Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China.
Transl Vis Sci Technol. 2024 Jul 1;13(7):9. doi: 10.1167/tvst.13.7.9.
This study aimed to investigate the expression levels of progranulin (PGRN) in the tears of patients with diabetic retinopathy (DR) versus healthy controls. Additionally, we sought to explore the correlation between PGRN levels and the severity of ocular surface complications in patients with diabetes.
In this prospective, single-visit, cross-sectional study, patients with DR (n = 48) and age-matched healthy controls (n = 22) were included and underwent dry eye examinations. Tear fluid was collected, and its components were analyzed using the Luminex assay. The subbasal nerve plexus of all participants was evaluated by in vivo confocal microscopy.
Patients with DR exhibited more severe dry eye symptoms, along with a reduction in nerve fiber density, length, and branch density within the subbasal nerve plexus, accompanied by an increase in the number of dendritic cells. Tear PGRN levels were also significantly lower in patients with diabetes than in normal controls, and the levels of some inflammatory factors (TNF-α, IL-6, and MMP-9) were higher in patients with DR. Remarkably, the PGRN level significantly correlated with nerve fiber density (R = 0.48, P < 0.001), nerve fiber length (R = 0.65, P < 0.001), and nerve branch density (R = 0.69, P < 0.001).
Tear PGRN levels might reflect morphological changes in the corneal nerve plexus under diabetic conditions, suggesting that PGRN itself is a reliable indicator for predicting the advancement of neurotrophic keratopathy in patients with diabetes.
PGRN insufficiency on the ocular surface under diabetic conditions was found to be closely associated with nerve impairment, providing a novel perspective to discover the pathogenesis of diabetic complications, which could help in developing innovative therapeutic strategies.
本研究旨在探讨糖尿病视网膜病变（DR）患者与健康对照者的泪液中颗粒蛋白前体（PGRN）的表达水平。此外，我们还探讨了 PGRN 水平与糖尿病患者眼表并发症严重程度之间的相关性。
这是一项前瞻性、单访视、横断面研究，纳入了 48 例 DR 患者和 22 例年龄匹配的健康对照者，并进行了干眼症检查。采集泪液，使用 Luminex assay 分析其成分。使用活体共聚焦显微镜评估所有参与者的基底神经丛。
DR 患者表现出更严重的干眼症状，基底神经丛内神经纤维密度、长度和分支密度降低，同时树突状细胞数量增加。糖尿病患者的泪液 PGRN 水平也明显低于正常对照组，一些炎症因子（TNF-α、IL-6 和 MMP-9）的水平在 DR 患者中也较高。值得注意的是，PGRN 水平与神经纤维密度（R = 0.48，P < 0.001）、神经纤维长度（R = 0.65，P < 0.001）和神经分支密度（R = 0.69，P < 0.001）显著相关。
泪液 PGRN 水平可能反映糖尿病状态下角膜神经丛的形态变化，表明 PGRN 本身是预测糖尿病患者神经营养性角膜病变进展的可靠指标。
马素慧
Zotero 插件
