1
|
Letter to the editor: No increased incidence of retinopathy linked to hydroxychloroquine in RA patients with diabetes. Diabetes Metab Syndr 2024; 18:103101. [PMID: 39146905 DOI: 10.1016/j.dsx.2024.103101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 08/05/2024] [Accepted: 08/09/2024] [Indexed: 08/17/2024]
|
2
|
Bisen AC, Dubey A, Agrawal S, Biswas A, Rawat KS, Srivastava S, Bhatta RS. Recent updates on ocular disease management with ophthalmic ointments. Ther Deliv 2024; 15:463-480. [PMID: 38888757 DOI: 10.1080/20415990.2024.2346047] [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: 10/31/2023] [Accepted: 04/18/2024] [Indexed: 06/20/2024] Open
Abstract
Ophthalmic diseases can result in permanent vision loss and blindness. Convenient topical and systemic treatments are preferred to address these sight-threatening conditions. However, the unique anatomy of the eye presents challenges for drug delivery. Various ophthalmic ointment formulations have been developed to enhance bioavailability in the eye to prolong residence time and improve corneal permeability. This article explores a wide range of ocular diseases affecting individuals globally and how ointments are used to manage them. From eye to ocular barriers, this review focuses on published scientific research and formulation strategies for severe ocular complications using conventional topical ointments. Additionally, it delves through patented technologies and marketed formulations supporting the use of ointments in ocular drug delivery.
Collapse
Affiliation(s)
- Amol Chhatrapati Bisen
- Pharmaceutics & Pharmacokinetics Division, CSIR-Central Drug Research Institute, Lucknow, 226031, Uttar Pradesh, India
- Academy of Scientific & Innovative Research (AcSIR), Ghaziabad, 201002, Uttar Pradesh, India
- Sophisticated Analytical Instrument Facility and Research, CSIR-Central Drug Research Institute, Lucknow, 226031, Uttar Pradesh, India
| | - Ayush Dubey
- Pharmaceutics & Pharmacokinetics Division, CSIR-Central Drug Research Institute, Lucknow, 226031, Uttar Pradesh, India
- School of Pharmaceutical Sciences, CSJM University, Kanpur, 208024, Uttar Pradesh, India
| | - Sristi Agrawal
- Pharmaceutics & Pharmacokinetics Division, CSIR-Central Drug Research Institute, Lucknow, 226031, Uttar Pradesh, India
- Academy of Scientific & Innovative Research (AcSIR), Ghaziabad, 201002, Uttar Pradesh, India
| | - Arpon Biswas
- Pharmaceutics & Pharmacokinetics Division, CSIR-Central Drug Research Institute, Lucknow, 226031, Uttar Pradesh, India
| | - Kundan Singh Rawat
- Prof. Rajendra Singh Nanoscience & Chemistry D.S.B. Campus, Kumaun University, Nainital, 263001, Uttarakhand, India
| | - Saurabh Srivastava
- Pharmaceutics & Pharmacokinetics Division, CSIR-Central Drug Research Institute, Lucknow, 226031, Uttar Pradesh, India
- School of Pharmaceutical Sciences, CSJM University, Kanpur, 208024, Uttar Pradesh, India
| | - Rabi Sankar Bhatta
- Pharmaceutics & Pharmacokinetics Division, CSIR-Central Drug Research Institute, Lucknow, 226031, Uttar Pradesh, India
- Academy of Scientific & Innovative Research (AcSIR), Ghaziabad, 201002, Uttar Pradesh, India
| |
Collapse
|
3
|
Aerospace Medicine Clinic. Aerosp Med Hum Perform 2024; 95:341-343. [PMID: 38790128 DOI: 10.3357/amhp.6256.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2024]
|
4
|
Milcu AI, Anghel FM, Romanescu M, Chis AR, Anghel A, Boruga O. Plasma miR-19b, miR-34a, and miR-146a expression in patients with type 2 diabetes mellitus and cataract: A pilot study. BIOMOLECULES & BIOMEDICINE 2024; 24:537-544. [PMID: 38018996 PMCID: PMC11088884 DOI: 10.17305/bb.2023.9933] [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: 10/15/2023] [Revised: 11/19/2023] [Accepted: 11/28/2023] [Indexed: 11/30/2023]
Abstract
Cataract is among the most common ocular complications in diabetes mellitus (DM). While microRNA (miRNA) dysregulations in DM have been previously reported, consensus is still lacking concerning miRNA expression in cataract. Furthermore, the miRNA profile in diabetic cataract patients remains largely unexplored, and data on plasma expression levels are limited. Our study aimed to assess the plasma levels of three distinct miRNA species (hsa-miR-19b, hsa-miR-34a, and hsa-miR-146a) implicated in the development of cataract and/or DM.We investigated the circulating miRNA expression in DM patients diagnosed with cataract, compared to a non-DM cataract group. We employed qRT-PCR for relative quantification experiments and subsequently conducted a correlation analysis between miRNA expression levels and clinical characteristics. Our findings reveal that hsa-miR-34a and hsa-miR-146a are differentially expressed in the two cohorts. However, no significant correlation was observed between the clinical variables and miRNA levels. In summary, our results suggest a potential role for hsa-miR-34a and hsa-miR-146a in the biology of diabetic cataract.
Collapse
Affiliation(s)
- Adina Iuliana Milcu
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
- Discipline of Ophthalmology, Department of Surgery I, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
- Department of Ophthalmology, Municipal Emergency Clinical Hospital, Timisoara, Romania
| | - Flavia Medana Anghel
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
- Discipline of Biochemistry, Department of Biochemistry and Pharmacology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Mirabela Romanescu
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
- Discipline of Biochemistry, Department of Biochemistry and Pharmacology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
- Center for Complex Network Science, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Aimee Rodica Chis
- Discipline of Biochemistry, Department of Biochemistry and Pharmacology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
- Center for Complex Network Science, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Andrei Anghel
- Discipline of Biochemistry, Department of Biochemistry and Pharmacology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
- Center for Complex Network Science, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Ovidiu Boruga
- Discipline of Ophthalmology, Department of Surgery I, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
- Department of Ophthalmology, Municipal Emergency Clinical Hospital, Timisoara, Romania
| |
Collapse
|
5
|
Meissner JM, Chmielińska A, Ofri R, Cisło-Sankowska A, Marycz K. Extracellular Vesicles Isolated from Equine Adipose-Derived Stromal Stem Cells (ASCs) Mitigate Tunicamycin-Induced ER Stress in Equine Corneal Stromal Stem Cells (CSSCs). Curr Issues Mol Biol 2024; 46:3251-3277. [PMID: 38666934 PMCID: PMC11048834 DOI: 10.3390/cimb46040204] [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: 02/26/2024] [Revised: 03/29/2024] [Accepted: 04/03/2024] [Indexed: 04/28/2024] Open
Abstract
Corneal ulcers, characterized by severe inflammation of the cornea, can lead to serious, debilitating complications and may be vision-threatening for horses. In this study, we aimed to investigate the role of endoplasmic reticulum (ER) stress in corneal stem progenitor cell (CSSC) dysfunction and explore the potential of equine adipose-derived stromal stem cell (ASC)-derived extracellular vesicles (EVs) to improve corneal wound healing. We showed that CSSCs expressed high levels of CD44, CD45, and CD90 surface markers, indicating their stemness. Supplementation of the ER-stress-inducer tunicamycin to CSSCs resulted in reduced proliferative and migratory potential, accumulation of endoplasmic reticulum (ER)-stressed cells in the G0/G1 phase of the cell cycle, increased expression of proinflammatory genes, induced oxidative stress and sustained ER stress, and unfolded protein response (UPR). Importantly, treatment with EVs increased the proliferative activity and number of cells in the G2/Mitosis phase, enhanced migratory ability, suppressed the overexpression of proinflammatory cytokines, and upregulated the anti-inflammatory miRNA-146a-5p, compared to control and/or ER-stressed cells. Additionally, EVs lowered the expression of ER-stress master regulators and effectors (PERK, IRE1, ATF6, and XBP1), increased the number of mitochondria, and reduced the expression of Fis-1 and Parkin, thereby promoting metabolic homeostasis and protecting against apoptosis in equine CSSCs. Our findings demonstrate that MSCs-derived EVs represent an innovative and promising therapeutic strategy for the transfer of bioactive mediators which regulate various cellular and molecular signaling pathways.
Collapse
Affiliation(s)
- Justyna M. Meissner
- Department of Experimental Biology, Faculty of Biology and Animal Science, Wrocław University of Environmental and Life Sciences, Norwida 27B, 50-375 Wroclaw, Poland;
| | - Aleksandra Chmielińska
- International Institute of Translational Medicine, Jesionowa 11, Malin, 55-114 Wisznia Mala, Poland; (A.C.); (A.C.-S.)
| | - Ron Ofri
- Koret School of Veterinary Medicine, Hebrew University of Jerusalem, P.O. Box 12, Rehovot 7610001, Israel;
| | - Anna Cisło-Sankowska
- International Institute of Translational Medicine, Jesionowa 11, Malin, 55-114 Wisznia Mala, Poland; (A.C.); (A.C.-S.)
| | - Krzysztof Marycz
- Department of Experimental Biology, Faculty of Biology and Animal Science, Wrocław University of Environmental and Life Sciences, Norwida 27B, 50-375 Wroclaw, Poland;
- International Institute of Translational Medicine, Jesionowa 11, Malin, 55-114 Wisznia Mala, Poland; (A.C.); (A.C.-S.)
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA 95516, USA
| |
Collapse
|
6
|
Surico PL, Narimatsu A, Forouzanfar K, Singh RB, Shoushtari S, Dana R, Blanco T. Effects of Diabetes Mellitus on Corneal Immune Cell Activation and the Development of Keratopathy. Cells 2024; 13:532. [PMID: 38534376 DOI: 10.3390/cells13060532] [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: 01/16/2024] [Revised: 03/12/2024] [Accepted: 03/16/2024] [Indexed: 03/28/2024] Open
Abstract
Diabetes mellitus (DM) is one of the most prevalent diseases globally, and its prevalence is rapidly increasing. Most patients with a long-term history of DM present with some degree of keratopathy (DK). Despite its high incidence, the underlying inflammatory mechanism of DK has not been elucidated yet. For further insights into the underlying immunopathologic processes, we utilized streptozotocin-induced mice to model type 1 DM (T1D) and B6.Cg-Lepob/J mice to model type 2 DM (T2D). We evaluated the animals for the development of clinical manifestations of DK. Four weeks post-induction, the total frequencies of corneal CD45+CD11b+Ly-6G- myeloid cells, with enhanced gene and protein expression levels for the proinflammatory cytokines TNF-α and IL-1β, were higher in both T1D and T2D animals. Additionally, the frequencies of myeloid cells/mm2 in the sub-basal neural plexus (SBNP) were significantly higher in T1D and T2D compared to non-diabetic mice. DK clinical manifestations were observed four weeks post-induction, including significantly lower tear production, corneal sensitivity, and epitheliopathy. Nerve density in the SBNP and intraepithelial terminal endings per 40x field were lower in both models compared to the normal controls. The findings of this study indicate that DM alters the immune quiescent state of the cornea during disease onset, which may be associated with the progressive development of the clinical manifestations of DK.
Collapse
Affiliation(s)
- Pier Luigi Surico
- Laboratory of Ocular Immunology, Transplantation and Regeneration, Schepens Eye Research Institute, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA 02114, USA
| | - Akitomo Narimatsu
- Laboratory of Ocular Immunology, Transplantation and Regeneration, Schepens Eye Research Institute, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA 02114, USA
| | - Katayoon Forouzanfar
- Laboratory of Ocular Immunology, Transplantation and Regeneration, Schepens Eye Research Institute, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA 02114, USA
| | - Rohan Bir Singh
- Laboratory of Ocular Immunology, Transplantation and Regeneration, Schepens Eye Research Institute, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA 02114, USA
| | - Sara Shoushtari
- Laboratory of Ocular Immunology, Transplantation and Regeneration, Schepens Eye Research Institute, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA 02114, USA
| | - Reza Dana
- Laboratory of Ocular Immunology, Transplantation and Regeneration, Schepens Eye Research Institute, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA 02114, USA
| | - Tomas Blanco
- Laboratory of Ocular Immunology, Transplantation and Regeneration, Schepens Eye Research Institute, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA 02114, USA
| |
Collapse
|
7
|
Choudhary A, Gopalakrishnan N, Joshi A, Balakrishnan D, Chhablani J, Yadav NK, Reddy NG, Rani PK, Gandhi P, Shetty R, Roy R, Bavaskar S, Prabhu V, Venkatesh R. Recommendations for diabetic macular edema management by retina specialists and large language model-based artificial intelligence platforms. Int J Retina Vitreous 2024; 10:22. [PMID: 38419083 PMCID: PMC10900631 DOI: 10.1186/s40942-024-00544-6] [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: 01/13/2024] [Accepted: 02/15/2024] [Indexed: 03/02/2024] Open
Abstract
PURPOSE To study the role of artificial intelligence (AI) in developing diabetic macular edema (DME) management recommendations by creating and comparing responses to clinicians in hypothetical AI-generated case scenarios. The study also examined whether its joint recommendations followed national DME management guidelines. METHODS The AI hypothetically generated 50 ocular case scenarios from 25 patients using keywords like age, gender, type, duration and control of diabetes, visual acuity, lens status, retinopathy stage, coexisting ocular and systemic co-morbidities, and DME-related retinal imaging findings. For DME and ocular co-morbidity management, we calculated inter-rater agreements (kappa analysis) separately for clinician responses, AI-platforms, and the "majority clinician response" (the maximum number of identical clinician responses) and "majority AI-platform" (the maximum number of identical AI responses). Treatment recommendations for various situations were compared to the Indian national guidelines. RESULTS For DME management, clinicians (ĸ=0.6), AI platforms (ĸ=0.58), and the 'majority clinician response' and 'majority AI response' (ĸ=0.69) had moderate to substantial inter-rate agreement. The study showed fair to substantial agreement for ocular co-morbidity management between clinicians (ĸ=0.8), AI platforms (ĸ=0.36), and the 'majority clinician response' and 'majority AI response' (ĸ=0.49). Many of the current study's recommendations and national clinical guidelines agreed and disagreed. When treating center-involving DME with very good visual acuity, lattice degeneration, renal disease, anaemia, and a recent history of cardiovascular disease, there were clear disagreements. CONCLUSION For the first time, this study recommends DME management using large language model-based generative AI. The study's findings could guide in revising the global DME management guidelines.
Collapse
Affiliation(s)
- Ayushi Choudhary
- Dept. of Retina and Vitreous, Narayana Nethralaya, #121/C, 1st R Block, Chord Road, Rajaji Nagar, 560010, Bengaluru, Karnataka, India
| | - Nikhil Gopalakrishnan
- Dept. of Retina and Vitreous, Narayana Nethralaya, #121/C, 1st R Block, Chord Road, Rajaji Nagar, 560010, Bengaluru, Karnataka, India
| | - Aishwarya Joshi
- Dept. of Retina and Vitreous, Narayana Nethralaya, #121/C, 1st R Block, Chord Road, Rajaji Nagar, 560010, Bengaluru, Karnataka, India
| | - Divya Balakrishnan
- Dept of Retina and Vitreous, Little Flower Hospital and Research Centre, 683572, Angamaly, Kerala, India
| | - Jay Chhablani
- Medical Retina and Vitreoretinal Surgery, University of Pittsburgh School of Medicine, 203 Lothrop Street, Suite 800, 15213, Pittsburg, PA, USA
| | - Naresh Kumar Yadav
- Dept. of Retina and Vitreous, Narayana Nethralaya, #121/C, 1st R Block, Chord Road, Rajaji Nagar, 560010, Bengaluru, Karnataka, India
| | - Nikitha Gurram Reddy
- Anant Bajaj Retina Institute, L V Prasad Eye Institute, Kallam Anji Reddy Campus, 500034, Hyderabad, Telangana, India
| | - Padmaja Kumari Rani
- Anant Bajaj Retina Institute, L V Prasad Eye Institute, Kallam Anji Reddy Campus, 500034, Hyderabad, Telangana, India
| | - Priyanka Gandhi
- Dept. of Retina and Vitreous, Narayana Nethralaya, #121/C, 1st R Block, Chord Road, Rajaji Nagar, 560010, Bengaluru, Karnataka, India
| | - Rohit Shetty
- Dept. of Cornea and Refractive Services, Narayana Nethralaya, #121/C, 1st R Block, Chord Road, Rajaji Nagar, 560010, Bengaluru, Karnataka, India
| | - Rupak Roy
- Dept. of Vitreo-Retina, Aditya Birla Sankara Nethralaya, 700099, Kolkata, India
| | - Snehal Bavaskar
- Dept. of Retina and Vitreous, Narayana Nethralaya, #121/C, 1st R Block, Chord Road, Rajaji Nagar, 560010, Bengaluru, Karnataka, India
| | - Vishma Prabhu
- Dept. of Retina and Vitreous, Narayana Nethralaya, #121/C, 1st R Block, Chord Road, Rajaji Nagar, 560010, Bengaluru, Karnataka, India
| | - Ramesh Venkatesh
- Dept. of Retina and Vitreous, Narayana Nethralaya, #121/C, 1st R Block, Chord Road, Rajaji Nagar, 560010, Bengaluru, Karnataka, India.
| |
Collapse
|
8
|
Wang CL, Skeie JM, Allamargot C, Goldstein AS, Nishimura DY, Huffman JM, Aldrich BT, Schmidt GA, Teixeira LBC, Kuehn MH, Yorek M, Greiner MA. Rat Model of Type 2 Diabetes Mellitus Recapitulates Human Disease in the Anterior Segment of the Eye. THE AMERICAN JOURNAL OF PATHOLOGY 2024:S0002-9440(24)00073-7. [PMID: 38403162 DOI: 10.1016/j.ajpath.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 02/01/2024] [Accepted: 02/09/2024] [Indexed: 02/27/2024]
Abstract
Changes in the anterior segment of the eye due to type 2 diabetes mellitus (T2DM) are not well-characterized, in part due to the lack of a reliable animal model. This study evaluates changes in the anterior segment, including crystalline lens health, corneal endothelial cell density, aqueous humor metabolites, and ciliary body vasculature, in a rat model of T2DM compared with human eyes. Male Sprague-Dawley rats were fed a high-fat diet (45% fat) or normal diet, and rats fed the high-fat diet were injected with streptozotocin i.p. to generate a model of T2DM. Cataract formation and corneal endothelial cell density were assessed using microscopic analysis. Diabetes-related rat aqueous humor alterations were assessed using metabolomics screening. Transmission electron microscopy was used to assess qualitative ultrastructural changes ciliary process microvessels at the site of aqueous formation in the eyes of diabetic rats and humans. Eyes from the diabetic rats demonstrated cataracts, lower corneal endothelial cell densities, altered aqueous metabolites, and ciliary body ultrastructural changes, including vascular endothelial cell activation, pericyte degeneration, perivascular edema, and basement membrane reduplication. These findings recapitulated diabetic changes in human eyes. These results support the use of this model for studying ocular manifestations of T2DM and support a hypothesis postulating blood-aqueous barrier breakdown and vascular leakage at the ciliary body as a mechanism for diabetic anterior segment pathology.
Collapse
Affiliation(s)
- Cheryl L Wang
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Jessica M Skeie
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa; Iowa Lions Eye Bank, Coralville, Iowa
| | - Chantal Allamargot
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa; Office of the Vice President for Research, Central Microscopy Research Facility, University of Iowa, Iowa City, Iowa
| | - Andrew S Goldstein
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa; Iowa Lions Eye Bank, Coralville, Iowa
| | - Darryl Y Nishimura
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa; Iowa Lions Eye Bank, Coralville, Iowa
| | - James M Huffman
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Benjamin T Aldrich
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa; Iowa Lions Eye Bank, Coralville, Iowa
| | - Gregory A Schmidt
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa; Iowa Lions Eye Bank, Coralville, Iowa
| | - Leandro B C Teixeira
- Department of Pathobiological Sciences, University of Wisconsin-Madison School of Veterinary Medicine, Madison, Wisconsin
| | - Markus H Kuehn
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa; Center for the Prevention and Treatment of Visual Loss, Iowa City Veterans Affairs Health Care System, Iowa City, Iowa
| | - Mark Yorek
- Center for the Prevention and Treatment of Visual Loss, Iowa City Veterans Affairs Health Care System, Iowa City, Iowa
| | - Mark A Greiner
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa; Iowa Lions Eye Bank, Coralville, Iowa.
| |
Collapse
|
9
|
Okruszko MA, Szabłowski M, Zarzecki M, Michnowska-Kobylińska M, Lisowski Ł, Łapińska M, Stachurska Z, Szpakowicz A, Kamiński KA, Konopińska J. Inflammation and Neurodegeneration in Glaucoma: Isolated Eye Disease or a Part of a Systemic Disorder? - Serum Proteomic Analysis. J Inflamm Res 2024; 17:1021-1037. [PMID: 38370463 PMCID: PMC10874189 DOI: 10.2147/jir.s434989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 01/23/2024] [Indexed: 02/20/2024] Open
Abstract
Introduction Glaucoma is the most common optic neuropathy and the leading cause of irreversible blindness worldwide, which affects 3.54% of the population aged 40-80 years. Despite numerous published studies, some aspects of glaucoma pathogenesis, serum biomarkers, and their potential link with other diseases remain unclear. Recent articles have proposed that autoimmune, oxidative stress and inflammation may be involved in the pathogenesis of glaucoma. Methods We investigated the serum expression of 92 inflammatory and neurotrophic factors in glaucoma patients. The study group consisted of 26 glaucoma patients and 192 healthy subjects based on digital fundography. Results Patients with glaucoma had significantly lower serum expression of IL-2Rβ, TWEAK, CX3CL1, CD6, CD5, LAP TGF-beta1, LIF-R, TRAIL, NT-3, and CCL23 and significantly higher expression of IL-22Rα1. Conclusion Our results indicate that patients with glaucoma tend to have lower levels of neuroprotective proteins and higher levels of neuroinflammatory proteins, similar to those observed in psychiatric, neurodegenerative and autoimmune diseases, indicating a potential link between these conditions and glaucoma pathogenesis.
Collapse
Affiliation(s)
| | - Maciej Szabłowski
- Department of Ophthalmology, Medical University of Bialystok, Białystok, 15-089, Poland
| | - Mateusz Zarzecki
- Department of Ophthalmology, Medical University of Bialystok, Białystok, 15-089, Poland
| | | | - Łukasz Lisowski
- Department of Ophthalmology, Medical University of Bialystok, Białystok, 15-089, Poland
| | - Magda Łapińska
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Białystok, Białystok, Poland
| | - Zofia Stachurska
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Białystok, Białystok, Poland
| | - Anna Szpakowicz
- Department of Cardiology, Medical University of Bialystok, Białystok, Poland
| | - Karol Adam Kamiński
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Białystok, Białystok, Poland
| | - Joanna Konopińska
- Department of Ophthalmology, Medical University of Bialystok, Białystok, 15-089, Poland
| |
Collapse
|
10
|
Gopalakrishnan N, Joshi A, Chhablani J, Yadav NK, Reddy NG, Rani PK, Pulipaka RS, Shetty R, Sinha S, Prabhu V, Venkatesh R. Recommendations for initial diabetic retinopathy screening of diabetic patients using large language model-based artificial intelligence in real-life case scenarios. Int J Retina Vitreous 2024; 10:11. [PMID: 38268046 PMCID: PMC10809735 DOI: 10.1186/s40942-024-00533-9] [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: 12/01/2023] [Accepted: 01/19/2024] [Indexed: 01/26/2024] Open
Abstract
PURPOSE To study the role of artificial intelligence (AI) to identify key risk factors for diabetic retinopathy (DR) screening and develop recommendations based on clinician and large language model (LLM) based AI platform opinions for newly detected diabetes mellitus (DM) cases. METHODS Five clinicians and three AI applications were given 20 AI-generated hypothetical case scenarios to assess DR screening timing. We calculated inter-rater agreements between clinicians, AI-platforms, and the "majority clinician response" (defined as the maximum number of identical responses provided by the clinicians) and "majority AI-platform" (defined as the maximum number of identical responses among the 3 distinct AI). Scoring was used to identify risk factors of different severity. Three, two, and one points were given to risk factors requiring screening immediately, within a year, and within five years, respectively. After calculating a cumulative screening score, categories were assigned. RESULTS Clinicians, AI platforms, and the "majority clinician response" and "majority AI response" had fair inter-rater reliability (k value: 0.21-0.40). Uncontrolled DM and systemic co-morbidities required immediate screening, while family history of DM and a co-existing pregnancy required screening within a year. The absence of these risk factors required screening within 5 years of DM diagnosis. Screening scores in this study were between 0 and 10. Cases with screening scores of 0-2 needed screening within 5 years, 3-5 within 1 year, and 6-12 immediately. CONCLUSION Based on the findings of this study, AI could play a critical role in DR screening of newly diagnosed DM patients by developing a novel DR screening score. Future studies would be required to validate the DR screening score before it could be used as a reference in real-life clinical situations. CLINICAL TRIAL REGISTRATION Not applicable.
Collapse
Affiliation(s)
- Nikhil Gopalakrishnan
- Department of Retina and Vitreous, Narayana Nethralaya Eye Hospital, #121/C, 1st R Block, Chord Road, Rajaji Nagar, Bengaluru, Karnataka, 560010, India
| | - Aishwarya Joshi
- Department of Retina and Vitreous, Narayana Nethralaya Eye Hospital, #121/C, 1st R Block, Chord Road, Rajaji Nagar, Bengaluru, Karnataka, 560010, India
| | - Jay Chhablani
- Medical Retina and Vitreoretinal Surgery, University of Pittsburgh School of Medicine, 203 Lothrop Street, Suite 800, Pittsburg, PA, 15213, USA
| | - Naresh Kumar Yadav
- Department of Retina and Vitreous, Narayana Nethralaya Eye Hospital, #121/C, 1st R Block, Chord Road, Rajaji Nagar, Bengaluru, Karnataka, 560010, India
| | - Nikitha Gurram Reddy
- Anant Bajaj Retina Institute, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, 500034, India
| | - Padmaja Kumari Rani
- Anant Bajaj Retina Institute, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, 500034, India
| | - Ram Snehith Pulipaka
- Prime Retina Eye Care Center, 3-6-106/1, Street Number 19, Opposite to Vijaya Diagnostic Centre, Himayatnagar, Hyderabad, Telangana, 500029, India
| | - Rohit Shetty
- Department of Cornea and Refractive Services, Narayana Nethralaya Eye Hospital, #121/C, 1st R Block, Chord Road, Rajaji Nagar, Bengaluru, Karnataka, 560010, India
| | - Shivani Sinha
- Department of Vitreo-Retina, Regional Institute of Ophthalmology, Indira Gandhi Institute of Medical Sciences, Sheikhpura, Patna, Bihar, 800014, India
| | - Vishma Prabhu
- Department of Retina and Vitreous, Narayana Nethralaya Eye Hospital, #121/C, 1st R Block, Chord Road, Rajaji Nagar, Bengaluru, Karnataka, 560010, India
| | - Ramesh Venkatesh
- Department of Retina and Vitreous, Narayana Nethralaya Eye Hospital, #121/C, 1st R Block, Chord Road, Rajaji Nagar, Bengaluru, Karnataka, 560010, India.
| |
Collapse
|
11
|
Maugeri G, D'Amico AG, Magrì B, Giunta S, Saccone S, Federico C, Bucolo C, Musumeci G, D'Agata V. Protective effect of pituitary adenylate cyclase activating polypeptide in diabetic keratopathy. Peptides 2023; 170:171107. [PMID: 37775045 DOI: 10.1016/j.peptides.2023.171107] [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: 07/10/2023] [Revised: 09/20/2023] [Accepted: 09/26/2023] [Indexed: 10/01/2023]
Abstract
Diabetic keratopathy (DK) is the major complication of the cornea characterizing diabetes-affected patients. This ocular pathology is correlated with the hyperglycemic state leading to delayed corneal wound healing and recurrent corneal ulcers. Pituitary adenylate cyclase-activating polypeptide (PACAP) is a neuropeptide with widespread distribution throughout the body, and exerting cytoprotective effects in the neural and non-neuronal parts of the eye, including the cornea. The purpose of the present study was to investigate whether changes in PACAP expression can concur for delayed epithelial wound healing in diabetic cornea and whether the protective effect of the peptide could be mediated through the activation of the EGFR signaling pathway, which has been reported to be impaired in DK. Expression and distribution of PACAP, PAC1R, and EGFR were investigated through immunohistochemistry analysis in the cornea of normal and diabetic rats. The role of the peptide on wound healing during DK was evaluated in an in vitro model represented by rabbit corneal epithelial cells grown in high glucose conditions. Western blotting and immunofluorescence analysis were used to examine the ability of PACAP to induce the activation of the EGFR/ERK1/2 signaling pathway. Our results showed that in diabetic cornea the expression of PACAP, PAC1R, and EGFR is drastically reduced. The treatment with PACAP via PAC1R activation enhanced cell viability and corneal epithelium wound healing in cells grown under high glucose conditions. Furthermore, both EGFR and ERK1/2 signaling was induced upon the peptide treatment. Overall, our results showed the trophic efficiency of PACAP for enhancing the corneal epithelium re-epithelialization suggesting that the peptide could be beneficially valuable as a treatment for DK.
Collapse
Affiliation(s)
- Grazia Maugeri
- Section of Anatomy, Histology and Movement Sciences, Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
| | - Agata Grazia D'Amico
- Section of System Biology, Department of Drug and Health Sciences, University of Catania, 95123 Catania, Italy
| | - Benedetta Magrì
- Section of Anatomy, Histology and Movement Sciences, Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
| | - Salvatore Giunta
- Section of Anatomy, Histology and Movement Sciences, Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
| | - Salvatore Saccone
- Section of Animal Biology, Department of Biological, Geological and Environmental Sciences, University of Catania, 95123 Catania, Italy
| | - Concetta Federico
- Section of Animal Biology, Department of Biological, Geological and Environmental Sciences, University of Catania, 95123 Catania, Italy
| | - Claudio Bucolo
- Pharmacology Section, Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
| | - Giuseppe Musumeci
- Section of Anatomy, Histology and Movement Sciences, Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
| | - Velia D'Agata
- Section of Anatomy, Histology and Movement Sciences, Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy.
| |
Collapse
|
12
|
Sapoznik KA, Gast TJ, Carmichael-Martins A, Walker BR, Warner RL, Burns SA. Retinal Arteriolar Wall Remodeling in Diabetes Captured With AOSLO. Transl Vis Sci Technol 2023; 12:16. [PMID: 37962539 PMCID: PMC10653262 DOI: 10.1167/tvst.12.11.16] [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: 04/27/2023] [Accepted: 10/11/2023] [Indexed: 11/15/2023] Open
Abstract
Purpose Adaptive optics scanning laser ophthalmoscopy (AOSLO) enables the visualization and measurement of the retinal microvasculature structure in humans. We investigated the hypothesis that diabetes mellitus (DM) induces remodeling to the wall structure in small retinal arterioles. These alterations may allow better understanding of vascular remodeling in DM. Methods We imaged retinal arterioles in one eye of 48 participants (26 with DM and 22 healthy controls) with an AOSLO. Structural metrics of 274 arteriole segments (203 with DM and 71 healthy controls) ≤ 50 µm in outer diameter (OD) were quantified and we compared differences in wall thickness (WT), wall-to-lumen ratio (WLR), inner diameter (ID), OD, and arteriolar index ratio (AIR) between controls and participants with DM. We also compared the individual AIR (iAIR) in groups of individuals. Results The WLR, WT, and AIRs were significantly different in the arteriole segments of DM participants (P < 0.001). The iAIR was significantly deviated in the DM group (P < 0.001) and further division of the participants with DM into groups revealed that there was an effect of the presence of diabetic retinopathy (DR) on the iAIR (P < 0.001). Conclusions DM induces remodeling of wall structure in small retinal arterioles and in groups of individuals. The use of AIR allows us to assess remodeling independently of vessel size in the retina and to compute an index for each individual subject. Translational Relevance High-resolution retinal imaging allows noninvasive assessment of small retinal vessel remodeling in DM that can improve our understanding of DM and DR in living humans.
Collapse
Affiliation(s)
- Kaitlyn A. Sapoznik
- School of Optometry, Indiana University, Bloomington, IN, USA
- College of Optometry, University of Houston, Houston, TX, USA
| | - Thomas J. Gast
- School of Optometry, Indiana University, Bloomington, IN, USA
| | | | | | - Raymond L. Warner
- School of Optometry, Indiana University, Bloomington, IN, USA
- Scheie Eye Institute, Department of Ophthalmology, University of Pennsylvania, Philadelphia, PA, USA
| | | |
Collapse
|
13
|
Zhang X, Luo Z, Li J, Lin Y, Li Y, Li W. Sestrin2 in diabetes and diabetic complications. Front Endocrinol (Lausanne) 2023; 14:1274686. [PMID: 37920252 PMCID: PMC10619741 DOI: 10.3389/fendo.2023.1274686] [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: 08/08/2023] [Accepted: 10/03/2023] [Indexed: 11/04/2023] Open
Abstract
Diabetes is a global health problem which is accompanied with multi-systemic complications. It is of great significance to elucidate the pathogenesis and to identify novel therapies of diabetes and diabetic complications. Sestrin2, a stress-inducible protein, is primarily involved in cellular responses to various stresses. It plays critical roles in regulating a series of cellular events, such as oxidative stress, mitochondrial function and endoplasmic reticulum stress. Researches investigating the correlations between Sestrin2, diabetes and diabetic complications are increasing in recent years. This review incorporates recent findings, demonstrates the diverse functions and regulating mechanisms of Sestrin2, and discusses the potential roles of Sestrin2 in the pathogenesis of diabetes and diabetic complications, hoping to highlight a promising therapeutic direction.
Collapse
Affiliation(s)
- Xiaodan Zhang
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zirui Luo
- The Second Clinical Medicine School, Guangzhou Medical University, Guangzhou, China
| | - Jiahong Li
- The Second Clinical Medicine School, Guangzhou Medical University, Guangzhou, China
| | - Yaxuan Lin
- The Second Clinical Medicine School, Guangzhou Medical University, Guangzhou, China
| | - Yu Li
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Wangen Li
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| |
Collapse
|
14
|
Yilmaz YC, Hayat SC, Ipek SC. Analysis of Corneal and Lens Densitometry Changes in Patients With Type 1 Diabetes Mellitus. Am J Ophthalmol 2023; 254:23-30. [PMID: 37269970 DOI: 10.1016/j.ajo.2023.05.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 05/14/2023] [Accepted: 05/24/2023] [Indexed: 06/05/2023]
Abstract
PURPOSE By comparing the densitometry findings of patients with type 1 diabetes mellitus (T1DM) and the healthy group, we aimed to understand the possible changes that may occur in the cornea and lens in those with diabetes mellitus (DM). DESIGN Prospective, cross-sectional study. METHODS A total of 60 eyes of 60 patients with T1DM and 101 eyes of 101 healthy subjects were included in this study. A complete ophthalmologic evaluation was performed in all participants. Scheimpflug tomography was performed to record the corneal and lens densitometry and other tomographic data. Mean glycosylated hemoglobin (HbA1c) and mean DM duration were recorded. RESULTS The mean age of the patients with T1DM and patients in the control group was 29.93 ± 8.56 years and 27.27 ± 1 4.96 years, respectively. The mean HbA1c was 8.43 ± 1.92, and the mean DM duration was 14.10 ± 7.77 years. Corneal densitometry (CD) values were significantly higher in the 0- to 2-mm zone in all layers and in the anterior and central 6- to 10-mm zone in the diabetic group (P = .03, P = .018, P = .001, P = .000, P = .004). The mean crystalline lens densitometry was higher in the T1DM group (P = .129). There were positive correlations between DM duration and CD in the anterior 0- to 2-mm (P = .043), central 6- to 10-mm (P = .016), posterior 6- to 10-mm (P = .022), and posterior 10- to 12-mm zone (P = .043). CONCLUSIONS CD values were significantly higher in the diabetic group. Diabetes duration and HbA1c values showed correlations with densitometry especially in the 6- to 10-mm corneal zone. Evaluation of the cornea with optical densitometry will be useful in the early diagnosis and follow-up of clinical structural and functional changes in the cornea.
Collapse
Affiliation(s)
- Yusuf Cem Yilmaz
- From the The Agri İbrahim Cecen University Faculty of Medicine, Department of Ophthalmology, Agri, Turkey (Y.C.Y., S.C.I.).
| | - Serife Ciloglu Hayat
- Başakşehir Çam Sakura State Hospital, Department of Ophthalmology, Istanbul, Turkey (S.C.H.)
| | - Sefik Can Ipek
- From the The Agri İbrahim Cecen University Faculty of Medicine, Department of Ophthalmology, Agri, Turkey (Y.C.Y., S.C.I.)
| |
Collapse
|
15
|
Echiverri A, Harrison WW. Evaluation of retinal structure and function in prediabetes. DIABETES EPIDEMIOLOGY AND MANAGEMENT 2023; 12:100154. [PMID: 38037572 PMCID: PMC10688557 DOI: 10.1016/j.deman.2023.100154] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
Purpose Alterations in retinal structure and function have been well documented in type 2 diabetes (T2DM). However, few studies have evaluated the eye in prediabetes (preDM), a precursor to T2DM. It is unknown which retinal deficits, if any, occur before T2DM diagnosis. This study evaluates retinal structure via optical coherence tomography (OCT) and retinal function via multifocal electroretinogram (mfERG) N1 and P1 in those with PreDM. The goal is to evaluate associations between structure and function across glucose dysfunction. Methods 85 subjects (aged 28-69yrs) were tested with VERIS mfERG and Heidelberg Spectralis OCT. Demographic and health information was collected. Subjects were grouped by HbA1c: 33 controls (HbA1c <5.7%), 31 with preDM (HbA1c 5.7-6.4%), and 21 with T2DM (HbA1c >6.4% at the time of testing or diagnosed by physician) and mild or no retinopathy. mfERG N1 and P1 latency and amplitude were measured for the right eye in the foveal hexagon (central 2.4°). Average macular thickness was also measured over the central 3.3°. Groups were compared with ANOVA and corrected t-tests. Models of these associations with diabetes diagnosis (in groups above) were created with backward multivariate regression. Results The T2DM group was exceptionally well-controlled with an HbA1c of 7.0% ± 0.68 but also had elevated systolic blood pressure compared to other groups (P<0.01). The age of the control group was younger (P<0.01), so other testing was age controlled. There was a borderline but statistically significant difference in P1 between the control group and both the preDM and T2DM groups after Bonferroni corrections (P<0.03). There was also a difference in N1 latency between the control and other groups (P<0.001). A multivariate model demonstrated a significant relationship between T2DM/PreDM diagnosis and delayed N1 latency, reduced foveal thickness, and age. Conclusions Structure and function together can provide an associative model of preDM or T2DM changes for patients. Based on this multivariate model, N1 is strongly associated with preDM and T2DM. N1 findings and decreasing foveal thickness are additive and can together inform ocular health related to preDM. Future longitudinal studies are needed to understand changes in function and structure in preDM and T2DM.
Collapse
Affiliation(s)
- Angelica Echiverri
- University of Houston College of Optometry, 4401 Martin Luther King Blvd, Houston, TX 77204, USA
| | - Wendy W. Harrison
- University of Houston College of Optometry, 4401 Martin Luther King Blvd, Houston, TX 77204, USA
| |
Collapse
|
16
|
Regu VPR, Behera D, Sunkara SP, Gohel V, Tripathy S, Swain RP, Subudhi BB. Ocular Delivery of Metformin for Sustained Release and in Vivo Efficacy. J Pharm Sci 2023; 112:2494-2505. [PMID: 37031863 DOI: 10.1016/j.xphs.2023.04.002] [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: 02/17/2023] [Revised: 04/03/2023] [Accepted: 04/03/2023] [Indexed: 04/11/2023]
Abstract
Metformin is known to lower inflammation, independent of its anti-diabetic action. Thus, topical metformin can be a therapeutic strategy for managing ocular inflammation associated with diabetes. To achieve this and address the issues of ocular retention and controlled release an in situ gel of metformin was developed. The formulations were prepared using sodium hyaluronate, hypromellose, and gellan gum. The composition was optimized by monitoring gelling time/capacity, viscosity, and mucoadhesion. MF5 was selected as the optimized formulation. It showed both chemical and physiological compatibility. It was found to be sterile and stable. MF5 exhibited sustained release of metformin for 8h that fitted best with zero-order kinetics. Further, the release mode was found to be close to the Korsmeyer-Peppas model. Supported by an ex vivo permeation study, it showed potential for prolonged action. It showed a significant reduction in ocular inflammation that was comparable to that of the standard drug. MF5 shows translational potential as a safe alternative to steroids for managing ocular inflammation.
Collapse
Affiliation(s)
- Vara Prasada Rao Regu
- Drug Development and Analysis Laboratory, School of Pharmaceutical Sciences, Siksha O Anusandhan (Deemed to be) University, Bhubaneswar, Odisha, India
| | - Dhananjay Behera
- Drug Development and Analysis Laboratory, School of Pharmaceutical Sciences, Siksha O Anusandhan (Deemed to be) University, Bhubaneswar, Odisha, India
| | - Sai Prathyusha Sunkara
- Drug Development and Analysis Laboratory, School of Pharmaceutical Sciences, Siksha O Anusandhan (Deemed to be) University, Bhubaneswar, Odisha, India
| | - Vinit Gohel
- Drug Development and Analysis Laboratory, School of Pharmaceutical Sciences, Siksha O Anusandhan (Deemed to be) University, Bhubaneswar, Odisha, India; ProCyto Labs Pvt Ltd., KIIT-TBI, Bhubaneswar, Odisha 751024, India
| | - Shyamalendu Tripathy
- Drug Development and Analysis Laboratory, School of Pharmaceutical Sciences, Siksha O Anusandhan (Deemed to be) University, Bhubaneswar, Odisha, India
| | - Ranjit Prasad Swain
- Drug Development and Analysis Laboratory, School of Pharmaceutical Sciences, Siksha O Anusandhan (Deemed to be) University, Bhubaneswar, Odisha, India
| | - Bharat Bhusan Subudhi
- Drug Development and Analysis Laboratory, School of Pharmaceutical Sciences, Siksha O Anusandhan (Deemed to be) University, Bhubaneswar, Odisha, India.
| |
Collapse
|
17
|
Reihanifar T, Şahin M, Stefek M, Ceylan AF, Karasu Ç. Cemtirestat, an aldose reductase inhibitor and antioxidant compound, induces ocular defense against oxidative and inflammatory stress in rat models for glycotoxicity. Cell Biochem Funct 2023; 41:622-632. [PMID: 37272424 DOI: 10.1002/cbf.3818] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/15/2023] [Accepted: 05/27/2023] [Indexed: 06/06/2023]
Abstract
Fructose, endogenously produced as a consequence of activation of the polyol pathway under hyperglycemic conditions, contribute to formation of advanced glycoxidation end products (AGEs) and carbonyl stress. Oxidative stress is increased in diabetes (DM) due to AGEs formation and the utilization of NADPH by aldo-keto reductase, AKR1B1(AR), the first enzyme in polyol pathway. Since inhibition of AR is an attractive approach for the management of diabetic eye diseases, we aimed to compare the effects of a novel AR inhibitor (ARI)/antioxidant (AO) compound cemtirestat on eye tissues with the effects of ARI drug epalrestat and AO agent stobadine in rat model for glycotoxicity. One group of rats was fed high fructose (10% drinking water; 14 weeks), while type-2 DM was induced in the other group of rats with fructose plus streptozotocin (40 mg/kg-bw/day). Diabetic (D) and nondiabetic fructose-fed rats (F) were either untreated or treated with two different doses of cemtirestat (2.5 and 7.5 mg/kg-bw/day), epalrestat (25 and 50 mg/kg-bw/day), or stobadine (25 and 50 mg/kg-bw/day) for 14 weeks. Cemtirestat, epalrestat, and stobadine elaviate the increase in TNF-α, IL-1β, NF-ƙB, and caspase-3 in retina, lens, cornea, and sclera of F and D rats. Both glycotoxicity models resulted in a decrease in GSH to GSSG ratio and a change in glutathione S-transferase activity in eye tissues, but these alterations were improved especially with cemtirestat and stobadine. Lens D-sorbitol of D rats increased more than that of F rats, this increase was only attenuated by cemtirestat and epalrestat. Epalrestat was more effective than cemtirestat and stobadine in inhibiting the increase of vascular endothelial growth factor (VEGF) in the retina of F and D rats. Cemtirestat and stobadine but not epalrestat decreased high level of Nε-(carboxymethyl)lysine in the lens and retina of F and D rats. Cemtirestat is a potential therapeutic in protecting the rat eye against glycotoxicity insults.
Collapse
Affiliation(s)
- Tala Reihanifar
- Cellular Stress Response and Signal Transduction Research Laboratory, Department of Medical Pharmacology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Muzaffer Şahin
- Department of Ophthalmology, Ankara City Hospital General Hospital (MHC), Eye Section, Ankara, Turkey
| | - Milan Stefek
- Institute of Experimental Pharmacology and Toxicology, CEM, Slovak Academy of Sciences, Bratislava, Slovak Republic
| | - Aslı F Ceylan
- Department of Medical Pharmacology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Çimen Karasu
- Cellular Stress Response and Signal Transduction Research Laboratory, Department of Medical Pharmacology, Faculty of Medicine, Gazi University, Ankara, Turkey
| |
Collapse
|
18
|
Gverović Antunica A, Znaor L, Ivanković M, Puzović V, Marković I, Kaštelan S. Vitamin D and Diabetic Retinopathy. Int J Mol Sci 2023; 24:12014. [PMID: 37569392 PMCID: PMC10418882 DOI: 10.3390/ijms241512014] [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: 06/29/2023] [Revised: 07/23/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
Diabetic retinopathy (DR) is the most common eye disease complication of diabetes, and hypovitaminosis D is mentioned as one of the risk factors. Vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol) are the best-known forms of vitamin D. Calcitriol (1,25-dihydroxycholecalciferol) is the active form of vitamin D, with the sun being one of its main sources. Vitamin D is synthesized in the skin by exposure to sunlight without protective factors, but care must be taken to avoid the development of sunburn. It not only plays an important role in maintaining healthy bones and immune system but has also been highlighted in numerous studies to have an influence on various diseases, including diabetic retinopathy. A large number of people suffer from vitamin D hypovitaminosis worldwide, and diagnosis is made by measuring the concentration of 25-hydroxyvitamin D (25(OH)D) in serum. Its deficiency can cause numerous diseases and, as such, supplementation is necessary. Clinical studies have proven the effectiveness of vitamin D supplementation in the treatment of diabetic retinopathy, but with a doctor's recommendation and supervision due to possible negative side effects.
Collapse
Affiliation(s)
| | - Ljubo Znaor
- Clinical Department of Ophthalmology, University Hospital Center, 21000 Split, Croatia
| | - Mira Ivanković
- Department of Neurology, General Hospital Dubrovnik, 20000 Dubrovnik, Croatia
| | - Velibor Puzović
- Department of Pathology, General Hospital Dubrovnik, 20000 Dubrovnik, Croatia
| | - Irena Marković
- Clinical Department of Ophthalmology, University Hospital Center, 21000 Split, Croatia
| | - Snježana Kaštelan
- Department of Ophthalmology, University Hospital Dubrava, 10000 Zagreb, Croatia
| |
Collapse
|
19
|
Khan J, Shaw S. Risk of cataract and glaucoma among older persons with diabetes in India: a cross-sectional study based on LASI, Wave-1. Sci Rep 2023; 13:11973. [PMID: 37488196 PMCID: PMC10366202 DOI: 10.1038/s41598-023-38229-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 07/05/2023] [Indexed: 07/26/2023] Open
Abstract
According to the International Diabetes Federation-2019 estimates, India is home to 77 million diabetic individuals which is projected to grow up to 147.2 million by 2045. Diabetes being a progressive health disorder leads to multiple morbidities and complications including eye diseases and visual impairments. As the burden of diabetes mellitus is increasing, eye problems like cataracts and glaucoma are commonly cited problems among the older adults. In this context, this study aims to provide the public health evidences on diabetes associated burden and risk of developing cataracts and glaucoma among older adults aged 60 and above in India. The analytical sample of this cross-sectional study comprised of 31,464 individuals aged 60 and above. Bivariate cross-tabulation and chi-square test were performed to understand the differential in the prevalence of cataracts and glaucoma by diabetes mellitus including the socio-economic and demographic characteristics of the individuals. Binary logistic regression estimation was executed to estimate the adjusted odds ratio for each of the outcome variables within a multivariate framework. The cataract problem affects more than one-fifth of the older people, while glaucoma affects 2% of them. The prevalence of cataract and glaucoma is 29% among diabetic older adults compared to 22% among non-diabetic persons. In terms of gender, the cataract prevalence is comparatively higher among females (25%) than males (21%). It is important to note that while adjusting for socio-economic and demographic characteristics, the likelihood of cataract (AOR 1.495; p-value < 0.01) and glaucoma (AOR 1.554; p-value < 0.01) is significantly higher among older adults with diabetes than among their counterparts. Medical practitioners should conduct prognosis for diabetic eye problems among patients and raise awareness about the potential risks of developing vision loss, such as cataracts and glaucoma, which are more prevalent among individuals with diabetes.
Collapse
Affiliation(s)
- Junaid Khan
- Department of Population and Development, International Institute for Population Sciences, Mumbai, India
| | - Subhojit Shaw
- Department of Population and Development, International Institute for Population Sciences, Mumbai, India.
| |
Collapse
|
20
|
Tan Y, Sun X. Ocular images-based artificial intelligence on systemic diseases. Biomed Eng Online 2023; 22:49. [PMID: 37208715 DOI: 10.1186/s12938-023-01110-1] [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: 02/14/2023] [Accepted: 05/02/2023] [Indexed: 05/21/2023] Open
Abstract
PURPOSE To provide a summary of the research advances on ocular images-based artificial intelligence on systemic diseases. METHODS Narrative literature review. RESULTS Ocular images-based artificial intelligence has been used in a variety of systemic diseases, including endocrine, cardiovascular, neurological, renal, autoimmune, and hematological diseases, and many others. However, the studies are still at an early stage. The majority of studies have used AI only for diseases diagnosis, and the specific mechanisms linking systemic diseases to ocular images are still unclear. In addition, there are many limitations to the research, such as the number of images, the interpretability of artificial intelligence, rare diseases, and ethical and legal issues. CONCLUSION While ocular images-based artificial intelligence is widely used, the relationship between the eye and the whole body should be more clearly elucidated.
Collapse
Affiliation(s)
- Yuhe Tan
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Xufang Sun
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.
| |
Collapse
|
21
|
Jarab AS, Al-Qerem W, Alqudah S, Abu Heshmeh SR, Mukattash TL, Alzoubi KH. Blood pressure control and its associated factors in patients with hypertension and type 2 diabetes. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2023. [DOI: 10.29333/ejgm/13028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
In this retrospective study, the medical records of hypertensive patients with type 2 diabetes attending two major hospitals were reviewed to find the factors associated with poor blood pressure control in patients who have diabetes as a comorbid disease with hypertension. Binary regression analysis was conducted to find the factors independently associated with BP control. A total of 522 participants were included in the study. Most of the participants had uncontrolled hypertension (63.4%) and uncontrolled type 2 diabetes (51.3%). Regression results revealed that having retinopathy (OR=1.468 (95% CI: 1.020-2.113), p<0.05), and not receiving dipeptidyl-peptidase 4 (DPP4) inhibitors were independently associated with uncontrolled BP (OR=0.633 (95%CI 0.423-0.946), p<0.05). Therefore, greater efforts should be exerted to improve BP control in hypertensive patients with type 2 diabetes, particularly in those suffering from retinopathy.
Collapse
Affiliation(s)
- Anan S Jarab
- College of Pharmacy, Al Ain University, Abu Dhabi, UAE
- Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid, JORDAN
| | - Walid Al-Qerem
- Department of Pharmacy, Al-Zaytoonah University of Jordan, Amman, JORDAN
| | - Salam Alqudah
- Department of Pharmacy, Jordanian Royal Medical Services, Amman, JORDAN
| | - Shrouq R Abu Heshmeh
- Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid, JORDAN
| | - Tareq L Mukattash
- Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid, JORDAN
| | - Karem H Alzoubi
- Department of Pharmacy Practice and Pharmacotherapeutics, University of Sharjah, Sharjah, UAE
- Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, JORDAN
| |
Collapse
|
22
|
Hu WS, Lin CL. Diabetic patients with and without sodium-glucose cotransporter-2 inhibitors use and cataract risk: real-world observational investigation. Acta Diabetol 2023; 60:981-987. [PMID: 37083962 DOI: 10.1007/s00592-023-02087-y] [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: 02/11/2023] [Accepted: 03/22/2023] [Indexed: 04/22/2023]
Abstract
PURPOSE We tried to define the association of type 2 diabetes mellitus (T2DM) patients with and without sodium-glucose cotransporter-2 inhibitors (SGLT2I) use and incident cataract using nationwide data in Taiwan. METHODS In a Cox proportional hazards regression model, we estimated the hazard ratios (HR) and 95% confidence intervals (95% CI). We considered risk factors for variables of sex, age, comorbidities and medications that we adjusted in multivariable Cox model. RESULTS We identified 20,768 T2DM patients in this study; 10,384 patients in the SGLT2I cohort, and 10,384 controls in the non-SGLT2I cohort. Compared with the T2DM patients without SGLT2I, T2DM patients using SGLT2I had a 2.04-fold increased risk of cataract, after adjustment by sex, age, comorbidities and medications. CONCLUSION Increased risk of cataract among diabetic patients who took SGLT2I was found in this study.
Collapse
Affiliation(s)
- Wei-Syun Hu
- School of Medicine, College of Medicine, China Medical University, Taichung, 40402, Taiwan.
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, Taichung, 40447, Taiwan.
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, 40447, Taiwan
| |
Collapse
|
23
|
Mrugacz M, Pony-Uram M, Bryl A, Zorena K. Current Approach to the Pathogenesis of Diabetic Cataracts. Int J Mol Sci 2023; 24:ijms24076317. [PMID: 37047290 PMCID: PMC10094546 DOI: 10.3390/ijms24076317] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/13/2023] [Accepted: 03/25/2023] [Indexed: 03/30/2023] Open
Abstract
Cataracts remain the first or second leading cause of blindness in all world regions. In the diabetic population, cataracts not only have a 3–5 times higher incidence than in the healthy population but also affect people at a younger age. In patients with type 1 diabetes, cataracts occur on average 20 years earlier than in the non-diabetic population. In addition, the risk of developing cataracts increases with the duration of diabetes and poor metabolic control. A better understanding of the mechanisms leading to the formation of diabetic cataracts enables more effective treatment and a holistic approach to the patient.
Collapse
|
24
|
Lin CJ, Hsu AY, Tien PT, Chang CH, Lai CT, Hsia NY, Yang YC, Bair H, Chen HS, Chen WL, Tsai YY. Diabetic retinopathy as a potential risk factor for ptosis: A 13-year nationwide population-based cohort study in Taiwan. FRONTIERS IN EPIDEMIOLOGY 2023; 3:1093064. [PMID: 38455898 PMCID: PMC10910925 DOI: 10.3389/fepid.2023.1093064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 02/24/2023] [Indexed: 03/09/2024]
Abstract
Purpose To determine the risk of ptosis among diabetic retinopathy (DR) patients. Methods This is a population-based, retrospective, matched-cohort study where DR patients were recruited from the Taiwan National Health Insurance Research Database (NHIRD) to investigate the risk of developing ptosis. Preexisting co-factors of interest included smoking status and medical comorbidities of hyperlipidemia and hypertension. Statistical analysis was performed using T-test, Cox-proportional hazard ratios adjusted for comorbidities (aHR), Wilcoxon rank sum test, Kaplan-Meier estimators, and log rank tests. Results Follow-up data of 9,494 patients with DR and 37,976 matched control cohort (non-DR) from 2000 to 2012 were analyzed. DR patients were found to have significantly increased risk of developing ptosis (adjusted hazard ratio (HR) [95% CI]: 2.76 [1.74-4.38], p < 0.001) when compared to the control cohort. From analysis in different strata, adult age and non-smokers were shown to have higher risk for ptosis development among DR patients. Furthermore, DR patients was also found to have increased risk of developing ptosis when compared to matched controls, regardless of whether they had medical comorbidities of lipid metabolism disorders or hypertension. Conclusions In this large-scale study using real-world data, our results showed that DR patients were found to have increased risk of developing ptosis. Female gender, adult age, and non-smokers were also shown to increase the risk of ptosis among DR patients. This has implications towards the care of diabetic patients, complications such as ptosis should be properly screened for when encountering such patients. Before ptosis surgery, the possibility of underlying diabetes or DR should be also scrutinized and treated properly to avoid undesirable postoperative dissension.
Collapse
Affiliation(s)
- Chun-Ju Lin
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Optometry, Asia University, Taichung, Taiwan
| | - Alan Y. Hsu
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan
- Department of General Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Peng-Tai Tien
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan
- Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taichung, Taiwan
| | - Cheng-Hsien Chang
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan
- Department of Ophthalmology, Changhua Hospital, Changhua, Taiwan
| | - Chun-Ting Lai
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Ning-Yi Hsia
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Yu-Cih Yang
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - Henry Bair
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan
- Byers Eye Institute, Stanford University School of Medicine, Stanford, CA, United States
| | - Huan-Sheng Chen
- An-Shin Dialysis Center, NephroCare Ltd., Fresenius Medical Care, Taichung, Taiwan
| | - Wen-Lu Chen
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Yi-Yu Tsai
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Optometry, Asia University, Taichung, Taiwan
| |
Collapse
|
25
|
Evaluation and comparison of subjective and objective anterior ocular surface damage in patients with type 2 diabetes mellitus and dry eye disease. Graefes Arch Clin Exp Ophthalmol 2023; 261:447-452. [PMID: 36029307 DOI: 10.1007/s00417-022-05806-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 07/15/2022] [Accepted: 08/10/2022] [Indexed: 01/17/2023] Open
Abstract
PURPOSE To evaluate anterior ocular surface damage in patients with type 2 diabetes mellitus and dry eye disease in comparison to non-diabetic controls based on conjunctival impression cytology, objective scales (Efron, Oxford) and OSDI, to correlate vision-related quality of life with grades of squamous metaplasia in T2DM patients suffering from DED. METHODS All participants underwent complete ophthalmologic examination including Shirmer test, TBUT, conjunctival/corneal staining (Oxford scheme), evaluation of conjunctival redness (Efron grading scale), and conjunctival impression cytology (Nelson's scale). The OSDI questionnaire was completed by both groups of patients to assess severity of DED and QoL. RESULTS Squamous metaplasia was observed in 94% of the study group and 19.3% of controls (p = 0.0000). Based on the OSDI scores, 73.5% of patients reported mild DED and 26.5% suffered from moderate DED in the study group. The mean OSDI score for the study group with Nelson's grade 2 was 18 ± 3.52 and 20.8 ± 4.68 for Nelson's grade 3, respectively (p = 0.0745). Hence, no significant difference in QoL between grade 2 and grade 3 of squamous metaplasia was observed in patients of the study group. CONCLUSION Impression cytology is a reliable minimally invasive tool for an accurate evaluation of the ocular surface damage in patients with DED and type 2 diabetes mellitus. Severe squamous metaplasia (Nelson's grade 3) was observed in 29.4% (10/34) of T2DM patients. In contrast, it was not detected in the control group (p = 0.0032). The absence of goblet cells in T2DM patients nether significantly reduces QoL nor contributes to the subjective DED severity (OSDI) due to complex pathways leading to DED. Thus, diagnosis of DED severity should not be solely based on subjective symptoms in this population.
Collapse
|
26
|
Diplotti L, Pignatto S, Franco F, Zanatta M, Veritti D, Cogo P, Lanzetta P. Ocular complications of diabetes mellitus in a pediatric population and proposals for screening and follow-up programs. Ther Adv Ophthalmol 2023; 15:25158414231174141. [PMID: 37333996 PMCID: PMC10272666 DOI: 10.1177/25158414231174141] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 04/08/2023] [Indexed: 06/20/2023] Open
Abstract
Background Diabetes mellitus (DM) is one of the world's greatest health emergencies of the 21st century. Ocular complications of DM are commonly chronic and progressive, but vision loss can be effectively prevented or delayed with early detection and timely treatment. Therefore, regular comprehensive ophthalmologic examinations are mandatory. Ophthalmic screening and dedicated follow-up for adults with DM are well established, whereas, there is no consensus on optimal recommendations for the pediatric population, reflecting the lack of clarity about the current burden of disease in this age group. Objectives To determine the epidemiology of ocular complications of diabetes and to assess optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) macular features in a pediatric population with DM. To review ophthalmological screening and follow-up plans for the diabetic pediatric population. Design Observational study. Methods Retrospective consecutive cohort study of all 165 diabetic patients (330 eyes) aged 0-18 years, examined between January 2006 and September 2018 at the Pediatric Department of 'S. Maria della Misericordia' Udine Hospital who underwent at least one complete ophthalmologic examination at the Ophthalmology University Clinic at the Udine Hospital. OCT and OCTA data were available for 37 patients (72 eyes, 2 excluded). The associations between ocular complications and selected potential risk factors were evaluated by univariate analyses. Results No patient had signs of ocular diabetic complications or any macular morphological or micro-vascular impairment, regardless of any potential risk factor. The prevalence of strabismus and refractive errors in the study group, was found to be similar to non-diabetic pediatric populations. Conclusion Screening and follow-up of ocular diabetic complications in children and adolescents could be performed less frequently than in adults with diabetes. There is no need to screen potentially treatable visual disorders in diabetic children earlier or more frequently than in the healthy children thus reducing time spent in hospital and permitting a better tolerance to medical examinations in diabetic pediatric patients. We described the OCT and OCTA patterns in a pediatric population with DM.
Collapse
Affiliation(s)
- Laura Diplotti
- Department of Ophthalmology, Institute for Maternal and Child Health–IRCCS ‘Burlo Garofolo’, Trieste, Italy
| | - Silvia Pignatto
- Department of Medicine–Ophthalmology, University of Udine, Udine, Italy
| | - Francesca Franco
- Department of Paediatrics, Presidio Ospedaliero Universitario ‘Santa Maria della Misericordia’, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Manuela Zanatta
- Department of Rare Diseases, Presidio Ospedaliero Universitario ‘Santa Maria della Misericordia’, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Daniele Veritti
- Department of Medicine–Ophthalmology, University of Udine, Udine, Italy
| | - Paola Cogo
- Department of Paediatrics, Presidio Ospedaliero Universitario ‘Santa Maria della Misericordia’, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | | |
Collapse
|
27
|
Luo M, Wang YT, Wang XK, Hou WH, Huang RL, Liu Y, Wang JQ. A multi-granularity convolutional neural network model with temporal information and attention mechanism for efficient diabetes medical cost prediction. Comput Biol Med 2022; 151:106246. [PMID: 36343403 DOI: 10.1016/j.compbiomed.2022.106246] [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: 06/06/2022] [Revised: 09/30/2022] [Accepted: 10/22/2022] [Indexed: 12/27/2022]
Abstract
As the cost of diabetes treatment continues to grow, it is critical to accurately predict the medical costs of diabetes. Most medical cost studies based on convolutional neural networks (CNNs) ignore the importance of multi-granularity information of medical concepts and time interval characteristics of patients' multiple visit sequences, which reflect the frequency of patient visits and the severity of the disease. Therefore, this paper proposes a new end-to-end deep neural network structure, MST-CNN, for medical cost prediction. The MST-CNN model improves the representation quality of medical concepts by constructing a multi-granularity embedding model of medical concepts and incorporates a time interval vector to accurately measure the frequency of patient visits and form an accurate representation of medical events. Moreover, the MST-CNN model integrates a channel attention mechanism to adaptively adjust the channel weights to focus on significant medical features. The MST-CNN model systematically addresses the problem of deep learning models for temporal data representation. A case study and three comparative experiments are conducted using data collected from Pingjiang County. Through experiments, the methods used in the proposed model are analyzed, and the super contribution of the model performance is demonstrated.
Collapse
Affiliation(s)
- Min Luo
- School of Business, Central South University, Changsha, 410083, PR China
| | - Yi-Ting Wang
- School of Business, Central South University, Changsha, 410083, PR China
| | - Xiao-Kang Wang
- School of Business, Central South University, Changsha, 410083, PR China
| | - Wen-Hui Hou
- School of Business, Central South University, Changsha, 410083, PR China
| | - Rui-Lu Huang
- School of Business, Central South University, Changsha, 410083, PR China
| | - Ye Liu
- School of Business, Central South University, Changsha, 410083, PR China
| | - Jian-Qiang Wang
- School of Business, Central South University, Changsha, 410083, PR China.
| |
Collapse
|
28
|
Zhou Y, Li X, Sun Q, Wei J, Liu H, Wang K, Luo J. Adherence to Annual Fundus Exams among Chinese Population with Diagnosed Diabetes. J Clin Med 2022; 11:jcm11226859. [PMID: 36431336 PMCID: PMC9697630 DOI: 10.3390/jcm11226859] [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: 10/08/2022] [Revised: 11/08/2022] [Accepted: 11/14/2022] [Indexed: 11/22/2022] Open
Abstract
Adherence to annual fundus examinations in the Chinese population with diabetes and its correlates have not been investigated. The present study obtained data for the first nationally representative survey in China, China Health and Retirement Longitudinal Survey (CHARLS), which collected a wide range of data every 2 years, including demographic, socioeconomic, medical and lifestyle-related information. The adherence rates to annual fundus exams across four waves (2011−2018) were assessed. Univariate and multivariable logistic regressions were used to determine factors associated with adherence. The adherence rates to annual fundus examinations of ou study population were 23.6% in 2011, 15.3% in 2013, 17.5% in 2015 and 21.5% in 2018, respectively. Consistent results over four waves showed that non-adherent patients had a relatively lower educational level, insufficient diabetes medication use, fewer non-medication treatments and irregular physical examination compared to those who were adherent to the annual fundus exam (all p values < 0.05). These variables were further identified as factors associated with adherence according to univariate and multivariate logistic regression analyses (all p values < 0.05). The present study provides explicit evidence that the adherence rate to annual fundus examinations among Chinese population with diabetes is worryingly low. Insufficient educational attainment, especially specific diabetes education, has a negative impact on patients’ adherence to clinical guideline for eye health.
Collapse
Affiliation(s)
- Yifan Zhou
- Department of Ophthalmology, Putuo People’s Hospital, Tongji University, Shanghai 200060, China
| | - Xiaowen Li
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai 200032, China
- NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai 200032, China
- Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai 200032, China
| | - Qinglei Sun
- Department of Ophthalmology, Shanghai East Hospital, Shanghai 200120, China
| | - Jin Wei
- Department of Ophthalmology, Shanghai General Hospital (Shanghai First People’s Hospital), School of Medicine, Shanghai JiaoTong University, Shanghai 200080, China
- National Clinical Research Center for Eye Diseases, Shanghai 200080, China
- Shanghai Key Laboratory of Fundus Diseases, Shanghai 200080, China
| | - Haiyun Liu
- Department of Ophthalmology, Shanghai General Hospital (Shanghai First People’s Hospital), School of Medicine, Shanghai JiaoTong University, Shanghai 200080, China
- National Clinical Research Center for Eye Diseases, Shanghai 200080, China
- Shanghai Key Laboratory of Fundus Diseases, Shanghai 200080, China
| | - Keyan Wang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai 200031, China
- Correspondence: (K.W.); (J.L.)
| | - Jianfeng Luo
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai 200032, China
- NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai 200032, China
- Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai 200032, China
- Correspondence: (K.W.); (J.L.)
| |
Collapse
|
29
|
Impact of High Glucose on Ocular Surface Glycocalyx Components: Implications for Diabetes-Associated Ocular Surface Damage. Int J Mol Sci 2022; 23:ijms232214289. [PMID: 36430770 PMCID: PMC9696111 DOI: 10.3390/ijms232214289] [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: 10/19/2022] [Revised: 11/11/2022] [Accepted: 11/12/2022] [Indexed: 11/19/2022] Open
Abstract
Diabetes mellitus causes several detrimental effects on the ocular surface, including compromised barrier function and an increased risk of infections. The glycocalyx plays a vital role in barrier function. The present study was designed to test the effect of a high glucose level on components of glycocalyx. Stratified human corneal and conjunctival epithelial cells were exposed to a high glucose concentration for 24 and 72 h. Changes in Mucin (MUC) 1, 4, 16 expression were quantified using real-time PCR and ELISA. Rose bengal and jacalin staining were used to assess the spatial distribution of MUC16 and O-glycosylation. Changes in the gene expression of five glycosyltransferases and forty-two proteins involved in cell proliferation and the cell cycle were also quantified using PCR and a gene array. High glucose exposure did not affect the level or spatial distribution of membrane-tethered MUC 1, 4, and 16 either in the corneal or conjunctival epithelial cells. No change in gene expression in glycosyltransferases was observed, but a decrease in the gene expression of proteins involved in cell proliferation and the cell cycle was observed. A high-glucose-mediated decrease in gene expression of proteins involved in cellular proliferation of corneal and conjunctival epithelial cells may be one of the mechanisms underlying a diabetes-associated decrease in ocular surface's glycocalyx.
Collapse
|
30
|
Wang FY, Kang EYC, Liu CH, Ng CY, Shao SC, Lai ECC, Wu WC, Huang YY, Chen KJ, Lai CC, Hwang YS. Diabetic Patients With Rosacea Increase the Risks of Diabetic Macular Edema, Dry Eye Disease, Glaucoma, and Cataract. Asia Pac J Ophthalmol (Phila) 2022; 11:505-513. [PMID: 36417674 DOI: 10.1097/apo.0000000000000571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 08/29/2022] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Inflammation plays a role in diabetic eye diseases, but the association between rosacea and eye diseases in patients with diabetes remains unknown. DESIGN This retrospective cohort study used claims data from the National Health Insurance Research Database in Taiwan to investigate the association between rosacea and eye diseases in patients with diabetes. MATERIALS AND METHODS Taiwanese patients diagnosed as having diabetes mellitus between January 1, 1997, and December 31, 2013, and using any hypoglycemic agents were included and divided into rosacea and nonrosacea groups. After applying 1:20 sex and age matching and exclusion criteria, 1:4 propensity score matching (PSM) was conducted to balance the covariate distribution between the groups. The risk of time-to-event outcome between rosacea and nonrosacea groups in the PSM cohort was compared using the Fine and Gray subdistribution hazard model. RESULTS A total of 4096 patients with rosacea and 16,384 patients without rosacea were included in the analysis. During a mean follow-up period of 5 years, diabetic patients with rosacea had significantly higher risks of diabetic macular edema [subdistribution hazard ratio (SHR): 1.31, 95% confidence interval (CI): 1.05-1.63], glaucoma with medical treatment (SHR: 1.11, 95% CI: 1.01-1.21), dry eye disease (SHR: 1.55, 95% CI: 1.38-1.75), and cataract surgery (SHR: 1.13, 95% CI: 1.02-1.25) compared with diabetic patients without rosacea. A cumulative incidence analysis performed up to 14 years after the index date revealed that the risks of developing ocular diseases consistently increased over time. No significant differences in diabetic retinopathy, age-related macular degeneration, retinal vascular occlusion, ischemic optic neuropathy, optic neuritis, uveitis, or retinal detachment were identified according to rosacea diagnosis. However, we observed significant associations between rosacea and psoriasis, irritable bowel syndrome, anxiety, and major depressive disorder among patients with diabetes. CONCLUSIONS Rosacea is associated with diabetic macular edema, glaucoma, dry eye disease, and cataract development in diabetic patients, as well as increased risks of psoriasis, irritable bowel syndrome, anxiety, and depression in diabetic patients.
Collapse
Affiliation(s)
- Fang-Ying Wang
- Department of Biomedical Engineering, College of Medicine, College of Engineering, National Taiwan University, Taipei, Taiwan
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Eugene Yu-Chuan Kang
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
- Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan
| | - Chun-Hao Liu
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Psychiatry, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
| | - Chau Yee Ng
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shih-Chieh Shao
- Department of Pharmacy, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Edward Chia-Cheng Lai
- School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Wei-Chi Wu
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
| | - Yi-You Huang
- Department of Biomedical Engineering, College of Medicine, College of Engineering, National Taiwan University, Taipei, Taiwan
| | - Kuan-Jen Chen
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
| | - Chi-Chun Lai
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Ophthalmology, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Yih-Shiou Hwang
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
- Department of Ophthalmology, Chang Gung Memorial Hospital, Xiamen, China
- Department of Ophthalmology, Jen-Ai Hospital Dali Branch, Taichung, Taiwan
| |
Collapse
|
31
|
Shrestha P, Whelchel AE, Nicholas SE, Liang W, Ma JX, Karamichos D. Monocarboxylate Transporters: Role and Regulation in Corneal Diabetes. Anal Cell Pathol (Amst) 2022; 2022:6718566. [PMID: 36340268 PMCID: PMC9629935 DOI: 10.1155/2022/6718566] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 10/01/2022] [Indexed: 03/23/2024] Open
Abstract
Diabetes mellitus (DM) is a group of metabolic diseases that is known to cause structural and functional ocular complications. In the human cornea, DM-related complications affect the epithelium, stroma, and nerves. Monocarboxylate transporters (MCTs) are a family of proton-linked plasma membrane transporters that carry monocarboxylates across plasma membranes. In the context of corneal health and disease, their role, presence, and function are largely undetermined and solely focused on the most common MCT isoforms, 1 through 4. In this study, we investigated the regulation of MCT1, 2, 4, 5, 8, and 10, in corneal DM, using established 3D self-assembled extracellular matrix (ECM) in vitro models. Primary stromal corneal fibroblasts were isolated from healthy (HCFs), type I (T1DMs), and type II (T2DMs) DM donors. Monoculture 3D constructs were created by stimulating stromal cells on transwells with stable vitamin C for two or four weeks. Coculture 3D constructs were created by adding SH-SY5Y neurons at two different densities, 12 k and 500 k, on top of the monocultures. Our data showed significant upregulation of MCT1 at 4 weeks for HCF, T1DM, and T2DM monocultures, as well as the 500 k nerve cocultures. MCT8 was significantly upregulated in HCF and T1DM monocultures and all of the 500 k nerve cocultures. Further, MCT10 was only expressed at 4 weeks for all cocultures and was limited to HCFs and T1DMs in monocultures. Immunofluorescence analysis showed cytoplasmic MCT expression for all cell types and significant downregulation of both MCT2 and MCT4 in HCFs, when compared to T1DMs and T2DMs. Herein, we reveal the existence and modulation of MCTs in the human diabetic cornea in vitro. Changes appeared dependent on neuronal density, suggesting that MCTs are very likely critical to the neuronal defects observed in diabetic keratopathy/neuropathy. Further studies are warranted in order to fully delineate the role of MCTs in corneal diabetes.
Collapse
Affiliation(s)
- Pawan Shrestha
- North Texas Eye Research Institute, University of North Texas Health Science Center, 3430 Camp Bowie Blvd, Fort Worth, TX 76107, USA
- Department of Pharmaceutical Sciences, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX 76107, USA
| | - Amy E. Whelchel
- Department of Physiology, University of Oklahoma Health Sciences Center, 940 Stanton L Young Blvd, Oklahoma City, OK 73104, USA
| | - Sarah E. Nicholas
- North Texas Eye Research Institute, University of North Texas Health Science Center, 3430 Camp Bowie Blvd, Fort Worth, TX 76107, USA
- Department of Pharmaceutical Sciences, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX 76107, USA
| | - Wentao Liang
- Department of Physiology, University of Oklahoma Health Sciences Center, 940 Stanton L Young Blvd, Oklahoma City, OK 73104, USA
- Department of Biochemistry, Wake Forest University School of Medicine, 575 N Patterson Ave, Winston-Salem, NC 27101, USA
| | - Jian-Xing Ma
- Department of Biochemistry, Wake Forest University School of Medicine, 575 N Patterson Ave, Winston-Salem, NC 27101, USA
| | - Dimitrios Karamichos
- North Texas Eye Research Institute, University of North Texas Health Science Center, 3430 Camp Bowie Blvd, Fort Worth, TX 76107, USA
- Department of Pharmaceutical Sciences, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX 76107, USA
- Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX 76107, USA
| |
Collapse
|
32
|
Rusmayani E, Artini W, Sasongko MB. Ischemia Modified Albumin (IMA) as a New Biomarker in the Ophthalmology Field: A Brief Literature Review. Open Ophthalmol J 2022. [DOI: 10.2174/18743641-v16-e2208010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Purpose:
This study aimed to review the potential role of ischemia-modified albumin as a biomarker for diagnostic modalities in the ophthalmology field.
Methods:
Articles were reviewed without a specific date. A manual search was also performed by reviewing reference lists of meta-analyses and systematic reviews. All articles were reviewed, and a total of 18 articles were selected by the authors.
Results:
Oxidative stress increases structural and functional damage to proteins in many ocular diseases. The human serum albumin is a major circulating protein with antioxidative and anti-inflammatory properties. Oxidative stress has been shown to be an important part of etiology and pathogenesis in ocular diseases related to ischemia. Biomarkers that are specific to oxidative stress and ischemia-related ocular pathogenesis are needed to provide an extensive understanding regarding diagnosis, monitoring progression, and new potential target treatment. Ischemia-modified albumin (IMA) as a new promising biomarker might be useful in the early detection and treatment of ocular diseases with ischemic pathogenesis.
Conclusion:
IMA plays an important role in the progression of ophthalmology diseases, such as diabetic retinopathy, hypertensive retinopathy, cataract progression, seasonal allergies, and glaucoma. Further studies are needed to elaborate these results as a consideration in new testing modalities in clinical practice as well as a new target therapy research.
Collapse
|
33
|
Sorkhabi R, Ahoor MH, Ghorbani Haghjo A, Tabei E, Taheri N. Assessment of tear inflammatory cytokines concentration in patients with diabetes with varying severity of involvement. Exp Eye Res 2022; 224:109233. [PMID: 36058266 DOI: 10.1016/j.exer.2022.109233] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 08/08/2022] [Accepted: 08/19/2022] [Indexed: 11/04/2022]
Abstract
Diabetic retinopathy (DR), as one of the most important causes of blindness in Western societies, is a common micro-vasculopathy associated with diabetes. There is growing evidence of the role of inflammation in its development. This study was designed to measure cytokines in patients with diabetes with different stages of retinopathy .In this study, tear concentrations of three types of cytokines with different angiogenic properties including IL-1RA, IL-8, and TNF-α were measured in patients with diabetes without retinopathy, with non-proliferative retinopathy, with proliferative retinopathy, and in a healthy control group. The results showed that concentrations of TNF-α and IL-8 were higher in the tear sample of diabetics than in the control group and the concentrations of these cytokines were higher in patients with more advanced stages of diabetes, while the tear level of IL-1RA was significantly lower in diabetics. Based on these findings, it can be concluded that diabetes and its progression of severity affects the tear levels of IL-1RA, IL-8, and TNF-α inflammatory cytokines.
Collapse
Affiliation(s)
- Rana Sorkhabi
- Department of Ophthalmology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Hossein Ahoor
- Department of Ophthalmology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amir Ghorbani Haghjo
- Department of Biochemistry and Clinical Laboratories, Tabriz University of Medical Sciences, Faculty of Medicine, Tabriz, Iran
| | - Elnaz Tabei
- Department of Ophthalmology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nazli Taheri
- Department of Ophthalmology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
| |
Collapse
|
34
|
Ranganathan RS, K EV, R S, Manimozhian N. High Fasting Blood Sugar and Increased Waist Circumference as Risk Factors for Diabetic Retinopathy in Type 2 Diabetes Patients Older than 45 Years. Cureus 2022; 14:e28291. [PMID: 36158357 PMCID: PMC9494576 DOI: 10.7759/cureus.28291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction Diabetes mellitus (DM) has a long-term impact on retinal micro-blood vessels, culminating in the progression of diabetic retinopathy (DR); however; screening for DR is not widely used due to a lack of accessibility and economic constraints, especially in resource-limited settings. Thus, a longitudinal marker that is associated with the development of DR is required. This study sought to assess the association of DR with fasting blood sugar (FBS) levels and waist circumference. Methodology A cross-sectional study was conducted in a tertiary care hospital for one year. All individuals diagnosed with Type 2 DM (T2DM) and ≥45 years of age were included in the study. Individuals with fasting blood glucose levels of <126 mg/dl and <3 years of diagnosis with T2DM were excluded from the study. Individuals having one or more retinal microaneurysms or retinal blot hemorrhages, with or without any additional abnormalities, were diagnosed with DR. The results were analyzed using SPSS version 21 (IBM Corp., Armonk, NY). Results The prevalence of diabetic retinopathy among the study participants was 67.6 %. There was a significant association between increasing waist circumference (p = 0.009) and High FBS levels (p = 0.032) with the presence of DR. Conclusion Approximately two-thirds of the patients with T2DM aged >45 years and above have diabetic retinopathy. High FBS and waist circumference were associated with DR.
Collapse
|
35
|
Visual Acuity Outcomes in Diseases Associated with Reduced Visual Acuity: An Analysis of the National Health Insurance Service Database in Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148689. [PMID: 35886542 PMCID: PMC9323841 DOI: 10.3390/ijerph19148689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 07/13/2022] [Accepted: 07/16/2022] [Indexed: 02/01/2023]
Abstract
Visual acuity declines with age, and disease-related visual acuity changes vary. We evaluated factors affecting visual acuity and age-related visual acuity in diseases associated with reduced visual acuity such as hypertension, diabetes mellitus (DM), glaucoma, and diabetic retinopathy (DR). The Korean National Health Insurance Service 2015–2016 data were analyzed for age-related visual acuity changes and prevalence of diseases associated with reduced visual acuity. Among 993,062 participants, the prevalence rates of hypertension, DM, glaucoma, and DR were 27.0%, 15.1%, 13.8%, and 2.7%, respectively. Despite having the lowest prevalence, DR alone or DR with hypertension and glaucoma resulted in low visual acuity. Correlation analysis between disease frequency and mean age-related visual acuity revealed higher positive correlations in DR and hypertension than in DM and glaucoma, indicating lower visual acuity. Odds ratios for low visual acuity in cases including one disease such as hypertension, DM, glaucoma, and DR were 1.73, 1.23, 1.04, and 1.52, respectively. The prevalence and number of diseases associated with reduced visual acuity increased with age, and visual acuity decreased. The leading causes of vision loss were DR as a single disease and hypertension as a concomitant disease. Therefore, age-related vision management, through periodic eye examination and correction with age, should be performed along with management of diabetes and hypertension.
Collapse
|
36
|
Al Zabadi H, Taha I, Zagha R. Clinical and Molecular Characteristics of Diabetic Retinopathy and Its Severity Complications among Diabetic Patients: A Multicenter Cross-Sectional Study. J Clin Med 2022; 11:jcm11143945. [PMID: 35887709 PMCID: PMC9319242 DOI: 10.3390/jcm11143945] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 06/05/2022] [Accepted: 06/08/2022] [Indexed: 02/04/2023] Open
Abstract
Background: Diabetic retinopathy (DR) is a complication associated with uncontrolled DM. It is a leading preventable cause of visual impairment in the world and a cause of blindness in those under 75 years old in developing countries. We aimed to explore the prevalence and associated risk factors of DR among diabetic patients in the West Bank. Materials and Methods:A quantitative multicenter cross-sectional study was conducted in all West Bank cities. Nearly, 385 patients underwent a comprehensive eye examination in addition to blood and urine tests. A previously validated questionnaire for ocular examination classification was used together with a socio-demographic and past medical history information sheet. Results: The prevalence of all DR in the West Bank was 41.8%. The prevalence of non-proliferative diabetic retinopathy (NPDR) was 50.3% (38.5% for mild NPDR, 10.6% for moderate NPDR and 1.2% for severe NPDR). The prevalence of proliferative diabetic retinopathy (PDR) was 9.9% and 39.7% for diabetic macular edema (DME) (17.4% for mild, 15.5% for moderate and 6.8% for severe DME). The prevalence of vision-threatening PDR and DME was 49.7% for both. In a univariate analysis, DR was significantly associated with body mass index; BMI (p = 0.035), DM duration (p = 0.002), Low-density lipoprotein (LDL) (p = 0.034), glutamic-oxaloacetic transaminase (GOT) level (p = 0.016) andblood urea (BU) (p = 0.044). A multivariate analysis showed a strong significant association between DR andpatients who had DM for 10-19years (adjusted odds ratio; AOR (95%CI); 1.843 (1.05–3.22)), abnormal levels of LDL (AOR (95%CI); 0.50 (0.30–0.83)), abnormal levels of GOT (AOR (95%CI); 0.49 (0.27–0.89)), and overweight (AOR (95%CI); 0.39 (0.19–0.80)). Conclusions: We found that the prevalence of DR in Palestine was higher than the global prevalence. Referral coordination between ophthalmologists and internal physicians is necessary to better follow up with DR patients. An interventional educational program by clinicians and public health professionals is recommended.
Collapse
Affiliation(s)
- Hamzeh Al Zabadi
- Department of Public Health, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus P.O. Box 7, Palestine
- Public Health Program, Faculty of Graduate Studies, An-Najah National University, Nablus P.O. Box 7, Palestine;
- Correspondence: ; Tel.: +970-9-2342902; Fax: +972-9-2349739
| | - Ibrahim Taha
- Public Health Program, Faculty of Graduate Studies, An-Najah National University, Nablus P.O. Box 7, Palestine;
- Department of Molecular Medicine, University of Pavia, 27100 Pavia, Italy
| | - Rami Zagha
- Microbiology, Immunology and Pathology Department, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus P.O. Box 7, Palestine;
| |
Collapse
|
37
|
Gouldin AG, Brown ME, Puetzer JL. An inducible model for unraveling the effects of advanced glycation end-product accumulation in aging connective tissues. Connect Tissue Res 2022; 63:406-424. [PMID: 34706612 DOI: 10.1080/03008207.2021.1991333] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE In connective tissues there is a clear link between increasing age and degeneration. Advanced glycation end-products (AGEs) are believed to play a central role. AGEs are sugar-induced non-enzymatic crosslinks which accumulate in collagen with age and diabetes, altering tissue mechanics and cellular function. Despite ample correlative evidence linking collagen glycation to tissue degeneration, little is known how AGEs impact cell-matrix interactions, limiting therapeutic options. One reason for this limited understanding is that AGEs are typically induced using high concentrations of ribose which decrease cell viability, making it impossible to investigate cell-matrix interactions. The objective of this study was to develop a system to trigger AGE accumulation while maintaining cell viability. MATERIALS AND METHODS Using cell-seeded high density collagen gels, we investigated the effect of two systems for AGE induction, ribose at low concentrations (30, 100, and 200 mM) over 15 days of culture and riboflavin (0.25 and 0.75 mM) induced with blue light for 40 seconds (riboflavin-465 nm). RESULTS We found ribose and riboflavin-465 nm treatment produces fluorescent AGE quantities which match and/or exceed human fluorescent AGE levels for various tissues, ages, and diseases, without affecting cell viability or metabolism. Interestingly, a 40 second treatment of riboflavin-465 nm produced similar levels of fluorescent AGEs as 3 days of 100 mM ribose treatment. CONCLUSIONS Riboflavin-465 nm is a promising method to trigger AGEs on demand in vivo or in vitro without impacting cell viability and offers potential for unraveling the mechanism of AGEs in age and diabetes related tissue damage.
Collapse
Affiliation(s)
- Austin G Gouldin
- Departments of Biomedical Engineering; Orthopaedic Surgery, Virginia Commonwealth University, Richmond, Virginia, United States
| | - M Ethan Brown
- Departments of Biomedical Engineering; Orthopaedic Surgery, Virginia Commonwealth University, Richmond, Virginia, United States
| | - Jennifer L Puetzer
- Departments of Biomedical Engineering; Orthopaedic Surgery, Virginia Commonwealth University, Richmond, Virginia, United States
| |
Collapse
|
38
|
Abstract
Schizophrenia is increasingly recognized as a systemic disease, characterized by dysregulation in multiple physiological systems (eg, neural, cardiovascular, endocrine). Many of these changes are observed as early as the first psychotic episode, and in people at high risk for the disorder. Expanding the search for biomarkers of schizophrenia beyond genes, blood, and brain may allow for inexpensive, noninvasive, and objective markers of diagnosis, phenotype, treatment response, and prognosis. Several anatomic and physiologic aspects of the eye have shown promise as biomarkers of brain health in a range of neurological disorders, and of heart, kidney, endocrine, and other impairments in other medical conditions. In schizophrenia, thinning and volume loss in retinal neural layers have been observed, and are associated with illness progression, brain volume loss, and cognitive impairment. Retinal microvascular changes have also been observed. Abnormal pupil responses and corneal nerve disintegration are related to aspects of brain function and structure in schizophrenia. In addition, studying the eye can inform about emerging cardiovascular, neuroinflammatory, and metabolic diseases in people with early psychosis, and about the causes of several of the visual changes observed in the disorder. Application of the methods of oculomics, or eye-based biomarkers of non-ophthalmological pathology, to the treatment and study of schizophrenia has the potential to provide tools for patient monitoring and data-driven prediction, as well as for clarifying pathophysiology and course of illness. Given their demonstrated utility in neuropsychiatry, we recommend greater adoption of these tools for schizophrenia research and patient care.
Collapse
Affiliation(s)
- Steven M Silverstein
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
- Department of Ophthalmology, University of Rochester Medical Center, Rochester, NY, USA
- Department of Neuroscience, University of Rochester Medical Center, Rochester, NY, USA
- Center for Visual Science, University of Rochester, Rochester, NY, USA
| | - Joy J Choi
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - Kyle M Green
- Department of Ophthalmology, University of Rochester Medical Center, Rochester, NY, USA
| | | | - Rajeev S Ramchandran
- Department of Ophthalmology, University of Rochester Medical Center, Rochester, NY, USA
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| |
Collapse
|
39
|
Pereira-da-Mota AF, Vivero-Lopez M, Serramito M, Diaz-Gomez L, Serro AP, Carracedo G, Huete-Toral F, Concheiro A, Alvarez-Lorenzo C. Contact lenses for pravastatin delivery to eye segments: Design and in vitro-in vivo correlations. J Control Release 2022; 348:431-443. [PMID: 35688348 DOI: 10.1016/j.jconrel.2022.06.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 05/12/2022] [Accepted: 06/01/2022] [Indexed: 10/18/2022]
Abstract
Oral administration of cholesterol-lowering statins, HMG-CoA reductase inhibitors, is associated with beneficial effects on eye conditions. This work aims to design contact lenses (CLs) that can sustainedly deliver pravastatin and thus improve the ocular efficacy while avoiding systemic side effects of statins. Bioinspired hydrogels were prepared with monomers that resemble hydrophobic (ethylene glycol phenyl ether methacrylate) and amino (2-aminoethyl methacrylamide hydrochloride) functionalities of the active site of HMG-CoA. Best performing CLs loaded >6 mg/g, in vitro fulfilled the release demands for daily wearing, and showed anti-inflammatory activity (lowering TNF-α). High hydrostatic pressure sterilization preserved the stability of both the drug and the hydrogel network. Ex vivo tests revealed the ability of pravastatin to accumulate in cornea and sclera and to penetrate through transscleral route. In vivo tests (rabbits) confirmed that, compared to eye drops and for the same dose, CLs provided significantly higher pravastatin levels in tear fluid within 1 to 7 h of wearing. Moreover, after 8 h wearing pravastatin was present in cornea, sclera, aqueous humour and vitreous humour. Strong correlations between percentages of drug released in vitro and in vivo were found. Effects of volume and proteins on release rate and Levy plots were identified.
Collapse
Affiliation(s)
- Ana F Pereira-da-Mota
- Departamento de Farmacología, Farmacia y Tecnología Farmacéutica, I+D Farma Group (GI-1645), Facultad de Farmacia, Instituto de Materiales (iMATUS) and Health Research Institute of Santiago de Compostela (IDIS), Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Maria Vivero-Lopez
- Departamento de Farmacología, Farmacia y Tecnología Farmacéutica, I+D Farma Group (GI-1645), Facultad de Farmacia, Instituto de Materiales (iMATUS) and Health Research Institute of Santiago de Compostela (IDIS), Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Maria Serramito
- Ocupharm Research Group, Faculty of Optic and Optometry, University Complutense of Madrid, C/Arcos del Jalon 118, 28037 Madrid, Spain
| | - Luis Diaz-Gomez
- Departamento de Farmacología, Farmacia y Tecnología Farmacéutica, I+D Farma Group (GI-1645), Facultad de Farmacia, Instituto de Materiales (iMATUS) and Health Research Institute of Santiago de Compostela (IDIS), Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Ana Paula Serro
- Centro de Química Estrutural, Institute of Molecular Sciences and Departamento de Engenharia Química, Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais, 1049-001 Lisboa, Portugal
| | - Gonzalo Carracedo
- Ocupharm Research Group, Faculty of Optic and Optometry, University Complutense of Madrid, C/Arcos del Jalon 118, 28037 Madrid, Spain
| | - Fernando Huete-Toral
- Ocupharm Research Group, Faculty of Optic and Optometry, University Complutense of Madrid, C/Arcos del Jalon 118, 28037 Madrid, Spain
| | - Angel Concheiro
- Departamento de Farmacología, Farmacia y Tecnología Farmacéutica, I+D Farma Group (GI-1645), Facultad de Farmacia, Instituto de Materiales (iMATUS) and Health Research Institute of Santiago de Compostela (IDIS), Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Carmen Alvarez-Lorenzo
- Departamento de Farmacología, Farmacia y Tecnología Farmacéutica, I+D Farma Group (GI-1645), Facultad de Farmacia, Instituto de Materiales (iMATUS) and Health Research Institute of Santiago de Compostela (IDIS), Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain.
| |
Collapse
|
40
|
Archana R, Rajalakshmi T, Vijay Sai P. Non-invasive technique to detect diabetic retinopathy based on Electrooculography signal using machine learning classifiers. Proc Inst Mech Eng H 2022; 236:882-895. [DOI: 10.1177/09544119221085422] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Single-channel Electrooculogram (EOG) is proposed for detecting diabetic retinopathy. The Corneal-retinal potential of the eyes plays a vital role in the acquisition of Electrooculography. Diabetes is the most prevalent disease and for one out of three people with diabetes above 40 years, diabetic retinopathy occurs. It is necessary for the early detection of diabetic retinopathy as it is one of the primary reasons for blindness in the population. The potential difference between cornea and retina leads to the acquisition of EOG signal. The proposed study aims to design a low-cost miniaturized hardware circuit to obtain EOG signal using second order filters without compromising in accuracy of the outcome signal and to classify the signal into normal and diabetic retinopathy subjects by extracting the statistical features like kurtosis, mean, median absolute deviation, standard deviation, and range from software filtered EOG signal. Among the classifiers used, Support vector machine (SVM) shows a higher accuracy of 93.33%. The sensitivity, specificity and Area Under Curve (AUC) values of SVM are 96.43%, 90.625%, 0.93% is considered as more favorable outcome for the proposed method and it supports the developed prototype and processing methodology. The novelty of the research is based on proposing and exploring a non-invasive methodology for Diabetic retinopathy diagnosis based on EOG signal. Thus, the designed hardware is simple in operation and cost effective, provides an affordable and non-invasive diagnostic tool for diabetic retinopathy patients
Collapse
Affiliation(s)
- R Archana
- Department of Biomedical Engineering, SRMIST, Kattankulathur, Tamil Nadu, India
| | - T Rajalakshmi
- Department of Electronics and Communication Engineering, SRMIST, Kattankulathur, Tamil Nadu, India
| | - P Vijay Sai
- Department of Biomedical Engineering, SRMIST, Kattankulathur, Tamil Nadu, India
| |
Collapse
|
41
|
Cardiovascular Risk Stratification in Diabetic Retinopathy via Atherosclerotic Pathway in COVID-19/non-COVID-19 Frameworks using Artificial Intelligence Paradigm: A Narrative Review. Diagnostics (Basel) 2022; 12:diagnostics12051234. [PMID: 35626389 PMCID: PMC9140106 DOI: 10.3390/diagnostics12051234] [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] [Received: 04/14/2022] [Revised: 05/11/2022] [Accepted: 05/11/2022] [Indexed: 11/18/2022] Open
Abstract
Diabetes is one of the main causes of the rising cases of blindness in adults. This microvascular complication of diabetes is termed diabetic retinopathy (DR) and is associated with an expanding risk of cardiovascular events in diabetes patients. DR, in its various forms, is seen to be a powerful indicator of atherosclerosis. Further, the macrovascular complication of diabetes leads to coronary artery disease (CAD). Thus, the timely identification of cardiovascular disease (CVD) complications in DR patients is of utmost importance. Since CAD risk assessment is expensive for low-income countries, it is important to look for surrogate biomarkers for risk stratification of CVD in DR patients. Due to the common genetic makeup between the coronary and carotid arteries, low-cost, high-resolution imaging such as carotid B-mode ultrasound (US) can be used for arterial tissue characterization and risk stratification in DR patients. The advent of artificial intelligence (AI) techniques has facilitated the handling of large cohorts in a big data framework to identify atherosclerotic plaque features in arterial ultrasound. This enables timely CVD risk assessment and risk stratification of patients with DR. Thus, this review focuses on understanding the pathophysiology of DR, retinal and CAD imaging, the role of surrogate markers for CVD, and finally, the CVD risk stratification of DR patients. The review shows a step-by-step cyclic activity of how diabetes and atherosclerotic disease cause DR, leading to the worsening of CVD. We propose a solution to how AI can help in the identification of CVD risk. Lastly, we analyze the role of DR/CVD in the COVID-19 framework.
Collapse
|
42
|
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.
Collapse
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
| |
Collapse
|
43
|
Celik F, Aydin S. Blood and aqueous humor phoenixin, endocan and spexin in patients with diabetes mellitus and cataract with and without diabetic retinopathy. Peptides 2022; 150:170728. [PMID: 34971675 DOI: 10.1016/j.peptides.2021.170728] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/22/2021] [Accepted: 12/23/2021] [Indexed: 02/07/2023]
Abstract
Peptide phoenixin (PNX), endocan (EDC), and spexin (SPX) are associated with diabetes. Therefore, the purpose of this study was to investigate the levels of PNX, EDC and SPX in the blood and aqueous humor (AH) of patient with type 2 diabetes with and without DRP and cataract. 30 type 2 diabetes patients with cataract (DM + C), 30 DRP patient with cataract (DRP + C), 30 non-diabetic patient with only cataract and 30 control participants were enrolled into this study. PNX, EDC, and SPX were measured in blood and AH by ELISA. In patients with DRP + C, the levels of PNX and EDC were significantly higher in both AH and blood samples compared with the group of patients without DRP + C (<0.05). Also, in patients with DM + C, the levels of PNX and EDC were higher in both AH and blood samples compared with the group of patients without DM + C. However, in patients with DRP + C, the levels of SPX were significantly lower in both AH and blood samples compared with the group of patients without DRP + C (<0.05). Also, in patients with DM + C, the levels of SPX were also lower in both AH and blood samples compared with the group of patients without DM + C. These findings suggest that increased PNX, EDC, and decreased SPX amounts in blood and AH of DM + C and DRP + C groups when compared with control and cataract groups show that they might have a role in the pathophysiology of DM + C, especially in the DRP + C.
Collapse
Affiliation(s)
- Fatih Celik
- Department of Ophthalmology, Elazig Fethi Sekin City Hospital, Health Science University, Elazig Campus, Elazig, Turkey.
| | - Suleyman Aydin
- Department of Medical Biochemistry and Clinical Biochemistry, (Firat Hormones Research Group), School of Medicine, Firat University, Elazig, Turkey.
| |
Collapse
|
44
|
Firoz A, Talwar P. COVID-19 and Retinal Degenerative Diseases: Promising link “Kaempferol”. Curr Opin Pharmacol 2022; 64:102231. [PMID: 35544976 PMCID: PMC9080119 DOI: 10.1016/j.coph.2022.102231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 03/10/2022] [Accepted: 03/24/2022] [Indexed: 01/18/2023]
Abstract
Coronavirus disease (COVID-19) outbreak has caused unprecedented global disruption since 2020. Approximately 238 million people are affected worldwide where the elderly succumb to mortality. Post-COVID syndrome and its side effects have popped up with several health hazards, such as macular degeneration and vision loss. It thus necessitates better medical care and management of our dietary practices. Natural flavonoids have been included in traditional medicine and have also been used safely against COVID-19 and several other diseases. Kaempferol is an essential flavonoid that has been demonstrated to influence several vital cellular signaling pathways involved in apoptosis, angiogenesis, inflammation, and autophagy. In this review, we emphasize the plausible regulatory effects of Kaempferol on hallmarks of COVID-19 and macular degeneration.
Collapse
|
45
|
Borymska W, Zych M, Dudek S, Kaczmarczyk-Sedlak I. Silymarin from Milk Thistle Fruits Counteracts Selected Pathological Changes in the Lenses of Type 1 Diabetic Rats. Nutrients 2022; 14:1450. [PMID: 35406062 PMCID: PMC9003010 DOI: 10.3390/nu14071450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 03/12/2022] [Accepted: 03/28/2022] [Indexed: 02/08/2023] Open
Abstract
Diabetes is a metabolic disease affecting many tissues and organs. The main etiological factor for diabetic complications is hyperglycemia and subsequent pathologies, such as oxidative stress. One of the organs susceptible to the development of diabetic complications is the eye with all of its elements, including the lens. The aim of this study was to evaluate the effect of silymarin, an extract obtained from milk thistle fruit husks, on the oxidative stress markers in the lenses of type 1 diabetic rats. The study was performed on male rats in which type 1 diabetes was induced with 60 mg/kg streptozotocin injection. Diabetic animals were treated via an intragastric tube with silymarin at 50 and 100 mg/kg doses for four weeks. Multiple oxidative stress and polyol pathway-related parameters were measured in the lenses, and auxiliary biochemical tests in the serum were conducted. Diabetes induced severe pathological changes both in the lenses and the serum, and silymarin counteracted several of them. Nevertheless, the qualitative analyses encompassing all tested parameters indicate that silymarin slightly improved the overall state of diabetic animals. Upon the obtained results, it can be concluded that silymarin reveals a faint positive effect on the lenses in type 1 diabetic rats.
Collapse
Affiliation(s)
- Weronika Borymska
- Department of Pharmacognosy and Phytochemistry, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Katowice, Jagiellońska 4, 41-200 Sosnowiec, Poland; (M.Z.); (S.D.); (I.K.-S.)
| | | | | | | |
Collapse
|
46
|
Kebede SA, Tessema ZT, Balcha SA, Ayele TA. Joint modeling of time to diabetic retinopathy and change in fasting blood sugar among type 2 diabetic patients, Northwest Ethiopia. Sci Rep 2022; 12:2236. [PMID: 35140323 PMCID: PMC8828881 DOI: 10.1038/s41598-022-06240-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 01/24/2022] [Indexed: 11/09/2022] Open
Abstract
This study aimed to assess changes in fasting blood sugar (FBS) levels, time to diabetic retinopathy (DR) and its predictors among type 2 diabetes patients in Ethiopia. An institution-based retrospective follow-up study was conducted at the University of Gondar Comprehensive Specialized Hospital. The linear mixed effect model and Cox proportional hazard models were fitted separately, and later, the two models were fitted jointly using R software. Variables with a p value < 0.05 were considered significant predictors in the adjusted analysis. The incidence rate of DR was 2 per 100-person year of observation with a median follow-up time of 90.8 months (IQR 63.4). The current value and rate of change in FBS level were significant predictors of time to DR (AHR = 1.35; 95% CI 1.12-1.63) and (AHR = 1.70; 95% CI 1.21-2.39), respectively. Hypertension (AHR = 2.49; 95% CI 1.32-4.66), taking > 1 antidiabetic oral agent (AHR = 4.90; 95% CI 1.07-20.0) and more than 10 years duration (AHR = 0.17, 95% CI 0.06-0.46) were predictors of time to DR. This study revealed that the current value of FBS and the rate of FBS change were significantly associated with the time to DR.
Collapse
Affiliation(s)
- Sewnet Adem Kebede
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Zemenu Tadesse Tessema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Shitaye Alemu Balcha
- Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadesse Awoke Ayele
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
47
|
Seid MA, Ambelu A, Diress M, Yeshaw Y, Akalu Y, Dagnew B. Visual impairment and its predictors among people living with type 2 diabetes mellitus at Dessie town hospitals, Northeast Ethiopia: institution-based cross-sectional study. BMC Ophthalmol 2022; 22:52. [PMID: 35114950 PMCID: PMC8815255 DOI: 10.1186/s12886-022-02292-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 01/27/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Visual impairment is a functional limitation of the eye(s) that results in reduced visual acuity, visual field loss, visual distortion, perceptual difficulties, or any combination of the above. Type 2 diabetes mellitus is one of the common causes of visual impairment. Since there is no study conducted in Ethiopia so far in this regard, the current study aimed to determine the prevalence and predictors of visual impairment among people living with diabetes at Dessie town Hospitals, Northeast Ethiopia. METHODS Institution based cross-sectional study was carried out from 15 February to 15 March 2020 using simple random sampling to recruit study participants among type 2 diabetes. Visual impairment was measured using visual acuity test. We used Epi Data 3.1 and SPSS version 22 for data entry and statistical analysis, respectively. Bi-variable binary logistic regression was performed to check independent association of each factor with visual impairment. After selecting candidate variables at p < 0.25, we computed multivariable binary logistic regression to identify statistically associated factors of visual impairment. The degree of association was determined using adjusted odds ratio with 95%CI. In the final model, statistical significance was declared at p < 0.05. RESULTS Three hundred and twenty-two people living with T2DM participated in this study with 97% response rate. The prevalence of visual impairment was 37.58% (95% CI: 32.3, 42.9). Age (AOR: 1.06, 95% CI: 1.02, 1.09, p < or = 0.001), poor regular exercise (AOR = 2.91, 95%CI: 1.47-5.76, p < or = 0.001), duration of DM above 5 years (AOR = 2.42, 95% CI: 1.25-4.73, p < or = 0.01), insulin treatment (AOR = 14.05, 95% CI: 2.72, 72.35, p < or = 0.01), and poor glycemic control (AOR = 2.17, 95% CI: 1.13-4.14, p < 0.05) were statistically associated with visual impairment. CONCLUSION The prevalence of visual impairment in Dessie town hospitals accounted for more than a third of patients living with T2DM. Visual impairment is associated with increased age, poor regular exercise, longer duration of DM, and insulin treatment. Thus, early detection of VI through screening and regular follow-up is recommended to reduce the risk of VI and vision loss.
Collapse
Affiliation(s)
- Mohammed Abdu Seid
- Unit of Human Physiology, Department of Biomedical Sciences, College of Health Sciences, Debre Tabor University, P. O. Box 272, Debre Tabor, Ethiopia.
| | - Adugnaw Ambelu
- Department of Human Physiology, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia
| | - Mengistie Diress
- Department of Human Physiology, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia
| | - Yigizie Yeshaw
- Department of Human Physiology, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia
| | - Yonas Akalu
- Department of Human Physiology, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia
| | - Baye Dagnew
- Department of Human Physiology, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia
| |
Collapse
|
48
|
Zhou Q, Yang L, Wang Q, Li Y, Wei C, Xie L. Mechanistic investigations of diabetic ocular surface diseases. Front Endocrinol (Lausanne) 2022; 13:1079541. [PMID: 36589805 PMCID: PMC9800783 DOI: 10.3389/fendo.2022.1079541] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 12/02/2022] [Indexed: 12/23/2022] Open
Abstract
With the global prevalence of diabetes mellitus over recent decades, more patients suffered from various diabetic complications, including diabetic ocular surface diseases that may seriously affect the quality of life and even vision sight. The major diabetic ocular surface diseases include diabetic keratopathy and dry eye. Diabetic keratopathy is characterized with the delayed corneal epithelial wound healing, reduced corneal nerve density, decreased corneal sensation and feeling of burning or dryness. Diabetic dry eye is manifested as the reduction of tear secretion accompanied with the ocular discomfort. The early clinical symptoms include dry eye and corneal nerve degeneration, suggesting the early diagnosis should be focused on the examination of confocal microscopy and dry eye symptoms. The pathogenesis of diabetic keratopathy involves the accumulation of advanced glycation end-products, impaired neurotrophic innervations and limbal stem cell function, and dysregulated growth factor signaling, and inflammation alterations. Diabetic dry eye may be associated with the abnormal mitochondrial metabolism of lacrimal gland caused by the overactivation of sympathetic nervous system. Considering the important roles of the dense innervations in the homeostatic maintenance of cornea and lacrimal gland, further studies on the neuroepithelial and neuroimmune interactions will reveal the predominant pathogenic mechanisms and develop the targeting intervention strategies of diabetic ocular surface complications.
Collapse
Affiliation(s)
- Qingjun Zhou
- State Key Laboratory Cultivation Base, Eye Institute of Shandong First Medical University, Qingdao, China
- Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, China
| | - Lingling Yang
- State Key Laboratory Cultivation Base, Eye Institute of Shandong First Medical University, Qingdao, China
- Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, China
| | - Qun Wang
- State Key Laboratory Cultivation Base, Eye Institute of Shandong First Medical University, Qingdao, China
- Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, China
| | - Ya Li
- State Key Laboratory Cultivation Base, Eye Institute of Shandong First Medical University, Qingdao, China
- Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, China
| | - Chao Wei
- State Key Laboratory Cultivation Base, Eye Institute of Shandong First Medical University, Qingdao, China
- Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, China
| | - Lixin Xie
- State Key Laboratory Cultivation Base, Eye Institute of Shandong First Medical University, Qingdao, China
- Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, China
- *Correspondence: Lixin Xie,
| |
Collapse
|
49
|
Demirtas Ö, Pekel G, Pekel E, Cetin EN. Iris thickness measurements in patients with diabetic retinopathy. Eur J Ophthalmol 2022; 32:491-496. [DOI: 10.1177/1120672120972623] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Purpose: The aim of the study was to investigate iris alterations in diabetic retinopathy (DR). Methods: Sixty-nine eyes of 69 patients were recruited and three groups of patients were examined: proliferative DR ( n = 25), non-proliferative DR ( n = 21) and healthy controls ( n = 23). Macular optical coherence tomography (OCT), anterior segment iris OCT, and slit lamp digital camera photographs were taken. The thicknesses of the iris at a distance of 1 mm, 2 mm, and 3 mm from pupil margin were measured via iris OCT. Iris crypt count, furrow extent, color tone and collarette/diameter ratio were measured by means of anterior segment photography. Visual acuity, refractive error, intraocular pressure, and numbers of intravitreal injections were also recorded. Results: The iris thickness measurements at 1 mm from pupil margin were significantly correlated with the macular thickness measurements ( r = 0.32, p = 0.016). In the proliferative DR group, total number of injections were significantly correlated with the iris thickness measurements at 1 mm ( r = 0.25, p = 0.04). The iris thickness measurements at distances 1 mm, 2 mm, and 3 mm from the pupil margin were similar in all of the groups ( p > 0.05). Iris thickness did not correlate with age, intra-ocular pressure and collarette iris ratio in all the participants ( p > 0.05). Conclusion: Iris thickness is similar in diabetic patients and healthy controls. Meanwhile, iris thickness near the pupillary margin is positively correlated with macular thickness.
Collapse
Affiliation(s)
| | - Gökhan Pekel
- Department of Ophthalmology, Pamukkale University, Denizli, Turkey
| | - Evre Pekel
- Denizli State Hospital, Eye Clinic, Denizli, Turkey
| | - Ebru Nevin Cetin
- Department of Ophthalmology, Pamukkale University, Denizli, Turkey
| |
Collapse
|
50
|
Abstract
Background/Aim. Complications of diabetes mellitus (DM) in the eye are the leading cause of blindness in the world. Although research on eye complications of DM is mainly focused on retinal damage, changes in the cornea are also associated with DM. Central corneal thickness (CCT) reflects the metabolic status of the cornea and is also affected by DM. Knowledge of CCT changes that occur within DM is important for accurate IOP measurement, diagnosis, and monitoring of patients with glaucoma. The aim of the study was to examine the effect of DM type 2 on the central corneal thickness. Methods. The study was designed as a clinical, cross-sectional, observational study. It consists of 96 patients, divided into two groups. The first group consisted of 49 patients diagnosed with DM type 2. The second group was the control group and consisted of 47 healthy subjects. The DM group was divided into subgroups depending on the status of diabetic retinopathy, the length of DM treatment, and the levels of glycosylated hemoglobin (HbA1C). Results. A statistically significant difference in CCT was observed among DM patients and the control group. Analyzing only DM patients, the highest CCT values were observed in patients who had HbA1C > 7.0%, as well as those who have treated DM for more than 15 years, with a statistically significant difference in relation to the corresponding patient sub-groups (p = 0.002 and p = 0.037, respectively). No statistically significant difference was observed depending on the status of retinopathy. Intraocular pressure (IOP) was statistically significantly higher in patients with DM compared to the control group. Conclusion. Our research demonstrated that the status of retinopathy had no statistically significant influence on CCT. Knowing that the increase in CCT also affects the measured IOP values, this research will be useful in better understanding and control of the patients who have glaucoma in addition to DM type 2.
Collapse
|