scholarly journals Usefulness of the Vitreous Fluid Analysis in the Translational Research of Diabetic Retinopathy

2012 ◽  
Vol 2012 ◽  
pp. 1-11 ◽  
Author(s):  
Olga Simó-Servat ◽  
Cristina Hernández ◽  
Rafael Simó
Keyword(s):  
Diabetic Retinopathy ◽  
New Technologies ◽  
Vitreoretinal Surgery ◽  
Diabetic Patients ◽  
Pharmacological Treatments ◽  
Vitreous Fluid ◽  
Fluid Analysis ◽  
Working Age ◽  
Advanced Stages ◽  
Endothelial Growth Factor

Diabetic retinopathy (DR) is the major cause of acquired blindness in working-age adults. Current treatments for DR (laser photocoagulation, intravitreal corticosteroids, intravitreal antivascular endothelial growth factor (VEGF) agents, and vitreo-retinal surgery) are applicable only at advanced stages of the disease and are associated with significant adverse effects. Therefore, new pharmacological treatments for the early stages of the disease are needed. Vitreous fluid obtained from diabetic patients undergoing vitreoretinal surgery is currently used to explore the events that are taking place in the retina for clinical research. However, several confounding factors such as vitreous haemorrhage and concentration of vitreous proteins should be considered in the analysis of the results. In this paper we will focus on the vitreous fluid as a tool for exploring the mediators of DR and in particular the molecules related to inflammatory pathways. In addition, their role in the pathogenesis of DR will be discussed. The usefulness of new technologies such as flow cytometry and proteomics in identifying new candidates involved in the inflammatory process that occurs in DR will be overviewed. Finally, a more personalized treatment based on vitreous fluid analysis aiming to reduce the burden associated with DR is suggested.

scholarly journals Circulating Biomarkers of Diabetic Retinopathy: An Overview Based on Physiopathology

2016 ◽  
Vol 2016 ◽  
pp. 1-13 ◽  
Author(s):  
Olga Simó-Servat ◽  
Rafael Simó ◽  
Cristina Hernández
Keyword(s):  
Diabetic Retinopathy ◽  
Therapeutic Strategy ◽  
New Drugs ◽  
Diagnostic Tools ◽  
Diabetic Patients ◽  
Circulating Biomarkers ◽  
Pharmacological Treatments ◽  
Early Stages ◽  
Working Age ◽  
Advanced Stages

Diabetic retinopathy (DR) is the main cause of working-age adult-onset blindness. The currently available treatments for DR are applicable only at advanced stages of the disease and are associated with significant adverse effects. In early stages of DR the only therapeutic strategy that physicians can offer is a tight control of the risk factors for DR. Therefore, new pharmacological treatments for these early stages of the disease are required. In order to develop therapeutic strategies for early stages of DR new diagnostic tools are urgently needed. In this regard, circulating biomarkers could be useful to detect early disease, to identify those diabetic patients most prone to progressive worsening who ought to be followed up more often and who could obtain the most benefit from these therapies, and to monitor the effectiveness of new drugs for DR before more advanced DR stages have been reached. Research of biomarkers for DR has been mainly based on the pathogenic mechanism involved in the development of DR (i.e., AGEs, oxidative stress, endothelial dysfunction, inflammation, and proangiogenic factors). This review focuses on circulating biomarkers at both early and advanced stages that could be relevant for the prediction or detection of DR.

scholarly journals Nutraceuticals for the Treatment of Diabetic Retinopathy

Nutrients ◽  
2019 ◽  
Vol 11 (4) ◽  
pp. 771 ◽  
Author(s):  
Maria Grazia Rossino ◽  
Giovanni Casini
Keyword(s):  
Diabetic Retinopathy ◽  
Molecular Mechanisms ◽  
Treatment Options ◽  
Vitreoretinal Surgery ◽  
In Vivo Studies ◽  
Early Diabetes ◽  
Advanced Stages ◽  
Endothelial Growth Factor

Diabetic retinopathy (DR) is one of the most common complications of diabetes mellitus and is characterized by degeneration of retinal neurons and neoangiogenesis, causing a severe threat to vision. Nowadays, the principal treatment options for DR are laser photocoagulation, vitreoretinal surgery, or intravitreal injection of drugs targeting vascular endothelial growth factor. However, these treatments only act at advanced stages of DR, have short term efficacy, and cause side effects. Treatment with nutraceuticals (foods providing medical or health benefits) at early stages of DR may represent a reasonable alternative to act upstream of the disease, preventing its progression. In particular, in vitro and in vivo studies have revealed that a variety of nutraceuticals have significant antioxidant and anti-inflammatory properties that may inhibit the early diabetes-driven molecular mechanisms that induce DR, reducing both the neural and vascular damage typical of DR. Although most studies are limited to animal models and there is the problem of low bioavailability for many nutraceuticals, the use of these compounds may represent a natural alternative method to standard DR treatments.

scholarly journals Molecular Implications of the PPARs in the Diabetic Eye

PPAR Research ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-11 ◽  
Author(s):  
Andreea Ciudin ◽  
Cristina Hernández ◽  
Rafael Simó
Keyword(s):  
Diabetic Retinopathy ◽  
Molecular Mechanisms ◽  
Vitreoretinal Surgery ◽  
Developed Countries ◽  
Peroxisome Proliferator ◽  
New Approach ◽  
New Strategy ◽  
Working Age ◽  
Ppar Agonists ◽  
Advanced Stages

Diabetic retinopathy (DR) remains as the leading cause of blindness among working age individuals in developed countries. Current treatments for DR (laser photocoagulation, intravitreal corticosteroids, intravitreal anti-VEGF agents, and vitreoretinal surgery) are applicable only at advanced stages of the disease and are associated with significant adverse effects. Therefore, new pharmacological treatments for the early stages of the disease are needed. Emerging evidence indicates that peroxisome proliferator-activator receptors (PPARs) agonists (in particular PPARα) are useful for the treatment of DR. However, the underlying molecular mechanisms are far from being elucidated. This paper mainly focuses on PPARs expression in the diabetic eye, its molecular implications, and the effect of PPAR agonists as a new approach for the treatment of DR. The availability of this new strategy will not only be beneficial in treating DR but may also result in a shift towards treating earlier stages of diabetic retinopathy, thus easing the burden of this devastating disease (Cheung et al. (2010)).

Stem Cell Therapy for T1 D and T2 D Diabetic patients

2020 ◽  
Vol 11 (10) ◽  
pp. 23-25
Author(s):  
Nandakumar Ravichandran
Keyword(s):  
Diabetic Retinopathy ◽  
Beta Cells ◽  
Chronic Condition ◽  
Major Complication ◽  
Limb Ischemia ◽  
Diabetic Patients ◽  
Insulin Production ◽  
Working Age

Diabetes is a chronic condition that causes several diseases. Type 1 and Type 2 dependent diabetes are shown more concern in today’s world. Type1 dependent patients suffers from inability of the Beta cells to produce insulin whereas Type 2 dependent patients suffers from insufficient insulin production. Diabetic Retinopathy, Nephropathy, Critical Limb Ischemia and impaired glucose tolerance are some of the major risk factors of Diabetes. Diabetic Retinopathy is a major complication of Diabetes causing blindness in working age adults. This article discusses some research methods involved in the generation of Beta cells carried out by certain authors, hypothesis and future works in this field.

scholarly journals Vascular endothelial growth factor (VEGF)-related polymorphisms rs10738760 and rs6921438 are not risk factors for proliferative diabetic retinopathy (PDR) in patients with type 2 diabetes mellitus (T2DM)

2019 ◽  
Vol 19 (1) ◽  
pp. 94-100 ◽  
Author(s):  
Jana Sajovic ◽  
Ines Cilenšek ◽  
Sara Mankoč ◽  
Špela Tajnšek ◽  
Tanja Kunej ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Vascular Endothelial Growth Factor ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Diabetic Patients ◽  
Vascular Endothelial ◽  
Endothelial Growth Factor

Vascular endothelial growth factor (VEGF) is an important regulator of angiogenesis and has been investigated as a candidate gene in a number of conditions, including diabetes and its microvascular complications (e.g., retinopathy and nephropathy). Several VEGF-related polymorphisms have been shown to contribute to nearly half of the variability in circulating VEGF levels in healthy individuals. Our aim was to assess the association between VEGF-related rs10738760 and rs6921438 polymorphisms and proliferative diabetic retinopathy (PDR) in Slovenian patients with type 2 diabetes mellitus (T2DM). We also investigated the effect of these polymorphisms on VEGF receptor 2 (VEGFR-2) expression in fibrovascular membranes (FVMs) from patients with PDR. This case-control study enrolled 505 unrelated patients with T2DM: 143 diabetic patients with PDR as a study group, and 362 patients with T2DM of >10 years duration and with no clinical signs of PDR as a control group. Patient clinical and laboratory data were obtained from their medical records. rs10738760 and rs6921438 polymorphisms were genotyped using TaqMan SNP Genotyping assay. VEGFR-2 expression was assessed by immunohistochemistry in 20 FVMs from patients with PDR, and numerical areal density of VEGFR-2-positive cells was calculated. The occurrence of PDR was 1.7 times higher in diabetic patients carrying GA genotype of rs6921438 compared to patients with GG genotype, with a borderline statistical significance (OR = 1.7, 95% CI = 1.00 – 2.86, p = 0.05). In addition, A allele of rs6921438 was associated with increased VEGFR-2 expression in FVMs from PDR patients. However, we observed no association between AA genotype of rs6921438 nor between rs10738760 variants and PDR, indicating that the two polymorphisms are not genetic risk factors for PDR.

Steroid Therapy in Diabetic Retinopathy and Diabetic Macular Edema

2018 ◽  
pp. 160-164
Keyword(s):  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Vitreoretinal Surgery ◽  
Fluocinolone Acetonide ◽  
Intravitreal Triamcinolone ◽  
Intraocular Pressure Elevation ◽  
Risk Treatment ◽  
Therapeutic Alternatives ◽  
Endothelial Growth Factor

Diabetic macular edema (DME) is the leading cause of blindness in patients with diabetic retinopathy worldwide. Therapeutic alternatives now include focal/grid laser photocoagulation, vitreoretinal surgery, and intraocular injection of anti-angiogenic and steroid molecules. In patients with recalcitrant DME, especially in those cases when anti-vascular endothelial growth factor (VEGF) agents are contraindicated or a treatment regimen with fewer intravitreal injections is required, intravitreal administration of steroids represents a fundamental alternative. Three intravitreal corticosteroid options for DME treatment are currently available including the dexamethasone delivery system, the fluocinolone acetonide insert, and off-label intravitreal triamcinolone acetonide. All of these drugs are associated with the risk of cataract progression and intraocular pressure elevation. In patients unresponsive to anti-VEGF therapy, pseudophakic, at low risk for glaucoma, or who have significant cardiovascular risk, treatment with long-lasting intraocular steroids is suggested.

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