Influence of local and systemic factors of type 2 diabetes mellitus on the functional status of platelets in patients with diabetic retinopathy and maculopathy
Journal Title: Офтальмологический журнал - Year 2018, Vol 0, Issue 6
Abstract
Background: To date, there is no information on relationships of systemic (activation of the sympathoadrenal and renin- angiotensin systems, SAS and RAS, respectively) and local (inflammation and remodeling of the retinal extracellular matrix and activation of the ocular purinergic system) mechanisms of the development of diabetic maculopathy (DMP) and diabetic macular edema (DME). Purpose: To identify the influence of systemic and local factors of type 2 diabetes mellitus (DM) on functional status of platelets in DMP and DME under conditions of severe nonproliferative (NPDR) or proliferative diabetic retinopathy (PDR). Materials and Methods: This study included 42 type 2 DM patients (42 eyes), of which 31 patients (31 eyes) and 11 patients (11 eyes) were found to have DMP in the presence of PDR and severe NPDR, respectively. Platelet aggregation in vitro to ADP, adrenaline, angiotensin 2 (Ang2), platelet activation factor (PAF) and collagen were assessed spectrophotometrically with a Chrono-Log aggregometer. Results: As platelet hyperreactivity to AN II, adrenalin, PAF and collagen were found in all study patients, activation of the RAS and SAS, and inflammation and remodeling of retinal extracellular matrix are non-specific pathogenetic mechanisms of DMP. Platelet reactivity to ADP was higher in PDR than in severe NPDR (р=0.008), which reflected the features of the pathogenesis of PDR. Development of DME in patients with DMP could be caused by a pronounced dysregulation of purinergic signaling in the eye, activation of the RAS and inflammation, which was reflected by platelet hyperreactivity to ADP, AN II and PAF, whereas a high platelet reactivity to collagen was characteristic of the absence of DME. Conclusion: The analysis of functional status of platelets allowed elucidating platelet activation mechanisms and identifying major platelet agonists that enabled platelet involvement in progression of DMP and development of DME in type 2 DM patients with proliferative diabetic retinopathy.
Authors and Affiliations
S. Mogilevskyy, Yu. Panchenko, D. Ziablitsev
Keywords
Related Articles
- EP ID EP432241
- DOI 10.31288/oftalmolzh201862329
- Views 87
- Downloads 0
Changes in incidence rates of retinopathy of prematurity in Odessa region in the years of 2009 to 2016
Background. Although retinopathy of prematurity (ROP) is a wide-spread disease, statistical data are absent; so studying the incidence of ROP in Ukraine is of importance. Purpose. To study the incidence of retinopathy...
A Case Report of Kussmaul-Maier Disease
Background: Kussmaul-Maier disease (also known as polyarteritis nodosa or PAN) is a systemic disorder characterized by destructive and proliferative changes in the walls of arteries (mainly muscular arteries and arteriol...
Serum VEGF levels in infants at risk for developing retinopathy of prematurity
Background: Because excessive growth of abnormal retinal vessels in the developing eye of the premature infant underlies retinopathy of prematurity (ROP), it may be hypothesized that a change in vascular endothelial grow...
Toxoplasma chorioretinitis in primary myeloperoxidase MPO deficiency: A case report
We present a clinical case of primary partial myeloperoxidase (MPO) deficiency in a young female patient with recurrent episodes of opportunistic infections. Initially, she presented to the clinical immunologist (DVM) se...
Metabolic correction of experimental diabetic retinopathy
Introduction. Diabetic retinopathy (DR) is diagnosed in 50% of the total number of patients suffering from type 1 diabetes mellitus with diabetes duration of over 10 years and in 75-90% of patients with diabetes duration...