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2015 ; 12
(1-2
): 159-95
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Biomarkers in Diabetic Retinopathy
#MMPMID26676667
Jenkins AJ
; Joglekar MV
; Hardikar AA
; Keech AC
; O'Neal DN
; Januszewski AS
Rev Diabet Stud
2015[Spr]; 12
(1-2
): 159-95
PMID26676667
show ga
There is a global diabetes epidemic correlating with an increase in obesity. This
coincidence may lead to a rise in the prevalence of type 2 diabetes. There is
also an as yet unexplained increase in the incidence of type 1 diabetes, which is
not related to adiposity. Whilst improved diabetes care has substantially
improved diabetes outcomes, the disease remains a common cause of working age
adult-onset blindness. Diabetic retinopathy is the most frequently occurring
complication of diabetes; it is greatly feared by many diabetes patients. There
are multiple risk factors and markers for the onset and progression of diabetic
retinopathy, yet residual risk remains. Screening for diabetic retinopathy is
recommended to facilitate early detection and treatment. Common biomarkers of
diabetic retinopathy and its risk in clinical practice today relate to the
visualization of the retinal vasculature and measures of glycemia, lipids, blood
pressure, body weight, smoking, and pregnancy status. Greater knowledge of novel
biomarkers and mediators of diabetic retinopathy, such as those related to
inflammation and angiogenesis, has contributed to the development of additional
therapeutics, in particular for late-stage retinopathy, including intra-ocular
corticosteroids and intravitreal vascular endothelial growth factor inhibitors
('anti-VEGFs') agents. Unfortunately, in spite of a range of treatments
(including laser photocoagulation, intraocular steroids, and anti-VEGF agents,
and more recently oral fenofibrate, a PPAR-alpha agonist lipid-lowering drug),
many patients with diabetic retinopathy do not respond well to current
therapeutics. Therefore, more effective treatments for diabetic retinopathy are
necessary. New analytical techniques, in particular those related to molecular
markers, are accelerating progress in diabetic retinopathy research. Given the
increasing incidence and prevalence of diabetes, and the limited capacity of
healthcare systems to screen and treat diabetic retinopathy, there is need to
reliably identify and triage people with diabetes. Biomarkers may facilitate a
better understanding of diabetic retinopathy, and contribute to the development
of novel treatments and new clinical strategies to prevent vision loss in people
with diabetes. This article reviews key aspects related to biomarker research,
and focuses on some specific biomarkers relevant to diabetic retinopathy.
|Biomarkers
[MESH]
|Diabetes Mellitus, Type 2/*complications/metabolism/physiopathology
[MESH]
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