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Lingwei W. Tao, Robyn Langham, Liubov D. Robman, Danny Liew, Olga Ischenko, Jonathan K. Goh, Tania Cipriani, Andrea J. Richardson, Paul N. Baird, Robyn H. Guymer; Identification of Urinary Biomarkers for Age-related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4006.
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Age-related macular degeneration (AMD) is a leading cause of severe vision loss in developed nations. Despite recent improvements in the management of the neovascular complications of AMD, there is a need for an effective biomarker that improves early disease detection, identifies progression risk and enables monitoring intervention efficacy. As AMD is a complex genetic disease where chronic low-grade inflammation contributes to its aetiology, this study sought to determine the role of urinary profiles of pro-inflammatory cytokines, Transforming Growth Factor-β1 (TGF-β1), Macrophage Chemoattractant Protein-1 (MCP-1) and C3a-desArg, as potential biomarkers for detection and monitoring of AMD.
157 participants aged 73±9 years, were recruited in a cross-sectional study of association of urinary biomarkers with AMD. Bilateral macular photographs were taken and evaluated for AMD (54 controls, 51 early AMD, 19 geographic atrophy (GA) and 33 choroidal neovascularization (CNV) cases). Serum and urine cytokine levels of TGF-β1, MCP-1 and C3a-desArg were measured using Enzyme-linked immunoassay. Participants were also screened for the rs1061170 (Y402H) single nucleotide polymorphism of the complement factor H gene.
Logistic regression analyses, adjusted for age, demonstrated significant association of elevated urinary TGF-β1 levels [OR=1.25 (1.03, 1.52), p<0.022] and MCP-1 levels [OR=1.07 (1.02, 1.12), p<0.006] with early AMD and also elevated MCP-1 levels with GA [OR=1.10 (1.03, 1.17), p<0.003]. There was no correlation between urinary and serum cytokine levels. Individuals with one or more copies of the C allele (Y402H) were 2.5 times more likely to have urinary MCP-1 above median levels (p<0.040).
This study demonstrates a novel finding of an association between elevated urinary cytokine levels and AMD. Further development of a urinary biomarker profile could provide a practical tool for detection of early AMD, monitoring its progression, and assessment of treatment efficacy.
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