Purpose:The purpose was to measure the concentrations of various cytokines and growth factors (including vascular endothelial growth factor [VEGF] and pigment epithelium-derived factor [PEDF]) in the vitreous of patients with proliferative diabetic retinopathy (PDR) and to investigate interaction between inflammatory and proliferative factors in the genesis of PDR.Materials and Methods:Vitreous samples from 32 eyes with PDR and 25 eyes without diabetes mellitus and signs of DR (control) were collected. Vitreous concentrations of VEGF, PEDF, monocyte chemotactic protein-1 (MCP-1), interleukin-4 (IL-4), IL-6, IL-8, IL-10, IL-17A, and secretory immunoglobulin A (sIgA) were simultaneously measured using enzyme-linked immunoassay.Results:Vitreous levels of VEGF, PEDF, IL-17A, IL-6, IL-8, IL-4, and sIgA were significantly (Π < 0.05) higher in eyes with PDR compared to control. The concentration of VEGF was more than 17-times higher than in control, and the concentration of PEDF was not changed oppositely and was also higher (1.45-times) compared to control, that may indicate disturbances of compensatory mechanisms in angiogenesis regulation in PDR. Significant (P < 0.05) positive correlations were observed between vitreous concentrations of VEGF and IL-17A (r = 0.45), VEGF and IL-8 (r = 0.48), VEGF and IL-4 (r = 0.51), PEDF and IL-17A (r = 0.48), PEDF and IL-8 (r = 0.59), MCP-1 and PEDF (r = 0.72), MCP-1 and IL-8 (r = 0.45), IL-4 and IL-17A (r = 0.65), IL-4 and IL-8 (r = 0.71), IL-8 and IL-17A (r = 0.59).Conclusions:Significantly raised levels of inflammatory and proliferative factors and numerous positive correlations between them may demonstrate a significant role of activation of vascular proliferation and local inflammation in the pathogenesis of PDR.
Background. The influence of HAART on the clinical manifestations of atopic dermatitis in HIV-infected children in parallel with the assessment of its effectiveness in relation to the dynamics of diagnostically important indicator of immune status and viral load. Methods. During the period from 1998 to 2008 among children in the check-up at the Moscow Regional Center of AIDS with a confirmed diagnosis of HIV infection in the formation of a group of 26 children, who retrospectively analyzed the clinical and immunological characteristics. To study the dynamics of changes in clinical manifestations of atopic dermatitis on the background of HAART, analyzed the quantitative indicators of CD4 + T-lymphocytes and assessed the changes in viral load. Results. As of 01.01.2009 years in the Moscow region reported 224 children with HIV infection, of whom 111 are under HAART children. Of the children in the HAART, 26 children (29%) to destination therapy have pronounced symptoms of atopic dermatitis (AD). All children of the group was appointed by HAART in accordance with accepted standards. Laboratory indices and clinical manifestations of AD were recorded before HAART and after 9 months after initiation of therapy. According to the results of clinical observations in the survey group of patients in 20 children (77%) 9 months after the appointment of HAART AD symptoms disappeared completely, while 5 children (19%) noted a clear improvement. Only one HIV-infected child (4%) AD was recurrent in nature. Analysis of laboratory data showed that prior to the start of HAART, quantitative indicators of CD4 + T-lymphocytes in children from this group (n = 26) was 23,69 ±4,24 per cent of the total number of lymphocytes. As a result of HAART, the proportion of CD4 + T lymphocytes increased to 29,35±2,61%. When comparing the results of the quantification of HIV RNA in plasma observed decrease in the value decimal logarithm of viral load from 5,22 ±0,21 to 1,54 ±0,71. Conclusions. Highly active antiretroviral therapy of HIV-infected children leads to a cessation of manifestation of AD not giving in to conventional therapy. This effect is realized against the background of the normalization of the indicators of CD4 + T-lymphocytes and reduction in viral load to not defined level.
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