CLINICAL EPIDEMIOLOGY OF RETINAL DEGENERATIONS

描述：(申请人摘要)类胡萝卜素缺乏症 老年性黄斑变性(AMD)与大量证据的联系 类胡萝卜素对炎症过程的生物利用度降低。这个K23 该项目测试了系统性慢性低度病变的独特假设 炎症可能通过以下方式在某些AMD中发挥作用：(1)直接的 Bruch膜视网膜色素的炎性/氧化性损害 上皮-光感受器复合体，或(2)通过降低生物利用度 黄斑类胡萝卜素、叶黄素和玉米黄质通过 全身池的耗尽，或通过视网膜内池的耗尽。 候选人将参加一系列有指导的临床研究。 发展活动，同时进行以下一系列研究 旨在开始检验这一假说。(1)分析了现有的 第三次全国健康和营养检查调查(NHANES-III)数据集为 评估血清C-反应蛋白水平之间的可能联系 和AMD。(2)老年AMD横断面调查 已经参与了健康、老龄化和身体的持续动态 作文(健康ABC)研究。详细的视网膜检查将在 200名可能患有某种程度的AMD的受试者和100名未受影响的个体。 黄体素和玉米黄质的视网膜内光密度将被估计。 非侵入性地在每个对象中通过基于 异色闪烁测光原理。黄斑外观将会是 以照片形式记录，并使用国际认可的系统进行评级。 在此期间采集的血液样本，作为健康ABC研究的一部分 将分析方案中炎症标志物的水平和 类胡萝卜素。这些衡量标准之间的相关性和相关差异 将确定是否存在AMD，以测试基本的 炎症-类胡萝卜素-老年性黄斑变性假说的原则。未来的R01提案将 追问实际的机制是直接的还是间接的。 职业发展活动包括：正规的流行病学研究和 生物统计学.在使用复杂数据分析方面由导师指导的培训 来自现有研究的数据集以及临床设计和实施中的数据集 流行病学研究.黄斑色素光密度测量培训 方法；以及黄斑照片分析方法和眼底训练 摄影阅读中心运营。

DESCRIPTION: (Applicant's Abstract) Carotenoid deficiency has been implicated in age-related macular degeneration (AMD) and substantial evidence links reduced bioavailability of carotenoids to inflammatory processes. This K23 project tests the unique hypothesis that systemic chronic low-grade inflammation may play a role in some AMD by means of either (1) a direct inflammatory/oxidative insult to the Bruch's membrane-retinal pigment epithelium- photoreceptor complex, or (2) by reducing the bioavailability of the macular carotenoids, lutein and zeaxanthin to the retina, either via depletion of the systemic pool, or via depletion of the intraretinal pool. The candidate will partake in a series of mentored clinical-research development activities while conducting the following sequence of studies that are designed to begin testing this hypothesis. (1) An analysis on the existing Third National Health and Nutrition Examination Survey (NHANES-III) data set to evaluate the possible association between serum levels of C-reactive protein and AMD. (2) A cross-sectional investigation on AMD in an elderly population already participating in the ongoing Dynamics of Health, Aging, and Body Composition (Health ABC) Study. A detailed retinal exam will be performed on 200 subjects likely to have some level of AMD and 100 non-affected individuals. The intraretinal optical density of lutein and zeaxanthin will be estimated non-invasively in each subject by means of a validated method based on the principle of heterochromatic flicker photometry. Macular appearance will be documented photographically and graded with an internationally approved system. Blood samples collected during this period, as part of the Health ABC Study protocol will be analyzed for levels of markers of inflammation and carotenoids. Correlations between these measures and differences associated with presence or absence of AMD will be determined in order to test the basic tenet of the inflammation-carotenoid-AMD hypothesis. Future R01 proposals would pursue whether the actual mechanisms are direct or indirect. Career development activities include: formal studies of epidemiology and biostatistics; guided training by the mentor in complex data analyses using data sets from existing studies and in design and implementation of clinical epidemiologic studies; training in macular pigment optical density measurement methods; and training in macular photograph analysis methods and fundus photography Reading Center operations.