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Stefano Valente, Marco Mafrici, Paolo Trabucco, Cristina Diana, Michela Marcelli, Leopoldo Spadea, Enzo M Vingolo; Vitreous and serum concentration of cytokines in patients with diabetic retinopathy.. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1033. doi: https://doi.org/.
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The purpose of this study is to determine and compare serum and vitreous concentrations of three different cytokines (ET-1, AMD and VEGF-A) in diabetic and non-diabetic patients. Serious complications (retinal detachment and cystoid macular edema) that can reduce visual acuity or lead to complete blindness, are strictly connected with the serum and vitreous concentration of these cytokines.
We enrolled 20 patients (7males; 13 females) with mean age of 66,19 ± 4,18. We divided patients into two groups: group A(9 non diabetic patients) and group B( 11 diabetic patients). We evaluated the vitreous and serum concentration of endothelin-1 (ET-1), adrenomedullin (AMD) and vascular endothelial growth factor-A (VEGF-A). The vitreous fluid samples with a vitreous cutter into a syringe, before opening the infusion line were collected into a sterile tubes and quickly frozen at -80°C. Blood samples were collected into EDTA tubes before starting vitrectomy and were subjected to centrifugation for 10 minutes at 3000 revolutions per minute(RPM). The sample of vitreous were extracted during MIVS(mini-invasive vitrectomy) with 25 gauge. Blood samples were extracted from same patients, in order to compare serum and vitreous concentrations. Vitreous and blood samples were transported from operating room to laboratory, in a sterile container. Biochemical analysis of samples was performed with ELISA method. T-test was executed to determine statistic significance of differences (p-value<0,01).
In both groups AMD serum concentration was higher, compared with vitreous concentration. AMD serum concentration is higher in group A, compared with group B(p<0.01). The difference between AMD serum concentration and AMD vitreous concentration is reduced in group B(p<0.01). ET-1 serum and vitreous concentrations were similar in Group A and Group B, without statistic significance. VEGF-A vitreous concentration was increased in Group B, compared with group A (p<0.01).
Reduced AMD serum concentration and reduced AMD serum/ AMD vitreous difference in group B (diabetic patients), evidences an important difference between diabetic(group B) and non-diabetic patients (group A). Reduced AMD serum concentration and AMD serum/vitreous difference, in diabetic patients, could be used in future as early markers, and their trends could be useful in monitoring the pathology, even without clinical changes.
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