背景:抗糖尿病治疗是有效的,但可以间接改变眼部微环境中的炎症反应;因此,一项研究旨在评估糖尿病视网膜病变患者在接受抗糖尿病药物治疗时玻璃体液中的炎性细胞因子分布。
方法:观察性,比较,回顾性,横断面研究。白细胞介素1β,在2型糖尿病患者的玻璃体液中评估了6、8、10和肿瘤坏死因子-α(TNFα),增生性糖尿病视网膜病变,并伴有视网膜脱离或玻璃体出血,并且已经使用胰岛素或二甲双胍+格列本脲进行抗糖尿病治疗。通过细胞计数珠阵列(CBA)技术对每种细胞因子进行定量分析;获得中位数和四分位数范围,并使用Mann-WhitneyU检验在组间比较结果,其中p值<0.05被认为是显著的。
结果:38个样本;服用胰岛素的患者组中TNFα浓度的定量更高,而白细胞介素-8较低;在二甲双胍+格列本脲联合治疗组中,相反地发生了。在分层分析中,白细胞介素-8和肿瘤坏死因子α的最高浓度发生在玻璃体出血患者中;视网膜脱离患者存在唯一的统计学差异,联合治疗组中的TNFα浓度最低(53.50(33.03-86.66),p=0.03)。白细胞介素1β,6和10没有检测到。
结论:治疗组之间的白细胞介素-8和TNFα浓度相反;这种变化在增生性糖尿病视网膜病变和玻璃体出血患者中更为明显,这两种细胞因子的浓度最高,虽然只有TNFα有统计学差异。
BACKGROUND: Antidiabetic therapies are effective, but could indirectly modify the inflammatory response in the ocular microenvironment; therefore, a
study was developed to evaluate the inflammatory cytokine profile in the vitreous humor of diabetic patients with retinopathy under treatment with antidiabetic drugs.
METHODS: Observational, comparative, retrospective, cross-sectional
study. Interleukins 1β, 6, 8, 10, and tumor necrosis factor-alpha (TNFα) were evaluated in the vitreous humor obtained from patients with type 2 diabetes mellitus, proliferative diabetic retinopathy, and concomitant retinal detachment or vitreous hemorrhage, and who were already on antidiabetic treatment with insulin or metformin + glibenclamide. The quantification analysis of each cytokine was performed by the cytometric bead array (CBA) technique; medians and interquartile ranges were obtained, and the results were compared between groups using the Mann-Whitney U test, where a p-value < 0.05 was considered significant.
RESULTS: Thirty-eight samples; quantification of TNFα concentrations was higher in the group of patients administered insulin, while interleukin-8 was lower; in the metformin + glibenclamide combination therapy group, it occurred inversely. In the stratified analysis, the highest concentrations of interleukin-8 and TNFα occurred in patients with vitreous hemorrhage; however, the only statistical difference existed in patients with retinal detachment, whose TNFα concentration in the combined therapy group was the lowest value found (53.50 (33.03-86.66), p = 0.03). Interleukins 1β, 6, and 10 were not detected.
CONCLUSIONS: Interleukin-8 and TNFα concentrations are opposite between treatment groups; this change is more accentuated in patients with proliferative diabetic retinopathy and vitreous hemorrhage, where the highest concentrations of both cytokines are found, although only TNFα have statistical difference.