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M. Bartoli, F. Facchiano, L. Di Renzo, A. Montemari, B. Boccassini, M. Parravano, F. Lamoke, D. M. Marcus, M. Varano; Interleukin 17 (IL17) Levels in Diabetic Patients is Associated With Diabetic Macular Edema and Diabetic Retinopathy. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5625.
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Chronic inflammatory processes have been implicated in the pathogenesis of DR. Interleukin 17 (IL-17), a product of Th17 lymphocytes, has been recently shown to play a critical role in sustaining inflammatory processes associated with chronic conditions, such as rheumatoid arthritis and others. In the present study we wanted to investigate whether IL-17 was involved in the pathogenesis of DR.
Clinical assessment of DR was conducted by fluorescein angiography following standard protocols. Flow cytometry analysis (FACS) was used to measure the ratio of Th17 lymphocytes within the CD4+ population of circulating immunocytes of diabetic patients (Type 1 = 25 and Type 2= 40) and compared to healthy, age-matched control volunteers (20). Multiplex ELISA was used to measure plasma levels of IL-17 in diabetic patients (Type 1 and Type 2) and in post-mortem vitrei obtained from diabetic donors (Georgia Eye Bank).
The ratio of Th17 lymphocytes, within the CD4+ immunocytes, was increased in all the diabetic patients and this effect was maximal in patients presenting signs of retinopathy (28%, p<0.03). Plasma circulating levels of IL-17 were also increased in both Type 1 and Type 2 diabetic patients and were significantly elevated in patients presenting signs of retinopathy (p<0.02) and in post-mortem vitrei although levels of IL-17 found in this tissue were more modest of the plasma levels. Finally, correlation studies also revealed that levels of IL-17 correlated with presence of macular edema in both Type 1 and Type 2 diabetic patients.
The results of the present studies revealed that patients presenting clinical signs of DR, in particular macular edema, have increased levels of Th17 lymphocytes and plasma levels of IL-17. Given the emerging role of IL-17 in sustaining chronic inflammatory diseases, our data suggest a possible implication of this cytokine in the pathogenesis of DR.
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