Succinate Increases in the Vitreous Fluid of Patients With Active Proliferative Diabetic Retinopathy
Succinate Increases in the Vitreous Fluid of Patients With Active Proliferative Diabetic Retinopathy
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DOI：
10.1016/j.ajo.2011.10.006
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发表时间：
2012-05-01
影响因子：
4.2
通讯作者：
Kitaoka, Takashi
中科院分区：
文献类型：
--
作者：
Matsumoto, Makiko;Suzuma, Kiyoshi;Kitaoka, Takashi
目的：检测增殖型糖尿病视网膜病变(PDR)患者玻璃体琥珀酸水平，并探讨其与PDR活动性的关系。设计：对比病例系列。方法：将72例(81眼)PDR患者分为活动期PDR(22眼)、静止期PDR(21眼)和玻璃体内注射贝伐单抗(38眼)。结果：视网膜前膜(ERM)组玻璃体琥珀酸平均浓度为1.27 mU/M，PDR组为2.20 mU/M，差异有统计学意义(P=0.03)。比较平均玻璃体琥珀酸值(活动期PDR：3.32mU M；静止期PDR：1.02mU M；活动期PDR+贝伐单抗：1.20mU/M)，活动期PDR与静止期PDR之间、活动期PDR+贝伐单抗玻璃体内注射之间差异均有统计学意义(P<；0.01)。尽管琥珀酸水平很低，但玻璃体内注射贝伐单抗的活动期PDR患者的视网膜病变活动非常高。平均玻璃体血管内皮生长因子(VEGF)水平(活动期PDR：1696pg/mL；静止期PDR：110pg/mL；活动期PDR+贝伐单抗：N.D.)与之前的报道相似。活动期PDR患者玻璃体平均促红细胞生成素水平(活动期PDR：703mIU/mL；静止期PDR：305mIU/mL；活动期PDR+贝伐单抗：1562mIU/mL)提示，玻璃体内注射贝伐单抗后，活动期PDR患者的视网膜病变活性非常高。结论：琥珀酸与血管内皮生长因子一样，可能是PDR中缺血诱导的血管生成因子。虽然琥珀酸被报道可以促进血管内皮生长因子的表达，但抑制血管内皮生长因子的作用会减少琥珀酸。因此，血管内皮生长因子可能通过一种正反馈机制来调节琥珀酸。《眼科杂志》2012；153：896-902。(C)2012年由Elsevier Inc.保留所有权利。)
PURPOSE: To examine vitreous succinate levels from proliferative diabetic retinopathy (PDR) patients and ascertain their association with PDR activity.DESIGN: Comparative case series.METHODS: A total of 81 eyes of 72 PDR patients were divided into active PDR (22 eyes), quiescent PDR (21 eyes), and active PDR with intravitreal bevacizumab injection (38 eyes). Twenty epiretinal membrane (ERM) patients (21 eyes) served as controls.RESULTS: Mean vitreous succinate levels were 1.27 mu M in ERM and 2.20 mu M in PDR, with the differences statistically significant (P = .03). When comparing mean vitreous succinate levels (active PDR: 3.32 mu M; quiescent PDR: 1.02 mu M; active PDR with intravitreal bevacizumab injection: 1.20 mu M), significant differences were found between active and quiescent PDR (P < .01) and between active PDR and active PDR with intravitreal bevacizumab injection (P < .01). Even though succinate levels were low, retinopathy activities were very high in patients with active PDR with intravitreal bevacizumab injection. Mean vitreous vascular endothelial growth factor (VEGF) levels (active PDR: 1696 pg/mL; quiescent PDR: 110 pg/mL; active PDR with intravitreal bevacizumab injection: n.d.) were similar to previous reports. Mean vitreous erythropoietin levels (active PDR: 703 mIU/mL; quiescent PDR: 305 mIU/mL; active PDR with intravitreal bevacizumab injection: 1562 mIU/mL) suggested very high retinopathy activities in patients with active PDR with intravitreal bevacizumab injection.CONCLUSIONS: Succinate, like VEGF, may be an angiogenic factor that is induced by ischemia in PDR. Although succinate is reported to promote VEGF expression, VEGF inhibition decreases succinate. Thus, VEGF, via a positive feedback mechanism, may regulate succinate. (Am J Ophthalmol 2012;153:896-902. (C) 2012 by Elsevier Inc. All rights reserved.)