S1P在增殖型糖尿病性视网膜病变患者玻璃体液中的表达及意义

Expression and significance of S1P in vitreous humor of patients with proliferative diabetic retinopathy

摘要

目的 玻璃体液中1-磷酸鞘氨醇（sphingosine 1-phosphate,S1P）水平与增殖型糖尿病性视网膜病变（proliferative diabetic retinopathy,PDR）的相关性研究。方法 选取2023年10月—2024年5月就诊于苏州大学附属第三医院接受经睫状体平坦部玻璃体切割手术（pars plana vitrectomy,PPV）的患者33例（33眼）。其中包括22例（22眼）并发PDR的糖尿病患者作为PDR组,并根据术前7~15 d是否接受玻璃体腔抗血管内皮生长因子（vascular endothelial growth factor,VEGF）作为辅助治疗,将PDR组进一步分为注药组8例（8眼）和未注药组14例（14眼）;11例（11眼）接受PPV手术的非糖尿病患者为对照组。采用酶联免疫吸附试验检测每组患者玻璃体腔中S1P的浓度。结果 3组性别、年龄、血压、肝功能、肾功能以及血脂等生化指标差异无统计学意义。anti-VEGF-PDR组玻璃体腔S1P水平高于对照组[（61.02±14.74） μg/L vs. （34.57±23.14） μg/L,P=0.006];Non-anti-VEGF-PDR组患者玻璃体腔S1P水平高于对照组[（59.42±18.26） μg/L vs. （34.57±23.14） μg/L,P=0.003];Anti-VEGF-PDR组患者玻璃体腔S1P水平与non-anti-VEGF-PDR组相比,差异无统计学意义[（61.02±14.74） μg/L vs. （59.42±18.26） μg/L,P=0.853]。结论 S1P含量上升可能被视为PDR发展的生物学指标,而玻璃体腔是否注射抗VEGF药物并不会影响S1P的表达。

Abstract

Objective To investigate the correlation between vitreous humor levels of sphingosine 1-phosphate （S1P） and proliferative diabetic retinopathy （PDR）. Methods In total, 33 patients （33 eyes） undergoing pars plana vitrectomy （PPV） in the Third Affiliated Hospital of Soochow University from October 2023 to May 2024 were selected, including 22 diabetic patients （22 eyes） with PDR as the PDR group. Based on whether they received intravitreal anti-vascular endothelial growth factor （VEGF） as an adjunctive therapy at 7-15 d before surgery, the PDR group was further divided into an anti-VEGF-PDR subgroup （8 patients, 8 eyes） and a non-anti-VEGF-PDR subgroup （14 patients, 14 eyes）. A total of 11 non-diabetic patients （11 eyes） who underwent PPV served as the control group. The concentration of S1P in the vitreous humor of each group was measured using enzyme-linked immunosorbent assay. Results There was no significant difference in age, gender, blood pressure, and biochemical indicators such as liver function, kidney function and blood lipids between the three groups. The vitreous humor levels of S1P was higher in the anti-VEGF-PDR subgroup than in the control group [（61.02±14.74） μg/L vs. （34.57±23.14） μg/L, P=0.006] and higher in the non-anti-VEGF-PDR subgroup than in the control group [（59.42±18.26） μg/L vs. （34.57±23.14） μg/L, P=0.003], while the difference between the anti-VEGF-PDR subgroup and the non-anti-VEGF-PDR group was not significant [（61.02±14.74） μg/L vs. （59.42±18.26） μg/L, P=0.853]. Conclusion Elevated S1P levels may serve as a biomarker for the development of PDR, while intravitreal anti-VEGF injection does not affect the expression of S1P.

关键词

糖尿病视网膜病变 / 磷酸鞘氨醇 / 玻璃体液

Key words

diabetic retinopathy / sphingosine 1-phosphate / vitreous humor