Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Japan.
Am J Ophthalmol. 2012 May;153(5):896-902.e1. doi: 10.1016/j.ajo.2011.10.006. Epub 2012 Jan 20.
To examine vitreous succinate levels from proliferative diabetic retinopathy (PDR) patients and ascertain their association with PDR activity.
Comparative case series.
A total of 81 eyes of 72 PDR patients were divided into active PDR (22 eyes), quiescent PDR (21 eyes), and active PDR with intravitreal bevacizumab injection (38 eyes). Twenty epiretinal membrane (ERM) patients (21 eyes) served as controls.
Mean vitreous succinate levels were 1.27 μM in ERM and 2.20 μM in PDR, with the differences statistically significant (P = .03). When comparing mean vitreous succinate levels (active PDR: 3.32 μM; quiescent PDR: 1.02 μM; active PDR with intravitreal bevacizumab injection: 1.20 μM), significant differences were found between active and quiescent PDR (P < .01) and between active PDR and active PDR with intravitreal bevacizumab injection (P < .01). Even though succinate levels were low, retinopathy activities were very high in patients with active PDR with intravitreal bevacizumab injection. Mean vitreous vascular endothelial growth factor (VEGF) levels (active PDR: 1696 pg/mL; quiescent PDR: 110 pg/mL; active PDR with intravitreal bevacizumab injection: n.d.) were similar to previous reports. Mean vitreous erythropoietin levels (active PDR: 703 mIU/mL; quiescent PDR: 305 mIU/mL; active PDR with intravitreal bevacizumab injection: 1562 mIU/mL) suggested very high retinopathy activities in patients with active PDR with intravitreal bevacizumab injection.
Succinate, like VEGF, may be an angiogenic factor that is induced by ischemia in PDR. Although succinate is reported to promote VEGF expression, VEGF inhibition decreases succinate. Thus, VEGF, via a positive feedback mechanism, may regulate succinate.
检测增生性糖尿病视网膜病变（PDR）患者玻璃体琥珀酸水平，并确定其与 PDR 活动的关系。
比较病例系列。
将 72 例 PDR 患者的 81 只眼分为活动期 PDR（22 只眼）、静止期 PDR（21 只眼）和玻璃体腔注射贝伐单抗的活动期 PDR（38 只眼）。21 只眼的 21 例视网膜前膜（ERM）患者作为对照组。
ERM 组玻璃体琥珀酸平均水平为 1.27 μM，PDR 组为 2.20 μM，差异有统计学意义（P =.03）。当比较平均玻璃体琥珀酸水平（活动期 PDR：3.32 μM；静止期 PDR：1.02 μM；玻璃体腔注射贝伐单抗的活动期 PDR：1.20 μM）时，活动期 PDR 与静止期 PDR（P <.01）以及活动期 PDR 与玻璃体腔注射贝伐单抗的活动期 PDR（P <.01）之间存在显著差异。尽管琥珀酸水平较低，但玻璃体腔注射贝伐单抗的活动期 PDR 患者的视网膜病变活动度非常高。玻璃体血管内皮生长因子（VEGF）平均水平（活动期 PDR：1696 pg/mL；静止期 PDR：110 pg/mL；玻璃体腔注射贝伐单抗的活动期 PDR：未检测到）与以往报道相似。玻璃体促红细胞生成素平均水平（活动期 PDR：703 mIU/mL；静止期 PDR：305 mIU/mL；玻璃体腔注射贝伐单抗的活动期 PDR：1562 mIU/mL）表明玻璃体腔注射贝伐单抗的活动期 PDR 患者的视网膜病变活动度非常高。
琥珀酸与 VEGF 一样，可能是 PDR 缺血诱导的血管生成因子。虽然琥珀酸被报道可促进 VEGF 表达，但 VEGF 抑制可降低琥珀酸。因此，VEGF 通过正反馈机制可能调节琥珀酸。
