1
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Wu S, Yan X, Wu W, Hou L, Liang Y, Luo X. Early juvenile cataract in newly diagnosed type 1 diabetic patients: a description of two cases. J Pediatr Endocrinol Metab 2024; 37:652-656. [PMID: 38814569 DOI: 10.1515/jpem-2024-0005] [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: 01/02/2024] [Accepted: 05/17/2024] [Indexed: 05/31/2024]
Abstract
OBJECTIVES To analyze and summarize the clinical characteristics and treatment of juvenile patients with type 1 diabetes mellitus (T1DM) complicated by early cataract. CASE PRESENTATION This retrospective study collected clinical data from 210 children and adolescents newly diagnosed with T1DM who were admitted to the Department of Pediatrics, Tongji Hospital (Wuhan) between 2015 and 2022. Among 210 patients with T1DM, early cataract developed within 3 months before diabetes onset and 12 months thereafter in 2 (0.95 %) patients. The two patients were both females, aged 13 and 9 years, respectively. In both cases, cataracts in both eyes appeared in the early stages of T1DM, showing a short course and rapid development. After intensive insulin treatment for stringent and stable blood glucose control, one patient underwent cataract extraction with significant improvement, and her visual acuity returned to normal. The other patient received intensive insulin therapy and insulin pump therapy for 8 years. Subsequently, she underwent cataract surgery after achieving stable blood glucose levels, without complete recovery of vision. CONCLUSIONS Cataract is a rare complication in the early stages of T1DM in children and adolescents. Ophthalmic surgery is the preferred treatment for patients with diabetic cataract after achieving stable glycemic control, which may help prevent visual impairment.
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Affiliation(s)
- Shimin Wu
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, 12443 Huazhong University of Science and Technology , Wuhan, China
| | - Xiaoqin Yan
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wei Wu
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, 12443 Huazhong University of Science and Technology , Wuhan, China
| | - Ling Hou
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, 12443 Huazhong University of Science and Technology , Wuhan, China
| | - Yan Liang
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, 12443 Huazhong University of Science and Technology , Wuhan, China
| | - Xiaoping Luo
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, 12443 Huazhong University of Science and Technology , Wuhan, China
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2
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Agarkar S, Chandrasekaran A, Panicker GJ, Raman R. Cataract surgery outcomes in children and adolescents with type 1 diabetes mellitus. J AAPOS 2024:103926. [PMID: 38719142 DOI: 10.1016/j.jaapos.2024.103926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 01/16/2024] [Accepted: 02/11/2024] [Indexed: 05/19/2024]
Abstract
PURPOSE To report the outcomes of cataract surgery in children and adolescents with type 1 diabetes mellitus. METHODS The medical records of all pediatric patients (<18 years of age) with a diagnosis of type 1 diabetes mellitus who had undergone surgery for cataract between January 2000 and December 2019 at a tertiary care center were reviewed retrospectively. RESULTS A total of 27 eyes of 15 patients who met the inclusion criteria were included. Median age at cataract surgery was 13 (IQR, 9.5-16) years, and median follow-up was 3.8 (IQR, 1.25-7.2) years, with 11 eyes followed for more than 5 years. Visual acuity improved from a median preoperative value of 0.8 (IQR, 0.55-1.3) logMAR to 0.15 (IQR, 0-0.45) logMAR at final follow-up. Posterior capsular visual axis opacification in 40.7% and diabetic retinopathy in 14.8% were the common complications requiring additional intervention, including laser capsulotomy and panretinal photocoagulation, respectively. CONCLUSIONS Cataract surgery in children and adolescents with type 1 diabetes leads to improvement in visual acuity. Proliferative diabetic retinopathy can lead to poor visual outcomes in these children. Visual axis opacification occurs at similar rates with or without primary posterior capsulorhexis.
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Affiliation(s)
- Sumita Agarkar
- Pediatric Ophthalmology and Strabismus Services, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India.
| | - Akila Chandrasekaran
- Pediatric Ophthalmology and Strabismus Services, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Gayathri J Panicker
- Pediatric Ophthalmology and Strabismus Services, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Rajiv Raman
- Department of Vitreoretinal services, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
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3
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Bjornstad P, Dart A, Donaghue KC, Dost A, Feldman EL, Tan GS, Wadwa RP, Zabeen B, Marcovecchio ML. ISPAD Clinical Practice Consensus Guidelines 2022: Microvascular and macrovascular complications in children and adolescents with diabetes. Pediatr Diabetes 2022; 23:1432-1450. [PMID: 36537531 DOI: 10.1111/pedi.13444] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 10/27/2022] [Indexed: 12/24/2022] Open
Affiliation(s)
- Petter Bjornstad
- Section of Endocrinology, Department of Pediatrics, Division of Renal Diseases and Hypertension, Department of Medicine, University of Colorado School of Medicine, Denver, Colorado, USA
| | - Allison Dart
- Department of Pediatrics, Divison of Nephrology, Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
| | - Kim C Donaghue
- Department of Pediatrics, Division of Endocrinology, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.,Discipline of Child and Adolescent Health, University of Sydney, Sydney, New South Wales, Australia
| | - Axel Dost
- Department of Pediatrics, Division of Endocrinology, Jena University Hospital, Jena, Germany
| | - Eva L Feldman
- Department of Medicine, Division of Neurology, University of Michigan School of Medicine, Ann Arbor, Michigan, USA
| | - Gavin S Tan
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore.,Department of Ophthalmology and Visual Sciences, Duke-NUS Medical School, National University of Singapore, Singapore
| | - R Paul Wadwa
- Section of Endocrinology, Department of Pediatrics, Division of Renal Diseases and Hypertension, Department of Medicine, University of Colorado School of Medicine, Denver, Colorado, USA
| | - Bedowra Zabeen
- Department of Paediatrics and Changing Diabetes in Children Program, Bangladesh Institute of Research and Rehabilitation in Diabetes Endocrine and Metabolic Disorders, Dhaka, Bangladesh
| | - M Loredana Marcovecchio
- Department of Paediatrics, University of Cambridge, and Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
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4
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Reiter UM, Eckert AJ, Dunstheimer D, Bechtold-Dalla Pozza S, Lüllwitz C, Golembowski S, Freff M, Herrlinger S, von dem Berge T, Rehberg M, Lilienthal E, Holl RW. Cataract in children and adolescents with type 1 diabetes. Insights from the German/Austrian DPV registry. Pediatr Diabetes 2022; 23:362-369. [PMID: 35064955 DOI: 10.1111/pedi.13316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 01/12/2022] [Accepted: 01/12/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To study diabetic cataract in type 1 diabetes in a large pediatric cohort. METHODS The 92,633 patients aged 0.5-21 years from German/Austrian multicenter diabetes registry (DPV) were analyzed. The 235 patients (0.25%) with diabetic cataract were found, 200 could be categorized: 67 with early cataract (3 months before diabetes onset - 12 months afterwards), 133 with late cataract (>12 months after diabetes onset). Regression models adjusted for age and gender were used to compare clinical parameters at diabetes onset. Regression models for patients with late cataract were implemented for the total documentation period and additionally adjusted for diabetes duration. RESULTS Rate of cataract development shows a peak at diabetes onset and declines with longer diabetes duration. Patients with cataract showed strong female preponderance. Patients developing early cataract were older at diabetes onset (12.8 years [11.8/13.9] vs. 8.9 [8.9/9.0]; p < 0.001) and showed higher HbA1c than patients without cataract (9.0% [8.55/9.38] vs. 7.6% [7.60/7.61]; p < 0.001). They had lower height-SDS, (-0.22 [-0.48/0.04] vs. 0.25 [0.24/0.26]; p < 0.001), lower weight-SDS (-0.31 [-0.55/-0.08] vs. 0.21 [0.20/0.21]; p < 0.001) and lower BMI-SDS (-0.25 [-0.49/-0.02] vs. 0.12 [0.12/0.13); p = 0.002). Patients with late cataract showed higher HbA1c at diabetes onset (8.35% [8.08/8.62] vs. 8.04% [8.03/8.05]; p = 0.023) and higher mean HbA1c during total documentation period (8.00% [7.62/8.34] vs. 7.62% [7.61/7.63]; p = 0.048). CONCLUSIONS Our data confirm known demographic and clinical characteristics of patients developing early cataract. Hyperglycemia-induced osmotic damage to lens fibers at diabetes onset might be the main pathomechanism. Long term glycemic control is associated with cataract development.
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Affiliation(s)
- Ursula M Reiter
- Department of Pediatrics, University Children's Hospital Augsburg, Augsburg, Germany
| | - Alexander J Eckert
- Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany; German Centre for Diabetes Research (DZD), Neuherberg, Germany
| | - Desiree Dunstheimer
- Department of Pediatrics, University Children's Hospital Augsburg, Augsburg, Germany
| | - Susanne Bechtold-Dalla Pozza
- Pediatric Endocrinology and Diabetology, iSPZ, Haunersche Kinderklinik, Ludwig-Maximilians-University, Munich, Germany
| | - Caroline Lüllwitz
- Department of Pediatrics, University Hospital Magdeburg, Magdeburg, Germany
| | - Sven Golembowski
- Department of Pediatrics, Sana Hospital Lichtenberg, Berlin, Germany
| | - Markus Freff
- Department of Pediatrics, Kinderkliniken Prinzessin Margaret, Darmstadt, Germany
| | | | - Thekla von dem Berge
- Diabetes Centre for Children and Adolescents, Children's Hospital Auf der Bult, Hannover, Germany
| | - Mirko Rehberg
- Department of Pediatrics, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Eggert Lilienthal
- Department of Pediatrics, University Hospital St. Josef Bochum, Bochum, Germany
| | - Reinhard W Holl
- Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany; German Centre for Diabetes Research (DZD), Neuherberg, Germany
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5
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Li X, Sun M, Cheng A, Zheng G. LncRNA GAS5 regulates migration and epithelial-to-mesenchymal transition in lens epithelial cells via the miR-204-3p/TGFBR1 axis. J Transl Med 2022; 102:452-460. [PMID: 34916611 DOI: 10.1038/s41374-021-00713-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 11/15/2021] [Accepted: 11/19/2021] [Indexed: 12/19/2022] Open
Abstract
Diabetic cataract (DC) is a major ocular complication secondary to diabetes mellitus. The epithelial-mesenchymal transition (EMT) of lens epithelial cells (LECs) is an important event in DC progression. Long non-coding RNAs (lncRNAs) and microRNAs are involved in various biological processes and disorders. The aim of this study was to investigate the roles of lncRNA growth arrest-specific transcript 5 (GAS5) and microRNA-204-3p (miR-204-3p) deregulation in the pathogenic mechanism of high glucose (HG)-stimulated LECs. The results show that GAS5 was up-regulated, whereas miR-204-3p was down-regulated in anterior lens capsule tissues of DC patients and in HG-treated LECs compared to their controls, respectively. Functional experiments suggest that the lentivirus-mediated depletion of GAS5, as well as overexpression of miR-204-3p, suppressed migration and EMT in HG-treated LECs. Further mechanistic studies revealed that lncRNA GAS5/miR-204-3p/type 1 receptor of transforming growth factor-beta (TGFBR1) has a regulatory role in the process. Collectively, we demonstrated that dysregulation of GAS5 affects lens epithelial cell migration and EMT under HG conditions via the miR-204-3p/TGFBR1 axis. The current findings may provide new insights into the molecular mechanisms of DC development.
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Affiliation(s)
- Xiao Li
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou, 450000, Henan, China
| | - Miaomiao Sun
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou, 450000, Henan, China
| | - Anran Cheng
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou, 450000, Henan, China
| | - Guangying Zheng
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou, 450000, Henan, China.
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6
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Kovacova A, Shotliff K. Eye problems in people with diabetes: more than just diabetic retinopathy. PRACTICAL DIABETES 2022. [DOI: 10.1002/pdi.2378] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
| | - Kevin Shotliff
- Consultant Endocrinologist, Chelsea and Westminster Hospital London UK
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7
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Moghadam SS, Ghahramani M, Khoshaman K, Oryan A, Moosavi-Movahedi AA, Kurganov BI, Yousefi R. Relationship between the Structure and Chaperone Activity of Human αA-Crystallin after Its Modification with Diabetes-Associated Oxidative Agents and Protective Role of Antioxidant Compounds. BIOCHEMISTRY. BIOKHIMIIA 2022; 87:91-105. [PMID: 35508905 DOI: 10.1134/s000629792202002x] [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: 09/12/2021] [Revised: 10/16/2021] [Accepted: 10/16/2021] [Indexed: 06/14/2023]
Abstract
The study was aimed to evaluate the impact of peroxynitrite (PON, oxidative stress agent in diabetes), methylglyoxal (MGO, diabetes-associated reactive carbonyl compound), and their simultaneous application on the structural and functional features of human αA-crystallin (αA-Cry) using various spectroscopy techniques. Additionally, the surface tension and oligomer size distribution of the treated and untreated protein were tested using tensiometric analysis and dynamic light scattering, respectively. Our results indicated that the reaction of PON and MGO with human αA-Cry leads to the formation of new chromophores, alterations in the secondary to quaternary protein structure, reduction in the size of protein oligomers, and significant enhancement in the chaperone activity of αA-Cry. To reverse the effects of the tested compounds, ascorbic acid and glutathione (main components of lens antioxidant defense system) were applied. As expected, the two antioxidant compounds significantly prevented formation of high molecular weight aggregates of αA-Cry (according to SDS-PAGE). Our results suggest that the lens antioxidant defense system, in particular, glutathione, may provide a strong protection against rapid incidence and progression of diabetic cataract by preventing the destructive reactions of highly reactive DM-associated metabolites.
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Affiliation(s)
- Sogand Sasan Moghadam
- Protein Chemistry Laboratory, Department of Biology, College of Sciences, Shiraz University, Shiraz, Iran
| | - Maryam Ghahramani
- Protein Chemistry Laboratory, Department of Biology, College of Sciences, Shiraz University, Shiraz, Iran
| | - Kazem Khoshaman
- Protein Chemistry Laboratory, Department of Biology, College of Sciences, Shiraz University, Shiraz, Iran
| | - Ahmad Oryan
- Department of Pathology, School of Veterinary Medicine, Shiraz University, Shiraz, Iran
| | | | - Boris I Kurganov
- Bach Institute of Biochemistry, Research Center of Biotechnology of the Russian Academy of Sciences, Moscow, 119071, Russia
| | - Reza Yousefi
- Protein Chemistry Laboratory, Department of Biology, College of Sciences, Shiraz University, Shiraz, Iran.
- Institute of Biochemistry and Biophysics (IBB), University of Tehran, Tehran, Iran
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8
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Glover K, Mishra D, Singh TRR. Epidemiology of Ocular Manifestations in Autoimmune Disease. Front Immunol 2021; 12:744396. [PMID: 34795665 PMCID: PMC8593335 DOI: 10.3389/fimmu.2021.744396] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 10/14/2021] [Indexed: 01/19/2023] Open
Abstract
The global prevalence of autoimmune diseases is increasing. As a result, ocular complications, ranging from minor symptoms to sight-threatening scenarios, associated with autoimmune diseases have also risen. These ocular manifestations can result from the disease itself or treatments used to combat the primary autoimmune disease. This review provides detailed insights into the epidemiological factors affecting the increasing prevalence of ocular complications associated with several autoimmune disorders.
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Affiliation(s)
| | | | - Thakur Raghu Raj Singh
- School of Pharmacy, Medical Biology Centre, Queen’s University Belfast, Belfast, United Kingdom
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9
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Liu Q, Wang X, Yan H. Effect of thioltransferase on oxidative stress induced by high glucose and advanced glycation end products in human lens epithelial cells. Int J Ophthalmol 2021; 14:965-972. [PMID: 34282379 DOI: 10.18240/ijo.2021.07.02] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 04/08/2021] [Indexed: 12/30/2022] Open
Abstract
AIM To study the effect of thioltransferase (TTase) on oxidative stress in human lens epithelial cells (HLECs) induced by high glucose and advanced glycation end products (AGEs). METHODS HLECs were treated with 35.5 mmol/L glucose or 1.5 mg/mL AGEs modified bovine serum albumin (AGEs-BSA) as the experimental groups, respectively. Cells were collected at the time point of 1, 2, 3, and 4d. The TTase activity were measured accordingly. TTase mRNA levels were detected by quantitative reverse transcription polymerase chain response (qRT-RCR) and its protein level was detected by Western blot. The siRNA was used to knock down the expression of TTase. The activity of catalase (CAT) and superoxide dismutase (SOD), the content of reactive oxygen species (ROS) and the ratio of oxidized glutathione/total glutathione (GSSG/T-GSH) were assessed in different groups, respectively. RESULTS The level of TTase mRNA gradually increased and reached the top at 2d, then it decreased to the normal level at 4d, and the TTase activity increased from 2 to 3d in both high glucose and AGEs-BSA groups. The TTase expression elevated from 2d in high glucose group, and it began to rise from 3d in AGEs-BSA group. The activity of CAT and SOD showed a decrease and the content of ROS and the ratio of GSSG/T-GSH showed an increase in high glucose and AGEs-BSA group. These biochemical alterations were more prominent in the groups with TTase siRNA. CONCLUSION High glucose and AGEs can increase ROS content in HLECs; therefore, it induces oxidative stress. This may result in the decreased GSH and increased GSSG content, impaired activity of SOD and CAT. The up-regulated TTase likely provides oxidation damage repair induced by high glucose and AGEs in the early stage.
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Affiliation(s)
- Qing Liu
- Xi'an People's Hospital (Xi'an Fourth Hospital), Shaanxi Eye Hospital, Affiliated Guangren Hospital School of Medicine, Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China.,Department of Ophthalmology, No.986 Hospital of Air Force, PLA, Air Force Medical University, Xi'an 710054, Shaanxi Province, China
| | - Xu Wang
- Department of Ophthalmology, Xi'an Hong Hui Hospital, Xi'an Jiaotong University, Xi'an 710054, Shaanxi Province, China
| | - Hong Yan
- Xi'an People's Hospital (Xi'an Fourth Hospital), Shaanxi Eye Hospital, Affiliated Guangren Hospital School of Medicine, Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China.,Department of Ophthalmology, Tangdu Hospital, Air Force Medical University, Xi'an 710038, Shaanxi Province, China
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10
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Fundamentals of Diabetic Cataractogenesis and Promising Ways of its Pharmacological Correction. ACTA BIOMEDICA SCIENTIFICA 2021. [DOI: 10.29413/abs.2021-6.2.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Cataracts in diabetes mellitus lead to decreased visual function and blindness. Cataract surgery for diabetes mellitus has limitations and complications. The search for effective means of conservative cataract therapy continues. The review presents the analysis of data from scientific sources, mainly for 2015–2020 using Internet resources (PubMed, Web of Science, Medline, eLibrary.Ru, Cyberleninka). In the work, diabetic cataractogenesis is presented as a sum of interrelated pathobiochemical processes. The main ones are the polyol pathway of glucose conversion, non-enzymatic glycation and oxidative modification of lens proteins, which are enhanced in diabetes mellitus. The lens has a high protein content. The formation of high molecular weight protein aggregates is of particular importance for the appearance of light scattering zones and a decrease in lens transparency. This review presents data on anti-cataract compounds that affect post-translational crystallin modification, prevent osmotic and oxidative stress in the lens, and exhibit antiglycation properties. This information shows that the search for means of pharmacological correction of cataractogenesis should be carried out among compounds with antioxidant and antiglycation activity.
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11
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Chen P, Yao Z, He Z. Resveratrol protects against high glucose-induced oxidative damage in human lens epithelial cells by activating autophagy. Exp Ther Med 2021; 21:440. [PMID: 33747177 PMCID: PMC7967869 DOI: 10.3892/etm.2021.9871] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 07/01/2020] [Indexed: 12/21/2022] Open
Abstract
In the pathogenesis of diabetic cataract, high glucose levels induce oxidative damage in human lens epithelial cells (HLECs). Resveratrol has been demonstrated to be a potent antioxidant in various disease conditions; however, limited information is available on its effects on oxidative damage associated with the pathogenesis of diabetic cataract in HLECs. The present study aimed to determine whether resveratrol prevents high glucose-induced oxidative damage to human lens epithelial cells by activating autophagy. In the present study, HLECs treated with high glucose were used as a cellular model of diabetic cataract and treated with resveratrol for 24 h. Flow cytometry was performed to detect the cellular reactive oxygen species (ROS) content. Autophagy marker protein levels were determined by western blotting. Immunofluorescence assay was performed to analyze in vitro microtubule-associated protein 1 light chain 3 β (LC3B) protein expression. Autophagosome formation in HLECs was observed using transmission electron microscopy. The results demonstrated that high glucose suppressed HLEC viability and proliferation rate compared with normal glucose levels (5 mM), which were significantly reversed by resveratrol treatment. High glucose also increased the ROS content compared with ROS content in normal HLECs, which was reduced following resveratrol treatment. Further experiments demonstrated that resveratrol significantly reversed the high glucose-decreased protein levels of LC3II and beclin-1 proteins and the high glucose-increased protein levels of LC3I and p62 in HLECs. In conclusion, resveratrol inhibited the high glucose-induced oxidative damage in HLECs by promoting autophagy through the activation of the p38 mitogen-activated protein kinase signaling pathway. These results provide a theoretical basis for the application of resveratrol in diabetic cataract prevention and treatment.
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Affiliation(s)
- Pengzhi Chen
- Department of Ophthalmology, The Affiliated Hospital of Inner Mongolia University for Nationalities, Tongliao, Inner Mongolia 028006, P.R. China
| | - Zhenyu Yao
- Medical College, Inner Mongolia University for Nationalities, Tongliao, Inner Mongolia 028006, P.R. China
| | - Zhihui He
- Medical College, Inner Mongolia University for Nationalities, Tongliao, Inner Mongolia 028006, P.R. China
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12
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Cook E, Stratton E, Thornton MD. Acute Cataract Development in a Pediatric Patient With Type 1 Diabetes. J Emerg Med 2020; 58:e207-e209. [PMID: 32245686 DOI: 10.1016/j.jemermed.2020.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 01/31/2020] [Accepted: 02/16/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Type 1 diabetes mellitus (T1DM) is the most common form of diabetes mellitus in the pediatric population, with an estimated 500,000 children living with T1DM and an estimated 80,000 new cases each year in the United States. Ophthalmologic complications of diabetes are common in adult patients and those with longstanding disease, but can also be seen in patients with a recent diagnosis, even among the pediatric population. CASE REPORT We present the case of a 13-year-old girl with recently diagnosed T1DM who presented to the pediatric emergency department with acute onset of bilateral blurry vision due to cataract formation. Prompt recognition of the condition and ophthalmologic consultation allowed for timely diagnosis and restorative surgery. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: We present this case to increase awareness among emergency physicians of the potential for cataract formation in pediatric patients with T1DM, as well as the fact that it may be the first presenting sign of the disease. Furthermore, emergency physicians should be aware that pediatric patients who present with severe T1DM, either with extremely high hemoglobin A1c or glycemic blood levels, are at increased risk for cataract formation and should be evaluated for subtle signs of cataract formation even in the absence of obvious cataracts. We also discuss the pathophysiologic theories of cataract formation in patients with T1DM.
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Affiliation(s)
- Elana Cook
- Department of Emergency Medicine, SUNY Upstate Medical University, Syracuse, NY
| | - Emily Stratton
- Department of Emergency Medicine, SUNY Upstate Medical University, Syracuse, NY
| | - Matthew D Thornton
- Department of Emergency Medicine, SUNY Upstate Medical University, Syracuse, NY
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13
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Wojnar W, Zych M, Borymski S, Kaczmarczyk-Sedlak I. Chrysin Reduces Oxidative Stress but Does Not Affect Polyol Pathway in the Lenses of Type 1 Diabetic Rats. Antioxidants (Basel) 2020; 9:antiox9020160. [PMID: 32079112 PMCID: PMC7070579 DOI: 10.3390/antiox9020160] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 02/02/2020] [Accepted: 02/14/2020] [Indexed: 12/12/2022] Open
Abstract
Prolonged hyperglycemia is one of the main causes of reactive oxygen species and free radicals generation in diabetes which may affect various organs, including the eye. Oxidative damage to proteins and lipids in the eye lens could lead to cataract formation. To cope with oxidative stress, the endogenous antioxidative system may be supported by the supplementation of exogenous antioxidants. The aim of this study was to evaluate the effect of chrysin, a natural flavonoid, on oxidative stress and polyol pathway-related markers in the lenses of streptozotocin-induced type 1 male diabetic rats. Chrysin at doses of 50 and 100 mg/kg was administered by gavage for 28 days. This treatment resulted in a decrease in antioxidative enzymes activity and oxidative stress index. Moreover, chrysin administration elevated the reduced glutathione level in the lenses. A decrease in the markers linked to oxidative damage to proteins and lipids in the lenses was noted, especially after treatment with 50 mg/kg of chrysin. Neither of the chrysin doses affected glycemia-related markers in the serum or altered parameters related to the polyol pathway and advanced glycation end-products level in the lenses of diabetic rats. Upon obtaining results, it can be concluded that chrysin reveals antioxidative activity in the lenses but shows no antihyperglycemic or antiglycation properties.
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Affiliation(s)
- Weronika Wojnar
- Department of Pharmacognosy and Phytochemistry, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Katowice, Jagiellońska 4, 41-200 Sosnowiec, Poland; (M.Z.); (I.K.-S.)
- Correspondence: ; Tel.: +48-32-364-15-25
| | - Maria Zych
- Department of Pharmacognosy and Phytochemistry, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Katowice, Jagiellońska 4, 41-200 Sosnowiec, Poland; (M.Z.); (I.K.-S.)
| | - Sławomir Borymski
- Faculty of Natural Sciences, Institute of Biology, Biotechnology and Environmental Protection, University of Silesia, Jagiellońska 28, 40-032 Katowice, Poland;
| | - Ilona Kaczmarczyk-Sedlak
- Department of Pharmacognosy and Phytochemistry, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Katowice, Jagiellońska 4, 41-200 Sosnowiec, Poland; (M.Z.); (I.K.-S.)
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Lu WL, Shen PC, Lee CH, Su YT, Chen LM. High Risk of Early Cataracts in Young Type 1 Diabetes Group: A Nationwide Cohort Study. Int J Endocrinol 2020; 2020:8160256. [PMID: 33133186 PMCID: PMC7568800 DOI: 10.1155/2020/8160256] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 08/28/2020] [Accepted: 09/18/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Chronic hyperglycemia in type 1 diabetes (T1D) patients results in ocular problems over time, but only a few studies emphasized on cataracts. AIM To evaluate the epidemiology of cataracts in the T1D population. METHOD A two-part study was conducted using data from the National Health Insurance Research Database in Taiwan. Information from the Longitudinal Health Insurance Database (LHID) was served as a template of the general population. In the first part, a total of 3,622 T1D cases registered between 1998 and 2007 were enrolled and compared with a matched group from the LHID. For identifying risk factors of cataracts in the T1D population in the second part, a total of 9032 T1D cases registered between 1998 and 2013 were included. RESULT Compared to the LHID, the hazard ratio (HR) of cataracts in the T1D group was 5.81 (95% CI 4.60-7.33), and the HR was higher in females (6.29, 95% CI 4.63-8.55). The peak incidence of cataracts occurred between age 20 and 29 in the T1D group, while in the LHID, it was after 60. The overall incidence of cataracts in the T1D group was 9.1%. In T1D patients with cataracts, they were found with higher rates of associated diabetic complications. CONCLUSION Compared to the nondiabetic population, cataracts seemed more rampant and premature in T1D patients, especially those of female gender. Early ophthalmologic examination should be considered in T1D patients.
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Affiliation(s)
- Wen-Li Lu
- Division of Genetics and Metabolism, Children's Hospital of China Medical University, Taichung, Taiwan
| | - Po-Chih Shen
- Department of Orthopaedic Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chen-Hao Lee
- Department of Pediatrics, E-Da Hospital, Kaohsiung, Taiwan
- School of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Yu-Tsun Su
- Department of Pediatrics, E-Da Hospital, Kaohsiung, Taiwan
- School of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Li-Min Chen
- Department of Pediatrics, E-Da Hospital, Kaohsiung, Taiwan
- School of Medicine, I-Shou University, Kaohsiung, Taiwan
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15
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Li D, Liu GQ, Lu PR. High glucose: activating autophagy and affecting the biological behavior of human lens epithelial cells. Int J Ophthalmol 2019; 12:1061-1066. [PMID: 31341793 DOI: 10.18240/ijo.2019.07.02] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 10/22/2018] [Indexed: 02/06/2023] Open
Abstract
AIM To clarify the effect of autophagy on human lens epithelial cells (HLECs) under high glucose conditions. METHODS HLECs were cultured with different concentrations of glucose and 3-methyladenine (3-MA); the expression of autophagy-related protein LC3B was detected by Western blotting and immunofluorescence histochemistry. The migration of HLECs was quantified by scratch wound assay and the expression of transforming growth factor-β (TGF-β) was measured by real-time polymerase chain reaction. RESULTS Compared with 5 mmol/L normal glucose treatment, 40 mmol/L glucose treatment can significantly increase the generation of autophagosome in HLECs, which could be inhibited by 0.375 mmol/L 3-MA treatment. The migration of HLECs and the expression of TGF-β in HLECs induced by high glucose were significantly suppressed by 0.375 mmol/L 3-MA treatment. CONCLUSION Autophagy promotes HLECs cell migration and increases the expression of TGF-β after exposed to high glucose, which may relate to the development of diabetic cataract.
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Affiliation(s)
- Dan Li
- Department of Ophthalmology, the First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu Province, China
| | - Gao-Qin Liu
- Department of Ophthalmology, the First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu Province, China
| | - Pei-Rong Lu
- Department of Ophthalmology, the First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu Province, China
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16
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Kiziltoprak H, Tekin K, Inanc M, Goker YS. Cataract in diabetes mellitus. World J Diabetes 2019; 10:140-153. [PMID: 30891150 PMCID: PMC6422859 DOI: 10.4239/wjd.v10.i3.140] [Citation(s) in RCA: 124] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 03/06/2019] [Accepted: 03/08/2019] [Indexed: 02/05/2023] Open
Abstract
Diabetes mellitus (DM) is a chronic systemic disease that has increases in prevalence over time. DM can affect all ocular structures, with cataract being the most common ocular complication. Cataract is the leading cause of blindness worldwide. Due to several mechanisms, there is an increased incidence of cataract formation in the diabetic population. Advancements in technology have now made cataract surgery a common and safe procedure. However, the diabetic population is still at risk of vision-threatening complications, such as diabetic macular edema (ME), postoperative ME, diabetic retinopathy progression, and posterior capsular opacification.
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Affiliation(s)
- Hasan Kiziltoprak
- Department of Ophthalmology, University of Health Sciences, Ulucanlar Eye Training and Research Hospital, Ankara 06240, Turkey
| | - Kemal Tekin
- Ophthalmology Department, Ercis State Hospital, Van 65400, Ercis, Turkey
| | - Merve Inanc
- Ophthalmology Department, Ercis State Hospital, Van 65400, Ercis, Turkey
| | - Yasin Sakir Goker
- Department of Ophthalmology, University of Health Sciences, Ulucanlar Eye Training and Research Hospital, Ankara 06240, Turkey
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17
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Quintos JB, Torga AP, Simon MA. Diabetes cataract in a 10-year-old girl with new-onset type 1 diabetes mellitus. BMJ Case Rep 2019; 12:12/1/e227437. [PMID: 30700459 PMCID: PMC6352798 DOI: 10.1136/bcr-2018-227437] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Affiliation(s)
- Jose Bernardo Quintos
- Division of Pediatric Endocrinology and Diabetes, Rhode Island Hospital/Hasbro Children's Hospital, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Ana Patricia Torga
- Division of Pediatric Endocrinology and Diabetes, Rhode Island Hospital/Hasbro Children's Hospital, Providence, Rhode Island, USA
| | - Melissa A Simon
- Division of Ophthalmology, The Warren Alpert Medical School of Brown University, Hasbro Children's Hospital, Lifespan Physician Group, Providence, Rhode Island, USA
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18
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Donaghue KC, Marcovecchio ML, Wadwa RP, Chew EY, Wong TY, Calliari LE, Zabeen B, Salem MA, Craig ME. ISPAD Clinical Practice Consensus Guidelines 2018: Microvascular and macrovascular complications in children and adolescents. Pediatr Diabetes 2018; 19 Suppl 27:262-274. [PMID: 30079595 PMCID: PMC8559793 DOI: 10.1111/pedi.12742] [Citation(s) in RCA: 177] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 07/27/2018] [Indexed: 12/25/2022] Open
Affiliation(s)
- Kim C Donaghue
- The Children's Hospital at Westmead, Westmead, NSW, Australia
- Discipline of Child and Adolescent Health, University of Sydney, Camperdown, Australia
| | | | - R P Wadwa
- University of Colorado School of Medicine, Denver, Colorado
| | - Emily Y Chew
- Division of Epidemiology and Clinical Applications, the National Eye Institute, National Institutes of Health, Bethesda, Maryland
| | - Tien Y Wong
- Singapore Eye Research Institute, Singapore National Eye Center, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
| | | | - Bedowra Zabeen
- Department of Paediatrics and Changing Diabetes in Children Program, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders, Dhaka, Bangladesh
| | - Mona A Salem
- Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Maria E Craig
- The Children's Hospital at Westmead, Westmead, NSW, Australia
- Discipline of Child and Adolescent Health, University of Sydney, Camperdown, Australia
- School of Women's and Children's Health, University of New South Wales, Sydney, Australia
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