Violation of the cytokine regulation in patients with diabetic retinopathy
Summary. Aim — to study the levels of key pro- and anti-inflammatory cytokines in plasma and their production by immune cells of peripheral blood in patients with diabetic retinopathy (DR). Material and methods. The study surveyed 113 patients with type 2 diabetes, among whom 57 patients had associated DR (main group) and 56 — without DR (comparison group). Groups were randomized by age and sex. The control group consisted of 35 healthy persons. Results. It was established that patients with DR have a high plasma concentration of proinflammatory cytokines, the level of tumor necrosis factor-α was higher than healthy individuals to 2.66 times and 32.9% higher than in the comparison group (p<0.05); IL-1β — 2.65 times and 21.9% (p<0.05); IL-6 — 6.33 times and 2.95 times (p<0.05); IL-8 — 5.67 times and 2.34 times (p<0.05), respectively. Also it was detected increased spontaneous and mitogeninduced products of these cytokines by immune cells of peripheral blood and significantly higher levels of activated lymphocytes and soluble adhesion molecules. Conclusions. Patients with DR discovered a violation of the processes of adhesion and cooperation of immune cells, resulting in their enhanced activation, affective functions and migration in the focus of inflammation in the vascular wall, combined with increase of spontaneous production of proinflammatory cytokines and transforming growth factor-β, which also have a deleterious effect on the target organs. It is their constant uncontrolled hyper-production and will be the key point of the subsequent damage to your eyes in patients with diabetes mellitus with the development of more severe forms of DR.