Abstract

Diabetic retinopathy is a major complication of diabetes mellitus and a leading cause of blindness. The pathogenesis of diabetic retinopathy is accompanied by chronic low-grade inflammation. Evidence shows that the blockade of adenosine A2A receptors (A2AR) affords protection to the retina through the control of microglia-mediated neuroinflammation. Herein, we investigated the therapeutic potential of an antagonist of A2AR in a model of diabetic retinopathy. Type 1 diabetes was induced in 4–5 months old C57BL/6 J mice with a single intraperitoneal injection streptozotocin. Animals were treated one month after the onset of diabetes. The A2AR antagonist was delivered by intravitreal injection once a week for 4 weeks. Microglia reactivity and inflammatory mediators were increased in the retinas of diabetic animals. The treatment with the A2AR antagonist was able to control microglial reactivity and halt neuroinflammation. Furthermore, the A2AR antagonist rescued retinal vascular leakage, attenuated alterations in retinal thickness, decreased retinal cell death and the loss of retinal ganglion cells induced by diabetes. These results demonstrate that intravitreal injection of the A2AR antagonist controls inflammation, affords protection against cell loss and reduces vascular leakage associated with diabetes, which could be envisaged as a therapeutic approach for the early complications of diabetes in the retina.

Highlights

  • Diabetic retinopathy is a major complication of diabetes mellitus and a leading cause of blindness and vision impairment in working-age adults[1]

  • Since the aim of this work was to investigate the therapeutic potential of a selective A2A receptors (A2AR) antagonist for the treatment of diabetic retinopathy, we wanted to start the intravitreal injections after established retinal alterations

  • We demonstrate the therapeutic potential of an A2AR antagonist for the treatment of the retinal complications in diabetes

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Summary

Introduction

Diabetic retinopathy is a major complication of diabetes mellitus and a leading cause of blindness and vision impairment in working-age adults[1]. Diabetic retinopathy is considered a neuro-vascular disease in which a low-grade chronic inflammatory environment contribute to BRB breakdown and retinal dysfunction[1,4,5,6,7,8]. We hypothesized that the blockade of A2AR might confer protection to the retina by modulating microglia reactivity, altering the course of the effects of diabetes. To address this hypothesis, we used an animal model of type 1 diabetes, which. This experimental protocol allows the study of the therapeutic potential of the A2AR antagonist, since the retina is already affected by the disease when the treatment is initiated

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