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G. Astrid Limb, Julian Hickman–Casey, Robert D. Hollifield, Anthony H. Chignell; Vascular Adhesion Molecules in Vitreous from Eyes with Proliferative Diabetic Retinopathy. Invest. Ophthalmol. Vis. Sci. 1999;40(10):2453-2457.
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purpose. To investigate whether proliferative vitreoretinopathy (PDR) is associated with a
selective increase in vitreous levels of soluble vascular cell adhesion
molecules that mediate leukocyte extravasation and interaction with
endothelium during processes of inflammation and neovascularization.
methods. Vitreous from 55 patients undergoing vitrectomy for treatment of PDR
complicated by vitreous hemorrhage and/or traction retinal detachment
was assayed for the presence of the soluble vascular cell adhesion
molecules sICAM-1, sVCAM-1, and sE-selectin using a standard
enzyme-linked immunosorbent assays (ELISA). Vitreous from 12 cadaveric
eyes matching age and sex of the patients were used as control samples.
results. Vitreous levels of sICAM-1, sVCAM-1, and sE-selectin were significantly
higher in eyes with PDR than in control cadaveric vitreous, and levels
of all three molecules did not relate to the type or duration of
diabetes mellitus. However, eyes with either traction retinal
detachment alone or both traction retinal detachment and vitreous
hemorrhage exhibited significantly higher levels of sICAM-1 and
sE-selectin than eyes with vitreous hemorrhage alone. Vitreous levels
of sVCAM-1 were similar in eyes with either vitreous hemorrhage or
traction retinal detachment alone.
conclusions. The present observations suggest that molecular inflammatory mechanisms
may contribute to processes of neovascularization and fibrosis observed
in PDR, possibly not as the causative event, but as a result of
endothelial, Müller, and retinal pigment epithelial cell
activation. The results also indicate that retinal detachment amplifies
the existing inflammation within the diabetic retina. Identification of
any abnormalities in the production and control of specific adhesion
molecules could have important implications in the design of new
therapeutic regimens to treat and prevent this sight-threatening
complication of diabetes mellitus.
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