糖尿病黄斑水肿眼内液的炎症因子研究进展

Research progress of inflammatory cytokines in intraocular fluid of diabetic macular edema

糖尿病黄斑水肿(DME)是糖尿病视网膜病变常见的并发症,也是患者视力下降的主要原因。抗血管内皮生长因子(VEGF)药物是DME的一线治疗药物,但仍有部分患者在抗VEGF治疗后出现顽固性或复发性水肿。这表明DME的发病机制可能涉及除VEGF之外的与炎症相关的细胞因子。随着高通量检测技术的发展,DME患者房水和玻璃体等眼内液的炎症因子分析受到更多的关注。同时,认清目前治疗方法对炎症因子的影响有助于制定更高效的治疗方案。本文围绕白细胞介素(IL)-1β、IL-6、IL-8、单核细胞趋化因子1、细胞间黏附因子1等炎症因子在DME病程中的变化展开综述,分析其中可能涉及的机制,并讨论抗VEGF药物和糖皮质激素对这些炎症因子的影响。

Diabetic macular edema is a common complication of diabetic retinopathy,and is the main cause of vision decline.Antivascular endothelial growth factor(VEGF)agents are the first-line therapy for DME,but some patients still have refractory or recurrent macular edema after anti-VEGF treatment.This suggests that the pathogenesis of DME may involve inflammation-related cytokines other than VEGF.With the development of high-throughput detection technology,the analysis of inflammatory cytokines in the intraocular fluid of patients such as aqueous humor and vitreous humor has attracted more and more attention.At the same time,recognizing the impact of current treatments on inflammatory cytokines will help to formulate more efficient treatment plans.This article reviewed the changes of inflammatory cytokines,such as interleukin-1β(IL-1β),IL-6,IL-8,monocyte chemoattractant protein-1 and intercellular adhesion factor-1 in the course of DME,analyzed the possible mechanisms involved,and discussed the effects of anti-VEGF agents and glucocorticoids on these inflammatory cytokines.