Abstract
Aim To analyze the levels of B-cell-produced antibodies in the vitreous humor of patients with or without diabetic retinopathy (DR) both qualitatively and quantitatively. Methods A total of 52 type 2 diabetes mellitus (T2DM) with DR patients and 52 control subjects without diabetes mellitus or inflammatory diseases were included in this prospective study. The levels of immunoglobulin (Ig)A, IgM, and IgG subtypes were measured using a magnetic color-bead-based multiplex assay. Results The concentrations of IgA, IgM, and total antibodies in the DR group were significantly higher than those in the control group (all p < 0.001), but there was no significant difference in the 4 IgG subtypes between the two groups after Bonferroni correction. Pearson's correlation analysis revealed low negative correlations between levels of antibodies (IgA, IgM) and estimated glomerular filtration rate (eGFR, r = −0.443, r = −0.377, respectively, both p < 0.05). Furthermore, multiple linear regression analysis yielded three equations to predict the concentrations of IgA, IgM, and total antibodies in the vitreous humor according to eGFR and other clinical variables (r = 0.542, r = 0.461, and r = 0.312, respectively, all p < 0.05). Conclusion Increased levels of IgA, IgM, and total antibodies produced by B cells were observed in the vitreous humor of T2DM patients with DR. There were low negative correlations between levels of antibodies (IgA, IgM) and eGFR.
Highlights
Diabetes mellitus (DM) is a chronic metabolic disorder that is characterized by hyperglycemia, resulting in insulin resistance
All subjects underwent a complete ocular examination and blood pressure, fasting blood glucose (FBG), glycated hemoglobin (HbA1c), serum creatinine, blood urea nitrogen (BUN), estimated glomerular filtration rate, and urinary albumin to creatinine ratio (UACR) which were measured before surgery
Fiftytwo Diabetic retinopathy (DR) patients (10 eyes with vitreous hemorrhage, 24 eyes with proliferative epiretinal membrane, and 18 eyes with tractional retinal detachment according to the primary diagnosis) and 52 non-DR subjects (17 eyes with idiopathic preretinal membranes, eyes with idiopathic macular holes, and eyes with rhegmatogenous retinal detachment) were recruited, including 63 males and 41 females
Summary
Diabetes mellitus (DM) is a chronic metabolic disorder that is characterized by hyperglycemia, resulting in insulin resistance. According to the latest statistics, there are 463 million people currently with DM in the world, and this continues to rise [1]. Type 2 diabetes mellitus (T2DM) is the most common form of DM, accounting for 91% of DM. Hyperglycemia control reduces the mortality and microvascular complications associated with the disease [2, 3]. Diabetic retinopathy (DR) is one of the important microvascular complications of DM and is the leading cause of blindness in DM population. Inflammation is regarded as a critical component in the pathogenesis of DR [4, 5]. The clinical findings in patients with DR include (1) increased levels of inflammatory biomarkers such as vascular endothelial growth factor (VEGF) and C-reactive protein in the serum [6]; (2) increased levels of inflammatory cytokines and chemokines such as tumor necrosis factor-alpha, interleukin- (IL-) 1, IL-6, and C-C motif ligand (CCL) 3 in the aqueous and vitreous humor [7, 8]; and (3) detection of inflammatory cells such as neutrophils, macrophages, and lymphocytes in the proliferative
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