Abstract
Ischemic postconditioning (PC) is proved to efficiently protect diabetic patients with acute myocardial infarction from ischemia-reperfusion injury. We aimed to explore the protective roles of ischemic PC on diabetic retinopathy in tree shrews with diabetic cerebral ischemia. A diabetic tree shrew model was established through high-fat diet feeding combined with streptozotocin (STZ) injection, while cortical thrombotic cerebral ischemia was induced photochemically. Tree shrews were divided into the normal control group, sham operation group, diabetes mellitus group, diabetes mellitus+cerebral ischemia group, and diabetes mellitus+cerebral ischemia+PC group (in which the tree shrews with diabetic cerebral ischemia were treated with ischemic PC). H&E staining was used to examine the pathological changes in the retina, and immunohistochemistry was performed to determine the retinal expression of VEGF (vascular endothelial growth factor). The modeling resulted in 77% tree shrews with diabetes. Ischemic PC reduced the blood glucose levels in the tree shrews with diabetic cerebral ischemia. Tree shrews with diabetes had thinned retina with disordered structures, and these pathological changes were aggravated after cerebral ischemia. The retinopathy was alleviated after ischemic PC. Retina expression of VEGF was mainly distributed in the ganglion cell layer in tree shrews. Diabetes and cerebral ischemia increased retinal VEGF expression in a step-wise manner, while additional ischemic PC reduced retinal VEGF expression. Therefore, ischemic PC effectively alleviates retinopathy in tree shrews with diabetic cerebral ischemia, and this effect is associated with reduced retinal VEGF expression.
Highlights
Diabetic retinopathy (DR) is one of the serious microvascular complications of diabetes mellitus (DM), and it is a disease with a high incidence of blindness [1,2,3]
The purpose of high-fat diet feeding is to induce insulin resistance and to photocopy more risk factors such as high-fat and high-cholesterol levels which render the model with closer clinical characteristics of metabolic diseases and cerebrovascular diseases
This study determined the effects of ischemic postconditioning on diabetic retinopathy and the retinal expression of vascular endothelial growth factor (VEGF) from tree shrews with diabetic cerebral ischemia and provided experimental and theoretical evidence for future nonpharmacological treatment of clinical diabetes patients with cerebral ischemic retinopathy
Summary
Diabetic retinopathy (DR) is one of the serious microvascular complications of diabetes mellitus (DM), and it is a disease with a high incidence of blindness [1,2,3]. One-third of the people with diabetes have signs of DR, and one-third of DR cases develop a vision-threatening form of the disease. Diabetic patients have a disease course of more than 20 years, and more than 60% of them will develop retinopathy [4, 5]. With the increasing incidence of DM, the incidence of DR and its blindness rate show an increasing trend [6, 7]. Studies have shown that the blindness rate in patients with DR is 20 times higher than that in nondiabetic patients. The population in the Asia-Pacific region is more common for diabetes-caused vision loss. Since DR is the leading cause of vision loss in adults [8], increasing attention has been drawn for the basic and clinical research on DR recently
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