Effects Of Intravitreal Conbercept On The Expression Of IL-6,HIF-1? And VEGF In Aqueous Humor Of Patients With PDR

Objective:According to various expression of IL-6,HIF-laand VEGF in aqueous humor of patients with proliferative diabetic retinopathy before and after intravitreal conbercept injection,and the level of IL-6,HIF-1? and VEGF in aqueous humor of patients with non-diabetic patients,comparing the differences between and intra-groups of IL-6/HIF-1?/VEGF,to further understand the pathogenesis of PDR and to explore new targets for PDR treatment.Method:A prospective case series study was conducted in 38 PDR patients(38 eyes)and 38 age-related cataracts patients(38 eyes)without macular edema who admitted to our hosipital from April 2019 to January 2020.We set the PDR patients as the experimental group and the age-related cataracts patients as the control group,and record the general information of the patients.Patients in the experimental group were collected with 0.15-0.20ml of aqueous humor before the intravitreal injection and 3-5 days after injection of the vitreous cavity.Patients in the control group were collected with 0.15-0.20ml of aqueous humor during cataract surgery.The obtained aqueous humor were poured into a sterile enzyme-free centrifuge tube,and quickly transferred to a-80? refrigerator for storage.All samples were subjected to enzyme-linked immunosorbent assay(ELISA).The experimental results were analyzed by SPSS 23.0 software using paired t-test and independent t-test to analyze the differences between the groups of data and using Pearson correlation analysis to perform the correlation analysis.P<0.05 was considered statistically significant.Result:1.IL-6 expression level:There was a statistical difference between the pre-injection group and the control group(34.98±5.70ng/L vs.24.52±4.91ng/L;t=8.575,P=0.000);there was a statistical difference between the pre-injection group and the injection group(34.98±5.70ng/L and 32.15±5.89ng/L;t=3.410,P=0.002);there was a statistical difference between the injection group and the control group(32.15±5.89 ng/L and 24.52±4.91 ng/L;t=6.131,P=0.000).2.HIF-l? expression level:There was a statistical difference between the pre-injection group and the control group(HIF-1?:134.33±11.36ng/L vs 63.27±10.96ng/L;t=27.754,P=0.000);there was no statistical difference between the pre-injection group and the injection group(134.33±11.36ng/L vs 132.51±10.05ng/L;t=1.133,P=0.264);there was a statistical difference between the injection group and the control group(132.51±10.05ng/L vs 63.27±10.96ng/L;t=28.700,P=0.000).3.VEGF expression level:There was a statistical difference between the pre-injection group and the control group(898.64±141.37ng/L vs 323.77±86.70ng/L;t=21.369,P=0.000);there was a statistical difference in the pre-injection group and the injection group(898.64 ± 141.37ng/L vs 571.78± 108.35ng/L;t=16.896,P=0.000);there was a statistical difference in the injection group and the control group(571.78±108.35ng/L vs 1 323.77± 86.70ng/L;t=11.018,P=0.000).4.Correlation between IL-6/HIF-1?/VEGF before intravitreal injection in PDR patients:There is no correlation between IL-6 and VEGF expression(r=0.226,P=0.173),and HIF-l? has a positive correlation with VEGF expression(r=0.852,P=0.000),there was no correlation between HIF-1? and IL-6 expression(r=0.227,P=0.171).Correlation between IL-6/HIF-1?/VEGF after intravitreal injection in PDR patients:There was no correlation between IL-6 and VEGF expression(r=0.186,P=0.263),and there was no correlation between HIF-1? and VEGF expression(r=0.267,P=0.105),there was no correlation between HIF-1? and IL-6 expression(r=0.212,P=0.202).The correlation between IL-6/HIF-l?/VEGF in the control group:there was no correlation between IL-6 and VEGF expression(r=0.064,P=0.704),and there was no correlation between HIF-1? and VEGF expression(r=-0.278,P=0.091),there was no correlation between HIF-1? and IL-6 expression(r=-0.013,P=0.939).Conclusion:1.IL-6,HIF-1? and VEGFwere highly expressed in the aqueous humor of PDR patients and may participate in the pathogenesis of PDR.2.There was no correlation between the expression levels of IL-6 and VEGF before intravitreal injection in PDR patients,and there was no correlation between the expression levels of HIF-1? and IL-6.IL-6 may not directly participate in the mechanism of PDR neovascularization.3.Intravitreal injection of Conbercept in PDR patients reduced the expression levels of IL-6 and VEGF but was still higher than that in the control group.Conbercept inhibited the expression of IL-6 and VEGF to a certain extent.4.The expression level of HIF-1? before intravitreal injection in PDR patients was positively correlated with the expression of VEGF.HIF-1? may be the causative factor of PDR.There was no significant change in the expression level of HIF-1? and the expression of VEGF decreased after injection.Since HIF-1? is an upstream transcription factor of VEGF,HIF-1?may be new targets for PDR treatment.