Rheumatoid arthritis and the prevalence of diabetic retinopathy

Bartels, Christie M.; Wong, Joanna C.; Johnson, Sophia L.; Thorpe, Carolyn T.; Barney, Neal P.; Smith, Maureen A.

doi:10.1093/rheumatology/kev012

Cited by 9 publications

(7 citation statements)

References 16 publications

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“…Using iNOS knockout mice, investigators were able to demonstrate a direct role between iNOS and the development of DR in its early stages [118]. Moreover, it has been reported that patients treated for rheumatoid arthritis with salicylate-based drugs had lower incidences of DR [119, 120], indicating a possible role for anti-inflammatory drugs in modulating DR progression. In addition to hyperglycemic conditions, the alteration in retinal fatty acid metabolism, possibly via AGE/RAGE interactions and the activation of the MAPK pathway, can lead to chronic inflammation due to a decrease in retinal n-3 polyunsaturated fatty acids (PUFAs), such as docosohexanoic acid (DHA) [121].…”

Section: Molecular Mechanisms Of Diabetic Retinopathymentioning

confidence: 99%

Diabetic retinopathy: Breaking the barrier

et al. 2017

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Diabetic retinopathy (DR) remains a major complication of diabetes and a leading cause of blindness among adults worldwide. DR is a progressive disease affecting both type I and type II diabetic patients at any stage of the disease, and targets the retinal microvasculature. DR results from multiple biochemical, molecular and pathophysiological changes to the retinal vasculature, which affect both microcirculatory functions and ultimately photoreceptor function. Several neural, endothelial, and support cell (e.g., pericyte) mechanisms are altered in a pathological fashion in the hyperglycemic environment during diabetes that can disturb important cell surface components in the vasculature producing the features of progressive DR pathophysiology. These include loss of the glycocalyx, blood-retinal barrier dysfunction, increased expression of inflammatory cell markers and adhesion of blood leukocytes and platelets. Included in this review is a discussion of modifications that occur at or near the surface of the retinal vascular endothelial cells, and the consequences of these alterations on the integrity of the retina.

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Section: Molecular Mechanisms Of Diabetic Retinopathymentioning

confidence: 99%

Diabetic retinopathy: Breaking the barrier

et al. 2017

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“…Nonetheless, studies suggest a possible connection between arthritis and diabetes, specifically that individuals with rheumatoid arthritis, an inflammatory form of arthritis, may have a higher likelihood of developing type 2 diabetes. [32,33] Hyperglycemia, hypertension, dyslipidemia, and kidney disease are the most common risk factors for diabetic retinopathy, frequently present in type 2 diabetes patients. Therefore, those with both arthritis and type 2 diabetes may have a heightened risk of developing diabetic retinopathy due to these shared factors.…”

Section: Discussionmentioning

confidence: 99%

Discovering potential pathways between type 2 diabetes mellitus and diabetic retinopathy: A big data analysis of the South Korean National Sample Cohort

2023

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Diabetes mellitus, a prevalent metabolic disorder, is associated with a multitude of complications that necessitate vigilant management post-diagnosis. A notable complication, diabetic retinopathy, could lead to intense ocular injury, including vision impairment and blindness, due to the impact of the disease. Studying the transition from diabetes to diabetic retinopathy is paramount for grasping and halting the progression of complications. In this study, we examine the statistical correlation between type 2 diabetes mellitus and retinal disorders classified elsewhere, ultimately proposing a comprehensive disease network. The National Sample Cohort of South Korea, containing approximately 1 million samples and primary diagnoses based on the International Statistical Classification of Diseases and Related Health Problems 10th Revision classification, was utilized for this retrospective analysis. The diagnoses of both conditions displayed a statistically significant correlation with a chi-square test value of P < .001, and the t test for the initial diagnosis date also yielded a P < .001 value. The devised network, comprising 27 diseases and 142 connections, was established through statistical evaluations. This network offers insight into potential pathways leading to diabetic retinopathy and intermediary diseases, encouraging medical researchers to further examine various risk factors associated with these connections.

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“…Despite the speculated involvement of immune responses to type II collagen in the pathogenesis of both DR and RA, it seems rather uncommon that these two diseases develop simultaneously. In fact, it was previously reported that patients with RA were less predisposed to develop DR [ 67 ]. A number of studies have indicated the frequency of HLA-DR and -DQ antigens that were associated with disease susceptibility were different between DR and RA patients [ 15 , 16 , 68 ].…”

Section: Immunological Divergence Between Diabetic Retinopathy and Rheumatoid Arthritismentioning

confidence: 99%

Possible roles of anti-type II collagen antibody and innate immunity in the development and progression of diabetic retinopathy

Ikeda

Nakamura

Oku

2021

Graefes Arch Clin Exp Ophthalmol

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The pathogenesis of both diabetic retinopathy (DR) and rheumatoid arthritis (RA) has recently been considered to involve autoimmunity. Serum and synovial fluid levels of anti-type II collagen antibodies increase early after the onset of RA, thus inducing immune responses and subsequent hydrarthrosis and angiogenesis, which resemble diabetic macular edema and proliferative DR (PDR), respectively. We previously reported that DR is also associated with increased serum levels of anti-type II collagen antibodies. Retinal hypoxia in DR may induce pericytes to express type II collagen, resulting in autoantibody production against type II collagen. As the result of blood-retinal barrier disruption, anti-type II collagen antibodies in the serum come into contact with type II collagen around the retinal vessels. A continued loss of pericytes and type II collagen around the retinal vessels may result in a shift of the immune reaction site from the retina to the vitreous. It has been reported that anti-inflammatory M2 macrophages increased in the vitreous of PDR patients, accompanied by the activation of the NOD-like receptor family pyrin domain-containing 3 (NLRP3) inflammasome, a key regulator of innate immunity. M2 macrophages promote angiogenesis and fibrosis, which might be exacerbated and prolonged by dysregulated innate immunity.

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Rheumatoid arthritis and the prevalence of diabetic retinopathy

Cited by 9 publications

References 16 publications

Diabetic retinopathy: Breaking the barrier

Diabetic retinopathy: Breaking the barrier

Discovering potential pathways between type 2 diabetes mellitus and diabetic retinopathy: A big data analysis of the South Korean National Sample Cohort

Possible roles of anti-type II collagen antibody and innate immunity in the development and progression of diabetic retinopathy

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