Kinnunen K, Puustjärvi T, Teräsvirta M, Nurmenniemi P, Heikura T, Laidinen S, Paavonen T, Uusitalo H, Ylä-Herttuala S
Department of Ophthalmology, Kuopio University Hospital, Kuopio, Finland.
Br J Ophthalmol. 2009 Aug;93(8):1109-15. doi: 10.1136/bjo.2008.148841. Epub 2009 Mar 19.
The aim of the study was to evaluate the histopathology of neovascular tufts and vitreous samples collected from patients with diabetes.
Vitreous samples and neovascular tufts were collected from patients with type 1 (n = 13) and (n = 17) type 2 diabetes with proliferative retinopathy, and from controls with a macular hole (n = 5). Neovessels were analysed using immunohistochemistry and vitreous samples with an enzyme-linked immunosorbent assay (ELISA). The main outcome measure was to examine differences in the levels of growth factors in patients with type 1 and type 2 diabetes with proliferative retinopathy.
Vascular endothelial growth factor (VEGF)-A was most strongly present in the samples from patients with type 1 diabetes. In type 2 diabetes, VEGF-D was more abundantly present than in type 1 diabetes. Angiopoietin (ANG)-2 was also abundantly present. Macrophages and nuclear factor kappa B (NFkappaB) were found, indicating the presence of an inflammatory process in the neovascular tissues.
VEGF-A and ANG-2 are equally important in the neovascular process in both type 1 and type 2 diabetes. VEGF-D is abundantly present in type 2 diabetes. In order to achieve better control of diabetic retinopathy, it might be beneficial to develop treatments that prevent the actions of ANG-2 and VEGF-D.
本研究旨在评估从糖尿病患者收集的新生血管丛和玻璃体样本的组织病理学。
从患有增殖性视网膜病变的1型糖尿病患者（n = 13）和2型糖尿病患者（n = 17）以及患有黄斑裂孔的对照患者（n = 5）中收集玻璃体样本和新生血管丛。使用免疫组织化学分析新生血管，并用酶联免疫吸附测定（ELISA）分析玻璃体样本。主要结局指标是检查患有增殖性视网膜病变的1型和2型糖尿病患者中生长因子水平的差异。
血管内皮生长因子（VEGF）-A在1型糖尿病患者的样本中表达最强。在2型糖尿病中，VEGF-D的表达比1型糖尿病中更丰富。血管生成素（ANG）-2也大量存在。发现了巨噬细胞和核因子κB（NFκB），表明新生血管组织中存在炎症过程。
VEGF-A和ANG-2在1型和2型糖尿病的新生血管形成过程中同样重要。VEGF-D在2型糖尿病中大量存在。为了更好地控制糖尿病视网膜病变，开发预防ANG-2和VEGF-D作用的治疗方法可能有益。
