糖尿病视网膜病变血管和神经退行性表现患者泪液中先天免疫介质的含量

M. P. Ruchkin, E. Markelova, G. A. Fedyashev
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引用次数: 0

摘要

根据最近的研究结果,糖尿病视网膜病变不仅可以被认为是一种血管疾病,而且可以被认为是一种神经退行性过程。泪液成分的研究可用于评估眼部疾病发展过程中的局部免疫状态。然而,关于泪液成分在糖尿病视网膜病变中的作用的研究很少。本研究的目的是测定糖尿病视网膜病变血管和神经退行性表现患者泪液中IL-1β、IL-10、TGF-β3、MMP-7、TIMP-2、蛋白S100b、BDNF和NGF的水平。本研究纳入80例诊断为2型糖尿病的患者,将其分为两组:第一组40例无糖尿病眼底视网膜病变临床体征的患者;第二组包括40例初始症状为非增殖性糖尿病视网膜病变的患者。所有纳入研究的患者均在RTVue-100(美国)光学相干层析成像仪上进行检查;测定视网膜神经节细胞(FLV)的局灶性损失体积。FLV高于设备的标准基线被认为是视网膜神经变性的oct征象。根据OCT结果,将第一组和第二组的参与者再分为4个亚组:1A -眼底无血管改变且无OCT视网膜神经退行性变征象的患者(n = 12);1B -眼底无血管改变且存在视网膜神经退行性变OCT征象的患者(n = 28);2A -初始非增殖性DR且无OCT视网膜神经变性征象的患者(n = 10);2B -首发非增殖性DR且有OCT视网膜神经退行性变征象的患者(n = 30)。采用酶联免疫吸附法检测泪液中IL-1β、IL-10、TGF-β3、MMP-7、TIMP-2、蛋白s100b、BDNF、NGF水平。在整个研究过程中,所有亚组泪液中IL-1β和IL-10的水平与对照组相当。非增殖性DR初始症状组(2组)患者泪液中TGF-β3含量显著低于对照组和2组(p = 0.001)。但组内A、B亚组间差异无统计学意义(p > 0.05)。各亚组泪液中MMP-7浓度均显著低于对照组(p < 0.05)。然而,在有视网膜神经退行性变OCT体征的亚组(1B和2B)中,这种金属蛋白酶的缺乏更为明显(p = 0.0001)。在所有亚组中,泪液中所研究的神经肽NGF、BDNF和s100b的水平与对照组没有差异。
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Content of mediators of innate immunity in the tears of patients with vascular and neurodegenerative manifestations of diabetic retinopathy
According to the results of recent studies, diabetic retinopathy can be considered not only as a vascular disease, but also as a neurodegenerative process. Study of the composition of the tear fluid is used to assess the state of local immunity in the development of eye diseases. However, studies examining the effect of tear composition in diabetic retinopathy are few. The aim of the study is to determine the levels of IL-1β, IL-10, TGF-β3, MMP-7, TIMP-2, protein S100b, BDNF and NGF in the tear fluid ofpatients with vascular and neurodegenerative manifestations of diabetic retinopathy. The study included 80 patients diagnosed with type 2 diabetes which were divided into 2 groups: the 1st group included 40 patients who had no clinical signs of diabetic retinopathy on the fundus; the 2nd group included 40 patients with initial signs of non-proliferative diabetic retinopathy. All those included in the study were examined on an optical coherent tomograph RTVue-100 (USA); the volume of focal losses of retinal ganglion cells (FLV) was determined. An increase in FLV above the normative base of the device was regarded as an OCT-sign of retinal neurodegeneration. According to the results of OCT, the participants of the first and second groups were additionally divided into 4 subgroups: 1A — patients without vascular changes in the fundus and without OCT signs of retinal neurodegeneration (n = 12); 1B — patients without vascular changes in the fundus and with the presence of OCT signs of retinal neurodegeneration (n = 28); 2A — patients with initial non-proliferative DR and without OCT signs of retinal neurodegeneration (n = 10); and 2B — patients with initial non-proliferative DR and with OCT signs of retinal neurodegeneration (n = 30). The levels of IL-1β, IL-10, TGF-β3, MMP-7, TIMP-2, protein S100 b, BDNF, and NGF in tear fluid were determined by enzyme-linked immunosorbent assay. Levels of IL-1β and IL-10 in tear fluid in all subgroups were comparable to controls throughout the study. TGF-β3 content in the tear fluid of patients in the group with initial signs of non-proliferative DR (group 2) was significantly (p = 0.001) lower compared with control and group 2. However, there was no significant difference (p > 0.05) between subgroups A and B within groups. The concentration of MMP-7 in the tear fluid in all subgroups was significantly lower than in the control (p < 0.05). However, in the subgroups with OCT signs of retinal neurodegeneration (1B and 2B), the deficiency of this metalloproteinase was more pronounced (p = 0.0001). The levels of the neuropeptides under study NGF, BDNF and S100 B in tear fluid did not differ from controls in all subgroups.
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来源期刊
Medical Immunology (Russia)
Medical Immunology (Russia) Medicine-Immunology and Allergy
CiteScore
0.70
自引率
0.00%
发文量
88
审稿时长
12 weeks
期刊介绍: The journal mission is to promote scientific achievements in fundamental and applied immunology to various medical fields, the publication of reviews, lectures, essays by leading domestic and foreign experts in the field of fundamental and experimental immunology, clinical immunology, allergology, immunodiagnostics and immunotherapy of infectious, allergy, autoimmune diseases and cancer.
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