diabetes in developing and developed countries, the socio-economic burden of diabetic retinopathy (DR), the leading complication of diabetes, is growing. Diabetic retinopathy (DR) is currently one of the leading causes of blindness in working-age adults worldwide. Robust methodologies exist to detect and monitor DR; however, these rely on specialist imaging techniques and qualified practitioners. This makes detecting and monitoring DR expensive and time-consuming, which is particularly problematic in developing countries where many patients will be remote and have little contact with specialist medical centres. Diabetic retinopathy (DR) is largely asymptomatic until late in the pathology. Therefore, early identification and stratification of vision-threatening DR (VTDR) is highly desirable and will ameliorate the global impact of this disease. A simple, reliable and more cost-effective test would greatly assist in decreasing the burden of DR around the world. Here, we evaluate and review data on circulating protein biomarkers, which have been verified in the context of DR. We also discuss the challenges and developments necessary to translate these promising data into clinically useful assays, to detect VTDR, and their potential integration into simple point-of-care testing devices.
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Affiliation(s)
- Karen Frudd
- Institute of Ophthalmology University College London London UK
| | - Sobha Sivaprasad
- Institute of Ophthalmology University College London London UK
- NIHR Moorfields Biomedical Research Centre Moorfields Eye Hospital London UK
| | - Rajiv Raman
- Vision Research Foundation Sankara Nethralaya Chennai Tamil Nadu India
| | | | | | - Patric Turowski
- Institute of Ophthalmology University College London London UK
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15
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Metformin: Expanding the Scope of Application-Starting Earlier than Yesterday, Canceling Later. Int J Mol Sci 2022; 23:ijms23042363. [PMID: 35216477 PMCID: PMC8875586 DOI: 10.3390/ijms23042363] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/29/2022] [Accepted: 02/18/2022] [Indexed: 12/15/2022] Open
Abstract
Today the area of application of metformin is expanding, and a wealth of data point to its benefits in people without carbohydrate metabolism disorders. Already in the population of people leading an unhealthy lifestyle, before the formation of obesity and prediabetes metformin smooths out the adverse effects of a high-fat diet. Being prescribed at this stage, metformin will probably be able to, if not prevent, then significantly reduce the progression of all subsequent metabolic changes. To a large extent, this review will discuss the proofs of the evidence for this. Another recent important change is a removal of a number of restrictions on its use in patients with heart failure, acute coronary syndrome and chronic kidney disease. We will discuss the reasons for these changes and present a new perspective on the role of increasing lactate in metformin therapy.
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16
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Wei DYW, Chew M, Sabanayagam C. Obstructive Sleep Apnoea, Other Sleep Parameters and Diabetic Retinopathy. Curr Diab Rep 2021; 21:58. [PMID: 34902078 DOI: 10.1007/s11892-021-01425-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/12/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE OF REVIEW To summarise the association between obstructive sleep apnoea and diabetic retinopathy and diabetic macular oedema. To examine the effects of other sleep parameters on diabetic retinopathy and diabetic macular oedema. To discuss the pathophysiology of diabetic eye changes and how it is related to obstructive sleep apnoea. RECENT FINDINGS Conflicting data exists in terms of the association of diabetic eye changes with sleep apnoea and/or other sleep parameters. Various cross-sectional studies show PDR to be associated with the prevalence of OSA. Patients who underwent continuous positive airway pressure (CPAP) treatment were significantly less likely to develop pre/proliferative DR. Secondary sleep parameters generally are not associated with DR except for long duration of sleep. Differences in reporting could be due to the different thresholds set to define OSA/ODI and severity of DR/DME, in addition to factors used in multivariate analysis. There is a need for further studies with long-term follow-up and to assess the impact of CPAP on the development and progression of diabetic eye change(s).
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Affiliation(s)
- Dayna Yong Wei Wei
- Department of Ophthalmology, National University Hospital, National University Health System, Singapore, Singapore
| | - Merwyn Chew
- Department of Ophthalmology, JurongHealth, National University Health System, Singapore, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Charumathi Sabanayagam
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.
- Ophthalmology and Visual Science Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore.
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17
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Barutta F, Corbetta B, Bellini S, Guarrera S, Matullo G, Scandella M, Schalkwijk C, Stehouwer CD, Chaturvedi N, Soedamah-Muthu SS, Durazzo M, Gruden G. MicroRNA 146a is associated with diabetic complications in type 1 diabetic patients from the EURODIAB PCS. J Transl Med 2021; 19:475. [PMID: 34823560 PMCID: PMC8614036 DOI: 10.1186/s12967-021-03142-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 11/11/2021] [Indexed: 12/11/2022] Open
Abstract
Background MicroRNA-146a-5p (miR-146a-5p) is a key regulator of inflammatory processes. Expression of miR-146a-5p is altered in target organs of diabetic complications and deficiency of miR-146a-5p has been implicated in their pathogenesis. We investigated if serum miR-146a-5p levels were independently associated with micro/macrovascular complications of type 1 diabetes (DM1). Methods A nested case–control study from the EURODIAB PCS of 447 DM1 patients was performed. Cases (n = 294) had one or more complications of diabetes, whereas controls (n = 153) did not have any complication. Total RNA was isolated from all subjects and miR-146a-5p levels measured by qPCR. Both the endogenous controls U6 snRNA and the spike (Cel-miR-39) were used to normalize the results. Logistic regression analysis was carried out to investigate the association of miR-146a-5p with diabetes complications. Results MiR-146a-5p levels were significantly lower in cases [1.15 (0.32–3.34)] compared to controls [1.74 (0.44–6.74) P = 0.039]. Logistic regression analysis showed that levels of miR-146a-5p in the upper quartile were inversely associated with reduced odds ratio (OR) of all complications (OR 0.34 [95% CI 0.14–0.76]) and particularly with cardiovascular diseases (CVD) (OR 0.31 [95% CI 0.11–0.84]) and diabetic retinopathy (OR 0.40 [95% CI 0.16–0.99]), independently of age, sex, diabetes duration, A1c, hypertension, AER, eGFR, NT-proBNP, and TNF-α. Conclusions In this large cohort of DM1 patients, we reported an inverse and independent association of miR-146a-5p with diabetes chronic complications and in particular with CVD and retinopathy, suggesting that miR-146a-5p may be a novel candidate biomarker of DM1 complications. Supplementary Information The online version contains supplementary material available at 10.1186/s12967-021-03142-4.
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Affiliation(s)
- Federica Barutta
- Diabetic Nephropathy Laboratory, Department of Medical Sciences, University of Turin, C/so Dogliotti 14, 10126, Turin, Italy.
| | - Beatrice Corbetta
- Diabetic Nephropathy Laboratory, Department of Medical Sciences, University of Turin, C/so Dogliotti 14, 10126, Turin, Italy
| | - Stefania Bellini
- Diabetic Nephropathy Laboratory, Department of Medical Sciences, University of Turin, C/so Dogliotti 14, 10126, Turin, Italy
| | - Simonetta Guarrera
- Italian Institute for Genomic Medicine, IIGM, Candiolo, Italy.,Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
| | - Giuseppe Matullo
- Diabetic Nephropathy Laboratory, Department of Medical Sciences, University of Turin, C/so Dogliotti 14, 10126, Turin, Italy.,Medical Genetics Unit, AOU Città Della Salute E Della Scienza, Turin, Italy
| | - Michela Scandella
- Diabetic Nephropathy Laboratory, Department of Medical Sciences, University of Turin, C/so Dogliotti 14, 10126, Turin, Italy
| | - Casper Schalkwijk
- Department of Internal Medicine and Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Coen D Stehouwer
- Department of Internal Medicine and Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Nish Chaturvedi
- Institute of Cardiovascular Science, University College London, London, UK
| | - Sabita S Soedamah-Muthu
- Center of Research On Psychology in Somatic Diseases (CORPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.,Institute for Food, Nutrition and Health, University of Reading, Reading, UK
| | - Marilena Durazzo
- Diabetic Nephropathy Laboratory, Department of Medical Sciences, University of Turin, C/so Dogliotti 14, 10126, Turin, Italy
| | - Gabriella Gruden
- Diabetic Nephropathy Laboratory, Department of Medical Sciences, University of Turin, C/so Dogliotti 14, 10126, Turin, Italy
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18
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Erdem B, Kaya Y. Prediction of diabetic retinopathy in patients with type 2 diabetes mellitus by using monocyte to high-density lipoprotein-cholesterol ratio. Int J Diabetes Dev Ctries 2021. [DOI: 10.1007/s13410-021-01024-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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19
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Martorell M, Castro N, Victoriano M, Capó X, Tejada S, Vitalini S, Pezzani R, Sureda A. An Update of Anthraquinone Derivatives Emodin, Diacerein, and Catenarin in Diabetes. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2021; 2021:3313419. [PMID: 34589130 PMCID: PMC8476274 DOI: 10.1155/2021/3313419] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 09/09/2021] [Indexed: 12/15/2022]
Abstract
Diabetes is part of metabolic diseases and is characterized by high blood sugar levels over a prolonged period as result of an insulin-deficient production or an inappropriate response to insulin by our cells. This chronic disease was the direct cause of 1.6 million deaths in 2016 as reported by the World Health Organization. Emodin is a natural product and active ingredient of various Chinese herbs with the chemical formula 1,3,8-trihydroxy-6-methylanthraquinone. Diacerein is another naturally occurring anthraquinone (1,8-diacetoxy-3-carboxyanthraquinone) commonly used as commercial drug to treat osteoarthritis. These two anthraquinone derivatives have been shown to exert antidiabetic activities. Emodin seems to enhance the glucose tolerance and insulin sensibility via activation of PPARγ and modulation of metabolic-related genes. Diacerein seems to decrease inflammatory cytokines and increase insulin secretion enhancing insulin sensibility and therefore improving glucose control. Other naturally occurring anthraquinone derivatives, such as catenarin (1,4,6,8-tetrahydroxy-3-methylanthraquinone), have been shown to have antidiabetic activities although few studies have been performed. The synthesis of new emodin derivatives is increasing, but these new molecules have not been tested for diabetes treatment. In the current work, available literature on anthraquinone derivatives' effects in diabetes disease is reviewed. Moreover, we discuss the chemistry, food sources, bioavailability, and toxicity of the naturally occurring anthraquinone with antidiabetic effects.
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Affiliation(s)
- Miquel Martorell
- Department of Nutrition and Dietetics, Faculty of Pharmacy, University of Concepción, Concepción 4070386, Chile
- Centre for Healthy Living, University of Concepción, Concepción 4070386, Chile
| | - Natalia Castro
- Department of Nutrition and Dietetics, Faculty of Pharmacy, University of Concepción, Concepción 4070386, Chile
| | - Montserrat Victoriano
- Department of Nutrition and Dietetics, Faculty of Pharmacy, University of Concepción, Concepción 4070386, Chile
| | - Xavier Capó
- Research Group in Community Nutrition and Oxidative Stress, University Research Institute of Health Sciences (IUNICS), University of the Balearic Islands, Palma de Mallorca 07122, Spain
| | - Silvia Tejada
- Laboratory of Neurophysiology, Department of Biology, University Research Institute of Health Sciences (IUNICS), University of Balearic Islands, Palma E-07122, Balearic Islands, Spain
- CIBEROBN (Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, Madrid E-28029, Spain
- Research Institute of the Balearic Islands, Palma de Mallorca E-07120, Spain
| | - Sara Vitalini
- Department of Agricultural and Environmental Sciences, Università degli Studi di Milano, Via G. Celoria 2 20133, Milan, Italy
| | - Raffaele Pezzani
- Phytotherapy Lab (PhT-Lab), Endocrinology Unit, Department of Medicine (DIMED), University of Padova, via Ospedale 105, Padova 35128, Italy
- AIROB, Associazione Italiana per la Ricerca Oncologica di Base, Padova, Italy
| | - Antoni Sureda
- Research Group in Community Nutrition and Oxidative Stress, University Research Institute of Health Sciences (IUNICS), University of the Balearic Islands, Palma de Mallorca 07122, Spain
- CIBEROBN (Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, Madrid E-28029, Spain
- Research Institute of the Balearic Islands, Palma de Mallorca E-07120, Spain
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20
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Eckel RH, Bornfeldt KE, Goldberg IJ. Cardiovascular disease in diabetes, beyond glucose. Cell Metab 2021; 33:1519-1545. [PMID: 34289375 PMCID: PMC8411849 DOI: 10.1016/j.cmet.2021.07.001] [Citation(s) in RCA: 84] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 05/21/2021] [Accepted: 07/01/2021] [Indexed: 02/06/2023]
Abstract
Despite the decades-old knowledge that diabetes mellitus is a major risk factor for cardiovascular disease, the reasons for this association are only partially understood. While this association is true for both type 1 and type 2 diabetes, different pathophysiological processes may be responsible. Lipids and other risk factors are indeed important, whereas the role of glucose is less clear. This lack of clarity stems from clinical trials that do not unambiguously show that intensive glycemic control reduces cardiovascular events. Animal models have provided mechanisms that link diabetes to increased atherosclerosis, and evidence consistent with the importance of factors beyond hyperglycemia has emerged. We review clinical, pathological, and animal studies exploring the pathogenesis of atherosclerosis in humans living with diabetes and in mouse models of diabetes. An increased effort to identify risk factors beyond glucose is now needed to prevent the increased cardiovascular disease risk associated with diabetes.
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Affiliation(s)
- Robert H Eckel
- Divisions of Endocrinology, Metabolism and Diabetes, and Cardiology, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, USA.
| | - Karin E Bornfeldt
- Department of Medicine, Division of Metabolism, Endocrinology and Nutrition, and Department of Laboratory Medicine and Pathology, University of Washington Medicine Diabetes Institute, University of Washington, Seattle, WA, USA
| | - Ira J Goldberg
- Division of Endocrinology, Diabetes and Metabolism, NYU Grossman School of Medicine, New York, NY, USA
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21
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Zhou CD, Seah RL, Papatheodorou SI. The role of biomarker ykl-40 in risk stratification and diagnosis of gestational diabetes mellitus: A systematic review and meta-analysis. ENDOCRINE AND METABOLIC SCIENCE 2021. [DOI: 10.1016/j.endmts.2021.100094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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22
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Vural E, Hazar L. Assessment of Inflammation Biomarkers in Diabetic Macular Edema Treated with Intravitreal Dexamethasone Implant. J Ocul Pharmacol Ther 2021; 37:430-437. [PMID: 33961524 DOI: 10.1089/jop.2020.0130] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Purpose: To evaluate inflammation biomarkers in diabetic macular edema (DME) treated with intravitreal dexamethasone implant (Ozurdex®). Methods: This retrospective single-center study investigated 64 eyes of 64 patients with DME who were nonresponsive to prior antivascular endothelial growth factor and treated with intravitreal Ozurdex. The neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio (MLR), and platelet/lymphocyte ratio were calculated. Visual acuity and optical coherence tomography markers, including hyper-reflective dots and subretinal fluid (SRF), were determined, and central retinal thickness was also evaluated monthly for 3 months. Results: The average age was 64.06 ± 7.81 (48-84) years. The baseline NLR and MLR were significantly higher in patients with better visual outcomes (P = 0.029 and P = 0.048, respectively). Better anatomical outcomes were observed in the presence of SRF (P = 0.027). No significant differences were observed in the rates of the presence of SRF and hyper-reflective points about the better functional outcome (P > 0.05). Conclusions: SRF as an imaging biomarker, and NLR and MLR as blood biomarkers, stand out as markers of inflammation and were found to be associated with better response to Ozurdex implantation in DME.
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Affiliation(s)
- Esra Vural
- Department of Ophthalmology, Kayseri City Hospital, Kayseri, Turkey
| | - Leyla Hazar
- Department of Ophthalmology, Dicle University School of Medicine, Diyarbakır, Turkey
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23
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Hentati F, Melo AGR, Greenlee TE, Muste J, Chen AX, Conti TF, Hom GL, Singh RP. Management of Patients With DME With Good Visual Acuity in Routine Clinical Practice. Ophthalmic Surg Lasers Imaging Retina 2021; 52:247-256. [PMID: 34044713 DOI: 10.3928/23258160-20210429-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE To determine outcomes of eyes with diabetic macular edema (DME) and best visual acuity (BVA) of 20/25 or better in routine clinical practice. PATIENTS AND METHODS Retrospective study of 72 patients with DME and BVA of 20/25 or better. Patients were divided by anti-vascular endothelial growth factor (VEGF) treatment regimen: early (Group A), delayed (Group B), and none (Group C). RESULTS Group A had higher baseline central subfield thickness (CST) (325 ± 62 µm) compared to Groups B (292 ± 24 µm) and C (296 ± 35 µm) (P = .033). All groups had similar 24-month CST (299 ± 62 µm, 280 ± 64 µm, 296 ± 65 µm; P = .61). There was no difference in baseline BVA among groups (81.9 ± 2.4, 83.2 ± 2.4, 82.4 ± 2.5 Early Treatment Diabetic Retinopathy Study [ETDRS] letters, respectively; P = .290), but at 6 months, Group A had lower BVA (76.6 ± 9.6 ETDRS letters) than groups B (81.9 ±3.3 ETDRS letters) and C (82.4 ± 5.0 ETDRS letters) (P = .008). There was no difference among groups in 24-month BVA (78.9 ± 6.6, 78.4 ± 12.3, and 80.6 ± 6.9 ETDRS letters, respectively; P = .448). CONCLUSION Although observation may be indicated in eyes with stable BVA and CST less than 300 µm, anti-VEGF stabilizes BVA in eyes with CST greater than 300 µm and eyes with declining BVA. [Ophthalmic Surg Lasers Imaging Retina. 2021;52:247-256.].
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24
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Purohit S, Tran PMH, Tran LKH, Satter KB, He M, Zhi W, Bai S, Hopkins D, Gardiner M, Wakade C, Bryant J, Bernard R, Morgan J, Bode B, Reed JC, She JX. Serum Levels of Inflammatory Proteins Are Associated With Peripheral Neuropathy in a Cross-Sectional Type-1 Diabetes Cohort. Front Immunol 2021; 12:654233. [PMID: 33868296 PMCID: PMC8044415 DOI: 10.3389/fimmu.2021.654233] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 03/08/2021] [Indexed: 01/14/2023] Open
Abstract
Chronic low-grade inflammation is involved in the pathogenesis of type-1 diabetes (T1D) and its complications. In this cross-section study design, we investigated association between serum levels of soluble cytokine receptors with presence of peripheral neuropathy in 694 type-1 diabetes patients. Sex, age, blood pressure, smoking, alcohol intake, HbA1c and lipid profile, presence of DPN (peripheral and autonomic), retinopathy and nephropathy was obtained from patient’s chart. Measurement of soluble cytokine receptors, markers of systemic and vascular inflammation was done using multiplex immunoassays. Serum levels were elevated in in DPN patients, independent of gender, age and duration of diabetes. Crude odds ratios were significantly associated with presence of DPN for 15/22 proteins. The Odds ratio (OR) remained unchanged for sTNFRI (1.72, p=0.00001), sTNFRII (1.45, p=0.0027), sIL2Rα (1.40, p=0.0023), IGFBP6 (1.51, p=0.0032) and CRP (1.47, p=0.0046) after adjusting for confounding variables, HbA1C, hypertension and dyslipidemia. Further we showed risk of DPN is associated with increase in serum levels of sTNFRI (OR=11.2, p<10), sIL2Rα (8.69, p<10-15), sNTFRII (4.8, p<10-8) and MMP2 (4.5, p<10-5). We combined the serum concentration using ridge regression, into a composite score, which can stratify the DPN patients into low, medium and high-risk groups. Our results here show activation of inflammatory pathway in DPN patients, and could be a potential clinical tool to identify T1D patients for therapeutic intervention of anti-inflammatory therapies.
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Affiliation(s)
- Sharad Purohit
- Center for Biotechnology and Genomic Medicine, Augusta University, Augusta, GA, United States.,Department of Obstetrics and Gynecology, Medical College of Georgia, Augusta University, Augusta, GA, United States.,Department of Undergraduate Health Professionals, College of Allied Health Sciences, Augusta University, Augusta, GA, United States
| | - Paul Minh Huy Tran
- Center for Biotechnology and Genomic Medicine, Augusta University, Augusta, GA, United States
| | - Lynn Kim Hoang Tran
- Center for Biotechnology and Genomic Medicine, Augusta University, Augusta, GA, United States
| | - Khaled Bin Satter
- Center for Biotechnology and Genomic Medicine, Augusta University, Augusta, GA, United States
| | - Mingfang He
- Center for Biotechnology and Genomic Medicine, Augusta University, Augusta, GA, United States
| | - Wenbo Zhi
- Center for Biotechnology and Genomic Medicine, Augusta University, Augusta, GA, United States
| | - Shan Bai
- Center for Biotechnology and Genomic Medicine, Augusta University, Augusta, GA, United States
| | - Diane Hopkins
- Center for Biotechnology and Genomic Medicine, Augusta University, Augusta, GA, United States
| | - Melissa Gardiner
- Center for Biotechnology and Genomic Medicine, Augusta University, Augusta, GA, United States
| | - Chandramohan Wakade
- Center for Biotechnology and Genomic Medicine, Augusta University, Augusta, GA, United States
| | - Jennifer Bryant
- Center for Biotechnology and Genomic Medicine, Augusta University, Augusta, GA, United States
| | - Risa Bernard
- Center for Biotechnology and Genomic Medicine, Augusta University, Augusta, GA, United States
| | - John Morgan
- Department of Neurology, Medical College of Georgia, Augusta University, Augusta, GA, United States
| | - Bruce Bode
- Atlanta Diabetes Associates, Atlanta, GA, United States
| | - John Chip Reed
- Southeastern Endocrine & Diabetes, Atlanta, GA, United States
| | - Jin-Xiong She
- Center for Biotechnology and Genomic Medicine, Augusta University, Augusta, GA, United States.,Department of Obstetrics and Gynecology, Medical College of Georgia, Augusta University, Augusta, GA, United States
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25
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Saeed M, Tapia G, Ariansen I, Stene LC, Seljeflot I, Tell GS, Skrivarhaug T, Joner G. Serum Galectin-3 and Subsequent Risk of Coronary Heart Disease in Subjects With Childhood-Onset Type 1 Diabetes: A Cohort Study. Diabetes Care 2021; 44:810-816. [PMID: 33408220 PMCID: PMC7896257 DOI: 10.2337/dc20-1712] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 12/07/2020] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To study whether serum galectin-3 and other biomarkers of inflammation predict coronary heart disease (CHD) in subjects with long-standing childhood-onset type 1 diabetes. RESEARCH DESIGN AND METHODS A population-based nationwide cohort of 299 subjects with type 1 diabetes diagnosed in Norway at <15 years of age during 1973-1982 was examined in 2002-2003 at a mean age of 33 years (range 21-44), with mean diabetes duration of 24 years (range 19-30). Subjects were followed through 31 December 2017 for their first CHD event registered by a hospitalization or cause of death using nationwide registries. Stored serum samples were available for 296 subjects and analyzed for interleukin-6 (IL-6), IL-6 receptor, IL-18, hs-CRP, matrix metalloproteinase-9, tissue inhibitor of metalloproteinase-1 (TIMP-1), galectin-3, and high-sensitivity troponin T. Adjusted hazard ratios (aHRs) for CHD per SD increase in biomarker were estimated using Cox regression. RESULTS Of 295 subjects, 40 (13.6%) had a documented CHD event during a mean follow-up of 14.4 years (range 0.5-16). IL-6 (aHR 1.32 [95% CI 1.07-1.63]), galectin-3 (aHR 1.44 [95% CI 1.09-1.80]), and TIMP-1 (aHR 1.37 [95% CI 1.04-1.81]) were significant predictors of CHD after adjustment for conventional risk factors. CONCLUSIONS Galectin-3 was significantly associated with future CHD in subjects with type 1 diabetes, and if the results are replicated in larger studies, it may aid in prediction together with conventional risk factors for CHD.
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Affiliation(s)
- Maryam Saeed
- Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway .,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - German Tapia
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - Inger Ariansen
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - Lars C Stene
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - Ingebjørg Seljeflot
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Cardiology, Center for Clinical Heart Research, Oslo University Hospital, Oslo, Norway
| | - Grethe S Tell
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway.,Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Torild Skrivarhaug
- Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Geir Joner
- Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
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Micera A, Balzamino BO, Di Zazzo A, Dinice L, Bonini S, Coassin M. Biomarkers of Neurodegeneration and Precision Therapy in Retinal Disease. Front Pharmacol 2021; 11:601647. [PMID: 33584278 PMCID: PMC7873955 DOI: 10.3389/fphar.2020.601647] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 11/09/2020] [Indexed: 12/11/2022] Open
Abstract
Vision-threatening retinal diseases affect millions of people worldwide, representing an important public health issue (high social cost) for both technologically advanced and new-industrialized countries. Overall RD group comprises the retinitis pigmentosa, the age-related macular degeneration (AMD), the diabetic retinopathy (DR), and idiopathic epiretinal membrane formation. Endocrine, metabolic, and even lifestyles risk factors have been reported for these age-linked conditions that represent a "public priority" also in this COVID-19 emergency. Chronic inflammation and neurodegeneration characterize the disease evolution, with a consistent vitreoretinal interface impairment. As the vitreous chamber is significantly involved, the latest diagnostic technologies of imaging (retina) and biomarker detection (vitreous) have provided a huge input at both medical and surgical levels. Complement activation and immune cell recruitment/infiltration as well as detrimental intra/extracellular deposits occur in association with a reactive gliosis. The cell/tissue aging route shows a specific signal path and biomolecular profile characterized by the increased expression of several glial-derived mediators, including angiogenic/angiostatic, neurogenic, and stress-related factors (oxidative stress metabolites, inflammation, and even amyloid formation). The possibility to access vitreous chamber by collecting vitreous reflux during intravitreal injection or obtaining vitreous biopsy during a vitrectomy represents a step forward for an individualized therapy. As drug response and protein signature appear unique in each single patient, therapies should be individualized. This review addresses the current knowledge about biomarkers and pharmacological targets in these vitreoretinal diseases. As vitreous fluids might reflect the early stages of retinal sufferance and/or late stages of neurodegeneration, the possibility to modulate intravitreal levels of growth factors, in combination to anti-VEGF therapy, would open to a personalized therapy of retinal diseases.
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Affiliation(s)
- Alessandra Micera
- Research and Development Laboratory for Biochemical, Molecular and Cellular Applications in Ophthalmological Sciences, IRCCS - Fondazione Bietti, Rome, Italy
| | - Bijorn Omar Balzamino
- Research and Development Laboratory for Biochemical, Molecular and Cellular Applications in Ophthalmological Sciences, IRCCS - Fondazione Bietti, Rome, Italy
| | - Antonio Di Zazzo
- Ophthalmology Operative Complex Unit, University Campus Bio-Medico, Rome, Italy
| | - Lucia Dinice
- Research and Development Laboratory for Biochemical, Molecular and Cellular Applications in Ophthalmological Sciences, IRCCS - Fondazione Bietti, Rome, Italy
| | - Stefano Bonini
- Ophthalmology Operative Complex Unit, University Campus Bio-Medico, Rome, Italy
| | - Marco Coassin
- Ophthalmology Operative Complex Unit, University Campus Bio-Medico, Rome, Italy
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27
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Cutaș A, Drugan C, Roman G, Rusu A, Istrate D, Achimaș-Cadariu A, Drugan T. Inflammatory response and timeline of chronic complications in patients with type 1 and 2 diabetes mellitus. Int J Diabetes Dev Ctries 2020. [DOI: 10.1007/s13410-020-00824-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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28
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Ray SL, Coulson DJ, Yeoh MLY, Tamara A, Latief JS, Bakhashab S, Weaver JU. The Role of miR-342 in Vascular Health. Study in Subclinical Cardiovascular Disease in Mononuclear Cells, Plasma, Inflammatory Cytokines and PANX2. Int J Mol Sci 2020; 21:ijms21197217. [PMID: 33003647 PMCID: PMC7582278 DOI: 10.3390/ijms21197217] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 08/06/2020] [Accepted: 08/13/2020] [Indexed: 12/13/2022] Open
Abstract
Cardiovascular disease (CVD) correlates with inflammation and a reduction in circulating endothelial progenitor cells (cEPCs). Recently, CVD was shown to be the main cause of mortality in individuals with type 1 diabetes (T1DM). In animals, miR-342 was shown to exert an anti-inflammatory effect in CVD. Hypothesis: miR-342-3p/-5p are downregulated in subclinical CVD (T1DM), whereas inflammatory cytokines are upregulated. We studied miR -342 -3p/5p in plasma/peripheral blood mononuclear cells (PBMCs) in 29 T1DM and 20 controls (HC). Vascular health was measured by fibronectin adhesion assay (FAA), cEPCs (CD45dimCD34+133+ cells) and by assessing inflammation and tissue inhibition of metalloproteases (TIMP-1). In T1DM IL-7, IL-8, TNFα and VEGF-C were increased in plasma. MiR-342-3p/-5p were downregulated in PBMCs in T1DM, but not in plasma. PANX2, chemokine receptors CXCR1/2 mRNAs, were increased in PBMCs in T1DM. MiR-342-3p was negatively correlated with TIMP-1, IL-6, IL-8, TNF-α, HbA1c and CXCR2, whilst miR-342-5p was negatively correlated with TIMP-1, IL-6, IL-8 and HbA1c. There was a positive correlation among miR-342-3p, FAA and cEPCs, and between miR-342-5p and cEPCs. ROC curve analyses showed significant downregulation of miR-342-3p/-5p at HbA1c > 46.45 mmol/mol, indicating their potential as biomarkers for subclinical CVD. Our findings validated animal studies and confirmed the proangiogenic properties of miR-342-3p/-5p. MiR-342-3p/-5p-based intervention or monitoring may prove to be beneficial in managing CVD.
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Affiliation(s)
- Sabina L. Ray
- Translational & Clinical Research Institute, Newcastle University, Newcastle Upon Tyne NE2 4HH, UK; (S.L.R.); (D.J.C.); (M.L.Y.Y.); (A.T.); (J.S.L.); (S.B.)
| | - David J. Coulson
- Translational & Clinical Research Institute, Newcastle University, Newcastle Upon Tyne NE2 4HH, UK; (S.L.R.); (D.J.C.); (M.L.Y.Y.); (A.T.); (J.S.L.); (S.B.)
| | - Megan Li Yuen Yeoh
- Translational & Clinical Research Institute, Newcastle University, Newcastle Upon Tyne NE2 4HH, UK; (S.L.R.); (D.J.C.); (M.L.Y.Y.); (A.T.); (J.S.L.); (S.B.)
| | - Alice Tamara
- Translational & Clinical Research Institute, Newcastle University, Newcastle Upon Tyne NE2 4HH, UK; (S.L.R.); (D.J.C.); (M.L.Y.Y.); (A.T.); (J.S.L.); (S.B.)
| | - Jevi Septyani Latief
- Translational & Clinical Research Institute, Newcastle University, Newcastle Upon Tyne NE2 4HH, UK; (S.L.R.); (D.J.C.); (M.L.Y.Y.); (A.T.); (J.S.L.); (S.B.)
| | - Sherin Bakhashab
- Translational & Clinical Research Institute, Newcastle University, Newcastle Upon Tyne NE2 4HH, UK; (S.L.R.); (D.J.C.); (M.L.Y.Y.); (A.T.); (J.S.L.); (S.B.)
- Biochemistry Department, King Abdulaziz University, P.O. Box 80218, Jeddah 21589, Saudi Arabia
| | - Jolanta U. Weaver
- Translational & Clinical Research Institute, Newcastle University, Newcastle Upon Tyne NE2 4HH, UK; (S.L.R.); (D.J.C.); (M.L.Y.Y.); (A.T.); (J.S.L.); (S.B.)
- Department of Diabetes, Queen Elizabeth Hospital, Gateshead, Newcastle Upon Tyne NE9 6SH, UK
- Vascular Biology and Medicine Theme, Newcastle University, Newcastle Upon Tyne NE2 4HH, UK
- Correspondence: ; Tel.: +44-(191)-445-2181
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Johansen NJ, Dejgaard TF, Lund A, Schlüntz C, Larsen EL, Poulsen HE, Goetze JP, Møller HJ, Vilsbøll T, Andersen HU, Knop FK. Effect of short-acting exenatide administered three times daily on markers of cardiovascular disease in type 1 diabetes: A randomized double-blind placebo-controlled trial. Diabetes Obes Metab 2020; 22:1639-1647. [PMID: 32543021 DOI: 10.1111/dom.14078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 04/21/2020] [Accepted: 04/29/2020] [Indexed: 11/30/2022]
Abstract
AIMS To investigate the effect of adding the short-acting glucagon-like peptide 1 receptor agonist (GLP-1RA) exenatide to insulin treatment on markers of cardiovascular risk in type 1 diabetes. MATERIALS AND METHODS In a randomized, double-blind, parallel-group trial, 108 individuals with type 1 diabetes aged ≥18 years on multiple daily injection therapy with a body mass index >22.0 kg/m2 and glycated haemoglobin concentration of 59 to 88 mmol/mol (7.5%-10.0%) were randomized (1:1) to preprandial subcutaneous injection of 10 μg exenatide (Byetta®) or placebo three times daily over 26 weeks as add-on treatment to existing insulin therapy. Reported markers of cardiovascular risk were secondary endpoints and were analyzed in a baseline-adjusted linear mixed model in the intention-to-treat population. The primary results of this study, the MAG1C (Meal-time Administration of exenatide for Glycaemic control in type 1 diabetes Cases) trial, were previously reported. RESULTS Exenatide changed total fat mass by -2.6 kg (95% confidence interval [CI] -3.6; -1.6; P < 0.0001) and lean body mass by -1.1 kg (95% CI -1.9; -0.4; P = 0.01) compared with placebo, as assessed by dual-energy X-ray absorptiometry. Fat mass reductions were similar for central and peripheral fat mass. Exenatide did not change levels of interleukin-2 or -6; tumour necrosis factor-α; C-reactive protein; N-terminal prohormone of brain natriuretic peptide; or 8-oxo-7,8-dihydroguanosine (RNA oxidation marker) and 8-oxo-7,8-dihydro-2'-deoxyguanosine (DNA oxidation marker). CONCLUSIONS Exenatide added to insulin therapy in type 1 diabetes for 26 weeks resulted in body weight loss primarily from fat mass reduction, but had no effect on biomarkers of cardiovascular disease risk.
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Affiliation(s)
- Nicklas J Johansen
- Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
- Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Thomas F Dejgaard
- Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
- Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Asger Lund
- Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Camilla Schlüntz
- Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Emil L Larsen
- Department of Clinical Pharmacology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Henrik E Poulsen
- Department of Clinical Pharmacology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jens P Goetze
- Department of Clinical Biochemistry, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Holger J Møller
- Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark
| | - Tina Vilsbøll
- Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
- Steno Diabetes Center Copenhagen, Gentofte, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Filip K Knop
- Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
- Steno Diabetes Center Copenhagen, Gentofte, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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30
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Melo LGN, Morales PH, Drummond KRG, Santos DC, Pizarro MH, Barros BSV, Pinheiro AA, Mallmann F, Leal FSL, Muniz LH, Malerbi FK, Gomes MB. Relationship between Proliferative Diabetic Retinopathy and Inflammatory Markers in Patients with Type 1 Diabetes in Brazil: A Nested Case Control Study. Ophthalmologica 2020; 243:471-478. [PMID: 32799201 DOI: 10.1159/000510879] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 08/13/2020] [Indexed: 01/13/2023]
Abstract
INTRODUCTION This study examined the relationship between proliferative diabetic retinopathy (PDR) and serum levels of C-reactive protein, VEGF, TNF-α, and IL-6 inflammatory biomarkers, related to the pathophysiology of diabetic retinopathy. METHODS This cross-sectional, case control study comprised 240 patients with type 1 diabetes (80 cases with PDR and 160 controls without diabetic retinopathy) who were matched for gender and duration of diabetes. RESULTS C-reactive protein was the only inflammatory biomarker that was positively related to PDR (OR 1.96; 95% CI 1.01-3.78, p = 0.0045). We also noted an association between high glycated hemoglobin levels, the use of angiotensin-converting enzyme inhibitor, low glomerular filtration rate, and PDR. CONCLUSION Patients with higher levels of C-reactive protein are more likely to present with PDR. We did not find a link between serum levels of VEGF, TNF-α, or IL-6 and PDR. The function of inflammatory biomarkers in PDR must be addressed in further studies.
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Affiliation(s)
| | | | | | - Deborah Conte Santos
- Department of Internal Medicine, Diabetes Unit, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Marcela Haas Pizarro
- Department of Internal Medicine, Diabetes Unit, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | | | | | - Felipe Mallmann
- Department of Ophthalmology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Luiza Harcar Muniz
- Department of Internal Medicine, Diabetes Unit, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | | | - Marilia Brito Gomes
- Department of Internal Medicine, Diabetes Unit, Rio de Janeiro State University, Rio de Janeiro, Brazil
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31
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Circulating Inflammatory Markers Are Inversely Associated with Heart Rate Variability Measures in Type 1 Diabetes. Mediators Inflamm 2020; 2020:3590389. [PMID: 32908447 PMCID: PMC7450314 DOI: 10.1155/2020/3590389] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 07/04/2020] [Indexed: 12/26/2022] Open
Abstract
Introduction A neuroimmune communication exists, and compelling evidence suggests that diabetic neuropathy and systemic inflammation are linked. Our aims were (1) to investigate biomarkers of the ongoing inflammation processes including cytokines, adhesion molecules, and chemokines and (2) to associate the findings with cardiovascular autonomic neuropathy in type 1 diabetes by measuring heart rate variability and cardiac vagal tone. Materials and Methods We included 104 adults with type 1 diabetes. Heart rate variability, time domain, and frequency domains were calculated from a 24-hour Holter electrocardiogram, while cardiac vagal tone was determined from a 5-minute electrocardiogram. Cytokines (interleukin- (IL-) 1α, IL-4, IL-12p70, IL-13, IL-17, and tumor necrosis factor- (TNF-) α), adhesion molecules (E-selectin, P-selectin, and intercellular adhesion molecule- (ICAM-) 1), and chemokines (chemokine (C-C motif) ligand (CCL)2, CCL3, CCL4, and C-X-C motif chemokine (CXCL)10) were assessed using a Luminex multiplexing technology. Associations between concentrations of inflammatory biomarkers and continuous variables of heart rate variability and cardiac vagal tone were estimated using multivariable linear regression adjusting for age, sex, disease duration, and smoking. Results Participants with the presence of cardiovascular autonomic neuropathy had higher systemic levels of IL-1α, IL-4, CCL2, and E-selectin than those without cardiovascular autonomic neuropathy. IL-1α, IL-4, IL-12, TNF-α, and E-selectin were inversely associated with both sympathetic and parasympathetic heart rate variability measures (p > 0.01). Discussion. Our results show that several pro- and anti-inflammatory factors, believed to be involved in the progression of diabetic polyneuropathy, are associated with cardiovascular autonomic neuropathy, suggesting that these factors may also contribute to the pathogenesis of cardiovascular autonomic neuropathy. Our findings emphasize the importance of the neuroimmune regulatory system in the pathogenesis of neuropathy in type 1 diabetes.
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Liu X, Wilson MW, Liu K, Lee P, Yeomans L, Hagen SE, Lin CM, Wen B, Sun D, White AD, Showalter HD, Antonetti DA. Synthesis and structure-activity relationships of thieno[2,3-d]pyrimidines as atypical protein kinase C inhibitors to control retinal vascular permeability and cytokine-induced edema. Bioorg Med Chem 2020; 28:115480. [PMID: 32327351 DOI: 10.1016/j.bmc.2020.115480] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 03/25/2020] [Accepted: 03/27/2020] [Indexed: 11/28/2022]
Abstract
Studies demonstrate that small molecule targeting of atypical protein kinase C (aPKC) may provide an effective means to control vascular permeability, prevent edema, and reduce inflammation providing novel and important alternatives to anti-VEGF therapies for certain blinding eye diseases. Based on a literature tricyclic thieno[2,3-d]pyrimidine lead (1), an ATP-competitive inhibitor of the aPKC iota (ι) and aPKC zeta (ζ) isoforms, we have synthesized a small series of compounds in 1-2 steps from a readily available chloro intermediate. A single pyridine congener was also made using 2D NMR to assign regiochemistry. Within the parent pyrimidine series, a range of potencies was observed against aPKCζ whereas the pyridine congener was inactive. Selected compounds were also tested for their effect toward VEGF-induced permeability in BREC cells. The most potent of these (7l) was further assayed against the aPKCι isoform and showed a favorable selectivity profile against a panel of 31 kinases, including kinases from the AGC superfamily, with a focus on PKC isoforms and kinases previously shown to affect permeability. Further testing of 7l in a luciferase assay in HEK293 cells showed an ability to prevent TNF-α induced NFκB activation while not having any effect on cell survival. Intravitreal administration of 7l to the eye yielded a complete reduction in permeability in a test to determine whether the compound could block VEGF- and TNFα-induced permeability across the retinal vasculature in a rat model. The compound in mice displayed good microsomal stability and in plasma moderate exposure (AUC and Cmax), low clearance, a long half-life and high oral bioavailability. With IV dosing, higher levels were observed in the brain and eye relative to plasma, with highest levels in the eye by either IV or PO dosing. With a slow oral absorption profile, 7l accumulates in the eye to maintain a high concentration after dosing with higher levels than in plasma. Compound 7l may represent a class of aPKC inhibitors for further investigation.
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Affiliation(s)
- Xuwen Liu
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI 48105, USA
| | - Michael W Wilson
- Department of Medicinal Chemistry, University of Michigan, Ann Arbor, MI 48109, USA; Vahlteich Medicinal Chemistry Core, University of Michigan, Ann Arbor, MI 48109, USA
| | - Kun Liu
- Department of Medicinal Chemistry, University of Michigan, Ann Arbor, MI 48109, USA; Vahlteich Medicinal Chemistry Core, University of Michigan, Ann Arbor, MI 48109, USA
| | - Pil Lee
- Department of Medicinal Chemistry, University of Michigan, Ann Arbor, MI 48109, USA; Vahlteich Medicinal Chemistry Core, University of Michigan, Ann Arbor, MI 48109, USA
| | - Larisa Yeomans
- Department of Medicinal Chemistry, University of Michigan, Ann Arbor, MI 48109, USA
| | - Susan E Hagen
- Department of Medicinal Chemistry, University of Michigan, Ann Arbor, MI 48109, USA; Vahlteich Medicinal Chemistry Core, University of Michigan, Ann Arbor, MI 48109, USA
| | - Cheng-Mao Lin
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI 48105, USA
| | - Bo Wen
- Department of Pharmaceutical Sciences, University of Michigan, Ann Arbor, MI 48109, USA
| | - Duxin Sun
- Department of Pharmaceutical Sciences, University of Michigan, Ann Arbor, MI 48109, USA
| | - Andrew D White
- Department of Medicinal Chemistry, University of Michigan, Ann Arbor, MI 48109, USA; Vahlteich Medicinal Chemistry Core, University of Michigan, Ann Arbor, MI 48109, USA
| | - Hollis D Showalter
- Department of Medicinal Chemistry, University of Michigan, Ann Arbor, MI 48109, USA
| | - David A Antonetti
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI 48105, USA; Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI 48109, USA.
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Kurtul BE, Ozer PA. Neutrophil-to-lymphocyte ratio in ocular diseases: a systematic review. Int J Ophthalmol 2019; 12:1951-1958. [PMID: 31850181 DOI: 10.18240/ijo.2019.12.18] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 05/18/2019] [Indexed: 12/30/2022] Open
Abstract
AIM To summarize the results of studies investigating neutrophil-to-lymphocyte ratio (NLR) and to identify the role of NLR in ocular diseases. METHODS With the aim of identifying the studies related to NLR, a search was conducted on http://www.ncbi.nlm.nih.gov/pubmed by utilizing the key words "neutrophil lymphocyte ratio, ocular diseases, and eye diseases" up to February 2018. All of the original articles were assessed according to date of publications, countries, clinics and topics. Studies about ocular inflammatory diseases were evaluated according to their qualifications, review methods and results. RESULTS A total of 4473 publications, including original research articles and reviews were screened. The number of publications was shown a regular logarithmic increase over the years. The majority of studies were performed by clinics in Turkey and many of these publications were performed by oncology and cardiology clinics. A total of 75 publications were identified to be about ocular diseases. CONCLUSION Elevated NLR as a cheap, reproducible, and readily available marker could be used as a diagnostic and/or prognostic marker in ocular diseases.
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Affiliation(s)
- Bengi Ece Kurtul
- Department of Ophthalmology, Hatay Mustafa Kemal University Tayfur Ata Sökmen Faculty of Medicine, Hatay 31040, Turkey
| | - Pinar Altiaylik Ozer
- Department of Ophthalmology, Ufuk University Faculty of Medicine, Ankara 06830, Turkey
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Darakhshan S, Fatehi A, Hassanshahi G, Mahmoodi S, Hashemi MS, Karimabad MN. Serum concentration of angiogenic (CXCL1, CXCL12) and angiostasis (CXCL9, CXCL10) CXC chemokines are differentially altered in normal and gestational diabetes mellitus associated pregnancies. J Diabetes Metab Disord 2019; 18:371-378. [PMID: 31890662 PMCID: PMC6915176 DOI: 10.1007/s40200-019-00421-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 06/28/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND The present study was aimed and designed to determine the serum levels of CXCL1 and CXCL12 as angiogenesis along with CXCL9 and CXCL10 as angiostasis, chemokines in, Gestational diabetes mellitus mothers (GDMM) and normal pregnancy mothers (NPM) and neonates who delivered by them. METHODS We have recruited 63 pregnant GDMM and 63 normal pregnant mothers at the third trimester of pregnancy to this cross-sectional study. Cord blood specimens were obtained from neonates who were delivered from GDMM and NPM. The serum and cord blood levels of chemokines were measured by ELISA in studied groups. Data were analyzed by chi-square and student's t test between two groups. The P-values less than 0.05 were considered significant. RESULTS Our results revealed that the serum levels of CXCL1, CXCL9 and CXCL12 were increased in GDMM, while no alteration was found in the serum levels of CXCL10 when compared to NPM. We have observed that in neonates the serum levels of angiogeneic chemokines followed an inverse fashion when compared to angiostasis chemokines. Interestingly, CXCL1 and CXCL12 were both increased in neonates who were delivered by GDMM, while, CXCL9 and CXCL10 were decreased in neonates delivered by GDMM.
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Affiliation(s)
- Shokoofeh Darakhshan
- Department of Pediatrics, Faculty of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Abbas Fatehi
- Department of Pediatrics, Faculty of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Gholamhossein Hassanshahi
- Department of Hematology, Faculty of Biomed, Biomedical Sciences Kerman University of Medical Sciences, Kerman, Iran
- Molecular Medicine Research Center, Research Institute of Basic Medical Sciences, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Soodabeh Mahmoodi
- Department of Pediatrics, Faculty of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Monireh Seyed Hashemi
- Department of Pediatrics, Faculty of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Mojgan Noroozi Karimabad
- Molecular Medicine Research Center, Research Institute of Basic Medical Sciences, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
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Abstract
Atherosclerosis is one of the main complications of diabetes involving multiple causative factors. Dysfunction of the vascular endothelium is a hallmark of most conditions that are associated with both diabetes and atherosclerosis. Although the pathological link between diabetes and atherosclerosis is well-established, better comprehension of the underlying mechanisms is of utmost importance to identify novel potential molecular targets. It is difficult to separate the effects of hyperglycaemia from those of other atherogenic factors: recent evidence shows that they share many common mechanisms, such as endothelial activation and inflammation, mitochondrial oxidative stress, changes in extracellular matrix components and disruption of cellular defence systems. The plausible hypothesis of the 'common soil' between diabetes and atherosclerosis seems to be born from a unique 'ancestor': the nuclear factor κB, a transcription factor able to guide multiple molecular processes. It seems that this master regulator triggers either some hyperglycaemia-induced effects on the endothelial function, or the expression of certain microRNAs (in particular miR-126, -21 and miR-146a-5p) involved in favouring atherosclerosis. Here, we review the latest evidence and proposed mechanisms, aiming to understand the link between diabetes and atherosclerosis.
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Affiliation(s)
- Lucia La Sala
- Department of Cardiovascular and Dysmetabolic Diseases, IRCCS MultiMedica, Italy
| | | | - Antonio Ceriello
- Department of Cardiovascular and Dysmetabolic Diseases, IRCCS MultiMedica, Italy
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Fickweiler W, Aiello LP, Sun JK, King GL. Retinol binding protein 3 as biomarker for diabetic retinopathy. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:706. [PMID: 31930216 DOI: 10.21037/atm.2019.10.95] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Ward Fickweiler
- Research Division, Joslin Diabetes Center, Boston, MA, USA.,Beetham Eye Institute, Joslin Diabetes Center, Boston, MA, USA
| | - Lloyd P Aiello
- Research Division, Joslin Diabetes Center, Boston, MA, USA.,Beetham Eye Institute, Joslin Diabetes Center, Boston, MA, USA.,Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Jennifer K Sun
- Research Division, Joslin Diabetes Center, Boston, MA, USA.,Beetham Eye Institute, Joslin Diabetes Center, Boston, MA, USA.,Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - George L King
- Research Division, Joslin Diabetes Center, Boston, MA, USA.,Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA
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Oh TJ, Lee JE, Choi SH, Jang HC. Association between Body Fat and Diabetic Peripheral Neuropathy in Middle-Aged Adults with Type 2 Diabetes Mellitus: A Preliminary Report. J Obes Metab Syndr 2019; 28:112-117. [PMID: 31294343 PMCID: PMC6604847 DOI: 10.7570/jomes.2019.28.2.112] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 03/13/2019] [Accepted: 05/13/2019] [Indexed: 12/26/2022] Open
Abstract
Background Previous epidemiologic studies showed that obesity increased the risk of diabetic peripheral neuropathy (DPN). However, there is very limited data about the impact of body fat measured by body composition analysis in DPN. Methods Subjects with type 2 diabetes mellitus (T2DM) between 20 to 55 years old were enrolled. DPN was diagnosed using the Michigan Neuropathy Screening Instrument. Body composition was assessed by bio-impedance analysis, and the association between body composition and DPN was investigated. Results Among 65 subjects, 44.6% were diagnosed with DPN. Subjects with DPN had higher body mass index and waist circumference than subjects without DPN. Body composition data showed that fat mass, fat percent, and visceral fat area were higher in subjects with DPN than in subjects without DPN. Furthermore, the presence of DPN was associated with waist circumference (odds ratio [OR], 1.151; 95% confidence interval [CI], 1.055-1.256; P=0.002), visceral fat area (OR, 1.026; 95% CI, 1.005-1.048; P=0.015), and insulin resistance (OR, 1.673; 95% CI, 1.091-2.565; P=0.018) after adjusting age, sex, diabetes duration, and smoking status. Conclusion Abdominal obesity was associated with DPN. Insulin resistance might mediate obesity and DPN in middle aged subjects with T2DM.
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Affiliation(s)
- Tae Jung Oh
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul; Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jie-Eun Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul; Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sung Hee Choi
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul; Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hak Chul Jang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul; Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
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El Sheikh WM, Alahmar IE, Salem GM, El-Sheikh MA. Tumor necrosis factor alpha in peripheral neuropathy in type 2 diabetes mellitus. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2019. [DOI: 10.1186/s41983-019-0080-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Lim SW, Bandala-Sanchez E, Kolic M, Rogers SL, McAuley AK, Lim LL, Wickremasinghe SS. The Influence of Intravitreal Ranibizumab on Inflammation-associated Cytokine Concentrations in Eyes With Diabetic Macular Edema. Invest Ophthalmol Vis Sci 2019; 59:5382-5390. [PMID: 30452591 DOI: 10.1167/iovs.17-23325] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To evaluate the effect of intravitreal ranibizumab injections on aqueous concentrations of angiogenic or inflammatory cytokines in patients with diabetic macular edema (DME). Methods Thirty eyes of 25 patients with center-involved DME were recruited to the study. All had a central macular thickness (CMT) of >300 μm and best-corrected visual acuity (BCVA) between 28 and 70 logMAR letters (Snellen equivalent 20/320-20/40). At baseline, all eyes had 0.1 mL of aqueous collected before ranibizumab treatment. At week 4, a second ranibizumab injection was administered and at week 8, aqueous sampling was repeated before a third ranibizumab injection. From week 12, all eyes were followed at 4-weekly intervals and the need for ranibizumab treatment was determined by BCVA and CMT measurements. Levels of 32 cytokines were assessed at baseline and at week 8 using a multiplex array assay. Results Following two consecutive ranibizumab injections, there was a statistically significant reduction in VEGF (P < 0.00001), as well as IL-1β (P = 0.00006), IL-7 (P = 0.00002), IL-8 (P = 0.00023), IL-10 (P < 0.00001), IL-12 (P < 0.00001), IL-17 (P = 0.00024), MCP-1 (P = 0.00023), and TNF-α (P < 0.00001). There was also an upregulation of soluble VEGF receptor-2 (P = 0.00004). A P < 0.0015 was considered significant in this study. Conclusions Ranibizumab treatment influences various inflammatory cytokine concentrations in addition to reducing aqueous VEGF concentrations in patients with DME. This may contribute to its therapeutic effect in patients with DME.
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Affiliation(s)
- Shueh Wen Lim
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Victoria, Australia
| | | | - Maria Kolic
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Victoria, Australia
| | - Sophie L Rogers
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Victoria, Australia
| | - Annie K McAuley
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Victoria, Australia.,Department of Epidemiology and Preventative Medicine, Monash University, Australia
| | - Lyndell L Lim
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Victoria, Australia
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Zur D, Iglicki M, Loewenstein A. The Role of Steroids in the Management of Diabetic Macular Edema. Ophthalmic Res 2019; 62:231-236. [DOI: 10.1159/000499540] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Accepted: 03/09/2019] [Indexed: 11/19/2022]
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Mihoubi E, Bouldjennet F, Raache R, Amroun H, Azzouz M, Benazouz N, Touil-Boukoffa C, Attal N. [T-786C endothelial nitric oxide gene polymorphism and type 1 diabetic retinopathy in the Algerian population]. J Fr Ophtalmol 2019; 42:579-585. [PMID: 30962068 DOI: 10.1016/j.jfo.2018.11.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 11/18/2018] [Accepted: 11/19/2018] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Diabetic retinopathy (DR) results from interactions between genetic and environmental factors. We were interested in the endothelial nitric oxide gene (eNOS), given the involvement of this enzyme in functional alterations in the retinal microvasculature in diabetes. The goal of our study was to assess the association of T-786C endothelial nitric oxide synthase (eNOS) gene polymorphism with diabetic retinopathy in the Algerian population. PATIENTS AND METHODS Our study enrolled 110 patients with and without DR. All subjects were genotyped for the T786C eNOS polymorphism using the PCR-RFLP method. We also investigated the association between this polymorphism and certain clinical and laboratory characteristics of patients with DR. RESULTS A significant increase in the frequency of the CC genotype is noted in subjects without DR (P=0.03). We also report a significant increase in the frequencies of the TT+TC genotypes in individuals with DR (P=0.03). However, the association between the different genotypes and clinical or laboratory profiles in patients with DR reveals that the NO level is lower in subjects carrying the TT genotype (P=0.039). CONCLUSION Our preliminary results suggest that the CC genotype could confer protection from type 1 diabetic retinopathy in the Algerian population, while the T allele seems to confer susceptibility.
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Affiliation(s)
- E Mihoubi
- Équipe cytokines et NO synthases/immunité et pathogénie, laboratoire de biologie cellulaire et moléculaire (LBCM), faculté des sciences biologiques, USTHB, BP 32, El Alia, 16111, Alger, Algérie; Département d'immunologie, institut Pasteur d'Algérie, route du Petit-Staouéli, Delly Brahim, Algérie.
| | - F Bouldjennet
- Équipe cytokines et NO synthases/immunité et pathogénie, laboratoire de biologie cellulaire et moléculaire (LBCM), faculté des sciences biologiques, USTHB, BP 32, El Alia, 16111, Alger, Algérie; Faculté des sciences, université M'Hamed Bougara de Boumerdès, avenue de l'indépendance, 35000 Boumerdès, Algérie
| | - R Raache
- Équipe cytokines et NO synthases/immunité et pathogénie, laboratoire de biologie cellulaire et moléculaire (LBCM), faculté des sciences biologiques, USTHB, BP 32, El Alia, 16111, Alger, Algérie
| | - H Amroun
- Laboratoire central de biologie. CHU N'fissa Hamoud, Hussein Dey, route de Bachdjerah, el magharia, 16008, Alger, Algérie
| | - M Azzouz
- Service de diabétologie, CHU Mustapha Bacha, Alger, Algérie
| | - N Benazouz
- Service d'ophtalmologie, CHU Beb el Oued, Alger, Algérie
| | - C Touil-Boukoffa
- Équipe cytokines et NO synthases/immunité et pathogénie, laboratoire de biologie cellulaire et moléculaire (LBCM), faculté des sciences biologiques, USTHB, BP 32, El Alia, 16111, Alger, Algérie
| | - N Attal
- Équipe cytokines et NO synthases/immunité et pathogénie, laboratoire de biologie cellulaire et moléculaire (LBCM), faculté des sciences biologiques, USTHB, BP 32, El Alia, 16111, Alger, Algérie
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Vallianou NG, Mitesh S, Gkogkou A, Geladari E. Chronic Kidney Disease and Cardiovascular Disease: Is there Any Relationship? Curr Cardiol Rev 2019; 15:55-63. [PMID: 29992892 PMCID: PMC6367692 DOI: 10.2174/1573403x14666180711124825] [Citation(s) in RCA: 112] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 07/02/2018] [Accepted: 07/06/2018] [Indexed: 01/11/2023] Open
Abstract
INTRODUCTION Chronic Kidney Disease is a growing health burden world wide. Traditional and mutual risk factors between CVD and CKD are age, hypertension, diabetes mellitus, dyslipidemia, tobacco use, family history and male gender. In this review, we will focus on whether or not early CKD is an important risk factor for the presence, severity and progression of CVD. Specifically, we will examine both traditional and novel risk factors of both CKD and CVD and how they relate to each other. CONCLUSION We will also assess if early treatment of CKD, intensive compared to standard, has an important effect on the halt of the development of CKD as well as CVD. Insights into the pathogenesis and early recognition of CKD as well as the importance of novel kidney biomarkers will be pointed out. Also, common pathogenetic mechanisms between CKD and CVD will be discussed.
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Affiliation(s)
| | - Shah Mitesh
- Evangelismos General Hospital, 45-47 Ipsilantou str, Athens, Greece
| | | | - Eleni Geladari
- Evangelismos General Hospital, 45-47 Ipsilantou str, Athens, Greece
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de Ritter R, Sep SJS, van der Kallen CJH, Schram MT, Koster A, Kroon AA, van Greevenbroek MMJ, Eussen SJPM, Dagnelie PC, de Jong M, Vos RC, Woodward M, Bots ML, Peters SAE, Stehouwer CDA. Adverse differences in cardiometabolic risk factor levels between individuals with pre-diabetes and normal glucose metabolism are more pronounced in women than in men: the Maastricht Study. BMJ Open Diabetes Res Care 2019; 7:e000787. [PMID: 31798903 PMCID: PMC6861068 DOI: 10.1136/bmjdrc-2019-000787] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Revised: 09/20/2019] [Accepted: 10/14/2019] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To investigate whether adverse differences in levels of cardiovascular risk factors in women than men, already established when comparing individuals with and without diabetes, are also present before type 2 diabetes onset. RESEARCH DESIGN AND METHODS In a population-based cohort study of individuals aged 40-75 years (n=3410; 49% women, 29% type 2 diabetes (oversampled by design)), we estimated associations with cardiometabolic and lifestyle risk factors of (1) pre-diabetes and type 2 diabetes (reference category: normal glucose metabolism) and (2) among non-diabetic individuals, of continuous levels of hemoglobin A1c (HbA1c). Age-adjusted sex differences were analyzed using linear and logistic regression models with sex interaction terms. RESULTS In pre-diabetes, adverse differences in cardiometabolic risk factors were greater in women than men for systolic blood pressure (difference, 3.02 mm Hg; 95% CI:-0.26 to 6.30), high-density lipoprotein (HDL) cholesterol (difference, -0.10 mmol/L; 95% CI: -0.18 to -0.02), total-to-HDL cholesterol ratio (difference, 0.22; 95% CI: -0.01 to 0.44), triglycerides (ratio: 1.11; 95% CI: 1.01 to 1.22), and inflammation markers Z-score (ratio: 1.18; 95% CI: 0.98 to 1.41). In type 2 diabetes, these sex differences were similar in direction, and of greater magnitude. Additionally, HbA1c among non-diabetic individuals was more strongly associated with several cardiometabolic risk factors in women than men: per one per cent point increase, systolic blood pressure (difference, 3.58 mm Hg; 95% CI: -0.03 to 7.19), diastolic blood pressure (difference, 2.10 mm Hg; 95% CI: -0.02 to 4.23), HDL cholesterol (difference, -0.09 mmol/L; 95% CI: -0.19 to 0.00), and low-density lipoprotein cholesterol (difference, 0.26 mmol/L; 95% CI: 0.05 to 0.47). With regard to lifestyle risk factors, no consistent pattern was observed. CONCLUSION Our results are consistent with the concept that the more adverse changes in cardiometabolic risk factors in women (than men) arise as a continuous process before the onset of type 2 diabetes.
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Affiliation(s)
- Rianneke de Ritter
- Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands
- CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
| | - Simone J S Sep
- Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands
- CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
- Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, The Netherlands
| | - Carla J H van der Kallen
- Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands
- CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
| | - Miranda T Schram
- Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands
- CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
- Heart and Vascular Centre, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Annemarie Koster
- Department of Social Medicine, Maastricht University, Maastricht, The Netherlands
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Abraham A Kroon
- Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands
- CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
| | - Marleen M J van Greevenbroek
- Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands
- CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
| | - Simone J P M Eussen
- CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
- Department of Epidemiology, Maastricht University, Maastricht, The Netherlands
| | - Pieter C Dagnelie
- Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands
- CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
| | - Marit de Jong
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Rimke C Vos
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Public Health and Primary Care / LUMC-Campus, Leiden University Medical Center, The Hague, The Netherlands
| | - Mark Woodward
- The George Institute for Global Health, University of Oxford, Oxford, United Kingdom
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
- Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Michiel L Bots
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Sanne A E Peters
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
- The George Institute for Global Health, University of Oxford, Oxford, United Kingdom
| | - Coen D A Stehouwer
- Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands
- CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
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44
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Gopinath G, V. Kakkanatt A, Bisto AA, Mathai M. Correlation of C-reactive protein and glycosylated hemoglobin on severity of diabetic macular edema. KERALA JOURNAL OF OPHTHALMOLOGY 2019. [DOI: 10.4103/kjo.kjo_38_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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45
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Alman AC, Talton JW, Wadwa RP, Urbina EM, Dolan LM, Hamman RF, D'Agostino RB, Marcovina SM, Dabelea DM. Inflammation, adiposity, and progression of arterial stiffness in adolescents with type 1 diabetes: The SEARCH CVD Study. J Diabetes Complications 2018; 32:995-999. [PMID: 30209019 PMCID: PMC6174105 DOI: 10.1016/j.jdiacomp.2018.08.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 12/28/2017] [Accepted: 08/06/2018] [Indexed: 11/30/2022]
Abstract
AIMS We examined the association between inflammation and progression of arterial stiffness in a population of youth with type 1 diabetes (T1D). METHODS A total of 287 youth with T1D (median age 13 years) from SEARCH CVD, an ancillary study to the SEARCH for Diabetes in Youth, were included. Markers of inflammation (CRP, IL-6, fibrinogen, leptin, and adiponectin) and measures of pulse wave velocity (PWV) of the arm (PWV-R), trunk (PWV-T), and lower extremity (PWV-LE) were measured at baseline. Measures of PWV were repeated approximately five years later. RESULTS PWV-R (0.50 m/s), PWV-T (0.65 m/s), and PWV-LE (1.0 m/s) significantly increased over the follow-up (p < 0.001 for each). A significant interaction was found between waist circumference and fibrinogen (p = 0.036) on the progression of PWV-T, suggesting that fibrinogen is more strongly associated with PWV progression in lean participants. CONCLUSIONS Improved understanding of adiposity, inflammation, and functional changes in the vascular system in patients with T1D is crucial.
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Affiliation(s)
- Amy C Alman
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, USA.
| | - Jennifer W Talton
- Department of Biostatistical Sciences, Wake Forest School of Medicine, USA
| | - R Paul Wadwa
- Barbara Davis Center, University of Colorado Denver, USA
| | - Elaine M Urbina
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, USA
| | - Lawrence M Dolan
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, USA
| | - Richard F Hamman
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, USA
| | - Ralph B D'Agostino
- Department of Biostatistical Sciences, Wake Forest School of Medicine, USA
| | - Santica M Marcovina
- Department of Metabolism, Endocrinology and Nutrition, University of Washington, USA
| | - Dana M Dabelea
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, USA
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46
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Cacciamani A, Esposito G, Scarinci F, Parravano M, Dinice L, Di Nicola M, Micera A. Inflammatory mediators in the vitreal reflux of patients with diabetic macular edema. Graefes Arch Clin Exp Ophthalmol 2018; 257:187-197. [PMID: 30377797 DOI: 10.1007/s00417-018-4169-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 08/28/2018] [Accepted: 10/16/2018] [Indexed: 02/07/2023] Open
Abstract
PURPOSE To quantify inflammatory, growth/angiogenic, and tissue remodeling mediators in vitreal reflux (VR) in patients with diabetic macular edema (DME), as collected at first and third intravitreal anti-vascular endothelial growth factor (anti-VEGF, ranibizumab) injection. METHODS Thirty (30) consecutive patients (type-2 diabetes mellitus) with visual impairments due to DME and undergoing the first (untreated DME) or the third (treated DME) intravitreal injection of anti-VEGF were included in the study. At the time of surgery, patients were subjected to clinical assessment and spectral domain-optical coherence tomography (SD-OCT), including central retinal thickness (CRT), macular volume, and outer nuclear layer/retinal pigment epithelial (ONL/RPE) measurements. VR sampling was performed at the time of needle removal and subjected to customized protein-array, Western blotting (WB), Ella™ microfluidic, and/or enzyme-linked immunosorbent assay (ELISA) analysis. Biostrumental and biochemical data were collected just prior to the surgery and are representative of disease state. Clinical, biostrumental, and numerous biomarkers and cytokines were statistically compared. RESULTS Decreased CRT values were detected in treated DME retinas, as compared to untreated ones (p ≤ 0.05). Differences in VEGF and other mediator expressions between treated and untreated DME were detected in VR samples. Particularly, osteopontin (p ≤ 0.05), interleukin 6 (IL6) (p ≤ 0.05), and VEGF (p ≤ 0.1) values were decreased after treatment. Significant changes were validated by WB, ELISA, and Ella™ analysis. CONCLUSION Overall, the biostrumental and biochemical data suggest the presence of a specific pattern of inflammation in VR after treatment. The data would suggest the presence of other mechanisms and mediators, in addition to VEGF, accountable for DME progression.
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Affiliation(s)
- Andrea Cacciamani
- IRCCS - Fondazione Bietti, Via S. Stefano Rotondo 6, 00184, Rome, Italy
| | - Graziana Esposito
- IRCCS - Fondazione Bietti, Via S. Stefano Rotondo 6, 00184, Rome, Italy
| | - Fabio Scarinci
- IRCCS - Fondazione Bietti, Via S. Stefano Rotondo 6, 00184, Rome, Italy
| | | | - Lucia Dinice
- IRCCS - Fondazione Bietti, Via S. Stefano Rotondo 6, 00184, Rome, Italy
| | - Marta Di Nicola
- Department of Medical, Oral and Biotechnological Sciences, Laboratory of Biostatistics, University G. d'Annunzio Chieti-Pescara, Chieti, Italy
| | - Alessandra Micera
- IRCCS - Fondazione Bietti, Via S. Stefano Rotondo 6, 00184, Rome, Italy.
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47
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Kostic M, Bates NM, Milosevic NT, Tian J, Smiddy WE, Lee WH, Somfai GM, Feuer WJ, Shiffman JC, Kuriyan AE, Gregori NZ, Pineda S, Cabrera DeBuc D. Investigating the Fractal Dimension of the Foveal Microvasculature in Relation to the Morphology of the Foveal Avascular Zone and to the Macular Circulation in Patients With Type 2 Diabetes Mellitus. Front Physiol 2018; 9:1233. [PMID: 30233408 PMCID: PMC6134047 DOI: 10.3389/fphys.2018.01233] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Accepted: 08/15/2018] [Indexed: 12/19/2022] Open
Abstract
In this study, we examined the relationship between the fractal dimension (FD), the morphology of the foveal avascular zone (FAZ) and the macular circulation in healthy controls and patients with type 2 diabetes mellitus (T2DM) with and with no diabetic retinopathy (DR). Cross-sectional data of 47 subjects were analyzed from a 5-year longitudinal study using a multimodal optical imaging approach. Healthy eyes from nondiabetic volunteers (n = 12) were selected as controls. Eyes from patients with T2DM were selected and divided into two groups: diabetic subjects with mild DR (MDR group, n = 15) and subjects with DM but without DR (DM group, n = 20). Our results demonstrated a higher FD in the healthy group (mean, 1.42 ± 0.03) than in the DM and MDR groups (1.39 ± 0.02 and 1.35 ± 0.03, respectively). Also, a bigger perimeter, area, and roundness of the FAZ were found in MDR eyes. A significant difference in area and perimeter (p ≤ 0.005) was observed for the MDR group supporting the enlargement of the FAZ due to diabetic complications in the eye. A moderate positive correlation (p = 0.014, R2 = 43.8%) between the FD and blood flow rate (BFR) was only found in the healthy control group. The BFR calculations revealed the lowest values in the MDR group (0.98 ± 0.27 μl/s vs. 1.36 ± 0.86 μl/s and 1.36 ± 0.57 μl/sec in the MDR, DM, and healthy groups, respectively, p = 0.2). Our study suggests that the FD of the foveal vessel arborization could provide useful information to identify early morphological changes in the retina of patients with T2DM. Our results also indicate that the enlargement and asymmetry of the FAZ might be related to a lower BFR because of the DR onset and progression. Interestingly, due to the lack of FAZ symmetry observed in the DM and MDR eyes, it appears that the distribution of flow within the retinal vessels loses complexity as the vascular structures distributing the flow are not well described by fractal branching. Further research could determine how our approach may be used to aid the diagnosis of retinal neurodegeneration and vascular impairment at the early stage of DR.
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Affiliation(s)
- Maja Kostic
- Miller School of Medicine, Bascom Palmer Eye Institute, University of Miami, Miami, FL, United States
| | - Nathan M Bates
- Miller School of Medicine, Bascom Palmer Eye Institute, University of Miami, Miami, FL, United States
| | | | - Jing Tian
- Miller School of Medicine, Bascom Palmer Eye Institute, University of Miami, Miami, FL, United States
| | - William E Smiddy
- Miller School of Medicine, Bascom Palmer Eye Institute, University of Miami, Miami, FL, United States
| | - Wen-Hsiang Lee
- Miller School of Medicine, Bascom Palmer Eye Institute, University of Miami, Miami, FL, United States
| | - Gabor M Somfai
- Retinology Unit, Pallas Kliniken, Olten, Switzerland.,Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - William J Feuer
- Miller School of Medicine, Bascom Palmer Eye Institute, University of Miami, Miami, FL, United States
| | - Joyce C Shiffman
- Miller School of Medicine, Bascom Palmer Eye Institute, University of Miami, Miami, FL, United States
| | - Ajay E Kuriyan
- Miller School of Medicine, Bascom Palmer Eye Institute, University of Miami, Miami, FL, United States
| | - Ninel Z Gregori
- Miller School of Medicine, Bascom Palmer Eye Institute, University of Miami, Miami, FL, United States
| | - Sandra Pineda
- Miller School of Medicine, Bascom Palmer Eye Institute, University of Miami, Miami, FL, United States
| | - Delia Cabrera DeBuc
- Miller School of Medicine, Bascom Palmer Eye Institute, University of Miami, Miami, FL, United States
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48
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Abdelnabi AM, Sadek AMEM. Role of interleukin 6 and highly sensitive C-reactive protein in diabetic nephropathy. THE EGYPTIAN JOURNAL OF INTERNAL MEDICINE 2018. [DOI: 10.4103/ejim.ejim_27_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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49
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Santiago AR, Boia R, Aires ID, Ambrósio AF, Fernandes R. Sweet Stress: Coping With Vascular Dysfunction in Diabetic Retinopathy. Front Physiol 2018; 9:820. [PMID: 30057551 PMCID: PMC6053590 DOI: 10.3389/fphys.2018.00820] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 06/12/2018] [Indexed: 12/15/2022] Open
Abstract
Oxidative stress plays key roles in the pathogenesis of retinal diseases, such as diabetic retinopathy. Reactive oxygen species (ROS) are increased in the retina in diabetes and the antioxidant defense system is also compromised. Increased ROS stimulate the release of pro-inflammatory cytokines, promoting a chronic low-grade inflammation involving various signaling pathways. An excessive production of ROS can lead to retinal endothelial cell injury, increased microvascular permeability, and recruitment of inflammatory cells at the site of inflammation. Recent studies have started unraveling the complex crosstalk between retinal endothelial cells and neuroglial cells or leukocytes, via both cell-to-cell contact and secretion of cytokines. This crosstalk is essential for the maintenance of the integrity of retinal vascular structure. Under diabetic conditions, an aberrant interaction between endothelial cells and other resident cells of the retina or invading inflammatory cells takes place in the retina. Impairment in the secretion and flow of molecular signals between different cells can compromise the retinal vascular architecture and trigger angiogenesis. In this review, the synergistic contributions of redox-inflammatory processes for endothelial dysfunction in diabetic retinopathy will be examined, with particular attention paid to endothelial cell communication with other retinal cells.
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Affiliation(s)
- Ana R Santiago
- Coimbra Institute for Clinical and Biomedical Research, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,CNC.IBILI, University of Coimbra, Coimbra, Portugal.,Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - Raquel Boia
- Coimbra Institute for Clinical and Biomedical Research, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,CNC.IBILI, University of Coimbra, Coimbra, Portugal
| | - Inês D Aires
- Coimbra Institute for Clinical and Biomedical Research, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,CNC.IBILI, University of Coimbra, Coimbra, Portugal
| | - António F Ambrósio
- Coimbra Institute for Clinical and Biomedical Research, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,CNC.IBILI, University of Coimbra, Coimbra, Portugal
| | - Rosa Fernandes
- Coimbra Institute for Clinical and Biomedical Research, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,CNC.IBILI, University of Coimbra, Coimbra, Portugal
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50
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Aryan Z, Ghajar A, Faghihi-Kashani S, Afarideh M, Nakhjavani M, Esteghamati A. Baseline High-Sensitivity C-Reactive Protein Predicts Macrovascular and Microvascular Complications of Type 2 Diabetes: A Population-Based Study. ANNALS OF NUTRITION AND METABOLISM 2018; 72:287-295. [PMID: 29694948 DOI: 10.1159/000488537] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 03/16/2018] [Indexed: 01/28/2023]
Abstract
BACKGROUND/AIMS This prospective study is aimed at examining the predictive value of high-sensitivity C-reactive protein (hs-CRP) for coronary heart disease (CHD) events and microvascular complications of type 2 diabetes mellitus (T2DM). METHODS A population-based study (NCT02958579) was conducted on 1,301 participants with T2DM (mean follow-up of 7.5 years). Risk assessment for vascular events was done at baseline, and serum hs-CRP was measured. End points of this study include CHD events, diabetic retinopathy, neuropathy, and diabetic kidney disease. Individuals with unavailable data or hs-CRP >20 mg/L were excluded. The discrimination and reclassification improvement of study end points were tested after addition of hs-CRP to traditional risk factors. RESULTS Median serum hs-CRP was 2.00 ranging from 0.1 to 17 mg/L. Hazards ratio of each SD increment in baseline hs-CRP was 1.028 (1.024-1.032) for CHD, 1.025 (1.021-1.029) for diabetic neuropathy, 1.037 (1.030-1.043) for diabetic retinopathy, and 1.035 (1.027-1.043) for diabetic kidney disease. The addition of hs-CRP to traditional risk factors of vascular complications of T2DM improved discrimination of all end points (p < 0.001). Net reclassification improvement ranged from 8% for diabetic neuropathy to 31% for diabetic kidney disease (p < 0.05). CONCLUSION Baseline hs-CRP predicts both of CHD events and microvascular complications of patients with T2D.
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Affiliation(s)
- Zahra Aryan
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Student's Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Ghajar
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Faghihi-Kashani
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Afarideh
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Manouchehr Nakhjavani
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Esteghamati
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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