Loukovaara Sirpa, Piippo Niina, Kinnunen Kati, Hytti Maria, Kaarniranta Kai, Kauppinen Anu
Unit of Vitreoretinal Surgery, Department of Ophthalmology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.
Acta Ophthalmol. 2017 Dec;95(8):803-808. doi: 10.1111/aos.13427. Epub 2017 Mar 8.
Innate immunity and dysregulation of inflammatory processes play a role in vascular diseases like atherosclerosis or diabetes. Nucleotide-binding domain and Leucine-rich repeat Receptor containing a Pyrin domain 3 (NLRP3) inflammasomes are pro-inflammatory signalling complexes that were found in 2002. In addition to pathogens and other extracellular threats, they can be activated by various endogenous danger signals. The purpose of this study was to find out whether NLRP3 activation occurs in patients with sight-threatening forms of diabetic retinopathy (DR).
Inflammasome components NLRP3 and caspase-1, inflammasome-related pro-inflammatory cytokines IL-1β and IL-18, vascular endothelial growth factor (VEGF), acute-phase cytokines TNF-α and IL-6, as well as adaptive immunity-related cytokine interferon gamma (IFN-γ) were measured from the vitreous samples of 15 non-proliferative diabetic retinopathy (non-PDR) and 23 proliferative diabetic retinopathy (PDR) patients using the enzyme-linked immunosorbent assay (ELISA) method. The adaptor protein apoptosis-associated speck-like protein containing a CARD (ASC) was determined using the Western blot technique.
Inflammasome components were present in the vitreous of DR patients. Along with VEGF, the levels of caspase-1 and IL-18 were significantly increased, especially in PDR eyes. Interestingly, clearly higher levels of NLRP3 were found in the PDR eyes with tractional retinal detachment (TRD) than from PDR eyes with fully attached retina. There were no significant differences in the amounts of IL-1β, TNF-α, IL-6, and IFN-γ that were detectable in the vitreous of both non-PDR and PDR patients.
Our results suggest that NLRP3 inflammasome activation can be associated especially with the pathogenesis of PDR. The lack of differences in TNF-α, IL-6, and IFN-γ also alludes that acute inflammation or T-cell-mediated responses do not dominate in PDR pathogenesis.
固有免疫和炎症过程失调在动脉粥样硬化或糖尿病等血管疾病中起作用。含pyrin结构域3的核苷酸结合寡聚化结构域样受体(NLRP3)炎性小体是2002年发现的促炎信号复合物。除病原体和其他细胞外威胁外,它们还可被各种内源性危险信号激活。本研究的目的是查明在患有威胁视力的糖尿病视网膜病变(DR)的患者中是否发生NLRP3激活。
采用酶联免疫吸附测定(ELISA)法,从15例非增殖性糖尿病视网膜病变(非PDR)和23例增殖性糖尿病视网膜病变(PDR)患者的玻璃体液样本中检测炎性小体成分NLRP3和半胱天冬酶-1、炎性小体相关促炎细胞因子白细胞介素-1β(IL-1β)和白细胞介素-18(IL-18)、血管内皮生长因子(VEGF)、急性期细胞因子肿瘤坏死因子-α(TNF-α)和白细胞介素-6,以及适应性免疫相关细胞因子干扰素-γ(IFN-γ)。采用蛋白质印迹技术测定衔接蛋白含半胱天冬酶激活和招募结构域的凋亡相关斑点样蛋白(ASC)。
DR患者的玻璃体液中存在炎性小体成分。与VEGF一起,半胱天冬酶-1和IL-18水平显著升高,尤其是在PDR患眼中。有趣的是,在伴有牵拉性视网膜脱离(TRD)的PDR患眼中发现的NLRP3水平明显高于视网膜完全附着的PDR患眼。在非PDR和PDR患者的玻璃体液中可检测到的IL-1β、TNF-α、IL-6和IFN-γ量没有显著差异。
我们的结果表明,NLRP3炎性小体激活可能尤其与PDR的发病机制有关。TNF-α、IL-6和IFN-γ缺乏差异也暗示急性炎症或T细胞介导的反应在PDR发病机制中不占主导地位。