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Shwetha Mangalesh, Supriya Dabir, Debashish Das, Jeyabalan Nallathambi, Naresh Yadav, Rohit Shetty; Differential systemic gene expression profile in patients with diabetic macular edema: responders versus non-responders. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1745.
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To identify signaling pathways involved in the development of diabetic macular edema and assess the differential systemic gene expression profile based on response to treatment.
A pilot, case control, prospective, observational series where DME patients were treated with bevacizumab and sub classified as treatment naïve, treatment responders and treatment non-responders. RNA extraction followed by labelling, amplification and hybridisation was done and microarray data analysed. Genes were classified based on functional category and pathways.
The total number of genes upregulated among all three experimental groups were 5 whereas 105 genes were downregulated. There were no common genes upregulated between the responders and non-responders. There was only 1 gene upregulated between the diabetic and diabetic responders post treatment. There were 19 genes upregulated and 8 genes downregulated in the inflammatory pathway in group 2 vs group 1. There were no down regulated genes detected in vascular angiogenesis and transcription group.There were identical numbers of genes up and down regulated in the inflammatory pathway. Seventeen genes were upreguated and 11 genes downregulated in receptor activity, that remained the predominant group in the group classification.
This study provides an insight into the probable signaling mechanisms for disease pathogenesis as well as progression. This eventually would aid in developing or improvising existing treatment modules with a rational approach towards personalized medicine, in future addressing the differential responses to treatment.This will herald the era of pharmacogenomics for titrating individualized treatment.
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