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Li Q, Wang P, Gong Y, Xu M, Wang M, Luan R, Liu J, Li X, Shao Y. α-Klotho prevents diabetic retinopathy by reversing the senescence of macrophages. Cell Commun Signal 2024; 22:449. [PMID: 39327553 PMCID: PMC11426092 DOI: 10.1186/s12964-024-01838-w] [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: 07/09/2024] [Accepted: 09/18/2024] [Indexed: 09/28/2024] Open
Abstract
BACKGROUND Diabetic retinopathy (DR) is a common microvascular complication of diabetes mellitus (DM) and a significant cause of acquired blindness in the working-age population worldwide. Aging is considered as an important risk factor for DR development. Macrophages in aged mice bear typical M2 marker proteins but simultaneously express a pro-inflammatory factor profile. This may explain why the level of intraocular inflammation does not decrease during proliferative diabetic retinopathy (PDR) despite the occurrence of neovascularization and fibrosis (M2 activation). α-Klotho (KL) was originally discovered as a soluble anti-aging factor, which is mainly expressed in kidney tubular epithelium, choroid plexus in the brain and secreted in the blood. However, the role of KL in DR pathophysiology has not been previously reported. METHODS Type 1 (streptozotocin [STZ]-induced) and type 2 (a high-fat diet along with a low dose of STZ) diabetic mouse models were established and injected with or without KL adenovirus via the tail vein for 12 weeks. Vldlr-/- mice were injected intravitreally with or without soluble KL protein from P8 to P15. The retinal structure and function were analyzed by electroretinogram and optical coherence tomography. The neovascular lesions were analyzed by retinal flat mount and RPE flat mount. The senescence markers, macrophage morphology, and KL expression levels were detected by immunofluorescence staining. A cell model was constructed using RAW264.7 cells stimulated by 4-hydroxynonenal (4HNE) and transfected with or without KL adenovirus. The senescence-associated secretory phenotypes were detected by qRT-PCR. Senescence was detected by SA-β-Gal staining. Serum, aqueous humor, and vitreous humor KL levels of proliferative diabetic retinopathy (PDR) patients were measured by enzyme-linked immunosorbent assay. Quantitative proteomics and bioinformatics were applied to predict the change of proteins and biological function after overexpression of KL in macrophages. The effects of KL on the HECTD1 binding to IRS1 were analyzed by bioinformatics, molecular docking, and Western Blot. RESULTS Serum, aqueous humor, and vitreous humor KL levels were lower in patients with PDR than in those with cataracts. KL relieved the retinal structure damage, improved retina function, and inhibited retinal senescence in diabetic mice. KL administration attenuated the neovascular lesions in VLDLR-/- mice by decreasing the secretion of VEGFA and FGF2 from macrophages. KL also protected RAW264.7 cells from 4HNE-induced senescence. Additionally, it inhibited E3 ubiquitin ligase HECTD1 expression in both diabetic mouse peripheral blood mononuclear cells and 4HNE-treated RAW264.7 cells. KL inhibited HECTD1 binding to IRS1 and reduced the ubiquitination of IRS1. CONCLUSIONS Macrophage aging is involved in DM-induced retinopathy. KL alleviates DM-induced retinal macrophage senescence by downregulating HECTD1 and decreasing IRS1 ubiquitination and degradation. Meanwhile, KL administration attenuated the neovascular lesions by altering the activation state of macrophages and decreasing the expression of VEGFA and FGF2.
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Affiliation(s)
- Qingbo Li
- Tianjin Key Laboratory of Retinal Functions and Diseases, Eye Institute & School of Optometry and Ophthalmology, Tianjin Medical University Eye Hospital, Nankai District, No. 251, Fukang Road, Tianjin, 300384, China
- Tianjin International Joint Research and Development Centre of Ophthalmology and Vision Science, Tianjin Medical University Eye Hospital, Nankai District, No. 251, Fukang Road, Tianjin, 300384, China
- Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Nankai District, No. 251, Fukang Road, Tianjin, 300384, China
| | - Peiyu Wang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Eye Institute & School of Optometry and Ophthalmology, Tianjin Medical University Eye Hospital, Nankai District, No. 251, Fukang Road, Tianjin, 300384, China
- Tianjin International Joint Research and Development Centre of Ophthalmology and Vision Science, Tianjin Medical University Eye Hospital, Nankai District, No. 251, Fukang Road, Tianjin, 300384, China
- Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Nankai District, No. 251, Fukang Road, Tianjin, 300384, China
| | - Yi Gong
- Tianjin Key Laboratory of Retinal Functions and Diseases, Eye Institute & School of Optometry and Ophthalmology, Tianjin Medical University Eye Hospital, Nankai District, No. 251, Fukang Road, Tianjin, 300384, China
- Tianjin International Joint Research and Development Centre of Ophthalmology and Vision Science, Tianjin Medical University Eye Hospital, Nankai District, No. 251, Fukang Road, Tianjin, 300384, China
- Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Nankai District, No. 251, Fukang Road, Tianjin, 300384, China
| | - Manhong Xu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Eye Institute & School of Optometry and Ophthalmology, Tianjin Medical University Eye Hospital, Nankai District, No. 251, Fukang Road, Tianjin, 300384, China
- Tianjin International Joint Research and Development Centre of Ophthalmology and Vision Science, Tianjin Medical University Eye Hospital, Nankai District, No. 251, Fukang Road, Tianjin, 300384, China
- Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Nankai District, No. 251, Fukang Road, Tianjin, 300384, China
| | - Manqiao Wang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Eye Institute & School of Optometry and Ophthalmology, Tianjin Medical University Eye Hospital, Nankai District, No. 251, Fukang Road, Tianjin, 300384, China
- Tianjin International Joint Research and Development Centre of Ophthalmology and Vision Science, Tianjin Medical University Eye Hospital, Nankai District, No. 251, Fukang Road, Tianjin, 300384, China
- Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Nankai District, No. 251, Fukang Road, Tianjin, 300384, China
| | - Rong Luan
- Tianjin Key Laboratory of Retinal Functions and Diseases, Eye Institute & School of Optometry and Ophthalmology, Tianjin Medical University Eye Hospital, Nankai District, No. 251, Fukang Road, Tianjin, 300384, China
- Tianjin International Joint Research and Development Centre of Ophthalmology and Vision Science, Tianjin Medical University Eye Hospital, Nankai District, No. 251, Fukang Road, Tianjin, 300384, China
- Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Nankai District, No. 251, Fukang Road, Tianjin, 300384, China
| | - Juping Liu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Eye Institute & School of Optometry and Ophthalmology, Tianjin Medical University Eye Hospital, Nankai District, No. 251, Fukang Road, Tianjin, 300384, China.
- Tianjin International Joint Research and Development Centre of Ophthalmology and Vision Science, Tianjin Medical University Eye Hospital, Nankai District, No. 251, Fukang Road, Tianjin, 300384, China.
- Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Nankai District, No. 251, Fukang Road, Tianjin, 300384, China.
| | - Xiaorong Li
- Tianjin Key Laboratory of Retinal Functions and Diseases, Eye Institute & School of Optometry and Ophthalmology, Tianjin Medical University Eye Hospital, Nankai District, No. 251, Fukang Road, Tianjin, 300384, China.
- Tianjin International Joint Research and Development Centre of Ophthalmology and Vision Science, Tianjin Medical University Eye Hospital, Nankai District, No. 251, Fukang Road, Tianjin, 300384, China.
- Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Nankai District, No. 251, Fukang Road, Tianjin, 300384, China.
| | - Yan Shao
- Tianjin Key Laboratory of Retinal Functions and Diseases, Eye Institute & School of Optometry and Ophthalmology, Tianjin Medical University Eye Hospital, Nankai District, No. 251, Fukang Road, Tianjin, 300384, China.
- Tianjin International Joint Research and Development Centre of Ophthalmology and Vision Science, Tianjin Medical University Eye Hospital, Nankai District, No. 251, Fukang Road, Tianjin, 300384, China.
- Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Nankai District, No. 251, Fukang Road, Tianjin, 300384, China.
- University of Tibetan Medicine, Lhasa, 850000, China.
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Ahmad S, Ahmad MFA, Khan S, Alouffi S, Khan M, Prakash C, Khan MWA, Ansari IA. Exploring aldose reductase inhibitors as promising therapeutic targets for diabetes-linked disabilities. Int J Biol Macromol 2024; 280:135761. [PMID: 39306154 DOI: 10.1016/j.ijbiomac.2024.135761] [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: 05/06/2024] [Revised: 09/12/2024] [Accepted: 09/16/2024] [Indexed: 09/30/2024]
Abstract
Diabetes mellitus significantly increases mortality and morbidity rates due to complications like neuropathy and nephropathy. It also leads to retinopathy and cataract formation, which is a leading cause of vision disability. The polyol pathway emerges as a promising therapeutic target among the various pathways associated with diabetic complications. This review focuses on the development of natural and synthetic aldose reductase inhibitors (ARIs), along with recent discoveries in diabetic complication treatment. AR, pivotal in the polyol pathway converting glucose to sorbitol, plays a key role in secondary diabetes complications' pathophysiology. Understanding AR's function and structure lays the groundwork for improving ARIs to mitigate diabetic complications. New developments in ARIs open up exciting possibilities for treating diabetes-related complications. However, it is still challenging to get preclinical successes to clinical effectiveness because of things like differences in how the disease starts, drug specificity, and the complexity of the AR's structure. Addressing these challenges is crucial for developing targeted and efficient ARIs. Continued research into AR's structural features and specific ARIs is essential. Overcoming these challenges could revolutionize diabetic complication treatment, enhance patient outcomes, and reduce the global burden of diabetes-related mortality and morbidity.
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Affiliation(s)
- Saheem Ahmad
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, University of Hail, 2440, Saudi Arabia.
| | | | - Saif Khan
- Department of Basic Dental and Medical Sciences, College of Dentistry, University of Hail, Saudi Arabia
| | - Sultan Alouffi
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, University of Hail, 2440, Saudi Arabia
| | - Mahvish Khan
- Department of Biology, College of Science, University of Hail, 2440, Saudi Arabia
| | - Chander Prakash
- University Centre for Research and Development, Chandigarh University, Mohali, Punjab, India
| | - Mohd Wajid Ali Khan
- Department of Chemistry, College of Science, University of Hail, 2440, Saudi Arabia; Medical and Diagnostic Research Center, University of Ha'il, Ha'il-55473, Saudi Arabia
| | - Irfan Ahmad Ansari
- Department of Biology, College of Science, University of Hail, 2440, Saudi Arabia.
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Khatun MM, Bhuia MS, Chowdhury R, Sheikh S, Ajmee A, Mollah F, Al Hasan MS, Coutinho HDM, Islam MT. Potential utilization of ferulic acid and its derivatives in the management of metabolic diseases and disorders: An insight into mechanisms. Cell Signal 2024; 121:111291. [PMID: 38986730 DOI: 10.1016/j.cellsig.2024.111291] [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: 05/22/2024] [Revised: 06/28/2024] [Accepted: 07/05/2024] [Indexed: 07/12/2024]
Abstract
Metabolic diseases are abnormal conditions that impair the normal metabolic process, which involves converting food into energy at a cellular level, and cause difficulties like obesity and diabetes. The study aimed to investigate how ferulic acid (FA) and its derivatives could prevent different metabolic diseases and disorders and to understand the specific molecular mechanisms responsible for their therapeutic effects. Information regarding FA associations with metabolic diseases and disorders was compiled from different scientific search engines, including Science Direct, Wiley Online, PubMed, Scopus, Web of Science, Springer Link, and Google Scholar. This review revealed that FA exerts protective effects against metabolic diseases such as diabetes, diabetic retinopathy, neuropathy, nephropathy, cardiomyopathy, obesity, and diabetic hypertension, with beneficial effects on pancreatic cancer. Findings also indicated that FA improves insulin secretion by increasing Ca2+ influx through the L-type Ca2+ channel, thus aiding in diabetes management. Furthermore, FA regulates the activity of inflammatory cytokines (TNF-α, IL-18, and IL-1β) and antioxidant enzymes (CAT, SOD, and GSH-Px) and reduces oxidative stress and inflammation, which are common features of metabolic diseases. FA also affects various signaling pathways, including the MAPK/NF-κB pathways, which play an important role in the progression of diabetic neuropathy and other metabolic disorders. Additionally, FA regulates apoptosis markers (Bcl-2, Bax, and caspase-3) and exerts its protective effects on cellular destruction. In conclusion, FA and its derivatives may act as potential medications for the management of metabolic diseases.
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Affiliation(s)
- Mst Muslima Khatun
- Department of Pharmacy, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj 8100, Bangladesh; Phytochemistry and Biodiversity Research Laboratory, BioLuster Research Center, Gopalganj 8100, Dhaka, Bangladesh
| | - Md Shimul Bhuia
- Department of Pharmacy, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj 8100, Bangladesh; Phytochemistry and Biodiversity Research Laboratory, BioLuster Research Center, Gopalganj 8100, Dhaka, Bangladesh
| | - Raihan Chowdhury
- Department of Pharmacy, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj 8100, Bangladesh; Phytochemistry and Biodiversity Research Laboratory, BioLuster Research Center, Gopalganj 8100, Dhaka, Bangladesh
| | - Salehin Sheikh
- Phytochemistry and Biodiversity Research Laboratory, BioLuster Research Center, Gopalganj 8100, Dhaka, Bangladesh
| | - Afiya Ajmee
- Department of Pharmacy, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj 8100, Bangladesh
| | - Faysal Mollah
- Department of Pharmacy, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj 8100, Bangladesh
| | - Md Sakib Al Hasan
- Department of Pharmacy, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj 8100, Bangladesh
| | - Henrique D M Coutinho
- Department of Biological Chemistry, Regional University of Cariri, Crato, CE 63105-000, Brazil.
| | - Muhammad Torequl Islam
- Department of Pharmacy, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj 8100, Bangladesh; Phytochemistry and Biodiversity Research Laboratory, BioLuster Research Center, Gopalganj 8100, Dhaka, Bangladesh; Pharmacy Discipline, Khulna University, Khulna 9208, Bangladesh.
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Kim DY, Park SH, Yoon Z, Kim J, Kang MK, Kang YH. Eucalyptol Ameliorates Retinal Microvascular Defects through Modulating ER Stress and Angiopoietin-Tie Signaling in Diabetic Eyes. Int J Mol Sci 2024; 25:7826. [PMID: 39063066 PMCID: PMC11277354 DOI: 10.3390/ijms25147826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Revised: 07/13/2024] [Accepted: 07/14/2024] [Indexed: 07/28/2024] Open
Abstract
Loss of the inner blood-retinal barrier (BRB) integrity is a main feature of ocular diseases such as diabetic macular edema. However, there is a lack of clarity on how inner BRB function is modulated within the diabetic retina. The current study examined whether eucalyptol inhibited inner BRB destruction and aberrant retinal angiogenesis in 33 mM glucose-exposed human retinal microvascular endothelial (RVE) cells and db/db mice. This study further examined the molecular mechanisms underlying endothelial dysfunction including retinal endoplasmic reticulum (ER) stress and angiopoietin (Ang)/Tie axis in conjunction with vascular endothelial growth factor (VEGF). Eucalyptol is a naturally occurring monoterpenoid and an achiral aromatic component of many plants including eucalyptus leaves. Nontoxic eucalyptol reduced the production of amyloid-β (Aβ) protein in glucose-loaded RVE cells and in diabetic mice. This natural compound blocked apoptosis of Aβ-exposed RVE cells in diabetic mouse eyes by targeting ER stress via the inhibition of PERK-eIF2α-ATF4-CHOP signaling. Eucalyptol promoted activation of the Ang-1/Tie-2 pathway and dual inhibition of Ang-2/VEGF in Aβ-exposed RVE cells and in diabetic eyes. Supply of eucalyptol reversed the induction of junction proteins in glucose/Aβ-exposed RVE cells within the retina and reduced permeability. In addition, oral administration of eucalyptol reduced vascular leaks in diabetic retinal vessels. Taken together, these findings clearly show that eucalyptol inhibits glucose-induced Aβ-mediated ER stress and manipulates Ang signaling in diabetic retinal vessels, which ultimately blocks abnormal angiogenesis and loss of inner BRB integrity. Therefore, eucalyptol provides new treatment strategies for diabetes-associated RVE defects through modulating diverse therapeutic targets including ER stress, Ang-1/Tie-2 signaling, and Ang-2/VEGF.
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Affiliation(s)
- Dong Yeon Kim
- Department of Food and Nutrition, Andong National University, Andong 36729, Republic of Korea; (D.Y.K.); (Z.Y.); (J.K.)
| | - Sin-Hye Park
- Department of Food and Nutrition and Korean Institute of Nutrition, Hallym University, Chuncheon 24252, Republic of Korea;
| | - Zaee Yoon
- Department of Food and Nutrition, Andong National University, Andong 36729, Republic of Korea; (D.Y.K.); (Z.Y.); (J.K.)
| | - Jimin Kim
- Department of Food and Nutrition, Andong National University, Andong 36729, Republic of Korea; (D.Y.K.); (Z.Y.); (J.K.)
| | - Min-Kyung Kang
- Department of Food and Nutrition, Andong National University, Andong 36729, Republic of Korea; (D.Y.K.); (Z.Y.); (J.K.)
| | - Young-Hee Kang
- Department of Food and Nutrition and Korean Institute of Nutrition, Hallym University, Chuncheon 24252, Republic of Korea;
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Alkan AA, Arslan B, Özcan D, Tekin K. Serum neopterin and orexin-A levels in different stages of diabetic retinopathy. Clin Exp Optom 2024:1-7. [PMID: 39009974 DOI: 10.1080/08164622.2024.2374875] [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: 05/24/2023] [Accepted: 06/25/2024] [Indexed: 07/17/2024] Open
Abstract
CLINICAL RELEVANCE Retinopathy is one of the most common microvascular complications of diabetes mellitus and is the leading cause of vision loss in the working middle-aged population. BACKGROUND This study aimed to investigate the value of neopterin and orexin-A levels in patients with diabetes mellitus with different stages of diabetic retinopathy and without diabetic retinopathy and to compare those findings with results from healthy individuals without diabetes mellitus. METHODS In total, 65 patients with type 2 diabetes mellitus and 22 healthy individuals without diabetes mellitus were enrolled in this prospective study. The participants were separated into four subgroups. The first subgroup included 25 patients without diabetic retinopathy, the second subgroup included 20 patients non-proliferative diabetic retinopathy, the third subgroup included 20 patients with proliferative diabetic retinopathy, and the fourth subgroup included 22 healthy individuals without diabetes mellitus as controls. Serum neopterin and orexin-A levels were analysed and compared among the groups. RESULTS The age and gender of the participants between the four subgroups were not statistically significantly different (p > 0.05). The mean neopterin levels were significantly higher in patients included in the diabetes mellitus subgroups compared with the controls (p < 0.001). Neopterin levels significantly increased as diabetic retinopathy progressed within the diabetes mellitus subgroups. Mean orexin-A levels were significantly lower in the diabetes mellitus subgroups compared with the controls (p < 0.001); however, orexin-A levels were not significantly different within the diabetes mellitus subgroups (p > 0.05). CONCLUSION Patients with diabetes mellitus have higher serum neopterin and lower serum orexin-A levels compared with healthy individuals without diabetes mellitus. Moreover, serum neopterin levels increase with progression of diabetic retinopathy.
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Affiliation(s)
| | - Burak Arslan
- Department of Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden
| | - Delil Özcan
- Ophthalmology Department, Seyrantepe Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Kemal Tekin
- Ophthalmology Department, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
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Grether U, Foxton RH, Gruener S, Korn C, Kimbara A, Osterwald A, Zirwes E, Uhles S, Thoele J, Colé N, Rogers-Evans M, Röver S, Nettekoven M, Martin RE, Adam JM, Fingerle J, Bissantz C, Guba W, Alker A, Szczesniak AM, Porter RF, Toguri TJ, Revelant F, Poirier A, Perret C, Winther L, Caruso A, Fezza F, Maccarrone M, Kelly MEM, Fauser S, Ullmer C. RG7774 (Vicasinabin), an orally bioavailable cannabinoid receptor 2 (CB2R) agonist, decreases retinal vascular permeability, leukocyte adhesion, and ocular inflammation in animal models. Front Pharmacol 2024; 15:1426446. [PMID: 39070793 PMCID: PMC11272598 DOI: 10.3389/fphar.2024.1426446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Accepted: 06/19/2024] [Indexed: 07/30/2024] Open
Abstract
Introduction Preclinical studies suggest that cannabinoid receptor type 2 (CB2R) activation has a therapeutic effect in animal models on chronic inflammation and vascular permeability, which are key pathological features of diabetic retinopathy (DR). A novel CB2R agonist, triazolopyrimidine RG7774, was generated through lead optimization of a high-throughput screening hit. The aim of this study was to characterize the pharmacology, absorption, distribution, metabolism, elimination, and toxicity (ADMET) profile of RG7774, and to explore its potential for managing the key pathological features associated with retinal disease in rodents. Methods The in vitro pharmacology of RG7774 was investigated for CB2R binding and receptor activation using recombinant human and mouse CB2R expression in Chinese hamster ovary cells, and endogenous CB2R expression in human Jurkat cells, and rat and mouse spleen cells. The ADMET profile was evaluated and the effects of RG7774 on retinal permeability, leukocyte adhesion, and choroidal neovascularization (CNV) were investigated in rodent models of retinal disease. Pharmacokinetic (PK) parameters and the exposure-response relationship were characterized in healthy animals and in animals with laser-induced CNV. Results RG7774 was found to be a potent (EC50: 2.8 nM and Ki: 51.3 nM), selective, and full CB2R agonist with no signs of cannabinoid receptor type 1 (CB1R) binding or activation. The ligand showed a favorable ADMET profile and exhibited systemic and ocular exposure after oral delivery. Functional potency in vitro translated from recombinant to endogenous expression systems. In vivo, orally administered RG7774 reduced retinal permeability and leukocyte adhesion in rodents with lipopolysaccharide (LPS)-induced uveitis and streptozotocin (STZ)-induced DR, and reduced lesion areas in rats with laser-induced CNV with an ED50 of 0.32 mg/kg. Anatomically, RG7774 reduced the migration of retinal microglia to retinal lesions. Discussion RG7774 is a novel, highly selective, and orally bioavailable CB2R agonist, with an acceptable systemic and ocular PK profile, and beneficial effects on retinal vascular permeability, leukocyte adhesion, and ocular inflammation in rodent animal models. Results support the development of RG7774 as a potential treatment for retinal diseases with similar pathophysiologies as addressed by the animal models.
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Affiliation(s)
- Uwe Grether
- F. Hoffmann-La Roche Ltd, Pharma Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland
| | - Richard H. Foxton
- F. Hoffmann-La Roche Ltd, Pharma Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland
| | - Sabine Gruener
- F. Hoffmann-La Roche Ltd, Pharma Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland
| | - Claudia Korn
- F. Hoffmann-La Roche Ltd, Pharma Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland
| | - Atsushi Kimbara
- F. Hoffmann-La Roche Ltd, Pharma Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland
| | - Anja Osterwald
- F. Hoffmann-La Roche Ltd, Pharma Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland
| | - Elisabeth Zirwes
- F. Hoffmann-La Roche Ltd, Pharma Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland
| | - Sabine Uhles
- F. Hoffmann-La Roche Ltd, Pharma Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland
| | - Janina Thoele
- F. Hoffmann-La Roche Ltd, Pharma Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland
| | - Nadine Colé
- F. Hoffmann-La Roche Ltd, Pharma Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland
| | - Mark Rogers-Evans
- F. Hoffmann-La Roche Ltd, Pharma Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland
| | - Stephan Röver
- F. Hoffmann-La Roche Ltd, Pharma Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland
| | - Matthias Nettekoven
- F. Hoffmann-La Roche Ltd, Pharma Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland
| | - Rainer E. Martin
- F. Hoffmann-La Roche Ltd, Pharma Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland
| | - Jean-Michel Adam
- F. Hoffmann-La Roche Ltd, Pharma Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland
| | - Jürgen Fingerle
- F. Hoffmann-La Roche Ltd, Pharma Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland
| | - Caterina Bissantz
- F. Hoffmann-La Roche Ltd, Pharma Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland
| | - Wolfgang Guba
- F. Hoffmann-La Roche Ltd, Pharma Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland
| | - André Alker
- F. Hoffmann-La Roche Ltd, Pharma Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland
| | - Anna M. Szczesniak
- Departments of Pharmacology, Anesthesia, Ophthalmology and Visual Sciences, Dalhousie University, Halifax, NS, Canada
| | - Ross F. Porter
- Departments of Pharmacology, Anesthesia, Ophthalmology and Visual Sciences, Dalhousie University, Halifax, NS, Canada
| | - Tom J. Toguri
- Departments of Pharmacology, Anesthesia, Ophthalmology and Visual Sciences, Dalhousie University, Halifax, NS, Canada
| | - Franco Revelant
- F. Hoffmann-La Roche Ltd, Pharma Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland
| | - Agnès Poirier
- F. Hoffmann-La Roche Ltd, Pharma Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland
| | - Camille Perret
- F. Hoffmann-La Roche Ltd, Pharma Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland
| | - Lotte Winther
- F. Hoffmann-La Roche Ltd, Pharma Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland
| | - Antonello Caruso
- F. Hoffmann-La Roche Ltd, Pharma Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland
| | - Filomena Fezza
- Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Mauro Maccarrone
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
- European Center for Brain Research (CERC), Santa Lucia Foundation IRCCS, Rome, Italy
| | - Melanie E. M. Kelly
- Departments of Pharmacology, Anesthesia, Ophthalmology and Visual Sciences, Dalhousie University, Halifax, NS, Canada
| | - Sascha Fauser
- F. Hoffmann-La Roche Ltd, Pharma Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland
| | - Christoph Ullmer
- F. Hoffmann-La Roche Ltd, Pharma Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland
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7
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Reddy SK, Devi V, Seetharaman ATM, Shailaja S, Bhat KMR, Gangaraju R, Upadhya D. Cell and molecular targeted therapies for diabetic retinopathy. Front Endocrinol (Lausanne) 2024; 15:1416668. [PMID: 38948520 PMCID: PMC11211264 DOI: 10.3389/fendo.2024.1416668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 05/27/2024] [Indexed: 07/02/2024] Open
Abstract
Diabetic retinopathy (DR) stands as a prevalent complication in the eye resulting from diabetes mellitus, predominantly associated with high blood sugar levels and hypertension as individuals age. DR is a severe microvascular complication of both type I and type II diabetes mellitus and the leading cause of vision impairment. The critical approach to combatting and halting the advancement of DR lies in effectively managing blood glucose and blood pressure levels in diabetic patients; however, this is seldom achieved. Both human and animal studies have revealed the intricate nature of this condition involving various cell types and molecules. Aside from photocoagulation, the sole therapy targeting VEGF molecules in the retina to prevent abnormal blood vessel growth is intravitreal anti-VEGF therapy. However, a substantial portion of cases, approximately 30-40%, do not respond to this treatment. This review explores distinctive pathophysiological phenomena of DR and identifiable cell types and molecules that could be targeted to mitigate the chronic changes occurring in the retina due to diabetes mellitus. Addressing the significant research gap in this domain is imperative to broaden the treatment options available for managing DR effectively.
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Affiliation(s)
- Shivakumar K. Reddy
- Centre for Molecular Neurosciences, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Vasudha Devi
- Department of Pharmacology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Amritha T. M. Seetharaman
- Department of Ophthalmology, The University of Tennessee Health Science Center, Memphis, TN, United States
| | - S. Shailaja
- Department of Ophthalmology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Kumar M. R. Bhat
- Department of Anatomy, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Rajashekhar Gangaraju
- Department of Ophthalmology, The University of Tennessee Health Science Center, Memphis, TN, United States
- Department of Anatomy & Neurobiology, The University of Tennessee Health Science Center, Memphis, TN, United States
| | - Dinesh Upadhya
- Centre for Molecular Neurosciences, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
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8
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Walicka M, Krysiński A, La Rosa GRM, Sun A, Campagna D, Di Ciaula A, Dugal T, Kengne A, Le Dinh P, Misra A, Polosa R, Raza SA, Russo C, Sammut R, Somasundaram N. Influence of quitting smoking on diabetes-related complications: A scoping review with a systematic search strategy. Diabetes Metab Syndr 2024; 18:103044. [PMID: 38810420 DOI: 10.1016/j.dsx.2024.103044] [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: 03/21/2024] [Revised: 05/13/2024] [Accepted: 05/17/2024] [Indexed: 05/31/2024]
Abstract
INTRODUCTION Smoking in people with diabetes markedly elevates their risk of developing complications and increases the likelihood of cardiovascular mortality. This review is the first to specifically provide evidence-based analysis about the influence of quitting smoking on diabetes-related complications in people with type 2 diabetes. METHOD The present review was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews. All human clinical studies assessing the effects of stopping smoking cessation on diabetes-related complications were included. PubMed and Embase were screened until January 2024. References of primary studies and principal peer-reviewed scientific journals in the field were manually screened. RESULTS We identified a total of 1023 studies. Only 26 met the criteria for eligibility. In general quitting smoking is associated with decreased risks of myocardial infarction and ischemic stroke. Regarding microvascular complications, the strongest evidence for the beneficial effects of smoking cessation is observed in diabetic nephropathy. However, the relationship between smoking cessation and retinopathy, neuropathy, diabetic foot complications and diabetic-related erectile dysfunction, is poorly investigated. CONCLUSION Quitting smoking offers significant advantages in managing diabetes-related complications, significantly lowering the risks of myocardial infarction, ischemic stroke, and diabetic nephropathy. This underscores the importance of cessation. Providing evidence-based information on the benefits of stopping smoking for people with type 2 diabetes who smoke, can bolster smoking cessation efforts in the context of diabetes management.
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Affiliation(s)
- Magdalena Walicka
- Department of Human Epigenetics, Mossakowski Medical Research Institute, Polish Academy of Sciences, Warsaw, Poland; Department of Internal Diseases, Endocrinology and Diabetology, National Medical Institute of the Ministry of the Interior and Administration, Warsaw, Poland.
| | - Arkadiusz Krysiński
- Department of Human Epigenetics, Mossakowski Medical Research Institute, Polish Academy of Sciences, Warsaw, Poland; Department of Internal Diseases, Endocrinology and Diabetology, National Medical Institute of the Ministry of the Interior and Administration, Warsaw, Poland
| | | | - Ang Sun
- Department of Biology, and Center for Biotechnology/Sbarro Institute for Cancer Research and Molecular Medicine, Temple University, Philadelphia, USA
| | - Davide Campagna
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Agostino Di Ciaula
- Clinica Medica "A. Murri" Department of Precision and Regenerative Medicine and Ionian Area [DiMePre-J], University "Aldo Moro" Medical School, Bari, Italy
| | - Tabinda Dugal
- Department of Endocrinology College of Physicians and Surgeons, Royal Cornwall Hospital NHS Trust, Truro, UK
| | - Andre Kengne
- Non-Communicable Diseases Research Unit, South African Medical Research Council and University of Cape Town, Cape Town, South Africa; Department of Biological and Environmental Science, Faculty of Science, Walter Sisulu University, Mthatha, South Africa
| | - Phuong Le Dinh
- General Practice, Family Medicine and Check-up Department, FV Hospital Ho Chi Minh City, Viet Nam
| | - Anoop Misra
- Diabetes Foundation [India], New Delhi, India; National Diabetes, Obesity and Cholesterol Foundation [N-DOC], New Delhi, India; Fortis C-DOC Centre for Excellence for Diabetes, Metabolic Disease, and Endocrinology, New Delhi, India
| | - Riccardo Polosa
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy; Center of Excellence for the acceleration of Harm Reduction [CoEHAR], University of Catania, Vietnam, Italy; Centre for the Prevention and Treatment of Tobacco Addiction (CPCT), University Teaching Hospital "Policlinico-Vittorio Emanuele", University of Catania, Catania, Italy
| | - Syed Abbas Raza
- Shaukat Khanum Cancer Hospital and Research Center, Peshawar, Pakistan
| | - Cristina Russo
- Ashford and Saint Peter's Hospitals NHS Foundation Trust, Chertsey, UK
| | - Roberta Sammut
- Department of Nursing, Faculty of Health Sciences, University of Malta, Msida, Malta
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9
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Li X, Fu YH, Tong XW, Zhang YT, Shan YY, Xu YX, Pu SD, Gao XY. RAAS in diabetic retinopathy: mechanisms and therapies. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2024; 68:e230292. [PMID: 38652701 PMCID: PMC11081058 DOI: 10.20945/2359-4292-2023-0292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 11/23/2023] [Indexed: 04/25/2024]
Abstract
Diabetic retinopathy (DR) is a complication of diabetes with a complex pathophysiology and multiple factors involved. Recently, it has been found that the upregulation of the renin-angiotensin-aldosterone system (RAAS) leads to overexpression of angiotensin II (Ang II), which induces oxidative stress, inflammation, and angiogenesis in the retina. Therefore, RAAS may be a promising therapeutic target in DR. Notably, RAAS inhibitors are often used in the treatment of hypertension. Still, the potential role and mechanism of DR must be further studied. In this review, we discuss and summarize the pathology and potential therapeutic goals of RAAS in DR.
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Affiliation(s)
- Xin Li
- First Affiliated Hospital of Harbin Medical University, Harbin Medical University, Department of Endocrinology, Harbin, China
| | - Yu-Hong Fu
- First Affiliated Hospital of Harbin Medical University, Harbin Medical University, Department of Endocrinology, Harbin, China
| | - Xue-Wei Tong
- First Affiliated Hospital of Harbin Medical University, Harbin Medical University, Department of Endocrinology, Harbin, China
| | - Yi-Tong Zhang
- First Affiliated Hospital of Harbin Medical University, Harbin Medical University, Department of Endocrinology, Harbin, China
| | - Yong-Yan Shan
- First Affiliated Hospital of Harbin Medical University, Harbin Medical University, Department of Endocrinology, Harbin, China
| | - Yu-Xin Xu
- First Affiliated Hospital of Harbin Medical University, Harbin Medical University, Department of Endocrinology, Harbin, China
| | - Sheng-Dan Pu
- First Affiliated Hospital of Harbin Medical University, Harbin Medical University, Department of Endocrinology, Harbin, China
| | - Xin-Yuan Gao
- First Affiliated Hospital of Harbin Medical University, Harbin Medical University, Department of Endocrinology, Harbin, China,
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10
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Mandava A, Pham B, Pedler M, Shieh B, Gopalakrishnan H, Petrash JM. High incidence of sebaceous gland inflammation in aldose reductase-deficient mice. Chem Biol Interact 2024; 392:110905. [PMID: 38373627 PMCID: PMC10960685 DOI: 10.1016/j.cbi.2024.110905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 01/29/2024] [Accepted: 02/06/2024] [Indexed: 02/21/2024]
Abstract
Aldose reductase is a member of the 1B1 subfamily of aldo-keto reductase gene superfamily. The action of aldose reductase (AR) has been implicated in the pathogenesis of a variety of disease states, most notably complications of diabetes mellitus including neuropathy, retinopathy, nephropathy, and cataracts. To explore for mechanistic roles for AR in disease pathogenesis, we established mutant strains produced using Crispr-Cas9 to inactivate the AKR1B3 gene in C57BL6 mice. Phenotyping AR-knock out (ARKO) strains confirmed previous reports of reduced accumulation of tissue sorbitol levels. Lens epithelial cells in ARKO mice showed markedly reduced epithelial-to-mesenchymal transition following lens extraction in a surgical model of cataract and posterior capsule opacification. A previously unreported phenotype of preputial sebaceous gland swelling was observed frequently in male ARKO mice homozygous for the mutant AKR1B3 allele. This condition, which was shown to be accompanied by infiltration of proinflammatory CD3+ lymphocytes, was not observed in WT mice or mice heterozygous for the mutant allele. Despite this condition, reproductive fitness of the ARKO strain was indistinguishable from WT mice housed under identical conditions. These studies establish the utility of a new strain of AKR1B3-null mice created to support mechanistic studies of cataract and diabetic eye disease.
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Affiliation(s)
- Anjali Mandava
- Department of Ophthalmology, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Binhan Pham
- Department of Ophthalmology, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Michelle Pedler
- Department of Ophthalmology, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Biehuoy Shieh
- Department of Ophthalmology, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Hari Gopalakrishnan
- Department of Ophthalmology, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - J Mark Petrash
- Department of Ophthalmology, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, 80045, USA.
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11
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Yuan Z, Lai Z, Zhang Y, Zhang J, Zhou J, Li D, Yu W, Zhou J, Li Z. N-glycosylation of disease-specific haptoglobin for the early screening of diabetic retinopathy. Proteomics Clin Appl 2024:e2300032. [PMID: 38456388 DOI: 10.1002/prca.202300032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 02/20/2024] [Accepted: 02/23/2024] [Indexed: 03/09/2024]
Abstract
PURPOSE Diabetic retinopathy (DR), as one of the microvascular complications of diabetes, is a leading cause of acquired vision loss. Most DR cases are detected in the advanced stage through fundoscopy, making molecular biomarkers urgently needed for early diagnosis of DR. EXPERIMENTAL DESIGN Serum disease-specific haptoglobin-β (Hp-β) chains of 100 patients with type 2 diabetes mellitus (T2DM) and 156 T2DM patients with non-proliferative diabetic retinopathy (NPDR) were separated using polyacrylamide gel electrophoresis. After in-gel digestion and enrichment, the intact N-glycopeptides were detected by mass spectrometry. RESULTS Fucosylation of Hp-β was significantly increased and sialylation of Hp-β was significantly decreased in background DR (BDR, an early-stage DR) patients compared with non-diabetic retinopathy patients (p < 0.05) and yielded area under curves (AUCs) of 0.801 and 0.829 in training and validation groups, respectively, which had an advantage over glycated hemoglobin A1c (AUC ≤ 0.691). Moreover, a significant increase in sialylated Hp-β was found in severe NPDR patients compared with BDR patients and yielded an AUC of 0.828 to distinguish severe NPDR from BDR. CONCLUSION Changes in Hp-β glycosylation are closely related to DR, and may be used for early diagnosis and screening of DR.
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Affiliation(s)
- Zhonghao Yuan
- Department of Biophysics and Structural Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Zhizhen Lai
- Department of Biophysics and Structural Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Yixin Zhang
- Department of Ophthalmology, Affiliated Hospital of Zunyi Medical University, Beijing, China
| | - Jiyun Zhang
- Department of Biophysics and Structural Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Jinyu Zhou
- Department of Biophysics and Structural Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Dan Li
- Department of Biophysics and Structural Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Weihong Yu
- Department of Ophthalmology, Peking Union Medical College Hospital, Peking Union Medical College, Beijing, China
- Key Laboratory of Ocular Fundus Disease, Chinese Academy of Medical Sciences, Beijing, China
| | - Jiang Zhou
- Analytical Instrumentation Center, College of Chemistry and Molecular Engineering, Peking University, Beijing, China
| | - Zhili Li
- Department of Biophysics and Structural Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing, China
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12
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Taylor DJ, Alquiza PJ, Jones PR, Wilson I, Bi W, Sim DA, Crabb DP. Tablet-based tests of everyday visual function in a diabetic macular oedema (DME) clinic waiting area: A feasibility study. Ophthalmic Physiol Opt 2024; 44:388-398. [PMID: 38131130 DOI: 10.1111/opo.13261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 11/28/2023] [Accepted: 11/29/2023] [Indexed: 12/23/2023]
Abstract
PURPOSE (1) To assess the feasibility of conducting tablet-based vision tests in hospital clinic waiting areas; (2) To test the hypothesis that increasing severity of diabetic macular oedema (DME) is associated with the performance of tablet-based surrogates of everyday tasks and self-reported visual function. METHODS Sixty-one people with mild (n = 28), moderate (n = 24) or severe (n = 9) DME performed two tablet-based tests of 'real-world' visual function (visual search and face recognition) while waiting for appointments in a hospital outpatient clinic. Participants also completed a tablet-based version of a seven-item, visual-functioning (VF-7) patient-reported outcome measure. Test performance was compared to previously published 99% normative limits for normally sighted individuals. RESULTS Thirty-four participants (56%; 95% confidence interval [CI] 43%-68%) exceeded normative limits for visual search, while eight (13%; 95% CI 65%-24%) exceeded normative limits for face discrimination. Search duration was significantly longer for people with severe DME than those with mild and moderate DME (p = 0.01). Face discrimination performance was not significantly associated with DME severity. VF-7 scores were statistically similar across DME severity groups. Median time to complete all elements (eligibility screening, both tablet-based tasks and the VF-7) was 22 (quartiles 19, 25) min. Further, 98% and 87% of participants, respectively, reported the search task and face discrimination task to be enjoyable, while 25% and 97%, respectively, reported finding the two tasks to be difficult. CONCLUSIONS Portable tablet-based tests are quick, acceptable to patients and feasible to be performed in a clinic waiting area with minimal supervision. They have the potential to be piloted in patients' homes for self-monitoring.
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Affiliation(s)
- Deanna J Taylor
- Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, UK
| | | | - Pete R Jones
- Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, UK
| | - Iain Wilson
- Nuffield Laboratory of Ophthalmology, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
- Oxford Eye Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Wei Bi
- Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, UK
| | - Dawn A Sim
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - David P Crabb
- Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, UK
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13
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Nanji K, Sarohia GS, Xie J, Patil NS, Phillips M, Zeraatkar D, Thabane L, Guymer RH, Kaiser PK, Sivaprasad S, Sadda SR, Wykoff CC, Chaudhary V. Anti-vascular endothelial growth factor therapy and retinal non-perfusion in diabetic retinopathy: A meta-analysis of randomised trials. Acta Ophthalmol 2024; 102:e31-e41. [PMID: 37042340 DOI: 10.1111/aos.15673] [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: 01/08/2023] [Revised: 02/19/2023] [Accepted: 03/27/2023] [Indexed: 04/13/2023]
Abstract
PURPOSE Retinal non-perfusion (RNP) is fundamental to disease onset and progression in diabetic retinopathy (DR). Whether anti-vascular endothelial growth factor (anti-VEGF) therapy can modify RNP progression is unclear. This investigation quantified the impact of anti-VEGF therapy on RNP progression compared with laser or sham at 12 months. METHODS A systematic review and meta-analysis of randomised controlled trials (RCTs) were performed; Ovid MEDLINE, EMBASE and CENTRAL were searched from inception to 4th March 2022. The change in any continuous measure of RNP at 12 months and 24 months was the primary and secondary outcomes, respectively. Outcomes were reported utilising standardised mean differences (SMD). The Cochrane Risk of Bias Tool version-2 and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines informed risk of bias and certainty of evidence assessments. RESULTS Six RCTs (1296 eyes) and three RCTs (1131 eyes) were included at 12 and 24 months, respectively. Meta-analysis demonstrated that RNP progression may be slowed with anti-VEGF therapy compared with laser/sham at 12 months (SMD: -0.17; 95% confidence interval [CI]: -0.29, -0.06; p = 0.003; I2 = 0; GRADE rating: LOW) and 24-months (SMD: -0.21; 95% CI: -0.37, -0.05; p = 0.009; I2 = 28%; GRADE rating: LOW). The certainty of evidence was downgraded due to indirectness and due to imprecision. CONCLUSION Anti-VEGF treatment may slightly impact the pathophysiologic process of progressive RNP in DR. The dosing regimen and the absence of diabetic macular edema may impact this potential effect. Future trials are needed to increase the precision of the effect and inform the association between RNP progression and clinically important events. PROSPERO REGISTRATION CRD42022314418.
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Affiliation(s)
- Keean Nanji
- Department of Surgery, Division of Ophthalmology, McMaster University, 2757 King Street East, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, Ontario, Canada
| | - Gurkaran S Sarohia
- Department of Ophthalmology and Visual Sciences, University of Alberta, 2319 Active Treatment Centre, 10240 Kingsway Avenue NW, Edmonton, Alberta, Canada, T5H 3V8
| | - Jim Xie
- Department of Surgery, Division of Ophthalmology, McMaster University, 2757 King Street East, Hamilton, Ontario, Canada
| | - Nikhil S Patil
- Department of Surgery, Division of Ophthalmology, McMaster University, 2757 King Street East, Hamilton, Ontario, Canada
| | - Mark Phillips
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, Ontario, Canada
| | - Dena Zeraatkar
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, Ontario, Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, Ontario, Canada
- Biostatistics Unit, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
- Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
| | - Robyn H Guymer
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
- Department of Surgery (Ophthalmology), the University of Melbourne, Melbourne, Australia
| | - Peter K Kaiser
- Cole Eye Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, Ohio, USA
| | - Sobha Sivaprasad
- NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital, London, UK
| | - Srinivas R Sadda
- Doheny Eye Institute, David Geffen School of Medicine, University of California - Los Angeles, Los Angeles, California, USA
| | - Charles C Wykoff
- Retina Consultants of Texas, Houston, Texas, Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas, USA
| | - Varun Chaudhary
- Department of Surgery, Division of Ophthalmology, McMaster University, 2757 King Street East, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, Ontario, Canada
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14
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Chen J, Wang Q, Li R, Li Z, Jiang Q, Yan F, Ye J. The role of Keap1-Nrf2 signaling pathway during the progress and therapy of diabetic retinopathy. Life Sci 2024; 338:122386. [PMID: 38159594 DOI: 10.1016/j.lfs.2023.122386] [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: 10/19/2023] [Revised: 12/09/2023] [Accepted: 12/22/2023] [Indexed: 01/03/2024]
Abstract
Diabetic retinopathy is a complex and progressive ocular complication of diabetes mellitus and is a leading cause of blindness in people of working age worldwide. The pathophysiology of diabetic retinopathy involves multifactorial processes, including oxidative stress, inflammation and vascular abnormalities. Understanding the underlying molecular mechanisms involved in its pathogenesis is essential for the development of effective therapeutic interventions. One of the pathways receiving increasing attention is the Keap1-Nrf2 signaling pathway, which regulates the cellular response to oxidative stress by activating Nrf2. In this review, we analyze the current evidence linking Keap1-Nrf2 signaling pathway dysregulation to diabetic retinopathy. In addition, we explore the potential therapeutic implications and the challenges of targeting this pathway for disease management. A comprehensive understanding of the molecular mechanisms of diabetic retinopathy and the therapeutic potential of the Keap1-Nrf2 pathway may pave the way for innovative and effective interventions to combat this vision-threatening disease.
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Affiliation(s)
- Jiawen Chen
- State Key Laboratory of Natural Medicines, Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing 211198, China; School of Life Science and Technology, China Pharmaceutical University, Nanjing 210006, China; Department of Ophthalmology, The First Affiliated Hospital of Yangtze University, Jingzhou, Hubei 434000, China
| | - Qi Wang
- Department of Ophthalmology, The First Affiliated Hospital of Yangtze University, Jingzhou, Hubei 434000, China
| | - Ruiyan Li
- School of Life Science and Technology, China Pharmaceutical University, Nanjing 210006, China
| | - Zhe Li
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China; Cardiovascular research Institute, Wuhan University, Wuhan 430060, China
| | - Qizhou Jiang
- School of Life Science and Technology, China Pharmaceutical University, Nanjing 210006, China
| | - Fangrong Yan
- State Key Laboratory of Natural Medicines, Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing 211198, China.
| | - Junmei Ye
- School of Life Science and Technology, China Pharmaceutical University, Nanjing 210006, China.
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15
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Sruthi R, Saikumar SJ, Gopalakrishnan M. Progression of diabetic retinopathy following uncomplicated phacoemulsification: A prospective study from South India. Oman J Ophthalmol 2024; 17:72-77. [PMID: 38524349 PMCID: PMC10957061 DOI: 10.4103/ojo.ojo_292_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 08/30/2023] [Accepted: 09/08/2023] [Indexed: 03/26/2024] Open
Abstract
AIM The aim of this study was to study the progression of diabetic retinopathy (DR) and macular edema in uncomplicated phacoemulsification in patients with diabetes mellitus with a follow-up of 6 months. METHODS A prospective, nonrandomized study was conducted on patients with established or no DR in a known case of diabetes mellitus undergoing cataract surgery by phacoemulsification, with no intraoperative complications. Detailed ophthalmic evaluation including fundus examination was done in all cases, and DR staging was done. Optical coherence tomography and fundus fluorescein angiography were done in indicated cases. Fundus evaluation was done during the follow-up visits in 3 weeks, 3 months, and 6 months postsurgery and the tests were repeated if necessary. RESULTS In the current study, there was a statistically significant improvement in best-corrected visual acuity after cataract surgery compared to the preoperative value. From the 330 eyes we analyzed, there was a progression of DR in only 18 eyes (5.45%) following phacoemulsification. There was a statistically significant increase in central macular thickness (CMT) at 3 weeks postoperative (433.82 ± 137.572) compared to that of the preoperative CMT (295.98 ± 97.959). From the 22 eyes which showed a progression of diabetic maculopathy, 11 eyes had developed new-onset macular edema following the cataract surgery, 11 eyes had progression of preexisting edema, and 4 of them had to undergo intravitreal anti-vascular endothelial growth factor injections as the treatment. CONCLUSION The chance of progression of DR staging is low after uncomplicated phacoemulsification, on a short term. However, the chances of worsening of macular edema as well as worsening of proliferative stages should be kept in mind while advising a patient for cataract surgery.
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Affiliation(s)
- R. Sruthi
- Department of Cataract and Glaucoma, Giridhar Eye Institute, Cochin, Kerala, India
| | - Seshadri J. Saikumar
- Department of Cataract and Glaucoma, Giridhar Eye Institute, Cochin, Kerala, India
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16
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Jiang S, Xia N, Buonfiglio F, Böhm EW, Tang Q, Pfeiffer N, Olinger D, Li H, Gericke A. High-fat diet causes endothelial dysfunction in the mouse ophthalmic artery. Exp Eye Res 2024; 238:109727. [PMID: 37972749 DOI: 10.1016/j.exer.2023.109727] [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: 07/13/2023] [Revised: 10/27/2023] [Accepted: 11/13/2023] [Indexed: 11/19/2023]
Abstract
Obesity is a significant health concern that leads to impaired vascular function and subsequent abnormalities in various organs. The impact of obesity on ocular blood vessels, however, remains largely unclear. In this study, we examined the hypothesis that obesity induced by high-fat diet produces vascular endothelial dysfunction in the ophthalmic artery. Mice were subjected to a high-fat diet for 20 weeks, while age-matched controls were maintained on a standard diet. Reactivity of isolated ophthalmic artery segments was assessed in vitro. Reactive oxygen species (ROS) were quantified in cryosections by dihydroethidium (DHE) staining. Redox gene expression was determined in ophthalmic artery explants by real-time PCR. Furthermore, the expression of nicotinamide adenine dinucleotide phosphate oxidase 2 (NOX2), the receptor for advanced glycation end products (RAGE), and of the lectin-like oxidized low-density-lipoprotein receptor-1 (LOX-1) was determined in cryosections using immunofluorescence microscopy. Ophthalmic artery segments from mice on a high-fat diet exhibited impaired vasodilation responses to the endothelium-dependent vasodilator acetylcholine, while endothelium-independent responses to nitroprusside remained preserved. DHE staining intensity in the vascular wall was notably stronger in mice on a high-fat diet. Messenger RNA expression for NOX2 was elevated in the ophthalmic artery of mice subjected to high fat diet. Likewise, immunostainings revealed increased expression of NOX2 and of RAGE, but not of LOX-1. These findings suggest that a high-fat diet triggers endothelial dysfunction by inducing oxidative stress in the ophthalmic artery via involvement of RAGE and NOX2.
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Affiliation(s)
- Subao Jiang
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany.
| | - Ning Xia
- Department of Pharmacology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany.
| | - Francesco Buonfiglio
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany.
| | - Elsa W Böhm
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany.
| | - Qi Tang
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany.
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany.
| | - Dominik Olinger
- Department of Pharmacology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany.
| | - Huige Li
- Department of Pharmacology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany.
| | - Adrian Gericke
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany.
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Zulhisham M, Suhaimi H, Shatriah I. Central Corneal Thickness and Intraocular Pressure in Children with Type 1 Diabetes Mellitus. KOREAN JOURNAL OF OPHTHALMOLOGY 2023; 37:462-467. [PMID: 37899288 PMCID: PMC10721407 DOI: 10.3341/kjo.2023.0040] [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: 04/01/2023] [Revised: 08/11/2023] [Accepted: 09/22/2023] [Indexed: 10/31/2023] Open
Abstract
PURPOSE The aim of this study is to determine the mean central corneal thickness (CCT) and mean intraocular pressure (IOP) in children with type 1 diabetes mellitus (T1DM) and to determine the relationship between CCT and IOP on the one hand and age, sex, retinopathy hemoglobin A1c (HbA1c), and duration of diabetes on the other. METHODS This is a case-control, hospital-based study conducted at Hospital Universiti Sains Malaysia between January and November 2022. Thirty-eight children with T1DM were recruited as cases, and 38 healthy children were recruited as controls. The cases and controls then underwent ophthalmic examination, IOP measurement, and CCT measurement using optical coherence tomography (OCT) of the right eye. The IOP measurements were adjusted for CCT for further analysis. RESULTS The means of CCT and IOP values were significantly higher in the T1DM group than in the control group (all p = 0.02). The mean CCT was 542.18 ± 20.40 μm in the T1DM group, and 529.52 ± 26.17 μm in the control group. The mean IOP was 14.68 ± 1.98 mmHg in the T1DM group, and 13.52 ± 1.66 mmHg in the control group. The mean HbA1c was 10.68% ± 2.49% in the T1DM group. Age and duration of DM were found to have a significant association with CCT in children with T1DM. The duration of DM was also found to be significantly associated with the IOP. Sex and HbA1c levels were found to have no significant relationship with either CCT or IOP. CONCLUSIONS Children with T1DM have significantly higher CCT and IOP than the average child. The duration of DM is a significant factor that impacts both CCT and IOP. In addition, age is another factor that affects CCT in children with T1DM.
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Affiliation(s)
- Mohmad Zulhisham
- Department of Ophthalmology and Visual Science, Hospital Universiti Sains Malaysia, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian,
Malaysia
| | - Hussain Suhaimi
- Department of Pediatrics, Hospital Universiti Sains Malaysia, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian,
Malaysia
| | - Ismail Shatriah
- Department of Ophthalmology and Visual Science, Hospital Universiti Sains Malaysia, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian,
Malaysia
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18
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Chen J, Wang Q, Li R, Li Z, Jiang Q, Yan F, Ye J. The role of sirtuins in the regulatin of oxidative stress during the progress and therapy of type 2 diabetes mellitus. Life Sci 2023; 333:122187. [PMID: 37858715 DOI: 10.1016/j.lfs.2023.122187] [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: 06/10/2023] [Revised: 10/12/2023] [Accepted: 10/16/2023] [Indexed: 10/21/2023]
Abstract
Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by insulin resistance and impaired glucose homeostasis. Oxidative stress, arising from an imbalance between reactive oxygen species (ROS) production and antioxidant defense systems, plays a significant role in the development and progression of T2DM. The sirtuin family, particularly Sirt1, Sirt3, and Sirt6, have emerged as key regulators of oxidative stress in various cellular processes. This review aims to explore the role of the sirtuin family in oxidative stress during the progression of T2DM and their potential as therapeutic targets. We discussed the mechanisms through which sirtuins modulate oxidative stress, their impact on insulin sensitivity, and beta-cell function involved in T2DM. Furthermore, we highlight drugs targeting sirtuin activation and related complications in T2DM. This review summarizes the role as well as mechanism of sirtuins in the regulation of oxidative stress in T2DM and available drugs targeting sirtuins in clinic, which may provide novel insights into the mechanism and therapy of T2DM.
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Affiliation(s)
- Jiawen Chen
- Department of Ophthalmology, The First Affiliated Hospital of Yangtze University, Jingzhou, Hubei 434000, PR China; State Key Laboratory of Natural Medicines, Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing 211198, PR China
| | - Qi Wang
- Department of Ophthalmology, The First Affiliated Hospital of Yangtze University, Jingzhou, Hubei 434000, PR China
| | - Ruiyan Li
- School of Life Science and Technology, China Pharmaceutical University, Nanjing 210006, China
| | - Zhe Li
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China; Cardiovascular research Institute, Wuhan University, Wuhan 430060, China
| | - Qizhou Jiang
- School of Life Science and Technology, China Pharmaceutical University, Nanjing 210006, China
| | - Fangrong Yan
- State Key Laboratory of Natural Medicines, Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing 211198, PR China.
| | - Junmei Ye
- School of Life Science and Technology, China Pharmaceutical University, Nanjing 210006, China.
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19
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Saitakis G, Roukas D, Hatziagelaki E, Efstathiou V, Theodossiadis P, Rizos E. Evaluation of Quality of Life and Emotional Disturbances in Patients with Diabetic Retinopathy. Eur J Investig Health Psychol Educ 2023; 13:2516-2528. [PMID: 37998065 PMCID: PMC10670728 DOI: 10.3390/ejihpe13110175] [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: 09/16/2023] [Revised: 10/26/2023] [Accepted: 10/30/2023] [Indexed: 11/25/2023] Open
Abstract
Diabetes has detrimental effects on many organs, including the kidneys, heart, and the central nervous system, with ophthalmic involvement and Diabetic Retinopathy (DR), specifically, being among the most severe and prominent consequences. Diabetic Retinopathy and especially advanced stages of the disease, have a crucial impact on patients' quality of life and emotional status. In this context, emotional imbalance, psychological side effects and comorbidities, like anxiety disorders, could emerge, deteriorating the patients' condition further. A number of questionnaires can be employed in the evaluation of the potential impact of Diabetic Retinopathy on patients' quality of life, including the Beck Anxiety Inventory (BAI) and The National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25). PURPOSE The purpose of this study was to evaluate the association of Diabetic Retinopathy (DR) and diabetic macular edema with vision-related quality of life, as well as the potential association between the disease's severity, emotional status of patients and the manifestation of anxiety and psychological features. RESULTS Patients with fundoscopic findings had significantly lower scores in all VFQ-25 subscales, indicating worse quality of life in comparison to patients without DR. Severity of DR, greater levels of anxiety, daily sitting time, unemployment and lower education level, were all found to be significantly, negatively associated with a worse quality of life. Regarding emotional status, more years of suffering from diabetes, treatment with insulin and the hours being idle per day were associated with an increased burden of anxiety. In addition, the presence of a concomitant disease, findings in fundoscopy, diabetic macular edema and treatment with anti-VEFG injections, as well as the number of doses, were significantly associated with greater anxiety. Multivariate analysis showed that having Severe Non-Proliferative Diabetic Retinopathy or having Proliferative Diabetic Retinopathy and receiving insulin therapy (alone or in combination with another treatment), were significantly associated with higher levels of anxiety. CONCLUSION The well-established impact of DR on the patients' well-being, quality of life and emotional status render DR and CME prevention, stabilization or delaying progression as a necessity in order to protect patients from developing psychiatric symptoms. On the other hand, the speculated bi-directional association between emotional problems and DR progression highlights the importance of acknowledging and dealing with psychological issues with the aim of delaying DR progression.
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Affiliation(s)
- George Saitakis
- Second Department of Ophthalmology, National and Kapodistrian University of Athens, ‘Attikon’ University General Hospital, 12462 Athens, Greece
| | - Dimitrios Roukas
- Department of Psychiatry, 417 VA (NIMITS) Hospital, 11521 Athens, Greece;
| | - Erifili Hatziagelaki
- Research Institute and Diabetes Center, Second Department of Internal Medicine-Propaedeutic, National and Kapodistrian University of Athens, ‘Attikon’ University General Hospital, 12462 Athens, Greece
| | - Vasiliki Efstathiou
- Second Department of Psychiatry, National and Kapodistrian University of Athens, Medical School of Athens, ‘Attikon’ University General Hospital, 12462 Athens, Greece; (V.E.); (E.R.)
| | - Panagiotis Theodossiadis
- Second Department of Ophthalmology, National and Kapodistrian University of Athens, ‘Attikon’ University General Hospital, 12462 Athens, Greece
| | - Emmanouil Rizos
- Second Department of Psychiatry, National and Kapodistrian University of Athens, Medical School of Athens, ‘Attikon’ University General Hospital, 12462 Athens, Greece; (V.E.); (E.R.)
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20
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Vivanco-Rojas O, López-Letayf S, Londoño-Angarita V, Magaña-Guerrero FS, Buentello-Volante B, Garfias Y. Risk Factors for Diabetic Retinopathy in Latin America (Mexico) and the World: A Systematic Review and Meta-Analysis. J Clin Med 2023; 12:6583. [PMID: 37892721 PMCID: PMC10607496 DOI: 10.3390/jcm12206583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/04/2023] [Accepted: 10/13/2023] [Indexed: 10/29/2023] Open
Abstract
Diabetic retinopathy (DR) is one of the main complications of diabetes, and the management of the main control parameters explains only an 11% reduction in the risk of progressing to DR, leaving 89% to be explained by other factors or correlations between the usual factors that are currently unknown. The objective of this systematic review and meta-analysis is to evaluate the similarities and differences between the possible risk factors for developing DR when comparing the world to Latin American populations. The search was performed first for Latin American (LA) populations and a second search for non-Latin American (Non-LA) populations. Using the PRISMA guidelines, five articles were found to be relevant for each of the groups. The patients who had elevated systolic blood pressure (SBP) developed DR more frequently than the patients without retinopathy (Z = 2.1, p = 0.03), an effect measured in the population at a global level (GL), behavior that becomes not significant when the LA and non-LA populations are grouped separately; relevant to this is that the diagnosis of hypertension (HBP) grouped globally and stratified does not present a risk factor for DR (Z = 0.79, p = 0.42). This indicates that SBP is a risk factor for the world population and that, by separating it into different regions, the omission could cause it not to be considered a possible risk factor. In conclusion, the relationship between the increase in DR associated with the risk factors present in different populations, the limited research conducted in Latin America, and the cultural, social, economic, and genetic differences makes for a complex condition, which reflects the necessity of researching in a more integrated way.
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Affiliation(s)
- Oscar Vivanco-Rojas
- Department of Biochemistry, Faculty of Medicine, Universidad Nacional Autónoma de México, Av. Universidad 3000, Mexico City 04510, Mexico; (O.V.-R.); (S.L.-L.)
- Cell and Tissue Biology, Research Unit, Institute of Ophthalmology, Conde de Valenciana, Chimalpopoca 14, Mexico City 06800, Mexico; (V.L.-A.); (F.S.M.-G.); (B.B.-V.)
| | - Sonia López-Letayf
- Department of Biochemistry, Faculty of Medicine, Universidad Nacional Autónoma de México, Av. Universidad 3000, Mexico City 04510, Mexico; (O.V.-R.); (S.L.-L.)
- Cell and Tissue Biology, Research Unit, Institute of Ophthalmology, Conde de Valenciana, Chimalpopoca 14, Mexico City 06800, Mexico; (V.L.-A.); (F.S.M.-G.); (B.B.-V.)
| | - Valentina Londoño-Angarita
- Cell and Tissue Biology, Research Unit, Institute of Ophthalmology, Conde de Valenciana, Chimalpopoca 14, Mexico City 06800, Mexico; (V.L.-A.); (F.S.M.-G.); (B.B.-V.)
| | - Fátima Sofía Magaña-Guerrero
- Cell and Tissue Biology, Research Unit, Institute of Ophthalmology, Conde de Valenciana, Chimalpopoca 14, Mexico City 06800, Mexico; (V.L.-A.); (F.S.M.-G.); (B.B.-V.)
| | - Beatriz Buentello-Volante
- Cell and Tissue Biology, Research Unit, Institute of Ophthalmology, Conde de Valenciana, Chimalpopoca 14, Mexico City 06800, Mexico; (V.L.-A.); (F.S.M.-G.); (B.B.-V.)
| | - Yonathan Garfias
- Department of Biochemistry, Faculty of Medicine, Universidad Nacional Autónoma de México, Av. Universidad 3000, Mexico City 04510, Mexico; (O.V.-R.); (S.L.-L.)
- Cell and Tissue Biology, Research Unit, Institute of Ophthalmology, Conde de Valenciana, Chimalpopoca 14, Mexico City 06800, Mexico; (V.L.-A.); (F.S.M.-G.); (B.B.-V.)
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21
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Lu Y, Wang W, Liu J, Xie M, Liu Q, Li S. Vascular complications of diabetes: A narrative review. Medicine (Baltimore) 2023; 102:e35285. [PMID: 37800828 PMCID: PMC10553000 DOI: 10.1097/md.0000000000035285] [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: 05/31/2023] [Accepted: 08/28/2023] [Indexed: 10/07/2023] Open
Abstract
Diabetes mellitus is a complex chronic metabolic disease characterized by hyperglycemia and various complications. According to the different pathophysiological mechanisms, these complications can be classified as microvascular or macrovascular complications, which have long-term negative effects on vital organs such as the eyes, kidneys, heart, and brain, and lead to increased patient mortality. Diabetes mellitus is a major global health issue, and its incidence and prevalence have increased significantly in recent years. Moreover, the incidence is expected to continue to rise as more people adopt a Western lifestyle and diet. Thus, it is essential to understand the epidemiology, pathogenesis, risk factors, and treatment of vascular complications to aid patients in managing the disease effectively. This paper provides a comprehensive review of the literature to clarify the above content. Furthermore, this paper also delves into the correlation between novel risk factors, such as long noncoding RNAs, gut microbiota, and nonalcoholic fatty liver disease, with diabetic vascular complications.
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Affiliation(s)
- Yongxia Lu
- Department of Endocrinology and Metabolism, Chengdu Seventh People’s Hospital, Chengdu, China
| | - Wei Wang
- Department of Endocrinology and Metabolism, Chengdu Seventh People’s Hospital, Chengdu, China
| | - Jingyu Liu
- Department of Endocrinology and Metabolism, Chengdu Seventh People’s Hospital, Chengdu, China
| | - Min Xie
- Department of Cardiovascular Medicine, Chengdu Seventh People’s Hospital, Chengdu, China
| | - Qiang Liu
- Department of Endocrinology and Metabolism, Chengdu Seventh People’s Hospital, Chengdu, China
| | - Sufang Li
- Department of Endocrinology and Metabolism, Chengdu Seventh People’s Hospital, Chengdu, China
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22
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Liu WJ, Chen JY, Niu SR, Zheng YS, Lin S, Hong Y. Recent advances in the study of circadian rhythm disorders that induce diabetic retinopathy. Biomed Pharmacother 2023; 166:115368. [PMID: 37647688 DOI: 10.1016/j.biopha.2023.115368] [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: 05/06/2023] [Revised: 08/18/2023] [Accepted: 08/22/2023] [Indexed: 09/01/2023] Open
Abstract
Diabetic retinopathy (DR) is a severe microvascular complication of diabetes mellitus and a major cause of blindness in young adults. Multiple potential factors influence DR; however, the exact mechanisms are poorly understood. Advanced treatments for DR, including laser therapy, vitrectomy, and intraocular drug injections, slow the disease's progression but fail to cure or reverse visual impairment. Therefore, additional effective methods to prevent and treat DR are required. The biological clock plays a crucial role in maintaining balance in the circadian rhythm of the body. Poor lifestyle habits, such as irregular routines and high-fat diets, may disrupt central and limbic circadian rhythms. Disrupted circadian rhythms can result in altered glucose metabolism and obesity. Misaligned central and peripheral clocks lead to a disorder of the rhythm of glucose metabolism, and chronically high sugar levels lead to the development of DR. We observed a disturbance in clock function in patients with diabetes, and a misaligned clock could accelerate the development of DR. In the current study, we examine the relationship between circadian rhythm disorders, diabetes, and DR. We conclude that: 1) abnormal function of the central clock and peripheral clock leads to abnormal glucose metabolism, further causing DR and 2) diabetes causes abnormal circadian rhythms, further exacerbating DR. Thus, our study presents new insights into the prevention and treatment of DR.
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Affiliation(s)
- Wen-Jing Liu
- Department of Ophthalmology, the Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province 362000, China; Centre of Neurological and Metabolic Research, the Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province 362000, China
| | - Jie-Yu Chen
- Department of Ophthalmology, the Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province 362000, China; Centre of Neurological and Metabolic Research, the Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province 362000, China
| | - Si-Ru Niu
- Department of Ophthalmology, the Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province 362000, China; Centre of Neurological and Metabolic Research, the Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province 362000, China
| | - Yi-Sha Zheng
- Department of Ophthalmology, the Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province 362000, China; Centre of Neurological and Metabolic Research, the Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province 362000, China
| | - Shu Lin
- Centre of Neurological and Metabolic Research, the Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province 362000, China; Group of Neuroendocrinology, Garvan Institute of Medical Research, 384 Victoria St, Sydney, Australia.
| | - Yu Hong
- Department of Ophthalmology, the Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province 362000, China; Centre of Neurological and Metabolic Research, the Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province 362000, China.
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23
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Satyadev N, Rivera MI, Nikolov NK, Fakoya AOJ. Exosomes as biomarkers and therapy in type 2 diabetes mellitus and associated complications. Front Physiol 2023; 14:1241096. [PMID: 37745252 PMCID: PMC10515224 DOI: 10.3389/fphys.2023.1241096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 08/23/2023] [Indexed: 09/26/2023] Open
Abstract
Type 2 diabetes mellitus (T2DM) is one of the most prevalent metabolic disorders worldwide. However, T2DM still remains underdiagnosed and undertreated resulting in poor quality of life and increased morbidity and mortality. Given this ongoing burden, researchers have attempted to locate new therapeutic targets as well as methodologies to identify the disease and its associated complications at an earlier stage. Several studies over the last few decades have identified exosomes, small extracellular vesicles that are released by cells, as pivotal contributors to the pathogenesis of T2DM and its complications. These discoveries suggest the possibility of novel detection and treatment methods. This review provides a comprehensive presentation of exosomes that hold potential as novel biomarkers and therapeutic targets. Additional focus is given to characterizing the role of exosomes in T2DM complications, including diabetic angiopathy, diabetic cardiomyopathy, diabetic nephropathy, diabetic peripheral neuropathy, diabetic retinopathy, and diabetic wound healing. This study reveals that the utilization of exosomes as diagnostic markers and therapies is a realistic possibility for both T2DM and its complications. However, the majority of the current research is limited to animal models, warranting further investigation of exosomes in clinical trials. This review represents the most extensive and up-to-date exploration of exosomes in relation to T2DM and its complications.
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Affiliation(s)
- Nihal Satyadev
- Department of Neurology, Mayo Clinic Florida, Jacksonville, FL, United States
| | - Milagros I. Rivera
- University of Medicine and Health Sciences, Basseterre, St. Kitts and Nevis
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24
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Buonfiglio F, Böhm EW, Pfeiffer N, Gericke A. Oxidative Stress: A Suitable Therapeutic Target for Optic Nerve Diseases? Antioxidants (Basel) 2023; 12:1465. [PMID: 37508003 PMCID: PMC10376185 DOI: 10.3390/antiox12071465] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/17/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
Optic nerve disorders encompass a wide spectrum of conditions characterized by the loss of retinal ganglion cells (RGCs) and subsequent degeneration of the optic nerve. The etiology of these disorders can vary significantly, but emerging research highlights the crucial role of oxidative stress, an imbalance in the redox status characterized by an excess of reactive oxygen species (ROS), in driving cell death through apoptosis, autophagy, and inflammation. This review provides an overview of ROS-related processes underlying four extensively studied optic nerve diseases: glaucoma, Leber's hereditary optic neuropathy (LHON), anterior ischemic optic neuropathy (AION), and optic neuritis (ON). Furthermore, we present preclinical findings on antioxidants, with the objective of evaluating the potential therapeutic benefits of targeting oxidative stress in the treatment of optic neuropathies.
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Affiliation(s)
- Francesco Buonfiglio
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany; (E.W.B.); (N.P.)
| | | | | | - Adrian Gericke
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany; (E.W.B.); (N.P.)
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25
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Fernández-Carneado J, Almazán-Moga A, Ramírez-Lamelas DT, Cuscó C, Alonso de la Fuente JI, Pastor JC, López Gálvez MI, Ponsati B. Quantification of Microvascular Lesions in the Central Retinal Field: Could It Predict the Severity of Diabetic Retinopathy? J Clin Med 2023; 12:3948. [PMID: 37373641 DOI: 10.3390/jcm12123948] [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: 03/24/2023] [Revised: 06/01/2023] [Accepted: 06/02/2023] [Indexed: 06/29/2023] Open
Abstract
Diabetic retinopathy (DR) is a neurodegenerative disease characterized by the presence of microcirculatory lesions. Among them, microaneurysms (MAs) are the first observable hallmark of early ophthalmological changes. The present work aims to study whether the quantification of MAs, hemorrhages (Hmas) and hard exudates (HEs) in the central retinal field could have a predictive value on DR severity. These retinal lesions were quantified in a single field NM-1 of 160 retinographies of diabetic patients from the IOBA's reading center. Samples included different disease severity levels and excluded proliferating forms: no DR (n = 30), mild non-proliferative (n = 30), moderate (n = 50) and severe (n = 50). Quantification of MAs, Hmas, and HEs revealed an increasing trend as DR severity progresses. Differences between severity levels were statistically significant, suggesting that the analysis of the central field provides valuable information on severity level and could be used as a clinical tool to assess DR grading in the eyecare routine. Even though further validation is needed, counting microvascular lesions in a single retinal field can be proposed as a rapid screening system to classify DR patients with different stages of severity according to the international classification.
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Affiliation(s)
- Jimena Fernández-Carneado
- BCN Peptides, S.A., Polígon Industrial Els Vinyets-Els Fogars II, 08777 Sant Quintí de Mediona, Barcelona, Spain
| | - Ana Almazán-Moga
- BCN Peptides, S.A., Polígon Industrial Els Vinyets-Els Fogars II, 08777 Sant Quintí de Mediona, Barcelona, Spain
| | - Dolores T Ramírez-Lamelas
- BCN Peptides, S.A., Polígon Industrial Els Vinyets-Els Fogars II, 08777 Sant Quintí de Mediona, Barcelona, Spain
| | - Cristina Cuscó
- BCN Peptides, S.A., Polígon Industrial Els Vinyets-Els Fogars II, 08777 Sant Quintí de Mediona, Barcelona, Spain
| | | | - J Carlos Pastor
- IOBA Reading Center, University of Valladolid, Paseo de Belén, 17, 47011 Valladolid, Spain
| | | | - Berta Ponsati
- BCN Peptides, S.A., Polígon Industrial Els Vinyets-Els Fogars II, 08777 Sant Quintí de Mediona, Barcelona, Spain
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26
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Wang E, Feng B, Chakrabarti S. MicroRNA 9 Is a Regulator of Endothelial to Mesenchymal Transition in Diabetic Retinopathy. Invest Ophthalmol Vis Sci 2023; 64:13. [PMID: 37279396 PMCID: PMC10249683 DOI: 10.1167/iovs.64.7.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 05/23/2023] [Indexed: 06/08/2023] Open
Abstract
Purpose Diabetic retinopathy (DR) is a significant cause of blindness. Most research around DR focus on late-stage developments rather than early changes such as early endothelial dysfunction. Endothelial-to-mesenchymal transition (EndMT), an epigenetically regulated process whereby endothelial cells lose endothelial characteristics and adopt mesenchymal-like phenotypes, contributes to early endothelial changes in DR. The epigenetic regulator microRNA 9 (miR-9) is suppressed in the eyes during DR. MiR-9 plays a role in various diseases and regulates EndMT-related processes in other organs. We investigated the role miR-9 plays in glucose-induced EndMT in DR. Methods We examined the effects of glucose on miR-9 and EndMT using human retinal endothelial cells (HRECs). We then used HRECs and an endothelial-specific miR-9 transgenic mouse line to investigate the effect of miR-9 on glucose-induced EndMT. Finally, we used HRECs to probe the mechanisms through which miR-9 may regulate EndMT. Results We found that miR-9 inhibition was both necessary and sufficient for glucose-induced EndMT. Overexpression of miR-9 prevented glucose-induced EndMT, whereas suppressing miR-9 caused glucose-like EndMT changes. We also found that preventing EndMT with miR-9 overexpression improved retinal vascular leakage in DR. Finally, we showed that miR-9 regulates EndMT at an early stage by regulating EndMT-inducing signals such as proinflammatory and TGF-β pathways. Conclusions We have shown that miR-9 is an important regulator of EndMT in DR, potentially making it a good target for RNA-based therapy in early DR.
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Affiliation(s)
- Eric Wang
- Department of Pathology and Laboratory Medicine, Western University, London, Ontario, Canada
| | - Biao Feng
- Department of Pathology and Laboratory Medicine, Western University, London, Ontario, Canada
| | - Subrata Chakrabarti
- Department of Pathology and Laboratory Medicine, Western University, London, Ontario, Canada
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27
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Kovács-Valasek A, Rák T, Pöstyéni E, Csutak A, Gábriel R. Three Major Causes of Metabolic Retinal Degenerations and Three Ways to Avoid Them. Int J Mol Sci 2023; 24:ijms24108728. [PMID: 37240082 DOI: 10.3390/ijms24108728] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 05/10/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023] Open
Abstract
An imbalance of homeostasis in the retina leads to neuron loss and this eventually results in a deterioration of vision. If the stress threshold is exceeded, different protective/survival mechanisms are activated. Numerous key molecular actors contribute to prevalent metabolically induced retinal diseases-the three major challenges are age-related alterations, diabetic retinopathy and glaucoma. These diseases have complex dysregulation of glucose-, lipid-, amino acid or purine metabolism. In this review, we summarize current knowledge on possible ways of preventing or circumventing retinal degeneration by available methods. We intend to provide a unified background, common prevention and treatment rationale for these disorders and identify the mechanisms through which these actions protect the retina. We suggest a role for herbal medicines, internal neuroprotective substances and synthetic drugs targeting four processes: parainflammation and/or glial cell activation, ischemia and related reactive oxygen species and vascular endothelial growth factor accumulation, apoptosis and/or autophagy of nerve cells and an elevation of ocular perfusion pressure and/or intraocular pressure. We conclude that in order to achieve substantial preventive or therapeutic effects, at least two of the mentioned pathways should be targeted synergistically. A repositioning of some drugs is considered to use them for the cure of the other related conditions.
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Affiliation(s)
- Andrea Kovács-Valasek
- Department of Experimental Zoology and Neurobiology, University of Pécs, Ifjúság útja 6, 7624 Pécs, Hungary
| | - Tibor Rák
- Department of Ophthalmology, Medical School, University of Pécs, Szigeti út 12, 7624 Pécs, Hungary
| | - Etelka Pöstyéni
- Department of Experimental Zoology and Neurobiology, University of Pécs, Ifjúság útja 6, 7624 Pécs, Hungary
| | - Adrienne Csutak
- Department of Ophthalmology, Medical School, University of Pécs, Szigeti út 12, 7624 Pécs, Hungary
| | - Robert Gábriel
- Department of Experimental Zoology and Neurobiology, University of Pécs, Ifjúság útja 6, 7624 Pécs, Hungary
- János Szentágothai Research Centre, University of Pécs, Ifjúság útja 20, 7624 Pécs, Hungary
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Lee GI, Han K, Park KA, Oh SY. Risk of optic neuritis in type 2 diabetes mellitus: A nationwide cohort study. J Neurol Sci 2023; 450:120673. [PMID: 37201268 DOI: 10.1016/j.jns.2023.120673] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 04/12/2023] [Accepted: 05/06/2023] [Indexed: 05/20/2023]
Abstract
BACKGROUND/PURPOSE This study aimed to investigate the association between the time course of type 2 diabetes mellitus (DM) and the development of optic neuritis (ON) in the Korean population aged 20 years and older. METHODS A total of 10,069,044 subjects were included in this study, which utilized stratified random sampling from the national cohort. The hazard ratios (HRs) for incident ON were compared between subjects with normal fasting glucose (NFG) levels, impaired fasting glucose (IFG) levels, patients with new-onset DM, diabetes duration of fewer than 5 years (early DM), and diabetes duration of 5 years or more (late DM). In addition, the HR for incident ON was assessed and stratified into 20 fasting glucose levels. RESULTS The cumulative incidence and HR for ON demonstrated a significant increase across the time course of diabetes (adjusted hazard ratio [aHR] = 1.05, 95% confidence interval [CI]: 1.00 to 1.10 for IFG; aHR = 1.31, 95% CI: 1.19 to 1.44 for new-onset DM; aHR = 1.46, 95% CI: 1.32 to 1.60 for early DM; and aHR = 1.92, 95% CI: 1.77 to 2.08 for late DM). Moreover, the HR for ON was 1.71-fold higher in individuals with fasting glucose levels of 132 mg/dL or more compared to those with levels below 75 mg/dL. CONCLUSION In this nationwide cohort study, the risk of ON was found to increase with the time course of diabetes and elevated glucose levels. These results suggest that efforts to regulate glucose levels and prevent DM progression could reduce the risk of ON.
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Affiliation(s)
- Ga-In Lee
- Hangil Eye Hospital, Incheon, Republic of Korea; Department of Ophthalmology, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Kyung-Ah Park
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
| | - Sei Yeul Oh
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
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Zhou J, Chen B. Retinal Cell Damage in Diabetic Retinopathy. Cells 2023; 12:1342. [PMID: 37174742 PMCID: PMC10177610 DOI: 10.3390/cells12091342] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 05/05/2023] [Accepted: 05/06/2023] [Indexed: 05/15/2023] Open
Abstract
Diabetic retinopathy (DR), the most common microvascular complication that occurs in diabetes mellitus (DM), is the leading cause of vision loss in working-age adults. The prevalence of diabetic retinopathy is approximately 30% of the diabetic population and untreated DR can eventually cause blindness. For decades, diabetic retinopathy was considered a microvascular complication and clinically staged by its vascular manifestations. In recent years, emerging evidence has shown that diabetic retinopathy causes early neuronal dysfunction and neurodegeneration that may precede vascular pathology and affect retinal neurons as well as glial cells. This knowledge leads to new therapeutic strategies aiming to prevent dysfunction of retinal neurons at the early stage of DR. Early detection and timely treatment to protect retinal neurons are critical to preventing visual loss in DR. This review provides an overview of DR and the structural and functional changes associated with DR, and discusses neuronal degeneration during diabetic retinopathy, the mechanisms underlying retinal neurodegeneration and microvascular complications, and perspectives on current and future clinic therapies.
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Affiliation(s)
| | - Bo Chen
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
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30
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Ansari-Mohseni N, Ghorani-Azam A, Mohajeri SA. Therapeutic effects of herbal medicines in different types of retinopathies: A systematic review. AVICENNA JOURNAL OF PHYTOMEDICINE 2023; 13:118-142. [PMID: 37333471 PMCID: PMC10274316 DOI: 10.22038/ajp.2022.62423.2977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 04/13/2022] [Indexed: 06/20/2023]
Abstract
Objective Retinopathy is an ocular manifestation of systemic diseases such as diabetes and vascular diseases. Herbal drugs have been considered as an effective therapeutic option with minimal side effects for the treatment of retinopathy by reducing the symptoms and improving visual acuity. The purpose of this systematic review was to collect studies on the effectiveness of medicinal plants in the treatment or prevention of retinopathy. Materials and Methods A systematic literature search was performed in PubMed, Scopus, Google Scholar, and other databases in April 2021 using "herbal products" and "Retinopathy" with all their equivalent and similar terms. For this purpose, human clinical trials with the English language were included and articles with subject irrelevancy were excluded from further evaluation. Results Overall, 30 articles with 2324 patients were studied for possible effects of herbal therapy on retinopathy. From 30 included articles, different herbal products had been evaluated. Out of 30 selected articles, 11 articles were for the treatment of age-related macular degeneration (AMD), 14 articles covered patients with diabetic retinopathy, and the other five studies were for other retinal disorders. The outcomes in majority of the studies include changes in visual acuity (VA), fundus performance, best-corrected visual acuity (BCVA), central macular thickness (CMT), focal electroretinogram (fERG), supplements and adjuvant medications appeared to be more beneficial in patients with AMD and diabetic maculopathy. Conclusion Herbal therapy can be considered as a potential candidate in the adjuvant and complementary therapies of retinopathy. However, further studies are required to verify such efficiency.
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Affiliation(s)
- Negin Ansari-Mohseni
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
- Equal first author
| | - Adel Ghorani-Azam
- Department of Forensic Medicine and Toxicology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
- Equal first author
| | - Seyed Ahmad Mohajeri
- Pharmacetical Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
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Sood A, Baishnab S, Gautam I, Choudhary P, Lang DK, Jaura RS, Singh TG. Exploring various novel diagnostic and therapeutic approaches in treating diabetic retinopathy. Inflammopharmacology 2023; 31:773-786. [PMID: 36745243 DOI: 10.1007/s10787-023-01143-x] [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: 07/19/2022] [Accepted: 01/20/2023] [Indexed: 02/07/2023]
Abstract
Diabetic retinopathy is regarded as a common manifestation of diabetes mellitus, being a prominent cause of visual impairment and blindness. This microvascular complication is marked by the appearance of microaneurysms, elevated vascular permeability, capillary blockage, and proliferation of neovasculature. The etiology behind retinopathy is ambiguous and the efficacy of current treatment strategies is minimal. Early diagnosis of this complication using a biomarker with high sensitivity and specificity is very essential for providing better therapeutic strategies. The current available therapeutic options are limited with various adverse effects. Laser treatment is not beneficial in all the situations, economic constraints being the major challenge. Surgical interventions are employed when pharmacotherapy and laser treatment fail. New pharmacological treatments are becoming a necessity for treating the condition. This review highlights the use of various diagnostic tools, emerging biomarkers for early detection of diabetic retinopathy, pathological mechanisms associated with the disease, current therapeutic approaches used and future strategies for more enhanced treatment options and more potent pharmacological actions.
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Affiliation(s)
- Ankita Sood
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
| | - Suman Baishnab
- Chitkara College of Pharmacy, Chitkara University, Punjab, India.
| | - Isha Gautam
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
| | - Priya Choudhary
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
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Dauth A, Bręborowicz A, Ruan Y, Tang Q, Zadeh JK, Böhm EW, Pfeiffer N, Khedkar PH, Patzak A, Vujacic-Mirski K, Daiber A, Gericke A. Sulodexide Prevents Hyperglycemia-Induced Endothelial Dysfunction and Oxidative Stress in Porcine Retinal Arterioles. Antioxidants (Basel) 2023; 12:antiox12020388. [PMID: 36829947 PMCID: PMC9952154 DOI: 10.3390/antiox12020388] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 01/27/2023] [Accepted: 02/02/2023] [Indexed: 02/09/2023] Open
Abstract
Diabetes mellitus may cause severe damage to retinal blood vessels. The central aim of this study was to test the hypothesis that sulodexide, a mixture of glycosaminoglycans, has a protective effect against hyperglycemia-induced endothelial dysfunction in the retina. Functional studies were performed in isolated porcine retinal arterioles. Vessels were cannulated and incubated with highly concentrated glucose solution (HG, 25 mM D-glucose) +/- sulodexide (50/5/0.5 μg/mL) or normally concentrated glucose solution (NG, 5.5 mM D-glucose) +/- sulodexide for two hours. Endothelium-dependent and endothelium-independent vasodilatation were measured by videomicroscopy. Reactive oxygen species (ROS) were quantified by dihydroethidium (DHE) fluorescence. Using high-pressure liquid chromatography (HPLC), the intrinsic antioxidant properties of sulodexide were investigated. Quantitative PCR was used to determine mRNA expression of regulatory, inflammatory, and redox genes in retinal arterioles, some of which were subsequently quantified at the protein level by immunofluorescence microscopy. Incubation of retinal arterioles with HG caused significant impairment of endothelium-dependent vasodilation, whereas endothelium-independent responses were not affected. In the HG group, ROS formation was markedly increased in the vascular wall. Strikingly, sulodexide had a protective effect against hyperglycemia-induced ROS formation in the vascular wall and had a concentration-dependent protective effect against endothelial dysfunction. Although sulodexide itself had only negligible antioxidant properties, it prevented hyperglycemia-induced overexpression of the pro-oxidant redox enzymes, NOX4 and NOX5. The data of the present study provide evidence that sulodexide has a protective effect against hyperglycemia-induced oxidative stress and endothelial dysfunction in porcine retinal arterioles, possibly by modulation of redox enzyme expression.
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Affiliation(s)
- Alice Dauth
- Department of Neurosurgery, University Medical Center, Johannes Gutenberg University, Langenbeckstr. 1, 55131 Mainz, Germany
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University, Langenbeckstr. 1, 55131 Mainz, Germany
- Correspondence:
| | - Andrzej Bręborowicz
- Department of Pathophysiology, Poznań University of Medical Sciences, 60-512 Poznań, Poland
| | - Yue Ruan
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Qi Tang
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Jenia K. Zadeh
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University, Langenbeckstr. 1, 55131 Mainz, Germany
- AbbVie Germany GmbH & Co. KG, 65189 Wiesbaden, Germany
| | - Elsa W. Böhm
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Pratik H. Khedkar
- Institute of Translational Physiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Andreas Patzak
- Institute of Translational Physiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Ksenija Vujacic-Mirski
- Department of Cardiology, Cardiology 1, University Medical Center, Johannes Gutenberg University, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Andreas Daiber
- Department of Cardiology, Cardiology 1, University Medical Center, Johannes Gutenberg University, Langenbeckstr. 1, 55131 Mainz, Germany
- Partner Site Rhine-Main, German Center for Cardiovascular Research (DZHK), 55131 Mainz, Germany
| | - Adrian Gericke
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University, Langenbeckstr. 1, 55131 Mainz, Germany
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Chen T, Wang F, Wei J, Feng L. Extracellular vesicles derived from different sources play various roles in diabetic retinopathy. Front Endocrinol (Lausanne) 2023; 13:1064415. [PMID: 36686474 PMCID: PMC9845915 DOI: 10.3389/fendo.2022.1064415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 12/13/2022] [Indexed: 01/05/2023] Open
Abstract
Extracellular vesicles (EVs) are present in almost all biological fluids and secreted by almost all cell types. A growing number of studies have revealed the potential roles of EVs in the diagnosis and treatment of the diabetic retinopathy (DR). Changes in the quantity and content of EVs may serve as biomarkers of cause or consequence of pathological status of DR, such as inflammation, neovascularization and epithelial-mesenchymal transition. In addition, as natural, safe and efficient drug carrier, EVs have been reported to play important roles in intercellular communication by acting for essential cell-specific information to target cells. In this review, we summarize the roles of EVs, secreted by various types of cells and participated in various biological processes, in the pathogenesis, diagnosis, and treatment of DR.
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Affiliation(s)
| | | | | | - Le Feng
- Department of Ophthalmology, Shanghai Tenth People’s Hospital Affiliated to Tongji University School of Medicine, Shanghai, China
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34
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Huang Y, Ma JH, Peng Y, Yang X, Chen J, Tang S. Methods for Analyzing the Gut Microbiota in Diabetic Retinopathy. Methods Mol Biol 2023; 2678:147-155. [PMID: 37326710 DOI: 10.1007/978-1-0716-3255-0_10] [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] [Indexed: 06/17/2023]
Abstract
The gut microbiome that inhabits human hosts plays an important role in the development of a healthy host immune system. Many studies have shown that gut microbiota is involved in the occurrence and development of diabetic retinopathy (DR). With the advent of sequencing technology of the bacterial 16S ribosomal RNA (rRNA) gene, microbiota studies are becoming more feasible. Here, we described a study protocol to characterize the microbiota composite in the DR and non-DR patients compared with healthy controls.
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Affiliation(s)
- Yinhua Huang
- Aier School of Ophthalmology, Central South University, Changsha, Hunan Province, People's Republic of China
- Aier Eye Institute, Changsha, Hunan Province, People's Republic of China
| | - Jacey Hongjie Ma
- Aier Eye Institute, Changsha, Hunan Province, People's Republic of China
| | - Yanfang Peng
- Aier Eye Institute, Changsha, Hunan Province, People's Republic of China
| | - Xu Yang
- Aier Eye Institute, Changsha, Hunan Province, People's Republic of China
| | - Jiansu Chen
- Aier School of Ophthalmology, Central South University, Changsha, Hunan Province, People's Republic of China
- Aier Eye Institute, Changsha, Hunan Province, People's Republic of China
- Changsha Aier Eye Hospital, Changsha, Hunan Province, People's Republic of China
| | - Shibo Tang
- Aier School of Ophthalmology, Central South University, Changsha, Hunan Province, People's Republic of China.
- Aier Eye Institute, Changsha, Hunan Province, People's Republic of China.
- Changsha Aier Eye Hospital, Changsha, Hunan Province, People's Republic of China.
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35
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Yue T, Shi Y, Luo S, Weng J, Wu Y, Zheng X. The role of inflammation in immune system of diabetic retinopathy: Molecular mechanisms, pathogenetic role and therapeutic implications. Front Immunol 2022; 13:1055087. [PMID: 36582230 PMCID: PMC9792618 DOI: 10.3389/fimmu.2022.1055087] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 11/25/2022] [Indexed: 12/15/2022] Open
Abstract
Diabetic retinopathy is one of the most common complications of diabetes mellitus and the leading cause of low vision and blindness worldwide. Mounting evidence demonstrates that inflammation is a key mechanism driving diabetes-associated retinal disturbance, yet the pathophysiological process and molecular mechanisms of inflammation underlying diabetic retinopathy are not fully understood. Cytokines, chemokines, and adhesion molecules interact with each other to form a complex molecular network that propagates the inflammatory and pathological cascade of diabetic retinopathy. Therefore, it is important to understand and elucidate inflammation-related mechanisms behind diabetic retinopathy progression. Here, we review the current understanding of the pathology and pathogenesis of inflammation in diabetic retinopathy. In addition, we also summarize the relevant clinical trials to further suggest inflammation-targeted therapeutics for prevention and management of diabetic retinopathy.
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Affiliation(s)
- Tong Yue
- Department of Endocrinology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Yu Shi
- Department of Endocrinology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Sihui Luo
- Department of Endocrinology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Jianping Weng
- Department of Endocrinology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Yali Wu
- Department of Ophthalmology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China,*Correspondence: Yali Wu, ; Xueying Zheng,
| | - Xueying Zheng
- Department of Endocrinology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China,*Correspondence: Yali Wu, ; Xueying Zheng,
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Akintunde JK, Abinu OS, Taiwo KF, Sodiq RA, Folayan AD, Ate AD. Disorders of Hippocampus Facilitated by Hypertension in Purine Metabolism Deficiency is Repressed by Naringin, a Bi-flavonoid in a Rat Model via NOS/cAMP/PKA and DARPP-32, BDNF/TrkB Pathways. Neurotox Res 2022; 40:2148-2166. [PMID: 36098940 DOI: 10.1007/s12640-022-00578-4] [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: 06/27/2022] [Revised: 06/27/2022] [Accepted: 09/02/2022] [Indexed: 01/04/2023]
Abstract
Individuals who are hypertensive have a higher tendency of predisposition to other genetic diseases including purine metabolism deficiency. Therefore, the search for nontoxic and effective chemo protective agents to abrogate hypertension-mediated genetic disease is vital. This study therefore investigated the repressive effect of naringin (NAR) against disorder of hippocampus facilitated by hypertension in purine metabolism deficiency. Male albino rats randomly assigned into nine groups (n = 7) were treated for 35 days. Group I: control animals, Group II was treated with 100 mg/kg KBrO3, Group III was treated with 250 mg/kg caffeine, and Group IV was treated with 100 mg/kg KBrO3 + 250 mg/kg caffeine. Group V was administered with 100 mg/kg KBrO3 + 100 mg/kg haloperidol. Group VI was administered with 100 mg/kg KBrO3 + 50 mg/kg NAR. Group VII was administered with 250 mg/kg caffeine + 50 mg/kg NAR, and Group VIII was administered with 100 mg/kg KBrO3 + 250 mg/kg caffeine + 50 mg/kg NAR. Finally, group IX was treated with 50 mg/kg NAR. The sub-acute exposure to KBrO3 and CAF induced hypertension and mediated impairment in the hippocampus cells. This was apparent by the increase in PDE-51, arginase, and enzymes of ATP hydrolysis (ATPase and AMPase) with a simultaneous increase in cholinergic (AChE and BuChE) and adenosinergic (ADA) enzymes. The hypertensive-mediated hippocampal impairment was associated to alteration of NO and AC signaling coupled with lower expression of brain-derived neurotrophic factor and its receptor (BDNF-TrkB), down regulation of Bcl11b and DARPP-32 which are neurodevelopmental proteins, and hypoxanthine accumulation. However, these features of CAF-mediated hippocampal damage in KBrO3-induced hypertensive rats were repressed by post-treatment with NAR via production of neuro-inflammatory mediators, attenuation of biochemical alterations, stabilizing neurotransmitter enzymes, regulating NOS/cAMP/PKA and DARPP-32, BDNF/TrkB signaling, and restoring hippocampal tissues.
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Affiliation(s)
- J K Akintunde
- Applied Biochemistry and Molecular Toxicology Research Group, Department of Biochemistry, College of Biosciences, Federal University of Agriculture, Abeokuta, Nigeria.
| | - O S Abinu
- Applied Biochemistry and Molecular Toxicology Research Group, Department of Biochemistry, College of Biosciences, Federal University of Agriculture, Abeokuta, Nigeria
| | - K F Taiwo
- Applied Biochemistry and Molecular Toxicology Research Group, Department of Biochemistry, College of Biosciences, Federal University of Agriculture, Abeokuta, Nigeria
| | - R A Sodiq
- Applied Biochemistry and Molecular Toxicology Research Group, Department of Biochemistry, College of Biosciences, Federal University of Agriculture, Abeokuta, Nigeria
| | - A D Folayan
- Applied Biochemistry and Molecular Toxicology Research Group, Department of Biochemistry, College of Biosciences, Federal University of Agriculture, Abeokuta, Nigeria
| | - A D Ate
- Applied Biochemistry and Molecular Toxicology Research Group, Department of Biochemistry, College of Biosciences, Federal University of Agriculture, Abeokuta, Nigeria
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37
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Kang Q, Dai H, Jiang S, Yu L. Advanced glycation end products in diabetic retinopathy and phytochemical therapy. Front Nutr 2022; 9:1037186. [PMID: 36466410 PMCID: PMC9716030 DOI: 10.3389/fnut.2022.1037186] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 10/31/2022] [Indexed: 10/12/2023] Open
Abstract
Advanced glycation end products (AGEs) are generated by the nonenzymatic glycation of proteins or lipids. Diabetic retinopathy (DR) is one common complication in patients with diabetes. The accumulation of AGEs in retinal cells is strongly associated with the development of DR. AGEs can induce the breakdown of redox balance and then cause oxidative stress in retinal cells, exerting cytopathic effects in the progression of DR. The interaction between AGEs and the receptor for AGE (RAGE) is involved in multiple cellular pathological alterations in the retina. This review is to elucidate the pathogenetic roles of AGEs in the progression of DR, including metabolic abnormalities, lipid peroxidation, structural and functional alterations, and neurodegeneration. In addition, disorders associated with AGEs can be used as potential therapeutic targets to explore effective and safe treatments for DR. In this review, we have also introduced antioxidant phytochemicals as potential therapeutic strategies for the treatment of DR.
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Affiliation(s)
- Qingzheng Kang
- Department of Hematology and Oncology, International Cancer Center, Shenzhen Key Laboratory, Shenzhen University General Hospital, Shenzhen University Clinical Medical Academy, Shenzhen University Health Science Center, Shenzhen University, Shenzhen, China
| | - Haiyu Dai
- School of Medicine, Shenzhen University, Shenzhen, China
| | - Suwei Jiang
- School of Medicine, Shenzhen University, Shenzhen, China
| | - Li Yu
- Department of Hematology and Oncology, International Cancer Center, Shenzhen Key Laboratory, Shenzhen University General Hospital, Shenzhen University Clinical Medical Academy, Shenzhen University Health Science Center, Shenzhen University, Shenzhen, China
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38
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Ijaz K, Bahoo MLA, Niaz S, Ahmad HU. Glycated Albumin and Angiopoietin-2: Possible indicators of Diabetic Retinopathy in Type-Two Diabetes. Pak J Med Sci 2022; 38:2202-2207. [PMID: 36415281 PMCID: PMC9676599 DOI: 10.12669/pjms.38.8.5579] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 08/15/2022] [Accepted: 09/06/2022] [Indexed: 01/29/2024] Open
Abstract
OBJECTIVES To compare the levels of glycated albumin and angiopoietin-2 in Type-Two diabetics with and without diabetic retinopathy. METHODS It was a cross-sectional comparative study done at University of Health Sciences, Lahore after collecting data from recruited patients from the outpatient department of Layton Rahmatulla Benevolent Trust Eye Hospital, Lahore from 1st July, 2016 to 30th Aug., 2017. A total of 80 type two diabetics of both genders fulfilling the inclusion criteria were included and divided in two groups based on absence and presence of diabetic retinopathy. Obtained data were analyzed using IBM SPSS for Windows software (version 22). For comparison of both groups, Independent "t" Test or Mann-Whitney U tests were applied accordingly. For correlation of quantitative variables in each group, Spearman rho correlation and Pearson correlation test were applied depending upon normality of data. RESULTS Among 80 type-two diabetics, 42 (52.5%) patients had diabetic retinopathy and 38 (47.5%) were without diabetic retinopathy. Overall, females (62.5%) outnumbered males (37.5%). Both study group were age matched (p=0.45). Mean serum albumin in diabetic retinopathy and non-diabetic retinopathy group was 4.20 ±0.56 gm/dL and 4.43 ±0.39 gm/dL respectively (p=0.031). In diabetic retinopathy group, mean glycated albumin was 1.48 (0.63-1.76) gm/dL and median IQR in non-diabetic retinopathy was 0.52 (0.23-1.10) gm/dL (p=0.003). In diabetic retinopathy group, mean glycated albumin (percent) was 30.71±18.63% and in non-diabetic retinopathy group, the median IQR was 11.80 (5.06-27.25) (p= 0.001). The angiopoietin-2 median IQR in diabetic retinopathy group 5.70 (5.47-5.80) was significantly different (p=0.033) from diabetics without diabetic retinopathy groups 5.40 (4.97-5.60). CONCLUSION Our study reported raised levels of glycated albumin (percent) and angiopoietin-2 in type-two diabetics, highlighting their possible involvement in disease and its progression.
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Affiliation(s)
- Kanwal Ijaz
- Dr. Kanwal Ijaz, MPhil. Assistant Professor, Department of Physiology, Azra Naheed Medical and Dental College, Lahore, Pakistan
| | - Muhammad Luqman Ali Bahoo
- Dr. Muhammad Luqman Ali Bahoo, FCPS, FICO, FACS. Fellowship in Refractive & Corneal Surgery Professor and Head, Department of Ophthalmology, CMH Institute of Medical Sciences, Bahawalpur, Pakistan
| | - Sobia Niaz
- Dr. Sobia Niaz, DCH, MPhil. Associate Professor, Department of Physiology, Gujranwala Medical College, Gujranwala, Pakistan
| | - Hafiz Usman Ahmad
- Hafiz Usman Ahmad, MLT. Department of Physiology and Cell Biology, University of Health Sciences, Lahore, Pakistan
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Ahadi M, Ebrahimi A, Ramin S. Long-Term Outcome of Photobiomodulation for Diabetic Macular Edema: A Case Report. Photobiomodul Photomed Laser Surg 2022; 40:742-746. [DOI: 10.1089/photob.2022.0059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Masoumeh Ahadi
- Optometry and Vision Science, Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Shahrokh Ramin
- Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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40
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Liu H, Stepicheva NA, Ghosh S, Shang P, Chowdhury O, Daley RA, Yazdankhah M, Gupta U, Hose SL, Valapala M, Fitting CS, Strizhakova A, Shan Y, Feenstra D, Sahel JA, Jayagopal A, Handa JT, Zigler JS, Fort PE, Sodhi A, Sinha D. Reducing Akt2 in retinal pigment epithelial cells causes a compensatory increase in Akt1 and attenuates diabetic retinopathy. Nat Commun 2022; 13:6045. [PMID: 36229454 PMCID: PMC9561713 DOI: 10.1038/s41467-022-33773-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 10/03/2022] [Indexed: 01/14/2023] Open
Abstract
The retinal pigment epithelium (RPE) plays an important role in the development of diabetic retinopathy (DR), a leading cause of blindness worldwide. Here we set out to explore the role of Akt2 signaling-integral to both RPE homeostasis and glucose metabolism-to DR. Using human tissue and genetically manipulated mice (including RPE-specific conditional knockout (cKO) and knock-in (KI) mice), we investigate whether Akts in the RPE influences DR in models of diabetic eye disease. We found that Akt1 and Akt2 activities were reciprocally regulated in the RPE of DR donor tissue and diabetic mice. Akt2 cKO attenuated diabetes-induced retinal abnormalities through a compensatory upregulation of phospho-Akt1 leading to an inhibition of vascular injury, inflammatory cytokine release, and infiltration of immune cells mediated by the GSK3β/NF-κB signaling pathway; overexpression of Akt2 has no effect. We propose that targeting Akt1 activity in the RPE may be a novel therapy for treating DR.
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Affiliation(s)
- Haitao Liu
- grid.21925.3d0000 0004 1936 9000Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA USA
| | - Nadezda A. Stepicheva
- grid.21925.3d0000 0004 1936 9000Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA USA
| | - Sayan Ghosh
- grid.21925.3d0000 0004 1936 9000Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA USA
| | - Peng Shang
- grid.21925.3d0000 0004 1936 9000Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA USA ,grid.280881.b0000 0001 0097 5623Present Address: Doheny Eye Institute, Pasadena, CA USA
| | - Olivia Chowdhury
- grid.21925.3d0000 0004 1936 9000Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA USA
| | - Rachel A. Daley
- grid.21925.3d0000 0004 1936 9000Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA USA
| | - Meysam Yazdankhah
- grid.21925.3d0000 0004 1936 9000Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA USA ,grid.443945.b0000 0004 0566 7998Present Address: Neural Stem Cell Institute, Rensselaer, NY USA
| | - Urvi Gupta
- grid.21925.3d0000 0004 1936 9000Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA USA
| | - Stacey L. Hose
- grid.21925.3d0000 0004 1936 9000Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA USA
| | - Mallika Valapala
- grid.411377.70000 0001 0790 959XSchool of Optometry, Indiana University, Bloomington, IN USA
| | - Christopher Scott Fitting
- grid.21925.3d0000 0004 1936 9000Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA USA
| | - Anastasia Strizhakova
- grid.21925.3d0000 0004 1936 9000Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA USA
| | - Yang Shan
- grid.214458.e0000000086837370Kellogg Eye Center, University of Michigan School of Medicine, Ann Arbor, MI USA
| | - Derrick Feenstra
- grid.417570.00000 0004 0374 1269Pharma Research and Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche, Ltd., Basel, Switzerland
| | - José-Alain Sahel
- grid.21925.3d0000 0004 1936 9000Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA USA ,grid.462844.80000 0001 2308 1657Institut de la Vision, INSERM, CNRS, Sorbonne Université, Paris, France
| | | | - James T. Handa
- grid.21107.350000 0001 2171 9311The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - J. Samuel Zigler
- grid.21107.350000 0001 2171 9311The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - Patrice E. Fort
- grid.214458.e0000000086837370Kellogg Eye Center, University of Michigan School of Medicine, Ann Arbor, MI USA
| | - Akrit Sodhi
- grid.21107.350000 0001 2171 9311The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - Debasish Sinha
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. .,The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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Agard NJ, Zhang G, Ridgeway J, Dicara DM, Chu PY, Ohri R, Sanowar S, Vernes JM, Chi H, Zhang J, Holz E, Paluch M, He G, Benson Y, Zhang J, Chan P, Tang N, Javale P, Wilson B, Barrett K, Rowntree RK, Hang J, Meng YG, Hass P, Fuh G, Piskol R, Bantseev V, Loyet KM, Tran JC, Wu C, Indjeian VB, Shivva V, Yan M. Direct Tie2 Agonists Stabilize Vasculature for the Treatment of Diabetic Macular Edema. Transl Vis Sci Technol 2022; 11:27. [PMID: 36255358 PMCID: PMC9587485 DOI: 10.1167/tvst.11.10.27] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose Diabetic macular edema (DME) is the leading cause of vision loss and blindness among working-age adults. Although current intravitreal anti-vascular endothelial growth factor (VEGF) therapies improve vision for many patients with DME, approximately half do not achieve the visual acuity required to drive. We therefore sought additional approaches to resolve edema and improve vision for these patients. Methods We explored direct agonists of Tie2, a receptor known to stabilize vasculature and prevent leakage. We identified a multivalent PEG–Fab conjugate, Tie2.1-hexamer, that oligomerizes Tie2 and drives receptor activation and characterized its activities in vitro and in vivo. Results Tie2.1-hexamer normalized and stabilized intercellular junctions of stressed endothelial cell monolayers in vitro, suppressed vascular leak in mice under conditions where anti-VEGF alone was ineffective, and demonstrated extended ocular exposure and robust pharmacodynamic responses in non-human primates. Conclusions Tie2.1-hexamer directly activates the Tie2 pathway, reduces vascular leak, and is persistent within the vitreal humor. Translational Relevance Our study presents a promising potential therapeutic for the treatment of DME.
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Affiliation(s)
- Nicholas J Agard
- Genentech Research and Early Development, South San Francisco, CA, USA
| | - Gu Zhang
- Genentech Research and Early Development, South San Francisco, CA, USA
| | - John Ridgeway
- Genentech Research and Early Development, South San Francisco, CA, USA
| | - Danielle M Dicara
- Genentech Research and Early Development, South San Francisco, CA, USA
| | - Phillip Y Chu
- Genentech Research and Early Development, South San Francisco, CA, USA
| | - Rachana Ohri
- Genentech Research and Early Development, South San Francisco, CA, USA
| | - Sarah Sanowar
- Genentech Research and Early Development, South San Francisco, CA, USA
| | | | - Hannah Chi
- Genentech Research and Early Development, South San Francisco, CA, USA
| | - Jiameng Zhang
- Genentech Research and Early Development, South San Francisco, CA, USA
| | - Emily Holz
- Genentech Research and Early Development, South San Francisco, CA, USA
| | - Maciej Paluch
- Genentech Research and Early Development, South San Francisco, CA, USA
| | - Guannan He
- Genentech Research and Early Development, South San Francisco, CA, USA
| | - Yingjia Benson
- Genentech Research and Early Development, South San Francisco, CA, USA
| | - Jianhuan Zhang
- Genentech Research and Early Development, South San Francisco, CA, USA
| | - Pamela Chan
- Genentech Research and Early Development, South San Francisco, CA, USA
| | - Nga Tang
- Genentech Research and Early Development, South San Francisco, CA, USA
| | - Prachi Javale
- Genentech Research and Early Development, South San Francisco, CA, USA
| | - Blair Wilson
- Genentech Research and Early Development, South San Francisco, CA, USA
| | - Kathy Barrett
- Genentech Research and Early Development, South San Francisco, CA, USA
| | | | - Julie Hang
- Genentech Research and Early Development, South San Francisco, CA, USA
| | - Y Gloria Meng
- Genentech Research and Early Development, South San Francisco, CA, USA
| | - Phil Hass
- Genentech Research and Early Development, South San Francisco, CA, USA
| | - Germaine Fuh
- Genentech Research and Early Development, South San Francisco, CA, USA
| | - Robert Piskol
- Genentech Research and Early Development, South San Francisco, CA, USA
| | - Vladimir Bantseev
- Genentech Research and Early Development, South San Francisco, CA, USA
| | - Kelly M Loyet
- Genentech Research and Early Development, South San Francisco, CA, USA
| | - John C Tran
- Genentech Research and Early Development, South San Francisco, CA, USA
| | - Cong Wu
- Genentech Research and Early Development, South San Francisco, CA, USA
| | - Vahan B Indjeian
- Genentech Research and Early Development, South San Francisco, CA, USA
| | - Vittal Shivva
- Genentech Research and Early Development, South San Francisco, CA, USA
| | - Minhong Yan
- Genentech Research and Early Development, South San Francisco, CA, USA
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Gouliopoulos N, Gazouli M, Karathanou K, Moschos MM. The association of AGER and ALDH2 gene polymorphisms with diabetic retinopathy. Eur J Ophthalmol 2022; 33:11206721221126287. [PMID: 36113108 DOI: 10.1177/11206721221126287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/11/2023]
Abstract
PURPOSE To evaluate the possible associations between AGER (rs1051993, rs2070600) and ALDH2 (rs671) gene polymorphisms with nonproliferative (NPDR) and proliferative (PDR) diabetic retinopathy, in a well-defined Greek population. MATERIALS 66 NPDR patients and 57 PDR patients participated in our study, along with 156 age- and gender-matched healthy-control subjects (CL). All the participants underwent a complete ophthalmological examination, while clinical and demographic data were collected. Furthermore, they were genotyped for the studied polymorphisms. RESULTS No significant differences were detected among the studied groups regarding the participants' age and gender status. We found that the ALDH2 AA genotype was significantly more frequent in PDR patients than in CL (p = 0.014). Furthermore, between NPDR and PDR groups, the AGER rs1051993 GT and TT genotype frequencies were significantly elevated in PDR patients (p < 0.0001 and 0.04, respectively). Moreover, we demonstrated that the heterozygous GT genotype in DR patients is accompanied by 71.11 times higher risk of developing PDR (OR = 71.11: 95% CI- 4.14-1215.2), while the homozygous TT genotype is associated with 12.71 times elevated risk for PDR development (OR = 12.71: 95% CI- 0.63-254.1). CONCLUSIONS We documented that the ALDH2 AA and AGER rs1051993 GT and TT genotypes were observed significantly more frequently in PDR Greek diabetic patients. Our findings also support the genetic theory, suggesting that heritability is significantly implicated in the development of DR, providing additional evidence in the understanding of DR pathogenesis.
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Affiliation(s)
- Nikolaos Gouliopoulos
- 1st Department of Ophthalmology, Medical School, 393206National and Kapodistrian University of Athens, Athens, Greece
- 2nd Department of Ophthalmology, Medical School, 393206National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Gazouli
- Department of Basic Medical Sciences, Laboratory of Biology Medical School, 393206National and Kapodistrian University of Athens, Athens, Greece
| | | | - Marilita M Moschos
- 1st Department of Ophthalmology, Medical School, 393206National and Kapodistrian University of Athens, Athens, Greece
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Nebbioso M, Franzone F, Lambiase A, Bonfiglio V, Limoli PG, Artico M, Taurone S, Vingolo EM, Greco A, Polimeni A. Oxidative Stress Implication in Retinal Diseases-A Review. Antioxidants (Basel) 2022; 11:antiox11091790. [PMID: 36139862 PMCID: PMC9495599 DOI: 10.3390/antiox11091790] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 09/06/2022] [Indexed: 11/16/2022] Open
Abstract
Oxidative stress (OS) refers to an imbalance between free radicals (FRs), namely highly reactive molecules normally generated in our body by several pathways, and intrinsic antioxidant capacity. When FR levels overwhelm intrinsic antioxidant defenses, OS occurs, inducing a series of downstream chemical reactions. Both reactive oxygen species (ROS) and reactive nitrogen species (RNS) are produced by numerous chemical reactions that take place in tissues and organs and are then eliminated by antioxidant molecules. In particular, the scientific literature focuses more on ROS participation in the pathogenesis of diseases than on the role played by RNS. By its very nature, the eye is highly exposed to ultraviolet radiation (UVR), which is directly responsible for increased OS. In this review, we aimed to focus on the retinal damage caused by ROS/RNS and the related retinal pathologies. A deeper understanding of the role of oxidative and nitrosative stress in retinal damage is needed in order to develop targeted therapeutic interventions to slow these pathologies.
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Affiliation(s)
- Marcella Nebbioso
- Department of Sense Organs, Faculty of Medicine and Odontology, Sapienza University of Rome, p.le A. Moro 5, 00185 Rome, Italy
- Correspondence:
| | | | - Alessandro Lambiase
- Department of Sense Organs, Faculty of Medicine and Odontology, Sapienza University of Rome, p.le A. Moro 5, 00185 Rome, Italy
| | - Vincenza Bonfiglio
- Department of Experimental Biomedicine and Clinical Neuroscience, Ophthalmology Section, University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
| | | | - Marco Artico
- Department of Sense Organs, Faculty of Medicine and Odontology, Sapienza University of Rome, p.le A. Moro 5, 00185 Rome, Italy
| | | | - Enzo Maria Vingolo
- Department of Sense Organs, Faculty of Medicine and Odontology, Sapienza University of Rome, p.le A. Moro 5, 00185 Rome, Italy
| | - Antonio Greco
- Department of Sense Organs, Faculty of Medicine and Odontology, Sapienza University of Rome, p.le A. Moro 5, 00185 Rome, Italy
| | - Antonella Polimeni
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome 5, p.le A. Moro 5, 00185 Rome, Italy
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Yoon Kim D, Kwon Lee J. Type 1 and 2 diabetes are associated with reduced natural killer cell cytotoxicity. Cell Immunol 2022; 379:104578. [DOI: 10.1016/j.cellimm.2022.104578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 07/05/2022] [Accepted: 07/15/2022] [Indexed: 11/03/2022]
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Usui‐Ouchi A, Eade K, Giles S, Ideguchi Y, Ouchi Y, Aguilar E, Wei G, Marra KV, Berlow RB, Friedlander M. Deletion of Tgfβ signal in activated microglia prolongs hypoxia-induced retinal neovascularization enhancing Igf1 expression and retinal leukostasis. Glia 2022; 70:1762-1776. [PMID: 35611927 PMCID: PMC9540888 DOI: 10.1002/glia.24218] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 05/05/2022] [Accepted: 05/05/2022] [Indexed: 12/20/2022]
Abstract
Retinal neovascularization (NV) is the major cause of severe visual impairment in patients with ischemic eye diseases. While it is known that retinal microglia contribute to both physiological and pathological angiogenesis, the molecular mechanisms by which these glia regulate pathological NV have not been fully elucidated. In this study, we utilized a retinal microglia-specific Transforming Growth Factor-β (Tgfβ) receptor knock out mouse model and human iPSC-derived microglia to examine the role of Tgfβ signaling in activated microglia during retinal NV. Using a tamoxifen-inducible, microglia-specific Tgfβ receptor type 2 (Tgfβr2) knockout mouse [Tgfβr2 KO (ΔMG)] we show that Tgfβ signaling in microglia actively represses leukostasis in retinal vessels. Furthermore, we show that Tgfβ signaling represses expression of the pro-angiogenic factor, Insulin-like growth factor 1 (Igf1), independent of Vegf regulation. Using the mouse model of oxygen-induced retinopathy (OIR) we show that Tgfβ signaling in activated microglia plays a role in hypoxia-induced NV where a loss in Tgfβ signaling microglia exacerbates and prolongs retinal NV in OIR. Using human iPSC-derived microglia cells in an in vitro assay, we validate the role of Transforming Growth Factor-β1 (Tgfβ1) in regulating Igf1 expression in hypoxic conditions. Finally, we show that Tgfβ signaling in microglia is essential for microglial homeostasis and that the disruption of Tgfβ signaling in microglia exacerbates retinal NV in OIR by promoting leukostasis and Igf1 expression.
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Affiliation(s)
- Ayumi Usui‐Ouchi
- Department of Molecular MedicineThe Scripps Research InstituteLa JollaCaliforniaUSA
- Department of OphthalmologyJuntendo University Urayasu HospitalChibaJapan
| | - Kevin Eade
- Department of Molecular MedicineThe Scripps Research InstituteLa JollaCaliforniaUSA
- The Lowy Medical Research InstituteLa JollaCaliforniaUSA
| | - Sarah Giles
- The Lowy Medical Research InstituteLa JollaCaliforniaUSA
| | - Yoichiro Ideguchi
- Department of Molecular MedicineThe Scripps Research InstituteLa JollaCaliforniaUSA
| | - Yasuo Ouchi
- Gene Expression LaboratorySalk Institute for Biological StudiesLa JollaCaliforniaUSA
- Department of Regenerative MedicineChiba University Graduate School of MedicineChibaJapan
| | - Edith Aguilar
- Department of Molecular MedicineThe Scripps Research InstituteLa JollaCaliforniaUSA
| | - Guoqin Wei
- Department of Molecular MedicineThe Scripps Research InstituteLa JollaCaliforniaUSA
| | - Kyle V. Marra
- Department of Molecular MedicineThe Scripps Research InstituteLa JollaCaliforniaUSA
- Department of BioengineeringUniversity of California San DiegoLa JollaCaliforniaUSA
| | - Rebecca B. Berlow
- Department of Integrative Structural and Computational BiologyThe Scripps Research InstituteLa JollaCaliforniaUSA
| | - Martin Friedlander
- Department of Molecular MedicineThe Scripps Research InstituteLa JollaCaliforniaUSA
- The Lowy Medical Research InstituteLa JollaCaliforniaUSA
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Lazzara F, Longo AM, Giurdanella G, Lupo G, Platania CBM, Rossi S, Drago F, Anfuso CD, Bucolo C. Vitamin D3 preserves blood retinal barrier integrity in an in vitro model of diabetic retinopathy. Front Pharmacol 2022; 13:971164. [PMID: 36091806 PMCID: PMC9458952 DOI: 10.3389/fphar.2022.971164] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 07/25/2022] [Indexed: 11/15/2022] Open
Abstract
The impairment of the blood retinal barrier (BRB) represents one of the main features of diabetic retinopathy, a secondary microvascular complication of diabetes. Hyperglycemia is a triggering factor of vascular cells damage in diabetic retinopathy. The aim of this study was to assess the effects of vitamin D3 on BRB protection, and to investigate its regulatory role on inflammatory pathways. We challenged human retinal endothelial cells with high glucose (HG) levels. We found that vitamin D3 attenuates cell damage elicited by HG, maintaining cell viability and reducing the expression of inflammatory cytokines such as IL-1β and ICAM-1. Furthermore, we showed that vitamin D3 preserved the BRB integrity as demonstrated by trans-endothelial electrical resistance, permeability assay, and cell junction morphology and quantification (ZO-1 and VE-cadherin). In conclusion this in vitro study provided new insights on the retinal protective role of vitamin D3, particularly as regard as the early phase of diabetic retinopathy, characterized by BRB breakdown and inflammation.
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Affiliation(s)
- Francesca Lazzara
- Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, Catania, Italy
| | - Anna Maria Longo
- Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, Catania, Italy
| | - Giovanni Giurdanella
- Faculty of Medicine and Surgery, University of Enna “Kore”, Enna, Italy
- Center for Research in Ocular Pharmacology–CERFO, University of Catania, Catania, Italy
| | - Gabriella Lupo
- Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, Catania, Italy
- Center for Research in Ocular Pharmacology–CERFO, University of Catania, Catania, Italy
| | - Chiara Bianca Maria Platania
- Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, Catania, Italy
- Center for Research in Ocular Pharmacology–CERFO, University of Catania, Catania, Italy
| | - Settimio Rossi
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Filippo Drago
- Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, Catania, Italy
- Center for Research in Ocular Pharmacology–CERFO, University of Catania, Catania, Italy
| | - Carmelina Daniela Anfuso
- Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, Catania, Italy
- Center for Research in Ocular Pharmacology–CERFO, University of Catania, Catania, Italy
| | - Claudio Bucolo
- Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, Catania, Italy
- Center for Research in Ocular Pharmacology–CERFO, University of Catania, Catania, Italy
- *Correspondence: Claudio Bucolo,
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Giblin MJ, Ontko CD, Penn JS. Effect of cytokine-induced alterations in extracellular matrix composition on diabetic retinopathy-relevant endothelial cell behaviors. Sci Rep 2022; 12:12955. [PMID: 35902594 PMCID: PMC9334268 DOI: 10.1038/s41598-022-12683-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 05/10/2022] [Indexed: 12/15/2022] Open
Abstract
Retinal vascular basement membrane (BM) thickening is an early structural abnormality of diabetic retinopathy (DR). Recent studies suggest that BM thickening contributes to the DR pathological cascade; however, much remains to be elucidated about the exact mechanisms by which BM thickening develops and subsequently drives other pathogenic events in DR. Therefore, we undertook a systematic analysis to understand how human retinal microvascular endothelial cells (hRMEC) and human retinal pericytes (hRP) change their expression of key extracellular matrix (ECM) constituents when treated with diabetes-relevant stimuli designed to model the three major insults of the diabetic environment: hyperglycemia, dyslipidemia, and inflammation. TNFα and IL-1β caused the most potent and consistent changes in ECM expression in both hRMEC and hRP. We also demonstrate that conditioned media from IL-1β-treated human Müller cells caused dose-dependent, significant increases in collagen IV and agrin expression in hRMEC. After narrowing our focus to inflammation-induced changes, we sought to understand how ECM deposited by hRMEC and hRP under inflammatory conditions affects the behavior of naïve hRMEC. Our data demonstrated that diabetes-relevant alterations in ECM composition alone cause both increased adhesion molecule expression by and increased peripheral blood mononuclear cell (PBMC) adhesion to naïve hRMEC. Taken together, these data demonstrate novel roles for inflammation and pericytes in driving BM pathology and suggest that inflammation-induced ECM alterations may advance other pathogenic behaviors in DR, including leukostasis.
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Affiliation(s)
- Meredith J Giblin
- Department of Cell and Developmental Biology, Vanderbilt University, Nashville, USA.
| | - Cayla D Ontko
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, USA
| | - John S Penn
- Department of Cell and Developmental Biology, Vanderbilt University, Nashville, USA
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, USA
- Department of Ophthalmology and Visual Sciences, Vanderbilt University Medical Center, Nashville, USA
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Pirmardvand Chegini S, Varshosaz J, Dehghani A, Minaiyan M, Mirmohammad Sadeghi H. Ocular delivery of sunitinib-loaded nanoparticles doped in tragacanthic acid hydrogel in treatment of diabetic retinopathy in rats. Drug Dev Ind Pharm 2022; 48:29-39. [PMID: 35723593 DOI: 10.1080/03639045.2022.2092745] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Diabetic retinopathy (DR) is a common microvascular complication of diabetes mellitus. This study aimed to compare the effect of sunitinib-loaded poly (glycerol sebacate) (PGS)/gelatin nanoparticles doped in an injectable hydrogel with bevacizumab as a standard treatment of DR. METHODS The shear-sensitive hydrogel was prepared based on tragacanthic acid (TA) cross-linked with sodium acetate. DR was induced in rats by streptozotocin (STZ), and the animals were injected intravitreally a single dose of 20 µL sunitinib solution in three different concentrations (12.5, 25, and 50 µg/mL), sunitinib-loaded nanoparticles in hydrogel (413 μg/mL) and bevacizumab solution (6.25 mg/mL). The efficacy of the treatments was studied by histological and immunohisitological tests, angiogenesis, and optical coherence tomography (OCT). Vascular endothelial growth factor (VEGF) concentration was measured in the retina. RESULTS The results revealed that 20 µL of sunitinib with the concentration of 25 µg/mL was effective in DR without any disruption in the retina or any other side effects. This dose was considered the therapeutic dose for nanoparticles. Sunitinib loaded PGS/gelatine nanoparticles that were incorporated in the injectable hydrogel were as effective as bevacizumab in controlling DR. Although sunitinib solution reduced VEGF production and neovascularization in the retina compared to the negative control group, it was not as suitable as the nanoparticles. TA-based hydrogel showed no toxicity on the normal retina, and the angiography and histologic studies confirmed the VEGF results. Conclusions: Sunitinib nanoparticles doped in TA hydrogel may be an appropriate substitution of bevacizumab in the treatment of DR.
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Affiliation(s)
- Sana Pirmardvand Chegini
- Department of Pharmaceutics, Faculty of Pharmacy and Novel Drug Delivery Systems Research Centre, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Jaleh Varshosaz
- Department of Pharmaceutics, Faculty of Pharmacy and Novel Drug Delivery Systems Research Centre, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Dehghani
- School of Medicine, Isfahan Eye Research Centre, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohsen Minaiyan
- Department of Pharmacology, Faculty of Pharmacy, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamid Mirmohammad Sadeghi
- Department of Pharmaceutical Biotechnology, Faculty of Pharmacy, Isfahan University of Medical Sciences, Isfahan, Iran
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Sharma I, Yadav KS, Mugale MN. Redoxisome and diabetic retinopathy: Pathophysiology and therapeutic interventions. Pharmacol Res 2022; 182:106292. [PMID: 35691540 DOI: 10.1016/j.phrs.2022.106292] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 05/21/2022] [Accepted: 06/05/2022] [Indexed: 10/18/2022]
Abstract
Diabetic retinopathy (DR) is a chronic microvascular complication of diabetes mellitus (DM). It is a worldwide growing epidemic disease considered to be the leading cause of vision-loss and blindness in people with DM. Redox reactions occurring at the extra- and intracellular levels are essential for the maintenance of cellular homeostasis. Dysregulation of redox homeostasis are implicated in the onset and development of DR. Thioredoxin1 (TRX1) and Thioredoxin2 (TRX2) are cytoplasmic and mitochondrially localized antioxidant proteins ubiquitously expressed in various cells and control cellular reactive oxygen species (ROS) by reducing the disulfides into thiol groups. Thioredoxin-interacting protein (TXNIP) binds to TRX system and inhibits the active reduced form of TRX through disulfide exchange reaction. Recent studies indicate the association of TRX/TXNIP with redox signal transduction pathways including activation of Nod-like receptor pyrin domain containing protein-3 (NLRP3) inflammasome, apoptosis, autophagy/mitophagy, epigenetic modifications in a redox-dependent manner. Thus, it is important to gain a more in-depth understanding about the cellular and molecular mechanisms that links redoxisome and ER/Mitochondrial dysfunction to drive the progression of DR. The purpose of this review is to provide a mechanistic understanding of the complex molecular mechanisms and pathophysiological roles associated with redoxisome, the TRX/TXNIP redox signaling complex under oxidative stress in the development of DR. Also, the molecular targets of FDA approved drugs and clinical trials in addition to effective antioxidant strategies for the treatment of diabetic retinopathy are reviewed.
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Affiliation(s)
- Isha Sharma
- Division of Toxicology and Experimental Medicine, CSIR-Central Drug Research Institute (CSIR-CDRI), Lucknow 226031, India
| | - Karan Singh Yadav
- Division of Toxicology and Experimental Medicine, CSIR-Central Drug Research Institute (CSIR-CDRI), Lucknow 226031, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad- 201002, India
| | - Madhav Nilakanth Mugale
- Division of Toxicology and Experimental Medicine, CSIR-Central Drug Research Institute (CSIR-CDRI), Lucknow 226031, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad- 201002, India.
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YILMAZ T, TÜZÜN D, ŞAHİN M, KILINÇ M. THE RELATIONSHIP BETWEEN OXIDATIVE STRESS AND SERUM PROLIDASE ACTIVITY IN PATIENTS WITH DIABETIC NEPHROPATHY, RETINOPATHY AND NEUROPATHY. KAHRAMANMARAŞ SÜTÇÜ İMAM ÜNIVERSITESI TIP FAKÜLTESI DERGISI 2022. [DOI: 10.17517/ksutfd.1079948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Amaç: Diyabetin mikrovasküler komplikasyonlarında oksidatif stresin belirteçlerini incelemek, prolidazın oksidatif stres göstergeleriyle ilişkisini incelemek, prolidazın prediktif değer olarak kullanılabilirliliğini araştırmaktır.
Gereç ve Yöntemler: Çalışmaya 112 tip 2 Diyabetes Mellitusu (DM) olan hasta ve 44 sağlıklı kontrol birey alındı. Hastaların ayrıntılı anamnezleri alınıp fizik muayeneleri yapıldı. Açlık plazma glukozu (APG), hemoglobin A1c (HbA1C), kreatinin, spot idrarda mikrototal protein düzeyleri bakıldı. Göz dibi muayenesi ile diyabetik retinopati varlığı araştırıldı. Nöropati varlığı açısından nörolojik muayeneleri yapıldı. Ayrıca tüm hastaların sabah alınan kan örneğinde oksidatif stress için katalaz (CAT), superoksit dismutaz(SOD), glutatyon peroksidaz (GPx), malondialdehit (MDA), nitrik oksit(NO), serum prolidaz aktivitesi ölçümü yapıldı.
Bulgular: Tip 2 DM olan hastaların 80’inde (%71,42) komplikasyon mevcut iken 41’inde (%28,58) komplikasyon yoktu. Açlık plazma glukozu diyabetik komplikasyonu olan grupta diğer gruplara anlamlı olarak yüksekti (p
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Affiliation(s)
- Tuğba YILMAZ
- KAHRAMANMARAŞ SÜTÇÜ İMAM ÜNİVERSİTESİ, TIP FAKÜLTESİ
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