Circulating antipericyte autoantibodies: a novel modifier of risk of progression of diabetic retinopathy?

Abstract

BACKGROUND:

Antipericyte autoantibodies (APAAs) are present in high frequency among diabetic subjects with and without nonproliferative retinopathy. This study aimed to determine whether progression of retinopathy in type 2 diabetes was associated with the same medical risk factors in APAA-positive subjects as in APAA-negative subjects.

METHODS:

Type 2 diabetic patients with nonproliferative diabetic retinopathy at baseline were followed prospectively for 2 years monitoring progression of retinopathy. Thirty-eight (21.7%) of 175 patients had progression in Early Treatment Diabetic Retinopathy Study grade by > or =2 steps in at least 1 eye. Serum APAAs were detected by immunofluorescence on tissue-cultured bovine retinal pericytes.

RESULTS:

Progression of retinopathy was associated with HbA(1c) level (P = 0.002), diabetes duration (P = 0.03), and albumin/creatinine ratio (P = 0.02) in APAA-negative subjects but not in APAA-positive subjects. The association between progression and APAAs was strongest in the upper quartile for HbA(1c) level (>8.0%), where 71.4% of patients negative for APAAs had progression of retinopathy while only 24.1% of patients positive for APAAs had progression (P = 0.007).

CONCLUSION:

The results suggest that APAA presence is a modifier of risk of progression of retinopathy due to hyperglycemia and that it could be useful as a biochemical marker of risk of progression of diabetic retinopathy in type 2 diabetic patients with poor metabolic control.

• Authors: Ramesh C Nayak, Kristian Lynch, Carin Gustavsson, Michael G K Kwok, Pamela J Farthing-Nayak, Carl-David Agardh, Elisabet Agardh
• Journal: Retina (Philadelphia, Pa.) (Retina) Vol. 27 Issue 2 Pg. 211-5 (Feb 2007) ISSN: 0275-004X [Print] United States
• PMID: 17290204 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Autoantibodies
• Glycated Hemoglobin A

Topics

• Adult
• Aged
• Aged, 80 and over
• Autoantibodies (blood)
• Chromatography, High Pressure Liquid
• Diabetes Mellitus, Type 2 (immunology)
• Diabetic Retinopathy (immunology)
• Disease Progression
• Female
• Fluorescent Antibody Technique, Indirect
• Glycated Hemoglobin (analysis)
• Humans
• Male
• Middle Aged
• Pericytes (immunology)
• Prospective Studies
• Retinal Neovascularization (immunology)
• Risk Factors