New strategy to treat diabetic retinopathy using stabilization of hyalocyte-vasucular endothelial cell correlation

眼血管生成受包括细胞因子在内的多肽调控，这些多肽已知会影响血管内皮细胞。我们研究了透明细胞与血管内皮细胞的相互作用，一些细胞因子影响这些相互作用。测定不同化学活性物质对内皮细胞单独和与透明细胞共培养的生存能力的影响。采用MTT法测定IL-1α、IL-1β、IL-6、TNFα和VEGF对人视网膜内皮细胞（HREC_s）的影响。这些结果与HRECs与暴露于不同类型细胞因子的猪透明质细胞共培养时的生存能力进行了比较。我们还评估了贝伐单抗、非诺贝特和地塞米松对HRECs与透明细胞共培养的影响。10微克/毫升贝伐单抗降低了无透明细胞的VEGF刺激的活HRECs的百分比，但有透明细胞时，需要100微克/毫升贝伐单抗才能降低VEGF刺激的活HRECs的百分比。地塞米松浓度为50 μg/ml时，可降低受IL-1α、IL-1β、IL-6和VEGF刺激的HRECs的活性，但不影响共培养的HRECs的活性。HRECs与玻璃体源性透明细胞共培养可抑制细胞因子、贝伐单抗、非诺贝特和地塞米松的作用。提示玻璃体透明细胞可能在体内致病性内皮细胞增殖中起作用。此外，炎症过程在糖尿病视网膜病变和黄斑病变中起重要作用，涉及透明细胞和内皮细胞。基于以上结果，我们研究了类固醇滴眼液治疗糖尿病黄斑病变的效果。我们评价0.05%二氟泼尼酸眼乳剂（DurezolR）治疗玻璃体切除术后难治性糖尿病黄斑水肿（DME）的疗效。本研究纳入我院难治性糖尿病黄斑水肿患者。所有受试者均已经过了3个月以上的治疗。在第1个月每日4次Durezol^(R)治疗，2个月后每日2次（滴眼液组）。视网膜平均厚度明显改善。0.05%二氟泼尼酯眼用乳剂滴注是一种安全有效的治疗方式，不需要手术干预，也不会产生严重的副作用。少

Ocular angiogenesis is regulated by polypeptides including cytokines, which are known to affect vascular endothelial cells. We have investigated that hyalocytes interact with vascular endothelial cells, and some cytokines affect these interactions. To determine the effect of various chemically active agents on the viability of endothelial cells alone and cocultured with hyalocytes. The viability of human retinal endothelial cells (HREC_s) was determined after exposure to IL-1α, IL-1β, IL-6, TNFα and VEGF using the MTT assay. These results were compared to the viability when the HRECs were cocultured with porcine hyalocytes that had been exposed to different types of cytokines. The effects of bevacizumab, fenofibrate and dexamethasone on the viability of HRECs in coculture with hyalocytes were also assessed. Ten micrograms/millilitre of bevacizumab decreased the percentage of living HRECs stimulated by VEGF without hyalocytes, but with the hyalocytes, 100 μg/ml of bevacizumab was requir … More ed to decrease the percentage of viable HRECs stimulated by VEGF. Dexamethasone at 50 μg/ml, decreased the viability of HRECs stimulated by IL-1α, IL-1β, IL-6 and VEGF without hyalocytes but could not decrease the viability of HRECs cocultured. Coculturing HRECs with vitreous-derived hyalocytes depressed the effects of cytokines, bevacizumab, fenofibrate and dexamethasone. This suggests that the vitreal hyalocytes may play a role in pathogenic endothelial cell proliferation in vivo. In addition, inflammatory processes play important roles in diabetic retinopathy and maculopathy involving hyalocytes and endothelial cells.Upon the above results, we examined the effects of steroid eye drops to treat diabetic maculopathy. We evaluated the efficacy of treatment refractory diabetic macular edema (DME) after vitrectomy with difluprednate ophthalmic emulsion 0.05% (DurezolR). This study enrolled patients with refractory diabetic macular edema in our clinic. In all subjects, more than 3 months had passed since any prior treatments. The subject eyes were treated with Durezol^(R) 4 times daily for the first month, and then twice daily for 2 months (eye drop group). The mean retinal thickness was improved significantly. Instillation of difluprednate ophthalmic emulsion 0.05% is a safe and effective treatment modality that does not require surgical intervention and does not produce severe side effects. Less