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K. Kinnunen, M. Teräsvirta, T. Puustjärvi, P. Nurmenniemi, R. Sihvola, S. Ylä–Herttuala, H. Uusitalo; Immunohistochemical Analysis of Retinal Neovascular Tissue in Diabetic Patients . Invest. Ophthalmol. Vis. Sci. 2006;47(13):962.
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© ARVO (1962-2015); The Authors (2016-present)
Proliferative diabetic retinopathy is one of the leading causes of blindness in middle–aged people in western countries. The aim of this study was to evaluate the structure of neovascular tissue in the eyes of diabetic patients by immunohistochemical methods and furthermore to find out possible pathogenic factors in the generation and proliferation of the new vessels.
The neovascular tissue of 13 diabetic patients was studied. Patients had proliferative diabetic retinopathy and clinically observed retinal neovascularization and vitrectomy was indicated for all. During the normal vitreoretinal surgery the neovascular tufts were removed, fixed with 4% paraformaldehyde, embedded in paraffin and processed for conventional immunohistochemistry. Specimens were immunostained with a mouse monoclonal antibody against endothelial cells (CD31), macrofages (CD68), vascular endothelial growth factors A (VEGF–A) and D (VEGF–D), vascular endothelial growth factor receptors 1 (FLT1), 2 (KDR) and 3 (FLT4) and nuclear factor kappa B (NFkappaB).
The endothelial cells of neovascular vessels of the tufts showed immunostaining of CD31. There were also number of macrofages indicating an inflammatory process involved in the neovascular tissues. Both VEGF–A and –D were present in the samples. Staining of VEGF–A was slightly more intensive than VEGF–D. The neovascular tissue showed also immunostaining to VEGF receptors 1,2 and 3. FLT–1 (VEGFR 1) and KDR (VEGFR 2) gave the strongest immunostaining. A transcription factor NFkappaB was also detected in these neovascular tufts.
This study demonstrates the presence of VEGF–A and VEGF–D as well as the VEGFR –1,–2 and in lesser extent –3 as well as NfkappaB in the neovascular tissue of diabetic retina. The presence of macrophages indicates a role of inflammatory process in the pathogenesis of neovascularization.
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