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Ultrastructure of neurovascular changes in human diabetic retinopathy.
Int J Immunopathol Pharmacol. 2018 Jan-Dec; 31:394632017748841.IJ

Abstract

The previous concept regarding diabetic retinopathy assigned a primary role to hyperglycemia-induced microvascular alterations, while neuronal and glial abnormalities were considered to be secondary to either ischemia or exudation. The aim of this study was to reveal the potential role of neuronal and glial cells in initial and advanced alterations of the retinopathy in human type 2 diabetes. Electron microscopy and histochemical studies were performed on 38 surgically removed human eyes (28 obtained from diabetic patients and 10 from non-diabetic patients). Morphometric analysis of basement membrane material and lipids was performed. An accumulation of metabolic by-products was found in the capillary wall with aging: this aspect was significantly more pronounced in diabetics. Müller glial cells were found to contribute to alterations of the capillary wall and to occlusion, as well as to the development of proliferative retinopathy and cystoid degeneration of the retina. Our results showed morphological evidence regarding the role of neuronal and glial cells in the pathology of diabetic retinopathy, prior and in addition to microangiopathy. These morphological findings support a neurovascular pathogenesis at the origin of diabetic retinopathy, thus the current treatment approach should be completed by neuroprotective measures.

Authors+Show Affiliations

1 Ophthalmic Neuroscience Program, Nutripharma Hungaria Ltd, Budapest, Hungary.2 IRCCS G.B. Bietti Foundation, Rome, Italy.3 Department of Sensory Organs, Sapienza University of Rome, Rome, Italy.4 Department of Ophthalmology, University of Pécs, Pécs, Hungary.4 Department of Ophthalmology, University of Pécs, Pécs, Hungary.5 Ophthalmology Unit, NESMOS Department, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.3 Department of Sensory Organs, Sapienza University of Rome, Rome, Italy.3 Department of Sensory Organs, Sapienza University of Rome, Rome, Italy.2 IRCCS G.B. Bietti Foundation, Rome, Italy.3 Department of Sensory Organs, Sapienza University of Rome, Rome, Italy.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29251013

Citation

Fehér, János, et al. "Ultrastructure of Neurovascular Changes in Human Diabetic Retinopathy." International Journal of Immunopathology and Pharmacology, vol. 31, 2018, p. 394632017748841.
Fehér J, Taurone S, Spoletini M, et al. Ultrastructure of neurovascular changes in human diabetic retinopathy. Int J Immunopathol Pharmacol. 2018;31:394632017748841.
Fehér, J., Taurone, S., Spoletini, M., Biró, Z., Varsányi, B., Scuderi, G., Orlando, M. P., Turchetta, R., Micera, A., & Artico, M. (2018). Ultrastructure of neurovascular changes in human diabetic retinopathy. International Journal of Immunopathology and Pharmacology, 31, 394632017748841. https://doi.org/10.1177/0394632017748841
Fehér J, et al. Ultrastructure of Neurovascular Changes in Human Diabetic Retinopathy. Int J Immunopathol Pharmacol. 2018 Jan-Dec;31:394632017748841. PubMed PMID: 29251013.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ultrastructure of neurovascular changes in human diabetic retinopathy. AU - Fehér,János, AU - Taurone,Samanta, AU - Spoletini,Marialuisa, AU - Biró,Zsolt, AU - Varsányi,Balázs, AU - Scuderi,Gianluca, AU - Orlando,Maria Patrizia, AU - Turchetta,Rosaria, AU - Micera,Alessandra, AU - Artico,Marco, Y1 - 2017/12/18/ PY - 2017/12/19/pubmed PY - 2018/8/21/medline PY - 2017/12/19/entrez KW - basement membrane KW - diabetic macular edema KW - diabetic retinopathy KW - glia KW - proliferative diabetic retinopathy SP - 394632017748841 EP - 394632017748841 JF - International journal of immunopathology and pharmacology JO - Int J Immunopathol Pharmacol VL - 31 N2 - The previous concept regarding diabetic retinopathy assigned a primary role to hyperglycemia-induced microvascular alterations, while neuronal and glial abnormalities were considered to be secondary to either ischemia or exudation. The aim of this study was to reveal the potential role of neuronal and glial cells in initial and advanced alterations of the retinopathy in human type 2 diabetes. Electron microscopy and histochemical studies were performed on 38 surgically removed human eyes (28 obtained from diabetic patients and 10 from non-diabetic patients). Morphometric analysis of basement membrane material and lipids was performed. An accumulation of metabolic by-products was found in the capillary wall with aging: this aspect was significantly more pronounced in diabetics. Müller glial cells were found to contribute to alterations of the capillary wall and to occlusion, as well as to the development of proliferative retinopathy and cystoid degeneration of the retina. Our results showed morphological evidence regarding the role of neuronal and glial cells in the pathology of diabetic retinopathy, prior and in addition to microangiopathy. These morphological findings support a neurovascular pathogenesis at the origin of diabetic retinopathy, thus the current treatment approach should be completed by neuroprotective measures. SN - 2058-7384 UR - https://www.unboundmedicine.com/medline/citation/29251013/Ultrastructure_of_neurovascular_changes_in_human_diabetic_retinopathy_ L2 - https://journals.sagepub.com/doi/10.1177/0394632017748841?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -