Expression of Apoptosis Markers in the Retinas of Human Subjects with Diabetes

Abu-El-Asrar, Ahmed M; Dralands, L; Missotten, Luc; Aljadaan, Ibrahim; Geboes, Karel

doi:10.1167/iovs.03-1392

Cited by 267 publications

(201 citation statements)

References 56 publications

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“…Postmortem human diabetic retinas exhibit increased markers of apoptosis in ganglion cells (44). Animal studies show accelerated apoptosis of retinal neurons (45,46), glial activation (47-49), impaired glial cell metabolism (50 -52), and microglial cell activation (11,53,54).…”

Section: Fig 2 Functional Anatomy Of the Retina Metabolic Interactmentioning

confidence: 99%

Diabetic Retinopathy

et al. 2006

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Diabetic retinopathy remains a frightening prospect to patients and frustrates physicians. Destruction of damaged retina by photocoagulation remains the primary treatment nearly 50 years after its introduction. The diabetes pandemic requires new approaches to understand the pathophysiology and improve the detection, prevention, and treatment of retinopathy. This perspective considers how the unique anatomy and physiology of the retina may predispose it to the metabolic stresses of diabetes. The roles of neural retinal alterations and impaired retinal insulin action in the pathogenesis of early retinopathy and the mechanisms of vision loss are emphasized. Potential means to overcome limitations of current animal models and diagnostic testing are also presented with the goal of accelerating therapies to manage retinopathy in the face of ongoing diabetes. Diabetes 55:2401-2411, 2006 D espite years of clinical and laboratory investigation, diabetic retinopathy remains the leading cause of vision impairment and blindness among working-age adults, yet the fundamental cause(s) remains uncertain. Retinal photocoagulation to reduce neovascularization and macular edema was developed in the 1950s and is still the standard of care (1). The number of people worldwide at risk of developing vision loss from diabetes is predicted to double over the next 30 years (2), so it is imperative to develop better means to identify, prevent, and treat retinopathy in its earliest stages rather than wait for the onset of vision-threatening lesions. Progress in these areas requires a new perspective on the problem that includes the roles of the neural retina, impaired insulin action, and inflammation. In this way, established neurobiological principles can inform us how diabetes impairs vision, and knowledge of metabolism, inflammation, and regenerative medicine may lead to new treatments.This perspective will discuss how the unique anatomy and physiology of the retina may render it vulnerable to the metabolic derangements of diabetes and lead to impaired vision. The intent of this unconventional approach is to encourage consideration of new opportunities for investigations that will advance the field. NORMAL RETINAL STRUCTURE AND PHYSIOLOGY Topographic and cellular organization of the retina.It is instructive to consider the functional organization of the retina (literally a network) to better understand the impact of diabetes (http://webvision.med.utah.edu). The retina is a transparent layer of neural tissue between the retinal pigmented epithelium and the vitreous body. Normal vision depends on intact cell-cell communication among the neuronal, glial, microglial, vascular, and pigmented epithelial cells of the retina. The fundamental functions of the retina are to capture photons, convert the photochemical energy into electrical energy, integrate the resulting action potentials, and transmit them to the occipital lobe of the brain, where they are deciphered and interpreted into recognizable images. The retina is partitioned from the syst...

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Section: Fig 2 Functional Anatomy Of the Retina Metabolic Interactmentioning

confidence: 99%

Diabetic Retinopathy

et al. 2006

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“…In a previous study, we demonstrated that ganglion cells in diabetic retinas expressed the apoptosispromoting factors caspase-3, Fas, and Bax, suggesting that these cells are the most vulnerable population. 9 A number of additional mediators that are either antiapoptotic or proapoptotic have been identified. 10 They include among others the serine/threonine protein kinase Akt (also known as protein kinase B), cyclooxygenase-2 (Cox-2), Mcl-1, Bcl-2-associated death promoter (Bad), cytochrome c, apoptosis-inducing factor (AIF), tumour necrosis factor receptor-1-associated death domain protein (TRADD), and Fas-associated death domain protein (FADD).…”

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confidence: 99%

Expression of antiapoptotic and proapoptotic molecules in diabetic retinas

El‐Asrar

Dralands

Missotten

et al. 2006

Eye

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“…These findings corroborate experimental data which suggest that neuronal apoptosis in the retina is an early and persistent event in diabetes (Abu‐El‐Asrar et al. 2004; Barber et al. 2011).…”

Section: Introductionmentioning

confidence: 99%

Correlation of retinal neurodegeneration with measures of peripheral autonomic neuropathy in type 1 diabetes

Pemp

Palkovits

Howorka

et al. 2018

Acta Ophthalmologica

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PurposeTo evaluate the relationship of neuroretinal layer thickness with sensitive measures of cardiovascular autonomic neuropathy in diabetic patients with non‐proliferative diabetic retinopathy (NPDR).MethodsTwenty‐seven eyes of 27 patients with type 1 diabetes presenting with mild‐to‐moderate NPDR were compared to 27 healthy control (HC) eyes matched for age and gender. The total macular volume (TMV) and the volumes of individual neurosensory layers in the macula were analysed from spectral domain optical coherence tomography using automated layer segmentation. Cardiovascular autonomic regulation was assessed by short‐term power spectrum analysis of heart rate variability (HRV) before, during and after an orthostatic challenge.ResultsThe patients had an age of 46 ± 12 years and diabetes since 28 ± 9 years. Diastolic and mean arterial pressure was lower in the patients compared to HCs. TMV (r = 0.58, p = 0.002), inner plexiform layer volume (IPLV; r = 0.39, p = 0.047) and inner nuclear layer volume (INLV; r = 0.60, p = 0.001) were associated with reduced recovery of low‐frequency (LF) spectral power of HRV after orthostatic load in diabetic patients but not in HCs. The response of LF spectral power during the orthostatic manoeuvre was blunted in patients compared to HCs (p = 0.02). Diabetes duration was negatively associated with TMV and INLV, whereas IPLV was significantly reduced in eyes with moderate NPDR compared to HCs.ConclusionThe results indicate a correlation between inner retinal tissue loss and diminished autonomic regulation in type 1 diabetic patients with mild‐to‐moderate NPDR. The observed changes can be interpreted as congruent early signs of retinal and systemic neuropathy in diabetes.

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Expression of Apoptosis Markers in the Retinas of Human Subjects with Diabetes

Cited by 267 publications

References 56 publications

Diabetic Retinopathy

Diabetic Retinopathy

Expression of antiapoptotic and proapoptotic molecules in diabetic retinas

Correlation of retinal neurodegeneration with measures of peripheral autonomic neuropathy in type 1 diabetes

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