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J.Z. Cui, D. Maberley, P. Ma, X.F. Wang, W.J. Nie, J.A. Matsubara; The Role of Leptin in Proliferative Diabetic Retinopathy . Invest. Ophthalmol. Vis. Sci. 2003;44(13):4023.
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Purpose: The aim of this study is to investigate the gene expression of leptin, a novel angiogenic factor, in a) human retinal pigment epithelial cells in culture, b) vitreous taps of patients with proliferative diabetic retinopathy (PDR) and c) surgical specimens of PDR membranes. Methods: Human RPE cells were isolated and cultured to passages 3-5. Total RNA was extracted and gene expression for leptin and the leptin receptor (Ob-Ra) was examined by reverse-transcriptase polymerase chain reaction (RT-PCR). Thirty patients with PDR, proliferative vitreoretinopathy (PVR), or macular disease undergoing a primary vitrectomy and/or membrane removal were enrolled in this study. The vitreous samples were analyzed by ELISA for the presence of leptin. Immunohistochemical methods were used to demonstrate the presence of leptin or the Ob-Ra in cryostat sections of four membranes removed at vitrectomy from patients with PDR. Results: Leptin receptor (Ob-Ra) was detected in the sample from human RPE cells by PCR, while leptin, itself, was not detected. In patients with PDR (n = 7), the average vitreous level of leptin (37.4 ng/ml) was significantly higher than that in patients with PVR (<1.0 ng/ml, P <0.05). Vitreous leptin level in patients with PVR or macular disease (n = 19), with or without diabetes, was not significantly different from the control subjects who had retinal detachment only (n = 4). Immunochemical examination of four surgically excised PDR membranes revealed that Ob-Ra was strongly present in the membranes, while leptin, itself, was mildly present in PDR membranes. Conclusions: The results show that the leptin level in vitreous taps is elevated in PDR. Leptin, and its receptor, are both present immunohistochemically in PDR membranes. The leptin receptor, but not leptin, itself, is expressed in human RPE cells, in vitro. Our finding suggests that leptin, a novel angiogenic factor, may play a role in the progression of proliferative diabetic retinopathy.
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