Glucagon-like Peptide 1 Receptor Agonists, Diabetic Retinopathy and Angiogenesis: The AngioSafe Type 2 Diabetes Study

AIMS

Recent trials provide conflicting results on the association between glucagon-like peptide 1 receptor agonists (GLP-1RA) and diabetic retinopathy (DR). The aim of the AngioSafe type 2 diabetes (T2D) study was to determine the role of GLP-1RA in angiogenesis using clinical and preclinical models.

METHODS

We performed two studies in humans. In study 1, we investigated the effect of GLP-1RA exposure from T2D diagnosis on the severity of DR, as diagnosed with retinal imaging (fundus photography). In study 2, a randomized 4-week trial, we assessed the effect of liraglutide on circulating hematopoietic progenitor cells (HPCs), and angio-miRNAs.We then studied the experimental effect of Exendin-4, on key steps of angiogenesis: in vitro on human endothelial cell proliferation, survival and three-dimensional vascular morphogenesis; and in vivo on ischemia-induced neovascularization of the retina in mice.

RESULTS

In the cohort of 3154 T2D patients, 10% displayed severe DR. In multivariate analysis, sex, disease duration, glycated hemoglobin (HbA1c), micro- and macroangiopathy, insulin therapy and hypertension remained strongly associated with severe DR, while no association was found with GLP-1RA exposure (o 1.139 [0.800-1.622], P = .47). We further showed no effect of liraglutide on HPCs, and angio-miRNAs. In vitro, we demonstrated that exendin-4 had no effect on proliferation and survival of human endothelial cells, no effect on total length and number of capillaries. Finally, in vivo, we showed that exendin-4 did not exert any negative effect on retinal neovascularization.

CONCLUSIONS

The AngioSafe T2D studies provide experimental and clinical data confirming no effect of GLP-1RA on angiogenesis and no association between GLP-1 exposure and severe DR.

Nanoscale Chemical Characterization of Solid-State Microbattery Stacks by Means of Auger Spectroscopy and Ion-Milling Cross Section Preparation

The current sustained demand for "smart" and connected devices has created a need for more miniaturized power sources, hence for microbatteries. Lithium-ion or "lithium-free" all-solid-state thin-film batteries are adapted solutions to this issue. The capability to carry out spatially resolved chemical analysis is fundamental for the understanding of the operation in an all-solid-state microbattery. Classically cumbersome and not straightforward techniques as TEM/STEM/EELS and FIB preparation methods could be used to address this issue. The challenge in this work is to make the characterization of Li-based material possible by coupling ion-milling cross section preparation method and AES techniques to characterize the behavior of a LiCoO₂ positive electrode in an all solid state microbattery. The surface chemistry of LiCoO₂ has been studied before and after LiPON deposition. Modifications of the chemical environments characteristic of the positive electrode have been reported at different steps of the electrochemical process. An original qualitative and a semiquantitative analysis has been used in this work with the peak deconvolution method based on real, certified reference spectra to better understand the lithiation/delithiation process. This original coupling has demonstrated that a full study of the pristine, cycled, and post mortem positive electrode in a microbattery is also possible. The ion-milling preparation method allows access to a large area, and the resolution of Auger analysis is highly resolved in energy to separate the lithium and the cobalt signals in an accurate way.