Resistance of retinal inflammatory mediators to suppress after reinstitution of good glycemic control: novel mechanism for metabolic memory

J Diabetes Complications. 2010 Jan-Feb;24(1):55-63. doi: 10.1016/j.jdiacomp.2008.10.002. Epub 2008 Dec 3.

Abstract

Diabetic retinopathy resists arrest of its progression after reestablishment of good glycemic control that follows a profound period of poor glycemic control. The objective of this study was to elucidate the role of inflammation in the resistance of retinopathy to arrest after termination of hyperglycemia. Streptozotocin-diabetic rats were (a) maintained either in poor glycemic control [PC group; glycated hemoglobin (GHb)>11%] or in good glycemic control (GC group; GHb<7%) for 12 months or (b) allowed to be in poor glycemic control for 6 months followed by good glycemic control for 6 additional months. At 12 months, retina was analyzed for pro-inflammatory mediators. Twelve months of PC increased retinal interleukin 1beta (IL-1beta) mRNA by 2-fold and its protein expression by 25% compared with the values obtained from normal rat retina. Tumor necrosis factor alpha (TNF-alpha) was elevated approximately 3-fold (both mRNA and protein), and the receptors for IL-1beta and TNF-alpha were increased by 40% each. The concentrations of intercellular cell adhesion molecule 1 and vascular cell adhesion molecule 1 were elevated by 40% and 150%, respectively, and inducible nitric oxide synthase transcripts were elevated by 6-fold. Six months of good glycemic control that followed 6 months of poor glycemic control failed to reverse the elevations in IL-1beta, TNF receptor type I, and intercellular cell adhesion molecule 1 but had some beneficial effects on TNF-alpha, inducible nitric oxide synthase, and vascular cell adhesion molecule 1, however these mediators remained significantly elevated. However, the GC group showed no significant change in the retinal pro-inflammatory mediators compared with the normal rats. Failure to reverse retinal inflammatory mediators supports their important role in the resistance of retinopathy to arrest after cessation of hyperglycemia.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Body Weight / drug effects
  • Cell Adhesion Molecules / genetics
  • Cell Adhesion Molecules / metabolism
  • Cyclooxygenase 2 / genetics
  • Cyclooxygenase 2 / metabolism
  • Diabetes Mellitus, Experimental / drug therapy
  • Diabetes Mellitus, Experimental / physiopathology*
  • Diabetic Retinopathy / physiopathology*
  • Disease Progression*
  • Gene Expression Regulation
  • Glycated Hemoglobin / analysis
  • Hyperglycemia / physiopathology
  • Inflammation Mediators / metabolism*
  • Insulin, Isophane / therapeutic use
  • Male
  • Nitric Oxide Synthase Type II / genetics
  • Nitric Oxide Synthase Type II / metabolism
  • RNA, Messenger / metabolism
  • Rats
  • Rats, Inbred Lew
  • Receptors, Cytokine / genetics
  • Receptors, Cytokine / metabolism
  • Retina / enzymology
  • Retina / metabolism*
  • Reverse Transcriptase Polymerase Chain Reaction

Substances

  • Cell Adhesion Molecules
  • Glycated Hemoglobin A
  • Inflammation Mediators
  • RNA, Messenger
  • Receptors, Cytokine
  • Insulin, Isophane
  • Nitric Oxide Synthase Type II
  • Cyclooxygenase 2