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Coelho ARDP, Silveira LC, Santos KDF, Santos RDS, Reis AADS. No Association of Angiotensin-Converting Enzyme Insertion/Deletion (ACE I/D) Gene Polymorphism in the Susceptibility to Diabetic Retinopathy in Type 2 Diabetes Mellitus Patients: An Updated Meta-Analysis. J Pers Med 2023; 13:1308. [PMID: 37763076 PMCID: PMC10533192 DOI: 10.3390/jpm13091308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/10/2023] [Accepted: 08/17/2023] [Indexed: 09/29/2023] Open
Abstract
Diabetic retinopathy (DR) is a complex and multifactorial pathology encompassing environmental, metabolic, and polygenic influences. Among the genes possibly involved in the development and progression of DR, the Angiotensin I-converting enzyme (ACE) gene stands out, which presents an insertion (I) or deletion (D) polymorphism of a 287 bp Alu repetitive sequence in intron 16. Thus, this study aimed to perform a systematic review with meta-analysis to elucidate the relationship between the ACE gene (I/D) polymorphism (rs1799752) and the development and progression of DR in type 2 diabetic patients. PubMed/MEDLINE, Embase, Web of Science, and Scopus databases were systematically searched to retrieve articles that investigated the association between ACE gene (I/D) polymorphism in DR patients. Sixteen articles were included in the systematic review. The results describe no significant association between the polymorphism and DR risk (OR = 1.12; CI = 0.96-1.31; and p = 0.1359) for genotypic analysis by the dominant model (II vs. ID+DD). Moreover, we also observed no significant association between the D allele on the allele frequency analysis (I vs. D) and the DR risk (OR = 1.10; CI = 0.98-1.23; and p = 0.1182). Forest plot analysis revealed that the discrepancy between previous studies most likely arose from variations in their sample sizes. In conclusion, I/D polymorphism appears to be not involved in the susceptibility to and progression of the DR in type 2 diabetic patients.
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Affiliation(s)
- Aline Ruilowa de Pinho Coelho
- Laboratory of Molecular Pathology, Biological Sciences Institute, Federal University of Goiás, Goiânia 74690-090, Brazil
| | - Luciana Carvalho Silveira
- Laboratory of Molecular Pathology, Biological Sciences Institute, Federal University of Goiás, Goiânia 74690-090, Brazil
| | - Kamilla de Faria Santos
- Laboratory of Molecular Pathology, Biological Sciences Institute, Federal University of Goiás, Goiânia 74690-090, Brazil
| | - Rodrigo da Silva Santos
- Laboratory of Molecular Pathology, Biological Sciences Institute, Federal University of Goiás, Goiânia 74690-090, Brazil
- Department of Biochemistry and Molecular Biology, Biological Sciences Institute, Federal University of Goiás, Goiânia 74690-090, Brazil
| | - Angela Adamski da Silva Reis
- Laboratory of Molecular Pathology, Biological Sciences Institute, Federal University of Goiás, Goiânia 74690-090, Brazil
- Department of Biochemistry and Molecular Biology, Biological Sciences Institute, Federal University of Goiás, Goiânia 74690-090, Brazil
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Walid AHD, Al-Bdour MD, El-Khateeb M. Lack of relationship between Alu repetitive elements in angiotensin converting enzyme and the severity of diabetic retinopathy. J Med Biochem 2021; 40:302-309. [PMID: 34177375 PMCID: PMC8199535 DOI: 10.5937/jomb0-27885] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 10/12/2020] [Indexed: 11/06/2022] Open
Abstract
Background Angiotensin-converting enzyme (ACE) stimulates angiogenesis that leads to the development of diabetic retinopathy (DR). Alu repetitive elements in ACE gene increase the expression of this enzyme. We investigated the frequency of Alu repetitive elements, insertion/deletion (I/D) polymorphism, in angiotensin-converting enzyme among diabetic retinopathy patients and whether this polymorphism is associated with the severity of retinopathy in Jordanians with type 2 diabetes. Methods A total of 277 subjects participated in this case/ control study (100 diabetic patients without DR, 82 diabetic patients with DR, and 95 healthy control). Blood samples were withdrawn, followed by DNA extraction. Alu repetitive elements were examined by polymerase chain reaction followed by gel electrophoresis. Results The genotype and allele frequencies among diabetic patients, were close to healthy controls (genotypes, II 44.4 vs. 44.7%, ID 44.4 vs. 42.6%, DD 12.2 vs. 12.8%, P = 0.402 and 0.677 respectively, alleles, I 65.6 vs. 66%, D 34.4 vs. 34%, P=0.863). Complicated diabetics with retinopathy showed similar genotype and allele frequency to those without complications. The severity of diabetic retinopathy in affected individuals was not correlated with I/D polymorphism (P=0.862). Conclusions We conclude that the presence of Alu repetitive elements did not increase the development or progression risk to retinopathy in Jordanian type 2 diabetic patients. No association between I or D alleles with the severity of DR was detected.
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Affiliation(s)
- Abu-Hassan Diala Walid
- University of Jordan, School of Medicine, Department of Physiology and Biochemistry, Amman, Jordan
| | - Muawyah D Al-Bdour
- University of Jordan, School of Medicine, Department of Ophthalmology, Amman, Jordan
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Pigeyre M, Sjaarda J, Chong M, Hess S, Bosch J, Yusuf S, Gerstein H, Paré G. ACE and Type 2 Diabetes Risk: A Mendelian Randomization Study. Diabetes Care 2020; 43:835-842. [PMID: 32019855 DOI: 10.2337/dc19-1973] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 01/07/2020] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To determine whether ACE inhibitors reduce the risk of type 2 diabetes using a Mendelian randomization (MR) approach. RESEARCH DESIGN AND METHODS A two-sample MR analysis included 17 independent genetic variants associated with ACE serum concentration in 4,147 participants from the Outcome Reduction with Initial Glargine INtervention (ORIGIN) (clinical trial reg. no. NCT00069784) trial, and their effects on type 2 diabetes risk were estimated from 18 studies of the DIAbetes Genetics Replication And Meta-analysis (DIAGRAM) consortium. A genetic risk score (GRS) underpinning lower ACE concentration was then tested for association with type 2 diabetes prevalence in 341,872 participants, including 16,320 with type 2 diabetes, from the UK Biobank. MR estimates were compared after standardization for blood pressure change, with the estimate obtained from a randomized controlled trial (RCT) meta-analysis of ACE inhibitors versus placebo (n = 31,200). RESULTS Genetically lower ACE concentrations were associated with a lower risk of type 2 diabetes (odds ratio [OR] per SD 0.92 [95% CI 0.89-0.95]; P = 1.79 × 10-7). This result was replicated in the UK Biobank (OR per SD 0.97 [0.96-0.99]; P = 8.73 × 10-4). After standardization, the ACE GRS was associated with a larger decrease in type 2 diabetes risk per 2.4-mmHg lower mean arterial pressure (MAP) compared with that obtained from an RCT meta-analysis (OR per 2.4-mmHg lower MAP 0.19 [0.07-0.51] vs. 0.76 [0.60-0.97], respectively; P = 0.007 for difference). CONCLUSIONS These results support the causal protective effect of ACE inhibitors on type 2 diabetes risk and may guide therapeutic decision making in clinical practice.
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Affiliation(s)
- Marie Pigeyre
- Population Health Research Institute, David Braley Cardiac, Vascular and Stroke Research Institute, Hamilton, Ontario, Canada.,Thrombosis and Atherosclerosis Research Institute, David Braley Cardiac, Vascular and Stroke Research Institute, Hamilton, Ontario, Canada.,Department of Medicine, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Jennifer Sjaarda
- Population Health Research Institute, David Braley Cardiac, Vascular and Stroke Research Institute, Hamilton, Ontario, Canada.,Thrombosis and Atherosclerosis Research Institute, David Braley Cardiac, Vascular and Stroke Research Institute, Hamilton, Ontario, Canada.,Department of Pathology and Molecular Medicine, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Michael Chong
- Population Health Research Institute, David Braley Cardiac, Vascular and Stroke Research Institute, Hamilton, Ontario, Canada.,Thrombosis and Atherosclerosis Research Institute, David Braley Cardiac, Vascular and Stroke Research Institute, Hamilton, Ontario, Canada.,Department of Pathology and Molecular Medicine, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Sibylle Hess
- R&D, Translational Medicine & Early Development, Biomarkers & Clinical Bioanalyses, Sanofi Aventis Deutschland GmbH, Frankfurt, Germany
| | - Jackie Bosch
- Population Health Research Institute, David Braley Cardiac, Vascular and Stroke Research Institute, Hamilton, Ontario, Canada.,School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Salim Yusuf
- Population Health Research Institute, David Braley Cardiac, Vascular and Stroke Research Institute, Hamilton, Ontario, Canada.,Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
| | - Hertzel Gerstein
- Population Health Research Institute, David Braley Cardiac, Vascular and Stroke Research Institute, Hamilton, Ontario, Canada.,Department of Medicine, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Guillaume Paré
- Population Health Research Institute, David Braley Cardiac, Vascular and Stroke Research Institute, Hamilton, Ontario, Canada .,Thrombosis and Atherosclerosis Research Institute, David Braley Cardiac, Vascular and Stroke Research Institute, Hamilton, Ontario, Canada.,Department of Pathology and Molecular Medicine, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.,Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
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Lin S, Peng Y, Cao M, Chen R, Hu J, Pu Z, Cai Z, Mou L. Association between Aldose Reductase Gene C(-106)T Polymorphism and Diabetic Retinopathy: A Systematic Review and Meta-Analysis. Ophthalmic Res 2020; 63:224-233. [PMID: 31962334 DOI: 10.1159/000503972] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 10/07/2019] [Indexed: 12/28/2022]
Abstract
Controversial results regarding the associations between aldose reductase (AR) genetic polymorphisms and diabetic retinopathy (DR) have been reported for many years. The present meta-analysis was performed to clarify the effects of the AR gene C(-106)T polymorphism on DR risk. The PubMed, Web of Sciences, Cochrane library, EMBASE, Chinese National Knowledge Infrastructure, and Wan Fang databases were extensively searched in Chinese to select relevant studies with an updated date of April 25, 2018. The Newcastle-Ottawa Scale (NOS) was applied to assess quality. The random-effects model was applied to calculate the pooled OR and 95% CI. This meta-analysis identified 23 studies with an average score of 7.52 for NOS analysis, including 4,313 DR cases and 5,128 diabetes mellitus (DM) control cases. In the overall analysis, a significant association between the AR gene C(-106)T polymorphism and DR susceptibility was found. In subgroups stratified by DM type and ethnicity, significantly increased risks for DR were found in DM type 1, East Asian populations, and Middle Eastern populations. Compared with DR control cases, the following associations were found: T vs. C: OR 0.91, 95% CI 0.85-0.97, I2 = 72.9%; CT + TT vs. CC: OR 0.75, 95% CI 0.68-0.81, I2 = 86.7%; and CT vs. CC: OR 0.86, 95% CI 0.78-0.94, I2 = 70.5%. The results of this meta-analysis showed a significant association between the AR gene C(-106)T polymorphism and susceptibility to DR in DM patients. DM patients with allele T and CT+TT genotype of the AR gene may have a lower risk of DR.
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Affiliation(s)
- Shan Lin
- Shenzhen Xenotransplantation Medical Engineering Research and Development Center, Institute of Translational Medicine, Shenzhen Second People's Hospital, Shenzhen University School of Medicine, First Affiliated Hospital of Shenzhen University, Shenzhen, China.,Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China
| | - Yuanzheng Peng
- Shenzhen Xenotransplantation Medical Engineering Research and Development Center, Institute of Translational Medicine, Shenzhen Second People's Hospital, Shenzhen University School of Medicine, First Affiliated Hospital of Shenzhen University, Shenzhen, China.,Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China
| | - Mengtao Cao
- Shenzhen Xenotransplantation Medical Engineering Research and Development Center, Institute of Translational Medicine, Shenzhen Second People's Hospital, Shenzhen University School of Medicine, First Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Ruiting Chen
- Shenzhen Xenotransplantation Medical Engineering Research and Development Center, Institute of Translational Medicine, Shenzhen Second People's Hospital, Shenzhen University School of Medicine, First Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Jiying Hu
- Shenzhen Xenotransplantation Medical Engineering Research and Development Center, Institute of Translational Medicine, Shenzhen Second People's Hospital, Shenzhen University School of Medicine, First Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Zuhui Pu
- Imaging Department, Shenzhen Second People's Hospital, First Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Zhiming Cai
- Shenzhen Xenotransplantation Medical Engineering Research and Development Center, Institute of Translational Medicine, Shenzhen Second People's Hospital, Shenzhen University School of Medicine, First Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Lisha Mou
- Shenzhen Xenotransplantation Medical Engineering Research and Development Center, Institute of Translational Medicine, Shenzhen Second People's Hospital, Shenzhen University School of Medicine, First Affiliated Hospital of Shenzhen University, Shenzhen, China,
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Multilocus genetic risk score for diabetic retinopathy in the Han Chinese population of Taiwan. Sci Rep 2018; 8:14535. [PMID: 30266984 PMCID: PMC6162301 DOI: 10.1038/s41598-018-32916-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 09/17/2018] [Indexed: 12/16/2022] Open
Abstract
The aim of this study is to explore the effect of genetic variation on diabetic retinopathy (DR) risk in a Taiwanese population. The logistic regression model was used to evaluate the relationship between DR status and risk factors, including the conventional parameters and genetic risk score (GRS). Candidate single nucleotide polymorphisms (SNPs) in GRS were selected based on previous reports with a combined P < 10-4 (genome-wide association) and P < 0.05 (meta-analysis). In total, 58 SNPs in 44 susceptibility loci were selected, and four were used to calculate GRS. After adjustment for age, systolic blood pressure, diabetes duration, and HbA1c, the DR risk was 4.95 times higher for patients in the top GRS third tile than for those in the bottom third tile (95% CI = 2.99-8.18; P < 0.001). The addition of genetic information improved DR prediction, increasing the area under the curve (AUC) from 0.72 to 0.77 (P = 0.0024) and improving the sensitivity of the model such that 40 more subjects were reclassified into DR status. The developed multivariate logistic regression model combining conventional risk factors and the multilocus GRS can predict DR, thus enabling timely treatment to reduce blindness in T2D patients.
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Luo S, Shi C, Wang F, Wu Z. Association between the Angiotensin-Converting Enzyme (ACE) Genetic Polymorphism and Diabetic Retinopathy-A Meta-Analysis Comprising 10,168 Subjects. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13111142. [PMID: 27854313 PMCID: PMC5129352 DOI: 10.3390/ijerph13111142] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 11/02/2016] [Accepted: 11/02/2016] [Indexed: 12/24/2022]
Abstract
Aims-to address the inconclusive findings of the association of angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism on risk of diabetic retinopathy (DR), a meta-analysis was conducted. Methods-we conducted a meta-analysis on 4252 DR cases and 5916 controls from 40 published studies by searching electronic databases and reference lists of relevant articles. A random-effects or fixed-effects model was used to estimate the overall and stratification effect sizes on ACE I/D polymorphism on the risk of DR. Results-we found a significant association between the ACE I/D polymorphism and the risk of DR for all genetic model (ID vs. II: OR = 1.14, 95% CI: 1.00-1.30; DD vs. II: OR = 1.38, 95% CI: 1.11-1.71; Allele contrast: OR = 1.17, 95% CI: 1.05-1.30; recessive model: OR = 1.24, 95% CI: 1.02-1.51 and dominant model: OR = 1.21, 95% CI: 1.06-1.38, respectively). In stratified analysis by ethnicity and DM type, we further found that the Asian group with T2DM showed a significant association for all genetic models (ID vs. II: OR = 1.14, 95% CI: 1.01-1.30; DD vs. II: OR = 1.54, 95% CI: 1.14-2.08; Allele contrast: OR = 1.26, 95% CI: 1.09-1.47; recessive model: OR = 1.42, 95% CI: 1.07-1.88 and dominant model: OR = 1.26, 95% CI: 1.07-1.49, respectively). Conclusion-our study suggested that the ACE I/D polymorphism may contribute to DR development, especially in the Asian group with type 2 diabetes mellitus (T2DM). Prospective and more genome-wide association studies (GWAS) are needed to clarify the real role of the ACE gene in determining susceptibility to DR.
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Affiliation(s)
- Shasha Luo
- Department of Ophthalmology, Nanjing Medical University Affiliated Wuxi Second Hospital, 68 Zhongshan Road, Wuxi 214002, China.
| | - Chao Shi
- Wuxi Center for Disease Control and Prevention, 499 Jincheng Road, Wuxi 214023, China.
| | - Furu Wang
- Jiangsu Provincial Center for Disease Prevention and Control, 172 Jiangsu Road, Nanjing 210029, China.
| | - Zhifeng Wu
- Department of Ophthalmology, Nanjing Medical University Affiliated Wuxi Second Hospital, 68 Zhongshan Road, Wuxi 214002, China.
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Priščáková P, Minárik G, Repiská V. Candidate gene studies of diabetic retinopathy in human. Mol Biol Rep 2016; 43:1327-1345. [PMID: 27730450 PMCID: PMC5102952 DOI: 10.1007/s11033-016-4075-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 09/09/2016] [Indexed: 12/13/2022]
Abstract
Diabetic retinopathy (DR) is a multifactorial disease with complex pathophysiology. It is the main cause of blindness among the people in productive age. The purpose of this literature review is to highlight recent achievements in the genetics of diabetic retinopathy with particular focus on candidate gene studies. We summarized most of the available published data about candidate genes for diabetic retinopathy with the goal to identify main genetic aspects. We conclude that genetic studies reported contradictory findings and no genetic variants meet criteria of a diagnostic marker, or significantly elucidate the root of DR development. Based on these findings it is important to continue with the research in the field of DR genetics, mainly due to the fact that currently new possibilities and approaches associated with utilization of next-generation sequencing are available.
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Affiliation(s)
- Petra Priščáková
- Faculty of Medicine, Institute of Medical Biology, Genetics and Clinical Genetics, University Hospital Bratislava, Comenius University in Bratislava, Sasinkova 4, 81108, Bratislava, Slovakia
| | - Gabriel Minárik
- Medirex Group Academy n.o., Galvaniho 17/C, 82016, Bratislava, Slovakia
| | - Vanda Repiská
- Faculty of Medicine, Institute of Medical Biology, Genetics and Clinical Genetics, University Hospital Bratislava, Comenius University in Bratislava, Sasinkova 4, 81108, Bratislava, Slovakia.
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Song ZD, Tao Y, Han N, Wu YZ. Association of the Aldose Reductase-106TT Genotype with Increased Risk for Diabetic Retinopathy in the Chinese Han Population: An Updated Meta-Analysis. Curr Eye Res 2015; 41:1087-1091. [DOI: 10.3109/02713683.2015.1084642] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Peng W, Xing Z, Yang J, Wang Y, Wang W, Huang W. The efficacy of erythropoietin in treating experimental traumatic brain injury: a systematic review of controlled trials in animal models. J Neurosurg 2014; 121:653-64. [PMID: 25036201 DOI: 10.3171/2014.6.jns132577] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECT Erythropoietin (EPO) shows promise as a neuroprotective agent in animal models of traumatic brain injury (TBI). However, clinical trials of the efficacy of EPO treatment in patients with TBI yield conflicting results. The authors conducted a systematic review and meta-analysis to assess the effect of EPO in experimental animal models of TBI, the goal being to inform the design of future clinical trials. METHODS The authors identified eligible studies by searching PubMed, Web of Science, MEDLINE, Embase, and Google Scholar in October 2013. Data were pooled using the random-effects model, and results were reported in terms of standardized mean difference. Statistical heterogeneity was examined using both I(2) and chi-square tests, and the presence of small study effects was investigated with funnel plots and Egger tests. In-depth analyses were performed for lesion volume and neurobehavioral outcome, and the studies' methodological quality was also evaluated. RESULTS Of a total of 290 studies, 13 found an effect of EPO on lesion volume and neurobehavioral outcome. Overall, the methodological quality of the studies was poor, and there was evidence of statistical heterogeneity among the publications as well as small-study effects. However, in-depth analyses showed statistically significant findings in favor of a beneficial effect of EPO after TBI. CONCLUSIONS Despite limitations of this systematic review that may have influenced the findings, the authors conclude that EPO might be beneficial in treating experimental TBI in terms of reducing lesion volume and improving neurobehavioral outcome. However, this review also indicates that more well-designed and well-reported animal studies are needed.
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Affiliation(s)
- Weijun Peng
- Institute of Integrated Medicine, Xiangya Hospital, Central South University, Changsha, Hunan Province, China
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Xia J, Wang Z, Zhang F. Association between Related Purine Metabolites and Diabetic Retinopathy in Type 2 Diabetic Patients. Int J Endocrinol 2014; 2014:651050. [PMID: 24688543 PMCID: PMC3943397 DOI: 10.1155/2014/651050] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Revised: 12/30/2013] [Accepted: 12/31/2013] [Indexed: 12/13/2022] Open
Abstract
Aims. The purpose of the study was to investigate the differences of adenosine, adenine, inosine, xanthine, hypoxanthine, and uric acid concentrations in patients with type 2 diabetes mellitus and diabetic retinopathy and assess the relationship between purine metabolites and disease. Materials and Methods. The study group consisted of 114 subjects which were divided into three groups: control (n = 40), type 2 diabetes without retinopathy (n = 35), and type 2 diabetes with retinopathy (n = 39). Levels of metabolites were measured in plasma of all participants. Results. There is a significant increase of levels of adenosine (0.94 ± 0.17 mg/L versus 0.17 ± 0.01 mg/L, P < 0.001), inosine (0.297 ± 0.078 mg/L versus 0.086 ± 0.010 mg/L, P < 0.001), xanthine (1.01 ± 0.21 mg/L versus 0.54 ± 0.05 mg/L, P = 0.009), and uric acid (70.55 ± 3.97 mg/L versus 53.81 ± 2.36 mg/L, P < 0.001) with diabetic retinopathy compared to diabetes mellitus. The levels of adenine, hypoxanthine, and xanthine oxidase did not change. Uric acid, xanthine, inosine, and adenosine correlated positively with systolic blood pressure and urea nitrogen. Conclusions. The levels of adenosine, inosine, uric acid, and xanthine may be useful for monitoring the progression of diabetic retinopathy and evaluating the treatment.
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Affiliation(s)
- Jianfei Xia
- College of Chemistry, Chemical Engineering and Environment, Qingdao University, Qingdao 266071, China
- *Jianfei Xia: and
| | - Zonghua Wang
- College of Chemistry, Chemical Engineering and Environment, Qingdao University, Qingdao 266071, China
- *Zonghua Wang:
| | - Feifei Zhang
- College of Chemistry, Chemical Engineering and Environment, Qingdao University, Qingdao 266071, China
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Petrovič D. Candidate genes for proliferative diabetic retinopathy. BIOMED RESEARCH INTERNATIONAL 2013; 2013:540416. [PMID: 24066292 PMCID: PMC3771247 DOI: 10.1155/2013/540416] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Accepted: 07/29/2013] [Indexed: 12/21/2022]
Abstract
Several candidate genes have been so far implicated in the pathogenesis of proliferative diabetic retinopathy (PDR) in subjects with type 2 diabetes. Since the principal pathogenetic mechanisms for diabetic retinopathy (DR) and PDR are different, the main pathogenetic mechanism in DR is increased vascular permeability, whereas in PDR the crucial pathogenetic mechanisms are fibrosis and neoangiogenesis. Due to that fact, different candidate genes are expected to be involved in the development of either DR or PDR. None of the candidate genes, however, can be fully and solely responsible for the development of PDR and for DR progression into PDR. Epigenetic mechanisms are expected to be involved in the pathogenesis of PDR as well. Gene polymorphisms responsible for PDR and epigenetic mechanisms responsible for PDR are reviewed in this paper.
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Affiliation(s)
- Daniel Petrovič
- Institute of Histology and Embryology, Medical Faculty, University Ljubljana, Korytkova 2, 1105 Ljubljana, Slovenia
- Zavod Srce, Dunajska 106, 1000 Ljubljana, Slovenia
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12
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Zhang T, Pang C, Li N, Zhou E, Zhao K. Plasminogen activator inhibitor-1 4G/5G polymorphism and retinopathy risk in type 2 diabetes: a meta-analysis. BMC Med 2013; 11:1. [PMID: 23281898 PMCID: PMC3565939 DOI: 10.1186/1741-7015-11-1] [Citation(s) in RCA: 136] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2012] [Accepted: 01/02/2013] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Mounting evidence has suggested that plasminogen activator inhibitor-1 (PAI-1) is a candidate for increased risk of diabetic retinopathy. Studies have reported that insertion/deletion polymorphism in the PAI-1 gene may influence the risk of this disease. To comprehensively address this issue, we performed a meta-analysis to evaluate the association of PAI-1 4G/5G polymorphism with diabetic retinopathy in type 2 diabetes. METHODS Data were retrieved in a systematic manner and analyzed using Review Manager and STATA Statistical Software. Crude odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the strength of associations. RESULTS Nine studies with 1, 217 cases and 1, 459 controls were included. Allelic and genotypic comparisons between cases and controls were evaluated. Overall analysis suggests a marginal association of the 4G/5G polymorphism with diabetic retinopathy (for 4G versus 5G: OR 1.13, 95%CI 1.01 to 1.26; for 4G/4G versus 5G/5G: OR 1.30, 95%CI 1.04 to 1.64; for 4G/4G versus 5G/5G + 4G/5G: OR 1.26, 95%CI 1.05 to 1.52). In subgroup analysis by ethnicity, we found an association among the Caucasian population (for 4G versus 5G: OR 1.14, 95% CI 1.00 to 1.30; for 4G/4G versus 5G/5G: OR 1.33, 95%CI 1.02 to 1.74; for 4G/4G versus 5G/5G + 4G/5G: OR 1.41, 95%CI 1.13 to 1.77). When stratified by the average duration of diabetes, patients with diabetes histories longer than 10 years have an elevated susceptibility to diabetic retinopathy than those with shorter histories (for 4G/4G versus 5G/5G: OR 1.47, 95%CI 1.08 to 2.00). We also detected a higher risk in hospital-based studies (for 4G/4G versus 5G/5G+4G/5G: OR 1.27, 95%CI 1.02 to 1.57). CONCLUSIONS The present meta-analysis suggested that 4G/5G polymorphism in the PAI-1 gene potentially increased the risk of diabetic retinopathy in type 2 diabetes and showed a discrepancy in different ethnicities. A higher susceptibility in patients with longer duration of diabetes (more than 10 years) indicated a gene-environment interaction in determining the risk of diabetic retinopathy.
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Affiliation(s)
- Tengyue Zhang
- Tianjin Medical University, 22 Qixiangtai Road, Tianjin, 300020, PR China
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Liu C, Lv XH, Li HX, Cao X, Zhang F, Wang L, Yu M, Yang JK. Angiotensin-(1-7) suppresses oxidative stress and improves glucose uptake via Mas receptor in adipocytes. Acta Diabetol 2012; 49:291-9. [PMID: 22042130 DOI: 10.1007/s00592-011-0348-z] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2011] [Accepted: 10/17/2011] [Indexed: 01/01/2023]
Abstract
Although reactive oxygen species (ROS) contribute to glucose intolerance induced by the renin-angiotensin system (RAS) is well documented, the role of the newly discovered pathway of RAS, angiotensin (Ang)-(1-7)/Mas axis, in this process remains unknown. Here, we examined the effect of Ang-(1-7) on oxidative stress and glucose uptake in adipocytes. We used primary cultured epididymal adipocytes from C57 mice to study Ang-(1-7) effects on glucose uptake. We also treated fully differentiated 3T3-L1 adipocytes with exogenous Ang-(1-7) or overexpression of angiotensin-converting enzyme 2 (ACE2) to induce endogenous generation of Ang-(1-7) to clarify its effects on ROS production. Intracellular ROS was measured by flow cytometry, dihydroethidium (DHE), and nitroblue tetrazolium assay. Levels of NADPH oxidase and adiponectin mRNA were measured by real-time PCR. Ang-(1-7) improved glucose uptake both in basal and insulin-stimulated states. ROS production was slightly but significantly decreased in adipocytes treated with Ang-(1-7). Additionally, Mas receptor antagonist D-Ala7-Ang-(1-7) (A779) reversed the effect of Ang-(1-7) on glucose uptake and oxidative stress. Furthermore, treatment of adipocytes with Ang-(1-7) decreased NADPH oxidase mRNA levels. We also found that oxidative stress induced by glucose oxidase-suppressed expression of adiponectin, an insulin-sensitive protein. However, the suppression of oxidative stress by Ang-(1-7) restored adiponectin expression, while A779 agonists these changes induced by Ang-(1-7). In conclusion, Ang-(1-7) can protect against oxidative stress and improve glucose metabolism in adipocytes. These results show that Ang-(1-7) is a novel target for the improvement of glucose metabolism by preventing oxidative stress.
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Affiliation(s)
- Chang Liu
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China
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Does Familial Clustering of Risk Factors for Long-Term Diabetic Complications Leave Any Place for Genes That Act independently? J Cardiovasc Transl Res 2012; 5:388-98. [DOI: 10.1007/s12265-012-9385-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Accepted: 05/30/2012] [Indexed: 10/28/2022]
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15
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Lu Y, Ge Y, Hu Q, Shi Y, Xue C, Shi Y, Chen S, Huang Z. Association between angiotensin-converting enzyme gene polymorphism and diabetic retinopathy in the Chinese population. J Renin Angiotensin Aldosterone Syst 2012; 13:289-95. [PMID: 22249557 DOI: 10.1177/1470320311432187] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Yan Lu
- Department of Ophthalmology, Jinling Hospital, Nanjing University, PR China
| | - Yirui Ge
- Department of Ophthalmology, Jinling Hospital, Nanjing University, PR China
| | - Qinrui Hu
- Department of Ophthalmology, Jinling Hospital, Nanjing University, PR China
| | - Yuhua Shi
- Department of Ophthalmology, Jinling Hospital, Nanjing University, PR China
| | - Chunyan Xue
- Department of Ophthalmology, Jinling Hospital, Nanjing University, PR China
| | - Yao Shi
- Department of Ophthalmology, Jinling Hospital, Nanjing University, PR China
| | - Suihua Chen
- Department of Ophthalmology, Jinling Hospital, Nanjing University, PR China
| | - Zhenping Huang
- Department of Ophthalmology, Jinling Hospital, Nanjing University, PR China
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Tang J, Kern TS. Inflammation in diabetic retinopathy. Prog Retin Eye Res 2011; 30:343-58. [PMID: 21635964 PMCID: PMC3433044 DOI: 10.1016/j.preteyeres.2011.05.002] [Citation(s) in RCA: 794] [Impact Index Per Article: 61.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2011] [Revised: 05/14/2011] [Accepted: 05/16/2011] [Indexed: 12/14/2022]
Abstract
Diabetes causes a number of metabolic and physiologic abnormalities in the retina, but which of these abnormalities contribute to recognized features of diabetic retinopathy (DR) is less clear. Many of the molecular and physiologic abnormalities that have been found to develop in the retina in diabetes are consistent with inflammation. Moreover, a number of anti-inflammatory therapies have been found to significantly inhibit development of different aspects of DR in animal models. Herein, we review the inflammatory mediators and their relationship to early and late DR, and discuss the potential of anti-inflammatory approaches to inhibit development of different stages of the retinopathy. We focus primarily on information derived from in vivo studies, supplementing with information from in vitro studies were important.
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Affiliation(s)
- Johnny Tang
- Department of Ophthalmology and Visual Sciences, University Hospitals Eye Institute, Case Western Reserve University, Cleveland, OH, USA
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17
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Human genetics of diabetic retinopathy: current perspectives. J Ophthalmol 2010; 2010. [PMID: 20706635 PMCID: PMC2913807 DOI: 10.1155/2010/172593] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2010] [Accepted: 06/16/2010] [Indexed: 01/15/2023] Open
Abstract
Diabetic retinopathy (DR) is a most severe microvascular complication which, if left unchecked, can be sight-threatening. With the global prevalence of diabetes being relentlessly projected to rise to 438 million subjects by 2030, DR will undoubtedly pose a major public health concern. Efforts to unravel the human genetics of DR have been undertaken using the candidate gene and linkage approaches, while GWAS efforts are still lacking. Aside from evidence for a few genes including aldose reductase and vascular endothelial growth factor, the genetics of DR remain poorly elucidated. Nevertheless, the promise of impactful scientific discoveries may be realized if concerted and collaborative efforts are mounted to identify the genes for DR. Harnessing new genetic technologies and resources such as the upcoming 1000 Genomes Project will help advance this field of research, and potentially lead to a rich harvest of insights into the biological mechanisms underlying this debilitating complication.
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