Clinical Physiology Department, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia.
J Diabetes Complications. 2010 May-Jun;24(3):179-85. doi: 10.1016/j.jdiacomp.2008.12.007. Epub 2009 Feb 12.
We investigated the b-wave latency of electroretinogram (ERG), human basic fibroblast growth factor (b-FGF), vascular endothelial growth factor (VEGF), soluble fatty acid synthase (s-Fas), and adrenomedullin (ADM) in diabetic retinopathy.
Thirty control and 60 type II diabetic women (mean age 45+/-3.9 years, duration of diabetes 10.1+/-2.1 years) were investigated. Diabetics without complications (Group II) and with retinopathy (Group III) were diagnosed depending on clinical findings, abnormal fundus examination, and ERG. Plasma levels of b-FGF, VEGF, s-Fas, and ADM were measured.
ERG showed a significant increase of b-wave absolute latency, plasma b-FGF, VEGF, s-Fas, and ADM in diabetic retinopathy (P<.05). A positive correlation was found between b-wave latency and VEGF and s-Fas, and a negative correlation with b-FGF and ADM.
This study elucidates the causative role of VEGF and s-Fas in diabetic retinopathy. VEGF may potently promote growth of endothelial cells and formation of new vessels implicated in proliferative retinopathy. s-Fas could be involved in advancement of apoptotic changes in retinopathy and high levels of b-FGF, and ADM may be compensatorily neuroprotective and vasculoprotective. The results showed that diabetic retinopathy is the result of multiple factors, so it is optimistic to believe that reversing VEGF or s-Fas will halt retinopathy, targeting multiple mechanisms simultaneously by administering combination treatments of VEGF antagonists; antiapoptotic drugs together with b-FGF and/or ADM may be prospective.
我们研究了电视网膜图(ERG)、人碱性成纤维细胞生长因子(b-FGF)、血管内皮生长因子(VEGF)、可溶性脂肪酸合酶(s-Fas)和肾上腺髓质素(ADM)在糖尿病视网膜病变中的 b 波潜伏期。
研究了 30 名对照和 60 名 2 型糖尿病女性(平均年龄 45+/-3.9 岁,糖尿病病程 10.1+/-2.1 年)。根据临床发现、异常眼底检查和 ERG,将无并发症的糖尿病患者(第 II 组)和有视网膜病变的糖尿病患者(第 III 组)诊断为糖尿病。测量血浆 b-FGF、VEGF、s-Fas 和 ADM 水平。
ERG 显示 b 波绝对潜伏期、血浆 b-FGF、VEGF、s-Fas 和 ADM 在糖尿病视网膜病变中显著增加(P<.05)。b 波潜伏期与 VEGF 和 s-Fas 呈正相关,与 b-FGF 和 ADM 呈负相关。
本研究阐明了 VEGF 和 s-Fas 在糖尿病视网膜病变中的致病作用。VEGF 可能强力促进内皮细胞的生长和新血管的形成,从而参与增生性视网膜病变。s-Fas 可能参与视网膜病变中凋亡变化的进展,以及 b-FGF 和 ADM 水平的升高可能具有神经保护和血管保护作用。研究结果表明,糖尿病视网膜病变是多种因素的结果,因此乐观地认为,通过同时靶向多种机制,用 VEGF 拮抗剂逆转 VEGF 或 s-Fas 将阻止视网膜病变的进展,联合使用 VEGF 拮抗剂、抗凋亡药物以及 b-FGF 和/或 ADM 的组合治疗可能具有前景。