Abstract
PurposeTo assess the concentrations of matrix metalloproteinase (MMP)-1 and MMP-9 in the aqueous humor of diabetic macular edema (DME) patients.MethodThe concentrations of MMP-1 and MMP-9 in the aqueous humors of 15 cataract patients and 25 DME patients were compared. DME patients were analyzed according to the diabetic retinopathy (DR) stage, diabetes mellitus (DM) duration, pan-retinal photocoagulation (PRP) treatment, recurrence within 3 months, HbA1C (glycated hemoglobin) level, and axial length.ResultsThe concentrations of MMP-1 and MMP-9 of the DME groups were higher than those of the control group (p = 0.005 and p = 0.002, respectively). There was a significant difference in MMP-1 concentration between the mild non-proliferative diabetic retinopathy (NPDR) group and the proliferative diabetic retinopathy (PDR) group (p = 0.012). MMP-1 concentrations were elevated in PRP-treated patients (p = 0.005). There was a significant difference in MMP-9 concentrations between the mild NPDR group and the PDR group (p < 0.001), and between the moderate and severe NPDR group and the PDR group (p < 0.001). The MMP-9 concentrations in PRP treated patients, DM patients with diabetes ≥ 10 years and recurrent DME within 3months were elevated (p = 0.023, p = 0.011, and p = 0.027, respectively). In correlation analyses, the MMP-1 level showed a significant correlation with age (r = -0.48, p = 0.01,), and the MMP-9 level showed significant correlations with axial length (r = -0.59, p < 0.01) and DM duration (r = 049, p = 0.01).ConclusionsConcentrations of MMP-1 and MMP-9 were higher in the DME groups than in the control group. MMP-9 concentrations also differed depending on DR staging, DM duration, PRP treatment, and degree of axial myopia. MMP-9 may be more important than MMP-1 in the induction of DM complications in eyes.
Highlights
Diabetic retinopathy (DR) is one of the most important causes of visual impairment in many developed countries, despite advances in laser and surgical treatments[1,2,3]
There was a significant difference in matrix metalloproteinases (MMPs)-1 concentration between the mild non-proliferative diabetic retinopathy (NPDR) group and the proliferative diabetic retinopathy (PDR) group (p = 0.012)
There was a significant difference in MMP-9 concentrations between the mild NPDR group and the PDR group (p < 0.001), and between the moderate and severe NPDR group and the PDR group (p < 0.001)
Summary
Diabetic retinopathy (DR) is one of the most important causes of visual impairment in many developed countries, despite advances in laser and surgical treatments[1,2,3]. Recent studies have reported that levels of VEGF and transforming growth factor, epidermal growth factor, human growth factor, interleukins, intercellular adhesion molecule-1, interferon gamma–induced protein, monocyte chemoattractant protein, matrix metalloproteinases (MMPs), plasminogen activator inhibitor-1, placenta growth factor, and tissue growth factor-beta are elevated in the vitreous and anterior chambers[6,7,8]. Their roles in DR may be associated with alterations in the blood-retinal barrier (BRB), their exact mechanisms of action remain unclear[7, 8]. Previous studies have reported that levels of MMPs may be associated with macro- and microvascular complications in DM [11,12,13,14,15,16,17]
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