Buchanan Ocular Therapeutics Unit, New Zealand National Eye Centre, Department of Ophthalmology, The University of Auckland, Auckland, 1023, New Zealand.
Department of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, 1023, New Zealand.
BMC Ophthalmol. 2022 May 27;22(1):238. doi: 10.1186/s12886-022-02439-2.
Activation of the NOD-like receptor protein 3 (NLRP3) inflammasome pathway has been implicated in Diabetic retinopathy (DR) pathogenesis, but its impact on DR development and progression remains unclear. Therefore, the primary aim of this systematic literature review was to determine the role of the inflammasome in DR development. Furthermore, the secondary aim was to determine whether systemic inflammasome activity can be used to predict DR progression. Studies measuring vitreous and/or serum inflammasome biomarkers in DR patients with Type 2 Diabetes Mellitus (T2DM) were searched systematically using online databases EMBASE, PubMed and Web of Science with the last search conducted on 29 of September 2021. The risk of bias was assessed using the Newcastle Ottawa Scale and 20 studies were eligible for narrative analysis. Limitations included the heterogeneity in detection assays used, the small and uneven sample size, a lack of vitreous data in earlier disease stages, and not accounting for patients with other systemic co-morbidities. Analysis showed that inflammasome biomarkers IL-1β and IL-18 increased significantly from non-proliferative DR to proliferative DR in both vitreous and serum, suggesting the inflammasome pathway is activated as DR progresses and that serum inflammasome levels could be explored as potential biomarkers for DR progression.
NOD 样受体蛋白 3 (NLRP3) 炎性小体途径的激活与糖尿病性视网膜病变 (DR) 的发病机制有关，但它对 DR 的发展和进展的影响尚不清楚。因此，本系统文献综述的主要目的是确定炎性小体在 DR 发展中的作用。此外，次要目的是确定全身炎性小体活性是否可用于预测 DR 的进展。使用在线数据库 EMBASE、PubMed 和 Web of Science 系统地搜索了测量 2 型糖尿病 (T2DM) 患者玻璃体和/或血清炎性小体生物标志物的研究，并于 2021 年 9 月 29 日进行了最后一次搜索。使用纽卡斯尔-渥太华量表评估偏倚风险，有 20 项研究符合叙事分析的条件。局限性包括所使用的检测分析的异质性、样本量小且不均匀、缺乏早期疾病阶段的玻璃体数据，以及未考虑其他全身性合并症的患者。分析表明，炎性小体标志物 IL-1β 和 IL-18 从非增殖性 DR 到增殖性 DR 在玻璃体和血清中均显著增加，表明随着 DR 的进展，炎性小体途径被激活，血清炎性小体水平可能作为 DR 进展的潜在生物标志物进行探索。
