The Role of Inflammation and Therapeutic Concepts in Diabetic Retinopathy—A Short Review

Gomułka, Krzysztof; Ruta, Michał

doi:10.3390/ijms24021024

Cited by 33 publications

(24 citation statements)

References 66 publications

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“…The role of ocular and systemic inflammation in the pathogenesis of diabetic retinopathy has been confirmed by many previous articles [12][13][14]. Impaired glucose and lipid metabolism lead to the accumulation of toxic metabolites and pro-inflammatory changes in the retina, leading to damage to the neurovascular unit [15,16].…”

Section: Introductionmentioning

confidence: 78%

The Value of White Cell Inflammatory Biomarkers as Potential Predictors for Diabetic Retinopathy in Type 2 Diabetes Mellitus (T2DM)

et al. 2023

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The pathogenesis of diabetic retinopathy is still challenging, with recent evidence proving the key role of inflammation in the damage of the retinal neurovascular unit. This study aims to investigate the predictive value of the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte (PLR), lymphocyte-to-monocyte ratio (LMR), and systemic inflammation index (SII) for diabetic retinopathy (DR) and its severity. We performed a retrospective study on 129 T2DM patients, divided into three groups: without retinopathy (NDR), non-proliferative DR (NPDR), and proliferative DR (PDR). NLR, MLR, and SII were significantly higher in the PDR group when compared to NDR and NPDR (3.2 ± 1.6 vs. 2.4 ± 0.9 and 2.4 ± 1.1; p = 0.005; 0.376 ± 0.216 vs. 0.269 ± 0.083 and 0.275 ± 0.111, p = 0.001; 754.4 ± 514.4 vs. 551.5 ± 215.1 and 560.3 ± 248.6, p = 0.013, respectively). PDR was correlated with serum creatinine (OR: 2.551), NLR (OR: 1.645), MPV (OR: 1.41), and duration of diabetes (OR: 1.301). Logistic regression analysis identified three predictive models with very good discrimination power for PDR (AUC ROC of 0.803, 0.809, and 0.830, respectively): combining duration of diabetes with NLR, MLR, and, respectively, PLR, MPV, and serum creatinine. NLR, MPV, SII, and LMR were associated with PDR and could be useful when integrated into comprehensive risk prediction models.

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Section: Introductionmentioning

confidence: 78%

The Value of White Cell Inflammatory Biomarkers as Potential Predictors for Diabetic Retinopathy in Type 2 Diabetes Mellitus (T2DM)

et al. 2023

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“…[ 19 ] Inflammation alters retinal microcirculation and favors retinal neurodegeneration through different effectors such as cytokines, which eventually produce retinal damage, edema, or neovascularization. [ 20 ] In this sense, the implementation of dietary interventions based on ACE oil and EVOO supplements could help reduce ocular damage in the setting of retinal pathologies.…”

Section: Introductionmentioning

confidence: 99%

Exploring the Potential of Wild Olive (Acebuche) Oil as a Pharm‐Food to Prevent Ocular Hypertension and Fibrotic Events in the Retina of Hypertensive Mice

Santana‐Garrido,

Reyes‐Goya,

André

et al. 2023

Molecular Nutrition Food Res

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ScopeOur laboratory has previously described the antioxidant and anti‐inflammatory potential of a wild olive (acebuche, ACE) oil against hypertension‐associated vascular retinopathies. The current study aims to analyze the antifibrotic effect of ACE oil on the retina of hypertensive mice.Methods and resultsMice are rendered hypertensive by administration of NG‐nitro‐L‐arginine‐methyl‐ester (L‐NAME) and simultaneously subjected to dietary supplementation with ACE oil or a reference extra virgin olive oil (EVOO). Intraocular pressure (IOP) is measured by rebound tonometry, and retinal vasculature/layers are analyzed by fundus fluorescein angiography and optical coherence tomography. Different fibrosis‐related parameters are analyzed in the retina and choroid of normotensive and hypertensive mice with or without oil supplementation. Besides preventing the alterations found in hypertensive animals, including increased IOP, reduced fluorescein signal, and altered retinal layer thickness, the ACE oil‐enriched diet improves collagen metabolism by regulating the expression of major fibrotic process modulators (matrix metalloproteinases, tissue inhibitors of metalloproteinases, connective tissue growth factor, and transforming growth factor beta family).ConclusionRegular consumption of EVOO and ACE oil (with better outcomes in the latter) might help reduce abnormally high IOP values in the context of hypertension‐related retinal damage, with significant reduction in the surrounding fibrotic process.

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“…Third, elevated vascular endothelial growth factor concentrations associated with visceral fat accumulation have been shown to be a potent mediator of angiogenesis and vascular permeability [ 11 ] and play a pivotal role in the retinal microvascular complications of diabetes [ 70 , 71 ]. Taken together, an excess of visceral fat could be linked to a state of chronic systemic inflammation and metabolic abnormalities, thereby predisposing patients to the complex progression of retinal vascular diseases [ 72 ].…”

Section: Discussionmentioning

confidence: 99%

Association of Visceral Obesity Indices With Incident Diabetic Retinopathy in Patients With Diabetes: Prospective Cohort Study

Chen,

Li,

Niu

et al. 2024

JMIR Public Health Surveill

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Background Visceral adipose tissue plays an active role in the pathogenesis of type 2 diabetes and vascular dysfunction. The lipid accumulation product (LAP), visceral adiposity index (VAI), and Chinese VAI (CVAI) have been proposed as simple and validated surrogate indices for measuring visceral adipose tissue. However, the evidence from prospective studies on the associations between these novel indices of visceral obesity and diabetic retinopathy (DR) remains scant. Objective This study aimed to investigate the longitudinal associations of LAP, VAI, and CVAI with incident DR in Chinese patients with diabetes. Methods This was a prospective cohort study conducted in Guangzhou in southern China. We collected baseline data between November 2017 and July 2020, while on-site follow-up visits were conducted annually until January 2022. The study participants consisted of 1403 patients with a clinical diagnosis of diabetes, referred from primary care, who were free of DR at baseline. The LAP, VAI, and CVAI levels were calculated by sex-specific equations based on anthropometric and biochemical parameters. DR was assessed using 7-field color stereoscopic fundus photographs and graded according to the modified Airlie House Classification scheme. Time-dependent Cox proportional hazard models were constructed to estimate the hazard ratios with 95% CIs. Restricted cubic spline curves were fitted to examine the dose-response relationship between the 3 indices of visceral obesity and new-onset DR. Subgroup analyses were performed to investigate the potential effect modifiers. Results The mean age of study participants was 64.5 (SD 7.6) years, and over half (816/1403, 58.2%) were female. During a median follow-up of 2.13 years, 406 DR events were observed. A 1-SD increment in LAP, VAI, or CVAI was consistently associated with increased risk for new-onset DR, with a multivariable‑adjusted hazard ratio of 1.24 (95% CI 1.09-1.41; P=.001), 1.22 (95% CI 1.09-1.36; P<.001), and 1.48 (95% CI 1.19-1.85; P=.001), respectively. Similar patterns were observed across tertiles in LAP (P for trend=.001), VAI (P for trend<.001), and CVAI (P for trend=.009). Patients in the highest tertile of LAP, VAI, and CVAI had an 84%, 86%, and 82% higher hazard of DR, respectively, compared to those in the lowest tertile. A nonlinear dose-response relationship with incident DR was noted for LAP and VAI (both P for nonlinearity<.05), but not for CVAI (P for nonlinearity=.51). We did not detect the presence of effect modification by age, sex, duration of diabetes, BMI, or comorbidity (all P for interaction>.10). Conclusions Visceral obesity, as measured by LAP, VAI, or CVAI, is independently associated with increased risk for new-onset DR in Chinese patients with diabetes. Our findings may suggest the necessity of incorporating regular monitoring of visceral obesity indices into routine clinical practice to enhance population-based prevention for DR.

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The Role of Inflammation and Therapeutic Concepts in Diabetic Retinopathy—A Short Review

Cited by 33 publications

References 66 publications

The Value of White Cell Inflammatory Biomarkers as Potential Predictors for Diabetic Retinopathy in Type 2 Diabetes Mellitus (T2DM)

The Value of White Cell Inflammatory Biomarkers as Potential Predictors for Diabetic Retinopathy in Type 2 Diabetes Mellitus (T2DM)

Exploring the Potential of Wild Olive (Acebuche) Oil as a Pharm‐Food to Prevent Ocular Hypertension and Fibrotic Events in the Retina of Hypertensive Mice

Association of Visceral Obesity Indices With Incident Diabetic Retinopathy in Patients With Diabetes: Prospective Cohort Study

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