| Objective:About 382 million people worldwide suffer from diabetes,and the number is expected to grow substantially every year.There are many known vascular complications that can lead to diabetes,including coronary heart disease,atherosclerosis,diabetic nephropathy,diabetic neuropathy,and diabetic retinopathy.The therapy of early stage of diabetic retinopathy is to control blood sugar,retinal photocoagulation treatment is performed when necessary.For the proliferative diabetic retinopathy,vitrectomy surgery and intravitreal injection anti-vascular endothelial growth factor is performed.However,none of the above treatments can effectively resolved diabetic retinopathy,so it is necessary to study pathogenesis of the disease in-depth and find out some new methods.Secretogranin III(SCG3)is a member of the secretory granule protein family that regulates the production of secretory granules.It has recently been extensively studied as an angiogenic factor,unlike many other known angiogenic factors.The role of SCG3 is limited to pathological conditions.Studies have identified SCG3 as a disease-associated endothelial ligand in a mouse model of diabetic retinopathy,which is considered to be a highly disease-associated angiogenic factor and to characterize its VEGF-independent signaling mechanism.SCG3 plays a role in reducing retinal vascular leakage,neovascularization in diabetic retinopathy and animal models of retinopathy of prematurity.The detection of SCG3 in peripheral blood and vitreous of patients with diabetic retinopathy has not been clearly studied and researched.This study aims to study the relevant real data of SCG3 in human body,and set foundation for clinical application of block SCG3 therapy.Methods:To explore the role of SCG3 in diabetic retinopathy.(1)Collecting patients with clinically required vitrectomy for diabetic retinopathy,and patients requiring vitrectomy for other non-diabetic factors,retaining some of the vitreous fluid that needs to be removed during vitrectomy,and applying enzyme-linked enzymes Enzyme Linked Immunosorbent Assay(ELISA)was used to detect the concentration of SCG3 in vitreous,to study the expression of SCG3 in vitreous of patients with proliferative diabetic retinopathy,the expression of SCG3 in vitreous of non-diabetic patients,and to explore the relationship between diabetic retinopathy and SCG3.The grouping was refined according to the patients’ blood lipids,height,body weight,BMI(Body Mass Index,BMI).All patients were regrouped into diabetic retinopathy with hyperlipidemia(PDR + hyperlipidemia group),diabetic retinopathy with normal lipid group(PDR + normal blood lipid group),non-diabetic combined with hyperlipidemia group(non-DM + hyperlipidemia group),non Diabetes combined with normal blood lipids group(non-DM + normal blood lipid group).Diabetic retinopathy with high BMI(PDR + high BMI group),diabetic retinopathy with normal BMI group(PDR + normal BMI group),non-diabetic combined with high BMI group(non-DM + high BMI group),non-diabetic combined with normal BMI group(non-diabetic DM+ normal BMI group)respectively for research comparison.(2)Collecting peripheral blood of diabetic retinopathy and non-diabetic patients who need to be admitted to hospital for ophthalmic surgery,and extracting mRNA of peripheral blood mononuclear cells for polymerase chain reaction(PCR)detection.(3)Collecting peripheral blood of diabetic retinopathy and non-diabetic patients who need to be admitted to hospital for ophthalmic surgery,separating peripheral blood plasma,and performing plasma enzyme-linked immunosorbent assay.(4)For all cases of diabetic retinopathy with vitreous,record preoperative and postoperative visual acuity,intraocular pressure,B-ultrasound,fundus photography,OCT,surgical procedure,postoperative visual acuity,intraocular pressure,and recurrent retinal detachment after surgery.The measurement of the vitreous SCG3 values of the patient tamponaded with silicone oil during the operation and the measurement of the vitreous SCG3 of the patient without the silicone oil were statistically analyzed,and the case characteristics were analyzed.Results:(1)A total of 43 cases of vitreous in patients with diabetic retinopathy were collected,and 34 cases of vitreous in non-diabetic patients were collected.The concentration of SCG3 in vitreous of patients with diabetic retinopathy was higher than that of non-diabetic patients.The former was 1.53 times of the latter,and there was a significant statistical difference between them(P=0.046).After refinement grouping,it was found that the concentration of SCG3 in vitreous of patients with diabetic retinopathy and hyperlipidemia was higher than that of non-diabetic patients without hyperlipidemia.The former was 2.0 times of the latter.There was a significant statistically difference(P=0.015).The concentration of SCG3 in vitreous of patients with diabetic retinopathy and hyperlipidemia was higher than that of patients with diabetic retinopathy without hyperlipidemia.The former was 1.37 times of the latter,but there was no statistical differences(P = 0.33).The concentration of SCG3 in vitreous of patients with diabetic retinopathy and hyperlipidemia was higher than that of non-diabetic patients with hyperlipidemia.The former was 1.42 times of the latter,but there was no statistical difference.(P = 0.25).The concentration of SCG3 in vitreous of patients with diabetic retinopathy without hyperlipidemia was higher than that of non-diabetic patients without hyperlipidemia..The former was 1.46 times of the latter,but there was no statistical difference(P=0.22).The concentration of SCG3 in vitreous of patients with diabetic retinopathy without hyperlipidemia was higher than that of non-diabetic patients with hyperlipidemia.The former was 1.03 times of the latter,but there was no statistical difference.(P=0.96).The concentration of SCG3 in vitreous of patients with non-diabetes without hyperlipidemia was lower than that of non-diabetic patients with hyperlipidemia.The latter was 1.4 times of the former,but there was no statistical difference(P = 0.15).The concentration of SCG3 in vitreous of patients with diabetic retinopathy and high BMI was higher than that of patients with diabetic retinopathy and normal BMI.The former was 1.21 times of the latter,but there was no statistical difference.(P=0.58).The concentration of SCG3 in vitreous of patients with diabetic retinopathy and high BMI was higher than that of non-diabetic patients with high BMI.The former was 1.22 times of the latter,but there was no statistical difference(P=0.47).The concentration of SCG3 in vitreous of patients with diabetic retinopathy and high BMI was higher than that of non-diabetic patients with normal BMI.The former was 2.7 times of the latter,with statistical difference(P=0.009).The concentration of vitreous SCG3 in patients with diabetic retinopathy and normal BMI were almost the same as those in non-diabetic patients with high BMI.There was no statistical difference(P=0.99).The concentration of SCG3 in vitreous of patients with diabetic retinopathy and normal BMI was higher than that of non-diabetic patients with normal BMI.The former was 2.0 times of the latter,which was statistical significant(P=0.02).The concentration of SCG3 in vitreous of patients with non-diabetic and high BMI was higher than that of non-diabetic patients with normal BMI.The former was 2.24 times of the latter,with statistical difference(P= 0.005).(2)26 cases of diabetic retinopathy and non-diabetic peripheral blood were collected,peripheral blood mononuclear cells were isolated,and polymerase chain reaction was detected.It was found that the PCR results of peripheral blood mononuclear cells in patients with diabetic retinopathy were lower than those of non-diabetic patients.There was significant statistically difference(P=0.03).(3)42 cases of diabetic retinopathy and non-diabetic peripheral blood were collected,plasma was separated,and plasma enzyme-linked immunosorbent assay was performed.It was found that the concentration of SCG3 in plasma was minimal or could not be detected.(4)It was found that among the 43 patients with diabetic retinopathy performed vitrectomy,10 patients were tampanoded with silicone oil during surgery,and the concentration of vitreous SCG3 in patients with silicone oil and the vitreous SCG3 of patients without silicone oil were statistical analyzed.It showed that SCG3 of the vitreous in patients with silicone oil was 1.66 times that of patients without silicone oil,but the difference was not statistically significant(P=0.05).Two patients(4.7%)had recurrent retinal detachment after silicone oil extraction and one case(2.3%)with retinal proliferation and detachment with silicone oil in the eye,all of the cases with higher concentration of SCG3 in vitreous.Conclusion:In diabetic retinopathy patients,up-regulation of vitreous SCG3 may be closely related to the pathogenesis of diabetic retinopathy.The signaling pathways of SCG3 and VEGF were different.Anti-SCG3 drugs may be used for the treatment of macular edema and choridal neovascular diseases.However,SCG3 is almost difficult to detect in normal vessel vasculature,which may highlight its advantages in using anti-SCG3 drugs in babies and children in future.The anti-SCG3 has less damage to normal tissues,especially in babies and children using safty.Higher SCG3 in vitreous may indicate a more severe degree of diabetic retinopathy,and there is more possibility of silicone oil tamponade during surgery,and more attention and treatment are needed after surgery.A new biological reference index for the prognosis of diabetic retinopathy in clinical work is proposed. |
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