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Ann Igbre, Stephanie Ecker, Joshua Hines, Bert Glaser; In-Office Vitreous Sampling shows that Levels of MMP-9 Correlate with the Severity of Proliferative Diabetic Retinopathy. Invest. Ophthalmol. Vis. Sci. 2013;54(15):276.
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© ARVO (1962-2015); The Authors (2016-present)
The purpose of this study is to explore potential proteomic biomarkers in vitreous samples of patients with different severities of proliferative diabetic retinopathy (PDR).
Ninety six (96) in-office vitreous aspirates were obtained from 42 patients with PDR and 24 age matched non-diabetic controls. All 96 samples were probed against 44 pathway proteins using reverse phase protein microarray (RPPM) technology.
When comparing PDR patients who had visual acuity (VA) better than 20/ 200 vs. patients with VA worse than 20/200 there were 20 proteins that had significantly different levels between the 2 groups. Among these proteins, MMP-9 had significantly higher vitreous levels in patients with better VA (<20/200) vs. patients with worse VA (>20/200). Between the two groups, the statistical significance is highest for MMP-9 among the 20 proteins (P=0.006, ROC: AUC= 0.7837, P= 0.006). Those eyes with better VA demonstrated significant correlation of MMP-9 with pro-inflammatory cytokines, while in those with worse VA MMP-9 correlates with pro-angiogenic cytokines. Additionally, MMP- 9 levels are higher in the vitreous of non-diabetic controls than in the vitreous from PDR patients (P<0.0001, ROC: AUC= 0.7979 P<0.0001), regardless of VA.
In-office vitreous sampling reveals MMP-9 levels in eyes with PDR to be higher in eyes with better VA. Vitreous levels of MMP-9 were highest in eyes of non-diabetic controls. In addition, evidence was found for activities of both pro-inflammatory and pro-angiogenic pathways in a manner that indicattes different roles for these important pathways in disease outcomes. This suggests a possible role for MMP-9 as a predictive biomarker of disease progression and severity as well as providing an enhanced understanding of the biochemical pathways involved in disease progression to provide the basis for improved disease management.
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