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Bynoe K, Wang J, Sachdeva MM. Association of systemic and demographic risk factors with prevalence of retinopathy in US adults with prediabetes. Eye (Lond) 2024:10.1038/s41433-024-03227-6. [PMID: 39003432 DOI: 10.1038/s41433-024-03227-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 06/13/2024] [Accepted: 07/05/2024] [Indexed: 07/15/2024] Open
Abstract
BACKGROUND/OBJECTIVES To investigate the relative contribution of systemic risk factors to retinopathy in prediabetes using a nationally representative cohort in the US. SUBJECTS/METHODS A group of 2098 participants aged ≥40 years with available HbA1c and gradable retinal images from the National Health and Nutrition Examination Survey 2005-2008 were included in this retrospective cross-sectional analysis. Participants were stratified into control, prediabetes, and diabetes groups based on HbA1c and anti-hyperglycaemic medication use. Logistic regression was used to assess the contribution of potential systemic risk factors to retinopathy prevalence. RESULTS The prevalence of retinopathy in the prediabetes group was 7.69%. Multivariable logistic regression revealed an inverse association of female sex (OR, 0.25; 95% CI, 0.08-0.74; p = 0.02), eGFR (OR, 0.98; 95% CI, 0.96-1.00; p = 0.04), and fasting glucose levels (OR, 0.92; 95% CI 0.87-0.98; p = 0.02) with retinopathy in individuals with prediabetes and a positive association with a Race/Ethnicity classification of "Other" (OR, 6.05; 95% CI, 1.65-22.1; p = 0.01). Comparison of ORs between groups indicated differential associations of "Other" race, fasting glucose, and C-reactive protein (CRP) with retinopathy in prediabetes compared with diabetes. CONCLUSIONS The prevalence of retinopathy among individuals with prediabetes in the NHANES database is similar to other studies. Our findings suggest that nonglycemic metabolic risk factors may be especially relevant to the risk of retinopathy in prediabetes and extend the previously suggested protective effect of female sex on retinopathy in diabetes to prediabetes. The increased odds of retinopathy in underrepresented racial/ethnic groups in the setting of prediabetes also have implications for risk assessment in this population.
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Affiliation(s)
- Kaela Bynoe
- Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jiangxia Wang
- Johns Hopkins Biostatistics Center, Department of Biostatistics, Johns Hopkins University, Baltimore, MD, USA
| | - Mira M Sachdeva
- Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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2
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Ooi H, Furukawa A, Takeuchi M, Koriyama Y. Toxic Advanced Glycation End-Products Inhibit Axonal Elongation Mediated by β-Tubulin Aggregation in Mice Optic Nerves. Int J Mol Sci 2024; 25:7409. [PMID: 39000515 PMCID: PMC11242247 DOI: 10.3390/ijms25137409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Revised: 06/23/2024] [Accepted: 07/02/2024] [Indexed: 07/16/2024] Open
Abstract
Advanced glycation end-products (AGEs) form through non-enzymatic glycation of various proteins. Optic nerve degeneration is a frequent complication of diabetes, and retinal AGE accumulation is strongly linked to the development of diabetic retinopathy. Type 2 diabetes mellitus is a major risk factor for Alzheimer's disease (AD), with patients often exhibiting optic axon degeneration in the nerve fiber layer. Notably, a gap exists in our understanding of how AGEs contribute to neuronal degeneration in the optic nerve within the context of both diabetes and AD. Our previous work demonstrated that glyceraldehyde (GA)-derived toxic advanced glycation end-products (TAGE) disrupt neurite outgrowth through TAGE-β-tubulin aggregation and tau phosphorylation in neural cultures. In this study, we further illustrated GA-induced suppression of optic nerve axonal elongation via abnormal β-tubulin aggregation in mouse retinas. Elucidating this optic nerve degeneration mechanism holds promise for bridging the knowledge gap regarding vision loss associated with diabetes mellitus and AD.
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Affiliation(s)
- Hayahide Ooi
- Graduate School and Faculty of Pharmaceutical Sciences, Suzuka University of Medical Science, 3500-3 Minamitamagaki, Suzuka 513-8670, Japan; (H.O.); (A.F.)
| | - Ayako Furukawa
- Graduate School and Faculty of Pharmaceutical Sciences, Suzuka University of Medical Science, 3500-3 Minamitamagaki, Suzuka 513-8670, Japan; (H.O.); (A.F.)
| | - Masayoshi Takeuchi
- Department of Advanced Medicine, Medical Research Institute, Kanazawa Medical University, 1-1 Daigaku, Uchinada-Machi, Kahoku 920-0293, Japan;
| | - Yoshiki Koriyama
- Graduate School and Faculty of Pharmaceutical Sciences, Suzuka University of Medical Science, 3500-3 Minamitamagaki, Suzuka 513-8670, Japan; (H.O.); (A.F.)
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3
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Hein M, Qambari H, An D, Balaratnasingam C. Current understanding of subclinical diabetic retinopathy informed by histology and high-resolution in vivo imaging. Clin Exp Ophthalmol 2024; 52:464-484. [PMID: 38363022 DOI: 10.1111/ceo.14363] [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: 10/30/2023] [Revised: 01/21/2024] [Accepted: 01/26/2024] [Indexed: 02/17/2024]
Abstract
The escalating incidence of diabetes mellitus has amplified the global impact of diabetic retinopathy. There are known structural and functional changes in the diabetic retina that precede the fundus photography abnormalities which currently are used to diagnose clinical diabetic retinopathy. Understanding these subclinical alterations is important for effective disease management. Histology and high-resolution clinical imaging reveal that the entire neurovascular unit, comprised of retinal vasculature, neurons and glial cells, is affected in subclinical disease. Early functional manifestations are seen in the form of blood flow and electroretinography disturbances. Structurally, there are alterations in the cellular components of vasculature, glia and the neuronal network. On clinical imaging, changes to vessel density and thickness of neuronal layers are observed. How these subclinical disturbances interact and ultimately manifest as clinical disease remains elusive. However, this knowledge reveals potential early therapeutic targets and the need for imaging modalities that can detect subclinical changes in a clinical setting.
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Affiliation(s)
- Martin Hein
- Physiology and Pharmacology Group, Lions Eye Institute, Perth, Western Australia, Australia
- Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Western Australia, Australia
| | - Hassanain Qambari
- Physiology and Pharmacology Group, Lions Eye Institute, Perth, Western Australia, Australia
- Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Western Australia, Australia
| | - Dong An
- Physiology and Pharmacology Group, Lions Eye Institute, Perth, Western Australia, Australia
- Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Western Australia, Australia
| | - Chandrakumar Balaratnasingam
- Physiology and Pharmacology Group, Lions Eye Institute, Perth, Western Australia, Australia
- Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Western Australia, Australia
- Department of Ophthalmology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
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4
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Anderson A, Alfahad N, Wimalachandra D, Bouzinab K, Rudzinska P, Wood H, Fazey I, Xu H, Lyons TJ, Barnes NM, Narendran P, Lord JM, Rauz S, Ganley IG, Curtis TM, Wallace GR, Hombrebueno JR. Relaxation of mitochondrial hyperfusion in the diabetic retina via N6-furfuryladenosine confers neuroprotection regardless of glycaemic status. Nat Commun 2024; 15:1124. [PMID: 38321058 PMCID: PMC10847490 DOI: 10.1038/s41467-024-45387-9] [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: 07/18/2023] [Accepted: 01/23/2024] [Indexed: 02/08/2024] Open
Abstract
The recovery of mitochondrial quality control (MQC) may bring innovative solutions for neuroprotection, while imposing a significant challenge given the need of holistic approaches to restore mitochondrial dynamics (fusion/fission) and turnover (mitophagy and biogenesis). In diabetic retinopathy, this is compounded by our lack of understanding of human retinal neurodegeneration, but also how MQC processes interact during disease progression. Here, we show that mitochondria hyperfusion is characteristic of retinal neurodegeneration in human and murine diabetes, blunting the homeostatic turnover of mitochondria and causing metabolic and neuro-inflammatory stress. By mimicking this mitochondrial remodelling in vitro, we ascertain that N6-furfuryladenosine enhances mitochondrial turnover and bioenergetics by relaxing hyperfusion in a controlled fashion. Oral administration of N6-furfuryladenosine enhances mitochondrial turnover in the diabetic mouse retina (Ins2Akita males), improving clinical correlates and conferring neuroprotection regardless of glycaemic status. Our findings provide translational insights for neuroprotection in the diabetic retina through the holistic recovery of MQC.
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Affiliation(s)
- Aidan Anderson
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Nada Alfahad
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | | | - Kaouthar Bouzinab
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Paula Rudzinska
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Heather Wood
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Isabel Fazey
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Heping Xu
- Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, UK
| | - Timothy J Lyons
- Division of Endocrinology and Diabetes, Medical University of South Carolina, Charleston, SC, USA
- Diabetes Free South Carolina, Columbia, SC, USA
| | - Nicholas M Barnes
- Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
| | - Parth Narendran
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - Janet M Lord
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Saaeha Rauz
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
- Birmingham & Midland Eye Centre, Birmingham, UK
| | - Ian G Ganley
- MRC Protein Phosphorylation and Ubiquitylation Unit, University of Dundee, Dundee, UK
| | - Tim M Curtis
- Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, UK
| | - Graham R Wallace
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Jose R Hombrebueno
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.
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5
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Erb C, Erb C, Kazakov A, Umetalieva M, Weisser B. Influence of Diabetes Mellitus on Glaucoma-Relevant Examination Results in Primary Open-Angle Glaucoma. Klin Monbl Augenheilkd 2024; 241:177-185. [PMID: 37643738 DOI: 10.1055/a-2105-0756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
Primary open-angle glaucoma (POAG) is no longer considered an isolated eye pressure-dependent optic neuropathy, but a neurodegenerative disease in which oxidative stress and neuroinflammation are prominent. These processes may be exacerbated by additional systemic diseases. The most common are arterial hypertension, dyslipidemia, and diabetes mellitus. Using diabetes mellitus as an example, it will be shown how far-reaching the influence of such a systemic disease can be on both the functional and the structural diagnostic methods for POAG. This knowledge is essential, since these interferences can lead to misinterpretations of POAG, which can also affect therapeutic decisions.
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Affiliation(s)
- Carl Erb
- Augenklinik am Wittenbergplatz, Berlin, Deutschland
| | | | - Avaz Kazakov
- Department of External Relations and Development, Salymbekov University, Bishkek, Kyrgyzstan
| | - Maana Umetalieva
- Medical Faculty of Medicine, Salymbekov University, Bishkek, Kyrgyzstan
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Gonzalez-Hernandez M, Betancor-Caro N, Mesa-Lugo F, Rodriguez-Talavera I, Pareja-Rios A, Guedes-Guedes I, Estevez-Jorge B, Trujillo-Blanco M, Cordova-Villegas R, Espinoza-Gonzalez J, Siguero-Martin L, Goya-Gonzalez C, Rodriguez-Dominguez M, Gonzalez-Hernandez D, Gonzalez de la Rosa M. Identification of Glaucoma in Diabetics Using the Laguna-ONhE Colourimetric Method and OCT Spectralis. J Clin Med 2023; 12:5876. [PMID: 37762816 PMCID: PMC10531930 DOI: 10.3390/jcm12185876] [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: 08/16/2023] [Revised: 09/01/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Previous retrospective results are evaluated prospectively and blinded. METHODS A total of 221 eyes previously classified as normal (G1), 279 as moderate risk of glaucoma (G2) and 217 as high risk (G3) according to the Globin Discriminant Function (GDF) Laguna-ONhE index were examined with OCT Spectralis- Results: In G1, the Bruch's Membrane Opening Minimum Rim Width (BMO-MRW) was 332 ± 55 microns; in G2, it was 252 ± 47 (p < 0.0001); and in G3, 231 ± 44 (p < 0.0001). In G1, the 1% and 5% percentiles were 233 and 248, respectively; in G2, they were lower in 28.80% and 42.29% of cases, respectively; and in G3, in 50.23% and 63.59% of cases, respectively. Most of the cases were normal-tension glaucomas. Laguna-ONhE indices showed a curvilinear correlation with BMO-MRW results. The Retinal Nerve Fibre Layer (RNFL) showed a poor relationship with BMO. Assuming G1 to be truly normal, BMO-MRW would have a Receiver operating characteristic (ROC) curve area of 0.901 for G2 and G3 and 0.651 for RNFL. A significant reduction in pixels corresponding to vessels was found in G2 and G3 vs. G1 (p < 0.0001). CONCLUSIONS In some cases, these defects appear to be mainly glaucomatous, and in others, they are associated with diabetic microangiopathy. In normal tension glaucoma, RNFL defects may be less severe than those inside the nerve.
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Affiliation(s)
- Marta Gonzalez-Hernandez
- Instrumentacion y Oftalmologia, INSOFT S.L., 38004 Santa Cruz de Tenerife, Spain; (D.G.-H.); (M.G.d.l.R.)
| | - Nisamar Betancor-Caro
- Hospital Universitario de Canarias, 38320 La Laguna, Spain; (N.B.-C.); (F.M.-L.); (I.R.-T.); (A.P.-R.)
| | - Fatima Mesa-Lugo
- Hospital Universitario de Canarias, 38320 La Laguna, Spain; (N.B.-C.); (F.M.-L.); (I.R.-T.); (A.P.-R.)
| | - Ivan Rodriguez-Talavera
- Hospital Universitario de Canarias, 38320 La Laguna, Spain; (N.B.-C.); (F.M.-L.); (I.R.-T.); (A.P.-R.)
| | - Alicia Pareja-Rios
- Hospital Universitario de Canarias, 38320 La Laguna, Spain; (N.B.-C.); (F.M.-L.); (I.R.-T.); (A.P.-R.)
| | - Isabel Guedes-Guedes
- Hospital Universitario Insular de Gran Canaria, 35016 Las Palmas de Gran Canarias, Spain; (I.G.-G.); (B.E.-J.); (M.T.-B.); (J.E.-G.); (L.S.-M.); (C.G.-G.); (M.R.-D.)
- Facultad de Medicina, Universidad de Las Palmas de Gran Canaria, 35001 Las Palmas de Gran, Spain
| | - Beatriz Estevez-Jorge
- Hospital Universitario Insular de Gran Canaria, 35016 Las Palmas de Gran Canarias, Spain; (I.G.-G.); (B.E.-J.); (M.T.-B.); (J.E.-G.); (L.S.-M.); (C.G.-G.); (M.R.-D.)
| | - Maricela Trujillo-Blanco
- Hospital Universitario Insular de Gran Canaria, 35016 Las Palmas de Gran Canarias, Spain; (I.G.-G.); (B.E.-J.); (M.T.-B.); (J.E.-G.); (L.S.-M.); (C.G.-G.); (M.R.-D.)
| | - Roberto Cordova-Villegas
- Hospital Universitario Insular de Gran Canaria, 35016 Las Palmas de Gran Canarias, Spain; (I.G.-G.); (B.E.-J.); (M.T.-B.); (J.E.-G.); (L.S.-M.); (C.G.-G.); (M.R.-D.)
| | - Juan Espinoza-Gonzalez
- Hospital Universitario Insular de Gran Canaria, 35016 Las Palmas de Gran Canarias, Spain; (I.G.-G.); (B.E.-J.); (M.T.-B.); (J.E.-G.); (L.S.-M.); (C.G.-G.); (M.R.-D.)
| | - Leticia Siguero-Martin
- Hospital Universitario Insular de Gran Canaria, 35016 Las Palmas de Gran Canarias, Spain; (I.G.-G.); (B.E.-J.); (M.T.-B.); (J.E.-G.); (L.S.-M.); (C.G.-G.); (M.R.-D.)
| | - Carolina Goya-Gonzalez
- Hospital Universitario Insular de Gran Canaria, 35016 Las Palmas de Gran Canarias, Spain; (I.G.-G.); (B.E.-J.); (M.T.-B.); (J.E.-G.); (L.S.-M.); (C.G.-G.); (M.R.-D.)
| | - Maria Rodriguez-Dominguez
- Hospital Universitario Insular de Gran Canaria, 35016 Las Palmas de Gran Canarias, Spain; (I.G.-G.); (B.E.-J.); (M.T.-B.); (J.E.-G.); (L.S.-M.); (C.G.-G.); (M.R.-D.)
| | - Daniel Gonzalez-Hernandez
- Instrumentacion y Oftalmologia, INSOFT S.L., 38004 Santa Cruz de Tenerife, Spain; (D.G.-H.); (M.G.d.l.R.)
| | - Manuel Gonzalez de la Rosa
- Instrumentacion y Oftalmologia, INSOFT S.L., 38004 Santa Cruz de Tenerife, Spain; (D.G.-H.); (M.G.d.l.R.)
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Han F, Kong X, Lv W, Li S, Sun Y, Wu Y. Association of diabetes mellitus with gait and falls in community-dwelling older adults: Serial mediation of vision and cognition. Arch Gerontol Geriatr 2023; 104:104827. [PMID: 36191493 DOI: 10.1016/j.archger.2022.104827] [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: 09/09/2022] [Accepted: 09/27/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND/OBJECTIVE Diabetes mellitus (DM) is associated with walking performance, but potential underlying mechanisms of this association remain unclear. The present study aims to disentangle the pathways linking DM to gait and falls through the serial mediation effect of vision and cognition among the older population. METHODS Data were taken from wave 9 (2018-2019) of the English Longitudinal Study of Aging (ELSA), including 5496 participants aged 60 years and older. DM was identified based on medical diagnosis and laboratory tests. Vision and falls were self-reported. Cognition was evaluated using questionnaire. Gait speed was measured by the "timed walking test". Serial mediation analysis was performed using Mplus 8.3. RESULTS DM was associated with impaired gait speed (c = 0.085, P < 0.05) and falls (c = 0.061, P < 0.05). The serial mediation model revealed that vision and cognition significantly mediated the association of DM with impaired gait speed, with 17.97% and 23.60% of the total effects explained by vision and cognition respectively, and 3.37% explained by the path through vision and then cognition. Similarly, vision and cognition significantly mediated the association of DM with falls, with 14.99% and 6.67% of the total effects explained by vision and cognition respectively, and 1.67% explained by the path through vision and then cognition. CONCLUSIONS These findings contribute to deeper understanding of the mechanism underlying the association of DM with walking performance. Evaluation and intervention targeted at vision and the cognition may be beneficial for improving gait or reducing falls in older adults with DM.
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Affiliation(s)
- Fulei Han
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, China
| | - Xiangjie Kong
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, China
| | - Wenshan Lv
- Department of Endocrinology and Metabolism, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Shiru Li
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, China
| | - Yanping Sun
- Department of Neurology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yili Wu
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, China.
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Antioxidant and anti-apoptotic effects of tocotrienol-rich fraction against streptozotocin-induced diabetic retinopathy in rats. Biomed Pharmacother 2022; 153:113533. [DOI: 10.1016/j.biopha.2022.113533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 08/08/2022] [Accepted: 08/08/2022] [Indexed: 11/22/2022] Open
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Mohammad G, Kowluru RA. Involvement of High Mobility Group Box 1 Protein in Optic Nerve Damage in Diabetes. Eye Brain 2022; 14:59-69. [PMID: 35586662 PMCID: PMC9109986 DOI: 10.2147/eb.s352730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 02/16/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Diabetic patients routinely have high levels of high mobility group box 1 (HMGB1) protein in their plasma, vitreous and ocular membranes, which is strongly correlated with subclinical chronic inflammation in the eye. Our previous work has suggested that high HMGB1 in diabetes plays a role in retinal inflammation and angiogenesis, but its role in the optic nerve damage is unclear. Therefore, our goal is to examine the role of HMGB1 in optic nerve damage in diabetes. Methods Gene expression of HMGB1 was quantified in the optic nerve from streptozotocin-induced diabetic mice by qRT-PCR, and their protein expressions by Western blot analysis and immunofluorescence staining. Using immunohistochemical technique, expression of reactive astrogliosis (indicator of neuroinflammation) and nerve demyelination/damage were determined by quantifying glial fibrillary acid protein (GFAP) and myelin basic protein (MBP), respectively. The role of HMGB1 in the optic nerve damage and alteration visual pathways was confirmed in mice receiving glycyrrhizin, a HMGB1 inhibitor. Similar parameters were measured in the optic nerve from human donors with diabetes. Results Compared to normal mice, diabetic mice exhibited increased levels of HMGB1, higher GFAP expression, and decreased MBP in the optic nerve. Double immunofluorescence microscopy revealed that diabetes induced increased HMGB1 immunoreactivities were significantly colocalized with GFAP in the optic nerve. Glycyrrhizin supplementation effectively reduced HMGB1 and maintained normal axonal myelination and visual conduction. Results from mice optic nerve confirmed the results obtained from human donors with diabetes. Discussions Thus, diabetes-induced HMGB1 upregulation promotes optic nerve demyelination and inflammation. The regulation of HMGB1 activation has potential to protect optic nerve damage and the abnormalities of visual pathways in diabetic patients.
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Affiliation(s)
- Ghulam Mohammad
- Department of Ophthalmology, Visual and Anatomical Sciences, Wayne State University, Detroit, MI, 48201, USA
- Correspondence: Ghulam Mohammad, Tel +1 313-577-0744, Email
| | - Renu A Kowluru
- Department of Ophthalmology, Visual and Anatomical Sciences, Wayne State University, Detroit, MI, 48201, USA
- Kresge Eye Institute, Wayne State University, Detroit, MI, 48201, USA
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10
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It is time for a moonshot to find “Cures” for diabetic retinal disease. Prog Retin Eye Res 2022; 90:101051. [DOI: 10.1016/j.preteyeres.2022.101051] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 01/19/2022] [Accepted: 01/31/2022] [Indexed: 12/13/2022]
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da Silva MO, do Carmo Chaves AEC, Gobbato GC, Dos Reis MA, Lavinsky F, Schaan BD, Lavinsky D. Early neurovascular retinal changes detected by swept-source OCT in type 2 diabetes and association with diabetic kidney disease. Int J Retina Vitreous 2021; 7:73. [PMID: 34865654 PMCID: PMC8647413 DOI: 10.1186/s40942-021-00347-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 11/21/2021] [Indexed: 12/23/2022] Open
Abstract
Purpose To evaluate retinal thickness and capillary density in patients with type 2 diabetes (T2D) and their association with diabetic kidney disease (DKD) using swept-source optical coherence tomography (SS-OCT). Methods A cross-sectional study was conducted with T2D patients with mild or no diabetic retinopathy (DR) and nondiabetic controls. Inner retinal layer thickness was measured with SS-OCT. Retinal capillary density and the foveal avascular zone (FAZ) were measured with SS-OCT angiography (OCTA). SS-OCT parameters were compared in patients with and without diabetic kidney disease (DKD) and nondiabetic controls. Results 131 DKD eyes showed decreased ganglion cell layer plus (GCL+) (p = 0.005 TI; p = 0.022 I), retinal nerve fiber layer (RNFL) (p = 0.003), and central retinal thickness (CRT) (p = 0.032), as well as foveal avascular zone (FAZ) enlargement (p = 0.003) and lower capillary density in the superficial vascular plexus (p = 0.016, central quadrant), compared to controls. No statistically significant changes were found between diabetic patients without significant DKD and controls. Conclusion Our findings suggest early neurovascular damage in patients with T2D; these changes were more significant in patients with DKD. Larger longitudinal studies are warranted to determine the role of early neurovascular damage in the pathophysiology of severe DR.
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Affiliation(s)
- Monica Oliveira da Silva
- Retina and Vitreous Research Center, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil. .,Graduate Program in Endocrinology, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, Brazil.
| | - Anne Elise Cruz do Carmo Chaves
- Retina and Vitreous Research Center, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil.,Graduate Program in Endocrinology, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, Brazil
| | - Glauber Corrêa Gobbato
- Retina and Vitreous Research Center, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil.,Lutheran University of Brazil Medical School, Porto Alegre, Brazil
| | - Mateus Augusto Dos Reis
- Department of Endocrinology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Graduate Program in Endocrinology, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, Brazil
| | - Fabio Lavinsky
- Retina and Vitreous Research Center, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil.,Medical School, UNISINOS University, Porto Alegre, Brazil
| | - Beatriz D'Agord Schaan
- Department of Endocrinology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Graduate Program in Endocrinology, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, Brazil
| | - Daniel Lavinsky
- Department of Ophthalmology, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, Brazil.,Retina and Vitreous Research Center, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil.,Graduate Program in Endocrinology, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, Brazil
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Montesano G, Ometto G, Higgins BE, Das R, Graham KW, Chakravarthy U, McGuiness B, Young IS, Kee F, Wright DM, Crabb DP, Hogg RE. Evidence for Structural and Functional Damage of the Inner Retina in Diabetes With No Diabetic Retinopathy. Invest Ophthalmol Vis Sci 2021; 62:35. [PMID: 33760040 PMCID: PMC7995918 DOI: 10.1167/iovs.62.3.35] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Purpose To provide structural and functional evidence of inner retinal loss in diabetes prior to vascular changes and interpret the structure-function relationship in the context of an established neural model. Methods Data from one eye of 505 participants (134 with diabetes and no clinically evident vascular alterations of the retina) were included in this analysis. The data were collected as part of a large population-based study. Functional tests included best-corrected visual acuity, Pelli-Robson contrast sensitivity, mesopic microperimetry, and frequency doubling technology perimetry (FDT). Macular optical coherence tomography volume scans were collected for all participants. To interpret the structure-function relationship in the context of a neural model, ganglion cell layer (GCL) thickness was converted to local ganglion cell (GC) counts. Results The GCL and inner plexiform layer were significantly thinner in participants with diabetes (P < 0.05), with no significant differences in the macular retinal nerve fiber layer or the outer retina. All functional tests except microperimetry showed a significant loss in diabetic patients (P < 0.05). Both FDT and microperimetry showed a significant relationship with the GC count (P < 0.05), consistent with predictions from a neural model for partial summation conditions. However, the FDT captured additional significant damage (P = 0.03) unexplained by the structural loss. Conclusions Functional and structural measurements support early neuronal loss in diabetes. The structure-function relationship follows the predictions from an established neural model. Functional tests could be improved to operate in total summation conditions in the macula, becoming more sensitive to early loss.
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Affiliation(s)
- Giovanni Montesano
- Optometry and Visual Sciences, City, University of London, London, United Kingdom.,NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
| | - Giovanni Ometto
- Optometry and Visual Sciences, City, University of London, London, United Kingdom.,NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
| | - Bethany E Higgins
- Optometry and Visual Sciences, City, University of London, London, United Kingdom
| | - Radha Das
- Centre for Public Health, Queen's University Belfast, Block B, Royal Hospital, Belfast, Northern Ireland
| | - Katie W Graham
- Centre for Public Health, Queen's University Belfast, Block B, Royal Hospital, Belfast, Northern Ireland
| | - Usha Chakravarthy
- Centre for Public Health, Queen's University Belfast, Block B, Royal Hospital, Belfast, Northern Ireland
| | - Bernadette McGuiness
- Centre for Public Health, Queen's University Belfast, Block B, Royal Hospital, Belfast, Northern Ireland
| | - Ian S Young
- Centre for Public Health, Queen's University Belfast, Block B, Royal Hospital, Belfast, Northern Ireland
| | - Frank Kee
- Centre for Public Health, Queen's University Belfast, Block B, Royal Hospital, Belfast, Northern Ireland
| | - David M Wright
- Centre for Public Health, Queen's University Belfast, Block B, Royal Hospital, Belfast, Northern Ireland
| | - David P Crabb
- Optometry and Visual Sciences, City, University of London, London, United Kingdom
| | - Ruth E Hogg
- Centre for Public Health, Queen's University Belfast, Block B, Royal Hospital, Belfast, Northern Ireland
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Abstract
Based on clinical findings, diabetic retinopathy (DR) has traditionally been defined as a retinal microvasculopathy. Retinal neuronal dysfunction is now recognized as an early event in the diabetic retina before development of overt DR. While detrimental effects of diabetes on the survival and function of inner retinal cells, such as retinal ganglion cells and amacrine cells, are widely recognized, evidence that photoreceptors in the outer retina undergo early alterations in diabetes has emerged more recently. We review data from preclinical and clinical studies demonstrating a conserved reduction of electrophysiological function in diabetic retinas, as well as evidence for photoreceptor loss. Complementing in vivo studies, we discuss the ex vivo electroretinography technique as a useful method to investigate photoreceptor function in isolated retinas from diabetic animal models. Finally, we consider the possibility that early photoreceptor pathology contributes to the progression of DR, and discuss possible mechanisms of photoreceptor damage in the diabetic retina, such as enhanced production of reactive oxygen species and other inflammatory factors whose detrimental effects may be augmented by phototransduction.
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