| In recent years, the incidence of diabetes is increased year by year with the continuous improvement of people’s living standard. According to the statistics of the World Health Organization in2011, The number of diabetic mellitus patients in the world has reached366million, which is become one of the major diseases that threat to human health in the21century. By2011, there are more than92million diabetic mellitus patients in our country. The total number of diabetic mellitus patients has reached the top of the world. Complications caused by diabetes (especially the kidneys, eyes and nervous system) bring a heavy burden and pain to the diabetic mellitus patients in material and spiritual.Diabetic retinopathy (DR) is one of the most common and severe complications of diabetic, which is currently a major blinding disease in our country and developed regions in the world. Especially in the middle and later stage of diabetic mellitus, that is say, proliferative diabetic retinopathy (PDR) happened. Among the diabetic mellitus patients in our country, incidence of diabetic retinopathy is up to38%～90%, about5%～8%diabetic mellitus patients lose their sights because of suffering proliferative diabetic retinopathy.The basic pathological change is characterized by proliferation of retinal neovascularization formed and fibrosis. On the process of its pathogenesis, retinal ischemia and hypoxia is the basic pathological changes that lead to many vasogenic growth factors produced and released, such as vascular endothelial growth factor, insulin-like growth factor, platelet derived growth factor, transforming growth factor-β and so on. These growth factors may cause the formation of neovascularizat-ion. With the progress of the disease, neovascularization gradually break through the membrane of posterior vitreous that give rise to neovascular membranes, and these neovascular membranes contraction and traction retinal finally lead to tractional retina detachment. The exactly mechanism of diabetic retinopathy is not quite clear. It is believed that diabetic retinopathy results from the cooperation of multiple factors.Transforming growth factor-β is a group of recently discovered with the regulation of cell growth and differentiation, which is a transforming growth factor-β superfamily. Initial research on the biological function of the transforming growth factor-β mainly in inflammation, tissue injury and repair and embryonic development. Recently years, transforming growth factor-β plays an important role in the regulation of cell growth and differentiation, and immune function. In particularly, transforming growth factor-β1is playing an important role in the process of neovascularization and fibrosis proliferation. Transforming growth factor-β1account for90%of the somatic cells and own the strongest activity. General speaking, transforming growth factor-β1is the most important cytokines that promote the development of fibrosis. Connective tissue growth factor is one of the major factor to promote fibrogenesis in vivo. It is regarded as transforming growth factor-β activated cell secretion and as its downstream mediator role in connective tissue cells, which caused cell proliferation and extracellular matrix synthesis. Connective tissue growth factor plays an important role in the repair of the injured tissue and fibrosis process. More and more attention has been received in a number of fibrotic diseases such as renal fibrosis, liver fibrosis, pulmonary fibrosis and other diseases.The purpose of this study is to investigate the expression and significance of transforming growth factor-β1(TGF-β1) and connective tissue growth factor (CTGF) in serum of patients with proliferative diabetic retinopathy and explore its roles in the pathogenesis of proliferative diabetic retinopathy. Moreove, providing new ideas for treatment in patients with proliferative diabetic retinopathy. Materials and methodsSelecting76cases patients with type2diabetes as test group who are treatment in endocrinology and ophthalmology outpatient or hospitalization in the First Affiliated Hospital of Zhengzhou University. They were divided into two groups: non-proliferative diabetic retinopathy group (40cases) and proliferative diabetic retinopathy group (36cases). Diagnosed of type2diabetes mellitus definitely according to1999World Health Organization Criteria. Clinical stage and diagnosis meets clinical standards that is established by the the national ocular fundus academic conference in1984. Each patients has complete line slit lamp ophthalmoscope or fundus photography and fundus fluorescein angiography and other tests. All subjects were excluded from the acute complications of diabetes, autoimmune diseases, malignant tumors, severe liver, kidney, heart and brain vascular lesions and other systemic chronic diseases as well as eye diseases caused by other reasons. Another36healthy people were chosen as normal control group, all come from the same period in the physical examination of the First Affiliated Hospital of Zhengzhou University, outpatient medical center. Selecting healthy people with no heart, brain, liver, kidney, the fundus and endocrine system diseases. The physical examination showed liver function, renal function, blood glucose and other biochemical markers are all within the normal range. All of the subjects in nearly half of the month has not suffering from infectious diseases. The First Affiliated Hospital of Zhengzhou University Ethics Committee for examination and approval before the start of the study, and all study subjects signed informed consent.The serum levels of TGF-βl and CTGF in76cases of diabetic retinopathy group and36cases of normal control group were measured by enzyme linked immunosorbent assay (ELISA) method. The results were analyzed with SPSS17.0software.Results1The serum levels of TGF-βl in NC, NPDR and PDR group were 0.39±0.05ng/ml,0.43±0.05ng/ml,0.80±0.08ng/ml, respectively. Three groups concentration has a significant difference (P<0.01) The serum levels of TGF-βl in PDR group was significantly increased compared with that in NPDR group and NC group (P<0.05). Compared with NC group, there was no significant increase in the serum levels of TGF-βl in NPDR group (P>0.05).2The serum levels of CTGF in NC, NPDR and PDR group were1.48±0.09ng/ml,1.57±0.12ng/ml,2.01±0.13ng/ml, respectively. Three groups concentration has a significant difference (P<0.01) The serum levels of CTGF in PDR group was significantly increased compared with that in NPDR group and NC group (P<0.05). Compared with NC group, there was no significant increase in the serum levels of CTGF in NPDR group (P>0.05).Conclusions1The expression of TGF-βl and CTGF are up-regulated in serum of patients with proliferative diabetic retinopathy.2TGF-βl and CTGF may play an important role in the process of proliferative diabetic retinopathy.3CTGF may be increasing the content of a follow-up increase in the level of TGF-βl in response. |
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