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比较糖尿病性视网膜病变患者房水中的炎症细胞因子水平。

Comparison of inflammatory cytokines levels in the aqueous humor with diabetic retinopathy.

机构信息

The First College of Clinical Medical Science, China Three Gorges University, Yichang, 443003, China.

The Department of Ophthalmology, Yichang Central People's Hospital, Yichang, 443003, China.

出版信息

Int Ophthalmol. 2020 Oct;40(10):2763-2769. doi: 10.1007/s10792-020-01463-9. Epub 2020 Jun 15.

Abstract

PURPOSE

Evidence has accumulated suggesting that various inflammatory cytokines are involved in the progress of diabetic retinopathy (DR), but there are few studies concerning the relationship between individual cytokines levels in the aqueous humor (AH) and the severity of DR. This study aimed to explore the differences of interleukin (IL)-23, IL-17, IL-10 and transforming growth factor (TGF)-β in AH form patients with different proliferative stages of DR.

METHODS

From June 2016 to June 2019, patients for senile cataract surgery were enrolled with the informed consent. All cases were graded into 4 groups: the control group (patients without diabetes), non-retinopathy (NDR) group (diabetic patients without retinopathy), non-proliferative diabetic retinopathy (NPDR) group, and proliferative diabetic retinopathy (PDR) group. The concentrations of IL-23, IL-17, IL-10, and TGF-β in AH were measured using ELISA and compared them within four groups by ANOVA.

RESULTS

In this study, 20 (28.57%), 18 (25.71%), 17 (24.29%), and 15 (21.43%) patients were included in the control, NDR, NPDR, and PDR groups, respectively. There had no significant differences in demographic characteristics (P > 0.05). Comparison of these cytokines within four groups revealed: the IL-23 level was increased in NDR group initially and raised along with the progression of DR (P < 0.01). The IL-17 level was significantly higher in NPDR and PDR groups compared to NDR and the control groups, and positively correlated with more-severe DR (P < 0.01). By contrast, The IL-10 level was significantly lower in diabetic patients than in non-diabetic controls, and decreased as the severity of DR increased (P < 0.05). In addition, TGF-β was also elevated in diabetic patients, but showed no differences based on the presence or severity of DR (P > 0.05).

CONCLUSIONS

The over-expression of IL-23 and IL-17 in AH might have a synergistic effect on the pathogenesis well before the proliferative stage, and was typical positively correlated with the severity of DR. These results offer a novel early therapeutic target for DR.

摘要

目的

有证据表明,多种炎症细胞因子参与了糖尿病性视网膜病变(DR)的进展,但关于房水中(AH)各种细胞因子水平与 DR 严重程度之间的关系的研究甚少。本研究旨在探讨不同增殖期 DR 患者房水中白细胞介素(IL)-23、IL-17、IL-10 和转化生长因子(TGF)-β的差异。

方法

2016 年 6 月至 2019 年 6 月,征得患者行老年性白内障手术的知情同意后,纳入患者。所有病例分为 4 组:对照组(无糖尿病患者)、非糖尿病视网膜病变(NDR)组(糖尿病无视网膜病变患者)、非增殖性糖尿病视网膜病变(NPDR)组和增殖性糖尿病视网膜病变(PDR)组。采用酶联免疫吸附试验(ELISA)法检测 AH 中 IL-23、IL-17、IL-10 和 TGF-β的浓度,并通过方差分析比较四组间的差异。

结果

本研究中,对照组、NDR 组、NPDR 组和 PDR 组患者分别为 20 例(28.57%)、18 例(25.71%)、17 例(24.29%)和 15 例(21.43%)。四组间的人口统计学特征差异无统计学意义(P>0.05)。对四组细胞因子进行比较:NDR 组 IL-23 水平最初升高,随着 DR 的进展而升高(P<0.01)。NPDR 组和 PDR 组的 IL-17 水平明显高于 NDR 组和对照组,与更严重的 DR 呈正相关(P<0.01)。相反,糖尿病患者的 IL-10 水平明显低于非糖尿病对照组,随着 DR 严重程度的增加而降低(P<0.05)。此外,糖尿病患者 TGF-β水平升高,但与 DR 的存在或严重程度无关(P>0.05)。

结论

AH 中 IL-23 和 IL-17 的过度表达可能在增殖期前对发病机制有协同作用,且与 DR 的严重程度呈典型的正相关。这些结果为 DR 提供了一个新的早期治疗靶点。

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