Differential Effects of Retinol-Binding Protein 3 and Anti-VEGF Antibodies on Retinal Dysfunctions in Diabetic Retinopathy.

Diabetes Pub Date : 2025-05-01 DOI:10.2337/db24-0822
Qin Li, Satoru Onizuka, Kyoungmin Park, Mingming Ma, Ward Fickweiler, Hyunseok Park, Qian Li, Fabricio Simao, Jared Boisclair, Maha Sharawy, I-Hsien Wu, Marc Gregory Yu, Lloyd P Aiello, Jennifer K Sun, George L King
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Abstract

Anti-vascular endothelial growth factor (anti-VEGF) therapies are effective treatment for severe diabetic retinopathy (DR) and macular edema, but a significant subset of people had inadequate response to anti-VEGF intervention. Because elevation or overexpression of retinol binding protein 3 (RBP3) decreases risks for retinal pathologies and progression to severe DR, we compared the therapeutic profiles of RBP3 and anti-VEGF antibody to normalize retinal dysfunctions induced by diabetes. Intravitreous injection of recombinant human RBP3 (rhRBP3) and anti-VEGF antibody (namely, bevacizumab) inhibited retinal vascular permeability in Lewis rats induced by VEGF-A or after 2 months of diabetes induced by streptozotocin, in parallel with reductions of retinal VEGF and VEGF receptor 2 expressions and tyrosine phosphorylation of VEGF receptor. Only rhRBP3 ameliorated diabetes-induced reduction of neural retinal function, measured by electroretinogram. Furthermore, rhRBP3 reduced retinal expressions of inflammatory cytokines (TNF-α and IL-6) in retinal pigmented epithelial and Müller cells exposed to hyperglycemia. Metabolic studies, using a Seahorse flux analyzer, showed only rhRBP3 normalized retinal glycolytic rates in diabetic rats. Thus, both intravitreous anti-VEGF antibody and RBP3 injections normalized retinal vascular dysfunctions caused by diabetes. Only RBP3 targeted both neural and vascular retina to reduce glycolytic rates, reverse neural-retinal dysfunctions, and reduce inflammatory cytokines induced by diabetes, to delay early changes of DR.

Article highlights:

视黄醇结合蛋白3和抗vegf抗体在糖尿病视网膜病变视网膜功能障碍中的差异作用。
抗血管内皮生长因子(anti-VEGF)治疗是严重糖尿病视网膜病变(DR)和黄斑水肿的有效治疗方法,但相当一部分人对抗vegf干预反应不足。由于视黄醇结合蛋白3 (RBP3)的升高或过表达降低了视网膜病变和进展为严重DR的风险,我们比较了RBP3和抗vegf对糖尿病诱导的视网膜功能障碍的治疗效果。在VEGF- a诱导的Lewis大鼠或链脲佐菌素诱导的糖尿病2个月后,玻璃体内注射重组人rhRBP3 (rhRBP3)和抗VEGF抗体(贝伐单抗)可抑制视网膜血管通透性,同时降低视网膜VEGF和VEGFR2表达以及VEGFR酪氨酸磷酸化。通过视网膜电图测量,只有rhRBP3能改善糖尿病引起的视网膜神经功能降低。此外,rhRBP3降低了暴露于高血糖的视网膜色素上皮细胞和 ller细胞中炎症因子(TNFα和IL6)的表达。海马代谢研究显示,只有rhRBP3使糖尿病大鼠的视网膜糖酵解率正常化。因此,玻璃体内注射抗vegf抗体和RBP3均能使糖尿病引起的视网膜血管功能障碍正常化。只有RBP3同时靶向神经视网膜和血管视网膜,降低糖酵解率,逆转神经视网膜功能障碍,降低糖尿病诱导的炎症细胞因子,延缓DR的早期变化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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