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Bonora BM, Albiero M, Morieri ML, Cappellari R, Amendolagine FI, Mazzucato M, Zambon A, Iori E, Avogaro A, Fadini GP. Fenofibrate increases circulating haematopoietic stem cells in people with diabetic retinopathy: a randomised, placebo-controlled trial. Diabetologia 2021; 64:2334-2344. [PMID: 34368894 DOI: 10.1007/s00125-021-05532-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 05/18/2021] [Indexed: 11/27/2022]
Abstract
AIM/HYPOTHESIS In two large RCTs, fenofibrate reduced the progression of diabetic retinopathy. We investigated whether fenofibrate increases circulating haematopoietic stem/progenitor cells (HSPCs), which have vascular properties and have been shown to protect from retinopathy. METHODS We conducted a 12 week parallel-group RCT comparing fenofibrate vs placebo. Patients with diabetic retinopathy and without other conditions that would affect HSPCs were enrolled at a tertiary diabetes outpatient clinic and randomised to receive fenofibrate or placebo based on a computer-generated sequence. Patients and study staff assessing the outcomes were blinded to group assignment. The primary endpoint was the change in the levels of circulating HSPCs, defined by expression of the stem cell markers CD34 and/or CD133. Secondary endpoints were the changes in endothelial progenitor cells, lipids, soluble mediators and gene expression. We used historical data on the association between HSPCs and retinopathy outcomes to estimate the effect of fenofibrate on retinopathy progression. RESULTS Forty-two participants with diabetic retinopathy were randomised and 41 completed treatment and were analysed (20 in the placebo group and 21 in the fenofibrate group). Mean age was 57.4 years, diabetes duration was 18.2 years and baseline HbA1c was 60 mmol/mol (7.6%). When compared with placebo, fenofibrate significantly increased levels of HSPCs expressing CD34 and/or CD133. CD34+ HSPCs non-significantly declined in the placebo group (mean ± SD -44.2 ± 31.6 cells/106) and significantly increased in the fenofibrate group (53.8 ± 31.1 cells/106). The placebo-subtracted increase in CD34+ HSPCs from baseline was 30% (99.3 ± 43.3 cells/106; p = 0.027) which, projected onto the relationship between HSPC levels and retinopathy outcomes, yielded an OR of retinopathy progression of 0.67 for fenofibrate vs placebo. Endothelial differentiation of CD34+ cells, estimated by the %KDR (kinase insert domain receptor) expression, was significantly reduced by fenofibrate. Fenofibrate decreased serum triacylglycerols, but the change in triacylglycerols was unrelated to the change in HSPCs. No effect was observed for endothelial progenitor cells, cytokines/chemokines (stromal-cell derived factor-1, vascular endothelial growth factor, monocyte chemoattractant protein-1) and gene expression in peripheral blood mononuclear cells. CONCLUSIONS/INTERPRETATION Fenofibrate increased HSPC levels in participants with diabetic retinopathy and this mechanism may explain why fenofibrate reduced retinopathy progression in previous studies. TRIAL REGISTRATION ClinicalTrials.gov NCT01927315.
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Affiliation(s)
- Benedetta Maria Bonora
- Department of Medicine, University of Padova, Padua, Italy
- Veneto Institute of Molecular Medicine, Padua, Italy
| | - Mattia Albiero
- Department of Medicine, University of Padova, Padua, Italy
- Veneto Institute of Molecular Medicine, Padua, Italy
| | | | | | | | | | - Alberto Zambon
- Department of Medicine, University of Padova, Padua, Italy
| | | | - Angelo Avogaro
- Department of Medicine, University of Padova, Padua, Italy
| | - Gian Paolo Fadini
- Department of Medicine, University of Padova, Padua, Italy.
- Veneto Institute of Molecular Medicine, Padua, Italy.
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Coughlin BA, Guha-Niyogi P, Sikorskii A, Glazer LC, Mohr S. Ranibizumab Alters Levels of Intraocular Soluble Cytokine Receptors in Patients with Diabetic Macular Edema. Curr Eye Res 2019; 45:509-520. [DOI: 10.1080/02713683.2019.1665187] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Brandon A. Coughlin
- Department of Physiology, Michigan State University, East Lansing, Michigan, USA
| | - Pratim Guha-Niyogi
- Department of Statistics and Probability, Michigan State University, East Lansing, Michigan, USA
| | - Alla Sikorskii
- Department of Statistics and Probability, Michigan State University, East Lansing, Michigan, USA
- Department of Psychiatry, Michigan State University, East Lansing, Michigan, USA
| | | | - Susanne Mohr
- Department of Physiology, Michigan State University, East Lansing, Michigan, USA
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Lindberg G, Longoni A, Lim K, Rosenberg A, Hooper G, Gawlitta D, Woodfield T. Intact vitreous humor as a potential extracellular matrix hydrogel for cartilage tissue engineering applications. Acta Biomater 2019; 85:117-130. [PMID: 30572166 DOI: 10.1016/j.actbio.2018.12.022] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 11/09/2018] [Accepted: 12/14/2018] [Indexed: 12/20/2022]
Abstract
Decellularisation of tissues, utilising their biochemical cues, poses exciting tissue engineering (TE) opportunities. However, removing DNA from cartilage (dCart) requires harsh treatments due to its dense structure, causing loss of bioactivity and limiting its application as a cartilaginous extra cellular matrix (ECM). In this study, we demonstrate for the first time the successful application of vitreous humor (VH), a highly hydrated tissue closely resembling the glycosaminoglycan (GAG) and collagen composition of cartilage, as an ECM hydrogel to support chondrogenic differentiation. Equine VH was extracted followed by biochemical quantifications, histological examinations, cytotoxicity (human mesenchymal stromal cells, hMSCs and human articular chondrocytes, hACs) and U937 cell proliferation studies. VH was further seeded with hACs or hMSCs and cultured for 3-weeks to study chondrogenesis compared to scaffold-free micro-tissue pellet cultures and collagen-I hydrogels. Viability, metabolic activity, GAG and DNA content, chondrogenic gene expression (aggrecan, collagen I/II mRNA) and mechanical properties were quantified and matrix deposition was visualised using immunohistochemistry (Safranin-O, collagen I/II). VH was successfully extracted, exhibiting negligible amounts of DNA (0.4 ± 0.4 µg/mg dry-weight) and notable preservation of ECM components. VH displayed neither cytotoxic responses nor proliferation of macrophage-like U937 cells, instead enhancing both hMSC and hAC proliferation. Interestingly, encapsulated cells self-assembled the VH-hydrogel into spheroids, resulting in uniform distribution of both GAGs and collagen type II with increased compressive mechanical properties, rendering VH a permissive native ECM source to fabricate cartilaginous hydrogels for potential TE applications. STATEMENT OF SIGNIFICANCE: Fabricating bioactive and cell-instructive cartilage extracellular matrix (ECM) derived biomaterials and hydrogels has over recent years proven to be a challenging task, often limited by poor retention of inherent environmental cues post decellularisation due to the dense and avascular nature of native cartilage. In this study, we present an alternative route to fabricate highly permissive and bioactive ECM hydrogels from vitreous humor (VH) tissue. This paper specifically reports the discovery of optimal VH extraction protocols and cell seeding strategy enabling fabrication of cartilaginous matrix components into a hydrogel support material for promoting chondrogenic differentiation. The work showcases a naturally intact and unmodified hydrogel design that improves cellular responses and may help guide the development of cell instructive and stimuli responsive hybrid biomaterials in a number of TERM applications.
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Shao Y, Li X, Wood JW, Ma JX. Mitochondrial dysfunctions, endothelial progenitor cells and diabetic retinopathy. J Diabetes Complications 2018; 32:966-973. [PMID: 30068485 DOI: 10.1016/j.jdiacomp.2018.06.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 06/18/2018] [Accepted: 06/28/2018] [Indexed: 12/11/2022]
Abstract
AIM Diabetic retinopathy (DR) is the leading cause of vision loss in the working age population. Endothelial progenitor cells (EPC) play a vital role in vascular damage repair. This article will review recent progress regarding mitochondrial and EPC dysfunction associated with DR. RESULTS EPCs represent a limited population of adult stem cells possessing vasculogenic potential postnatally; their number and function are changed in DR. Among all the function changes, mitochondrial dysfunction plays an important role in the dysregulation of EPCs, as mitochondria regulate energy balance, and cell fate determination. CONCLUSIONS Although the mechanism for the role of mitochondria dysregulation in EPC function remains elusive, mitochondria of EPCs represent a promising target for the treatment of the vasculopathy presented within DR.
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Affiliation(s)
- Yan Shao
- Tianjin Medical University Eye Hospital, Eye Institute & School of Optometry and Ophthalmology, Tianjin, China; Department of Physiology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73014, USA
| | - Xiaorong Li
- Tianjin Medical University Eye Hospital, Eye Institute & School of Optometry and Ophthalmology, Tianjin, China
| | - John W Wood
- Department of Physiology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73014, USA
| | - Jian-Xing Ma
- Department of Physiology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73014, USA.
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Di Venere M, Viglio S, Cagnone M, Bardoni A, Salvini R, Iadarola P. Advances in the analysis of “less-conventional” human body fluids: An overview of the CE- and HPLC-MS applications in the years 2015-2017. Electrophoresis 2017; 39:160-178. [DOI: 10.1002/elps.201700276] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 07/28/2017] [Accepted: 07/31/2017] [Indexed: 12/15/2022]
Affiliation(s)
- Monica Di Venere
- Department of Molecular Medicine; Biochemistry Unit; University of Pavia; Pavia PV Italy
| | - Simona Viglio
- Department of Molecular Medicine; Biochemistry Unit; University of Pavia; Pavia PV Italy
| | - Maddalena Cagnone
- Department of Molecular Medicine; Biochemistry Unit; University of Pavia; Pavia PV Italy
| | - Anna Bardoni
- Department of Molecular Medicine; Biochemistry Unit; University of Pavia; Pavia PV Italy
| | - Roberta Salvini
- Department of Molecular Medicine; Biochemistry Unit; University of Pavia; Pavia PV Italy
| | - Paolo Iadarola
- Department of Biology and Biotechnologies “L. Spallanzani”; Biochemistry Unit; University of Pavia; Pavia PV Italy
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Hammer SS, Beli E, Kady N, Wang Q, Wood K, Lydic TA, Malek G, Saban DR, Wang XX, Hazra S, Levi M, Busik JV, Grant MB. The Mechanism of Diabetic Retinopathy Pathogenesis Unifying Key Lipid Regulators, Sirtuin 1 and Liver X Receptor. EBioMedicine 2017; 22:181-190. [PMID: 28774737 PMCID: PMC5552206 DOI: 10.1016/j.ebiom.2017.07.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 07/06/2017] [Accepted: 07/07/2017] [Indexed: 12/30/2022] Open
Abstract
Diabetic retinopathy (DR) is a complication secondary to diabetes and is the number one cause of blindness among working age individuals worldwide. Despite recent therapeutic breakthroughs using pharmacotherapy, a cure for DR has yet to be realized. Several clinical trials have highlighted the vital role dyslipidemia plays in the progression of DR. Additionally, it has recently been shown that activation of Liver X receptor (LXRα/LXRβ) prevents DR in diabetic animal models. LXRs are nuclear receptors that play key roles in regulating cholesterol metabolism, fatty acid metabolism and inflammation. In this manuscript, we show insight into DR pathogenesis by demonstrating an innovative signaling axis that unifies key metabolic regulators, Sirtuin 1 and LXR, in modulating retinal cholesterol metabolism and inflammation in the diabetic retina. Expression of both regulators, Sirtuin 1 and LXR, are significantly decreased in diabetic human retinal samples and in a type 2 diabetic animal model. Additionally, activation of LXR restores reverse cholesterol transport, prevents inflammation, reduces pro-inflammatory macrophages activity and prevents the formation of diabetes-induced acellular capillaries. Taken together, the work presented in this manuscript highlights the important role lipid dysregulation plays in DR progression and offers a novel potential therapeutic target for the treatment of DR. Diabetes affects retinal Liver X Receptor and Sirtuin 1 expression levels. Liver X Receptor normalized reverse cholesterol transport and prevented diabetes-induced inflammation in retinal cells. Liver X Receptor activation reduced the number of pro-inflammatory macrophages and prevented DR-like pathology.
Results of recent clinical trials demonstrate strong association between lipid abnormalities and progression of diabetic retinopathy (DR), the sight-threatening secondary complication of diabetes. This study addresses the role of key metabolic lipid regulators, SIRT1 and LXR in the progression of DR. All the components of SIRT1-LXR axis were downregulated in retinal cells isolated from human donor tissue or a DR animal model. Activation of LXR normalized reverse cholesterol transport, prevented diabetes-induced inflammation, reduced the number of pro-inflammatory macrophages and prevented DR-like pathology, suggesting that control of SIRT1-LXR axis could be a promising therapeutic target for treatment of DR.
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Affiliation(s)
- Sandra S Hammer
- Department of Physiology, Michigan State University, East Lansing, MI, United States
| | - Eleni Beli
- Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Nermin Kady
- Department of Physiology, Michigan State University, East Lansing, MI, United States
| | - Qi Wang
- Department of Physiology, Michigan State University, East Lansing, MI, United States
| | - Kiana Wood
- Department of Physiology, Michigan State University, East Lansing, MI, United States
| | - Todd A Lydic
- Department of Physiology, Michigan State University, East Lansing, MI, United States
| | - Goldis Malek
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, United States
| | - Daniel R Saban
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, United States
| | - Xiaoxin X Wang
- Department of Medicine, University of Colorado, Aurora, CO, United States
| | - Sugata Hazra
- Department of Pharmacology, University of Florida, Gainesville, FL, United States
| | - Moshe Levi
- Department of Medicine, University of Colorado, Aurora, CO, United States
| | - Julia V Busik
- Department of Physiology, Michigan State University, East Lansing, MI, United States.
| | - Maria B Grant
- Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, IN, United States.
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Balaiya S, Zhou Z, Chalam KV. Characterization of Vitreous and Aqueous Proteome in Humans With Proliferative Diabetic Retinopathy and Its Clinical Correlation. PROTEOMICS INSIGHTS 2017; 8:1178641816686078. [PMID: 28469465 PMCID: PMC5398322 DOI: 10.1177/1178641816686078] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 11/06/2016] [Indexed: 12/28/2022]
Abstract
Aims: Proliferative diabetic retinopathy (PDR) is associated with microvascular complications that cause biochemical changes in the human retina and alter the proteome of vitreous humor and aqueous humor (AH). Methods: Human vitreous humor and AH of PDR subjects were collected. Subjects who had surgery for epiretinal membrane or macular hole served as controls. Protein profiles were obtained and analyzed after running the samples on a liquid chromatography-mass spectrometry/mass spectrometry. Results: In vitreous humor, 16 unique proteins were noted in PDR patients, but not in controls. Those were associated mainly with coagulation, complement, and kallikrein-kinin systems. Under coagulation, fibrinogen and prothrombin proteins were more evident and may emphasize the importance of angiogenesis in the development of PDR. Vitreous proteins showed replicative presence in AH too. As for AH samples, we detected 10 proteins found in PDR patients, which were related to transport, coagulation, and inflammatory responses. Conclusions: We found 57 proteins in human vitreous and 39 proteins in AH. Identification of these proteins that are involved in various pathways will be helpful to understand diabetic retinopathy pathogenesis and to develop proteome as a biomarker for PDR.
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Affiliation(s)
- Sankarathi Balaiya
- Department of Ophthalmology, College of Medicine, University of Florida, Jacksonville, FL, USA
| | - Zimei Zhou
- Department of Ophthalmology, College of Medicine, University of Florida, Jacksonville, FL, USA
| | - Kakarla V Chalam
- Department of Ophthalmology, College of Medicine, University of Florida, Jacksonville, FL, USA
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Dual Anti-Inflammatory and Anti-Angiogenic Action of miR-15a in Diabetic Retinopathy. EBioMedicine 2016; 11:138-150. [PMID: 27531575 PMCID: PMC5049929 DOI: 10.1016/j.ebiom.2016.08.013] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 07/26/2016] [Accepted: 08/06/2016] [Indexed: 11/22/2022] Open
Abstract
Activation of pro-inflammatory and pro-angiogenic pathways in the retina and the bone marrow contributes to pathogenesis of diabetic retinopathy. We identified miR-15a as key regulator of both pro-inflammatory and pro-angiogenic pathways through direct binding and inhibition of the central enzyme in the sphingolipid metabolism, ASM, and the pro-angiogenic growth factor, VEGF-A. miR-15a was downregulated in diabetic retina and bone marrow cells. Over-expression of miR-15a downregulated, and inhibition of miR-15a upregulated ASM and VEGF-A expression in retinal cells. In addition to retinal effects, migration and retinal vascular repair function was impaired in miR-15a inhibitor-treated circulating angiogenic cells (CAC). Diabetic mice overexpressing miR-15a under Tie-2 promoter had normalized retinal permeability compared to wild type littermates. Importantly, miR-15a overexpression led to modulation toward nondiabetic levels, rather than complete inhibition of ASM and VEGF-A providing therapeutic effect without detrimental consequences of ASM and VEGF-A deficiencies.
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