Gao Xin, Li Haosheng, Diao Jiale, Liu Dianjun, Sun Weifeng, Zhou Zhe
Department of Ophthalmology, People's Liberation Army Naval Medical Center, Shanghai 200050, P.R. China.
Department of General Medicine, Chinese People's Liberation Army Unit Hospital 94162, Xi'an, Shaanxi 710600, P.R. China.
Exp Ther Med. 2025 Jul 21;30(3):177. doi: 10.3892/etm.2025.12927. eCollection 2025 Sep.
The present study aimed to investigate the role of circulating plasma inflammatory factors as predictors for the clinical response to anti-vascular endothelial growth factor (VEGF) injections in patients with diabetic macular edema (DME). An observational clinical study was conducted with 58 participants confirmed to have DME involving the foveal center. Participants with a central retinal thickness (CRT) of 320 µm or greater were treated with intravitreal Ranibizumab. CRT, best-corrected visual acuity (BCVA) and vessel density were assessed at 3-month intervals during follow-up. The mean LogMAR BCVA significantly improved from 0.88±0.50 at baseline to 0.681±0.491 at month 3 (P<0.001), while the CRT value decreased from 568.66±105.87 µm at baseline to 450.26±90.22 µm at month 3 (P<0.001). Of the cases, 62.07% showed a favorable anatomic response and 46.55% exhibited a favorable visual acuity response. IL-17 was linked to a limited anatomic response (P=0.02) and also negatively correlated with a favorable BCVA response (P=0.018). Similar associations were observed for IL-8, which was associated with a limited anatomic response (P<0.001) and was negatively associated with a favorable BCVA response (P=0.023). Cases that improved by at least two visual acuity lines had notably lower intercellular adhesion molecule (ICAM)-1 concentrations (P=0.046). Multivariate logistic regression analysis identified IL-17 and IL-8 as independent risk factors significantly associated with CRT (IL-17, P=0.003; IL-8, P=0.043), while IL-17 and ICAM-1 were independent risk factors significantly associated with BCVA (IL-17, P=0.030; ICAM-1, P=0.029). In conclusion, elevated levels of serum IL-17, IL-8 and ICAM-1 at baseline are linked to a restricted clinical response to anti-VEGF therapy for DME.
本研究旨在探讨循环血浆炎症因子作为糖尿病性黄斑水肿（DME）患者抗血管内皮生长因子（VEGF）注射临床反应预测指标的作用。对58名确诊患有累及黄斑中心凹的DME患者进行了一项观察性临床研究。视网膜中央厚度（CRT）为320µm或更高的参与者接受玻璃体内注射雷珠单抗治疗。在随访期间，每隔3个月评估一次CRT、最佳矫正视力（BCVA）和血管密度。平均LogMAR BCVA从基线时的0.88±0.50显著改善至第3个月时的0.681±0.491（P<0.001），而CRT值从基线时的568.66±105.87µm降至第3个月时的450.26±90.22µm（P<0.001）。在这些病例中，62.07%显示出良好的解剖学反应，46.55%表现出良好的视力反应。IL-17与有限的解剖学反应相关（P=0.02），并且与良好的BCVA反应呈负相关（P=0.018）。对于IL-8也观察到类似的关联，其与有限的解剖学反应相关（P<0.001），并且与良好的BCVA反应呈负相关（P=0.023）。视力至少提高两行的病例细胞间黏附分子（ICAM）-1浓度显著较低（P=0.046）。多因素逻辑回归分析确定IL-17和IL-8是与CRT显著相关的独立危险因素（IL-17，P=0.003；IL-8，P=0.043），而IL-17和ICAM-1是与BCVA显著相关的独立危险因素（IL-17，P=0.030；ICAM-1，P=0.029）。总之，基线时血清IL-17、IL-8和ICAM-1水平升高与DME患者抗VEGF治疗的临床反应受限有关。
