microRNA Expression Profile in the Vitreous of Proliferative Diabetic Retinopathy Patients and Differences from Patients Treated with Anti-VEGF Therapy

Li²,

Evidence-Based Complementary and Alternative Medicine

et al. 2021

Objective. To explore the effects of the anti-VEGF drug and glucocorticoid by injection before the end of vitrectomy for proliferative diabetic retinopathy (PDR). Methods. Eighty PDR patients who underwent vitrectomy in our hospital (July 2020–June 2022) were selected as the research objects and randomized into group A (n = 40) and group B (n = 40) according to the order of admission. Before the end of surgery, group B was injected with glucocorticoid (triamcinolone acetonide) into the vitreous cavity, and group A was injected with anti-VEGF drug (conbercept). The ophthalmic parameters, incidence of complications, diabetes indexes, and surgical indexes of the two groups were compared. Results. The best corrected visual acuity (BCVA), central macular thickness (CMT), macular blood flow density and intraocular pressure in group A were remarkably better than those in group B ( P < 0.001 ). The incidence of complications ( P < 0.05 ) and VEG/F level ( P < 0.001 ) in group A were obviously lower than those in group B. There was no significant difference in fasting blood glucose (FBG) and surgical indexes between the two groups ( P > 0.05 ). Conclusion. Conbercept injection before the end of vitrectomy can improve the ophthalmic parameters, reduce the level of VEGF, and lower the possibility of postsurgical complications. Therefore, the low-cost and efficient anti-VEGF drug should be promoted and applied in practice.

Section: Discussionmentioning

confidence: 99%

Comparative Analysis of the Effects of the Anti-VEGF Drug and Glucocorticoid by Injection before the End of Vitrectomy for Proliferative Diabetic Retinopathy

Li²,

Evidence-Based Complementary and Alternative Medicine

et al. 2021

Graefes Arch Clin Exp Ophthalmol

“…Prognosis and response to treatment are two of the main points potentially addressed by the liquid biopsy approach. Recently, different studies have reported the response to DME treatment, by means of aqueous and vitreous samples [32,104,105,[111][112][113][114][115][116]. Sohn et al compared the AH concentration of VEGF and inflammatory molecules after the administration of triamcinolone and bevacizumab, showing that the first one was able to reduce several inflammatory molecules (IL-6, IP-10, MCP-1, PDGF-AA) and VEGF concentration, while bevacizumab just reduced VEGF concentration [32].…”

Section: Diabetic Macular Edema and Response To Treatmentmentioning

confidence: 99%

Intraocular fluid biomarkers (liquid biopsy) in human diabetic retinopathy

Midena

Frizziero

Midena

et al. 2021

Purpose This article aims to review the impact of detecting and quantifying intraocular biomarkers (liquid biopsy) in both aqueous and vitreous humor in eyes of people affected by diabetes mellitus. Methods This is a detailed review about aqueous and/or vitreous humor sampling in human diabetic eyes for proteomic and/or metabolomic analysis contributing to the understanding of the pathophysiology and treatment effects of diabetic retinopathy. Results Aqueous and vitreous humor molecular biomarkers proved to be directly correlated to each other and valuable to study retinal conditions. Moreover, proteomic and metabolomic analysis showed that the biomarkers of neuroinflammation, neurodegeneration, and vasculopathy are detectable in intraocular fluids and that their concentration changes in different stages of disease, and in response to treatment of all diabetic retinopathy aspects, mainly diabetic macular edema and proliferative retinopathy. Conclusions Liquid biopsy offers the possibility to improve our knowledge of intraocular eye disease induced by diabetes mellitus. The exact quantification of intraocular biomarkers contributes to the precision medicine approach even in the diabetic retinopathy scenario. The diffusion of this approach should be encouraged to have quantifiable information directly from the human model, which may be coupled with imaging data.

“…In addition to the direct inhibitory effect of miR-200b on VEGF expression in response to diabetes, it may also mediate such effect indirectly via p300, a histone acetylation and transcription coactivator in malignancies, affecting in this way the gene expression of multiple vasoactive genes [122]. A recent cohort study using vitreous samples from PDR patients has revealed that miR-20a-5p, miR-23b-3p, miR-142-3p, miR-185-5p, miR-223-3p, miR-362-5p, and miR-662 expression levels were significantly higher compared to controls (vitreous from non-diabetic patients with macular holes), whereas miR-199a-5p and miR-326 were significantly lower [123]. Interestingly, all six overexpressed miRNAs have been previously described as potentially targeting proteins that are increased in the vitreous during PDR, such as VEGF-A, angiopoietin 2, PDGF-B, and connective tissue growth factor (CTGF).…”

Section: Mirna In Dr: Role In Oxidative Stress and Inflammatory Signamentioning

confidence: 99%

“…Interestingly, all six overexpressed miRNAs have been previously described as potentially targeting proteins that are increased in the vitreous during PDR, such as VEGF-A, angiopoietin 2, PDGF-B, and connective tissue growth factor (CTGF). These authors claimed that the observed increase in miRNA expression can play a role in the regulation of angiogenesis and wound healing processes in the context of PDR, and the interplay between miRNA and their targets may result in a variety of gene expression profiles [123].…”

Section: Mirna In Dr: Role In Oxidative Stress and Inflammatory Signamentioning

confidence: 99%

“…In this regard, therapeutic and nutraceutical strategies targeting inflammation and oxidative stress have received renewed attention in recent years (Figure 3) [7,162,163]. In a small cohort, anti-VEGF therapy has been associated with a lower expression of miR-23b-3p in PDR as compared to untreated PDR patients, which suggests the involvement of a regulatory mechanism [123]. However, in this study it was not investigated whether differences exist between responders and non-responders to anti-VEGF therapy.…”

Section: Therapeutic and Nutraceutical Agents With Anti-inflammatory mentioning

confidence: 99%

See 1 more Smart Citation

Extracellular Vesicles and MicroRNA: Putative Role in Diagnosis and Treatment of Diabetic Retinopathy

et al. 2020

Diabetic retinopathy (DR) is a complex, progressive, and heterogenous retinal degenerative disease associated with diabetes duration. It is characterized by glial, neural, and microvascular dysfunction, being the blood-retinal barrier (BRB) breakdown a hallmark of the early stages. In advanced stages, there is formation of new blood vessels, which are fragile and prone to leaking. This disease, if left untreated, may result in severe vision loss and eventually legal blindness. Although there are some available treatment options for DR, most of them are targeted to the advanced stages of the disease, have some adverse effects, and many patients do not adequately respond to the treatment, which demands further research. Oxidative stress and low-grade inflammation are closely associated processes that play a critical role in the development of DR. Retinal cells communicate with each other or with another one, using cell junctions, adhesion contacts, and secreted soluble factors that can act in neighboring or long-distance cells. Another mechanism of cell communication is via secreted extracellular vesicles (EVs), through exchange of material. Here, we review the current knowledge on deregulation of cell-to-cell communication through EVs, discussing the changes in miRNA expression profiling in body fluids and their role in the development of DR. Thereafter, current and promising therapeutic agents for preventing the progression of DR will be discussed.