A cross-sectional study of vitreous and serum high mobility group box-1 levels in proliferative diabetic retinopathy

Acta Ophthalmol. 2020 Mar;98(2):e212-e216. doi: 10.1111/aos.14228. Epub 2019 Aug 17.

Abstract

Purpose: We determined vitreous and serum levels of high mobility group box-1 (HMGB-1) in patients with proliferative diabetic retinopathy (PDR) and elucidate their relationship with receptor for advanced glycation end products (RAGE), vascular endothelial growth factor (VEGF) and interleukin-1β (IL-1β).

Methods: In this cross-sectional study, patients with PDR who underwent vitrectomy were enrolled, and the control group included non-diabetic eyes. Vitreous and serum samples were analysed for HMGB-1, RAGE, VEGF and IL-1β by ELISA. We investigated the correlation between serum and vitreous levels of each cytokine, and we analysed the influence of intravitreal anti-VEGF treatment prior to vitrectomy on the cytokine levels in PDR.

Results: Of 78 eyes of 78 patients enrolled consecutively, there were 32 PDR eyes and 46 control eyes. The serum levels were higher in diabetic than in non-diabetic subjects for HMGB-1, RAGE, VEGF and IL-1β (all p < 0.001), respectively. Similarly, the vitreous levels were higher in diabetic than in non-diabetic subjects for HMGB-1 (p < 0.001), RAGE (p = 0.001), VEGF (p < 0.001) and IL-1β (p < 0.001), respectively. We found a positive correlation between serum and vitreous levels of HMGB-1 in patient with PDR (p = 0.047, R = 0.353). There was a negative correlation between serum and vitreous levels of VEGF in patient with PDR (p = 0.001, R = -0.546). For the subgroup analysis, we detected that the vitreous levels of RAGE were significantly lower in patients who underwent anti-VEGF injection prior to vitrectomy than those who did not (p < 0.001).

Conclusions: Our findings suggest that HMGB-1 is involved in PDR disorders, and it may be a novel therapeutic target to inhibit progression of PDR.

Keywords: HMGB-1; diabetic retinopathy; human; inflammation; vitreous humour.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Diabetic Retinopathy / blood*
  • Diabetic Retinopathy / diagnosis
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • HMGB1 Protein / blood*
  • Humans
  • Interleukin-1beta / blood
  • Male
  • Middle Aged
  • Receptor for Advanced Glycation End Products / blood
  • Retinal Neovascularization / blood*
  • Retinal Neovascularization / diagnosis
  • Vascular Endothelial Growth Factor A / blood
  • Vitrectomy
  • Vitreous Body / metabolism*
  • Young Adult

Substances

  • AGER protein, human
  • HMGB1 Protein
  • HMGB1 protein, human
  • Interleukin-1beta
  • Receptor for Advanced Glycation End Products
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A