| Background of the study:The urokinase-type plasminogen activator and its repceptor(uPA/uPAR)has the function of degrading the extracellular matrix and regulating cell proliferation,migration,angiogenesis,and inflammatory response.Current studies suggest that neovascularization and inflammatory responses are jointly involved in the development of proliferative diabetic retinopathy(PDR).Purpose:To analyze the correlation between uPA/uPAR and VEGF and MCP-1 by detecting and analyzing the expression levels of urokinase-type plasminogen activator and its receptor(uPA/uPAR),vascular endothelial growth factor(VEGF),and monocyte chemotactic protein-1(MCP-1)in serum,vitreous humor and pre-aqueous fluid of PDR patients,and to preliminarily explore the correlation between uPA/uPAR,VEGF,and MCP-1 in the pathogenesis of PDR,to open up new ideas for studying the pathological mechanism and treatment of PDR.Method:From May 2022 to December 2022,49 patients(49 eyes)with PDR who needed vitrectomy in our hospital,28 males and 21 females,with an average age of 53.41±11.80 years,were selected as the experimental group;In the same period,20 patients(20 eyes)with idiopathic macular epiretinal membrane and macular hole were selected from our hospital,10 males and 10 females,with an average age of 58.60±10.56 years,as the control group.Non-anticoagulant blood was extracted from all patients under the condition of fasting before surgery,and pre-aqueous fluid and vitreous humor were collected during surgery.The levels of uPA/uPAR,VEGF and MCP-1 in serum,vitreous humor and pre-aqueous fluid of the two groups of patients were detected by enzyme-linked immunosorbent assay(ELISA),and the correlation between uPA/uPAR and VEGF and MCP-1 was analyzed.Results:1)There was no statistically significant difference between serum uPA,uPAR,VEGF,and MCP-1 concentrations in the experimental group and the control group(P>0.05);the median levels of uPA,uPAR,VEGF,and MCP-1 in the vitreous humor of the experimental group were higher than those in the control group,and the difference was statistically significant(P<0.05);the median levels of uPAR,VEGF in the pre-aqueous fluid of the experimental group levels were all higher than those of the control group,and the differences were statistically significant(P<0.05),while there was no statistically significant difference in uPA concentration in pre-aqueous fluid between the two groups(P>0.05).2)When comparing uPA,uPAR and VEGF concentrations in serum,vitreous humor and pre-aqueous fluid in the experimental groups,there were statistically significant differences in the overall distribution of uPA concentrations in the three groups(P<0.05),and vitreous humor > serum > pre-aqueous fluid;there were statistically significant differences in the overall distribution of uPAR concentrations in the three groups(P<0.05),and serum> vitreous humor > pre-aqueous fluid;there were statistically significant differences in the overall distribution of VEGF concentrations in the three groups(P<0.05),and vitreous humor > pre-aqueous fluid>serum.In the experimental group,the differences in the overall distribution of MCP-1 concentrations in serum and vitreous humor were statistically significant(P<0.05),and vitreous humor > serum.3)There was no statistically significant difference between serum uPA,uPAR,VEGF,and MCP-1 levels in the experimental group of early and mid-late PDR(P>0.05);the difference between vitreous humor uPA,uPAR,and VEGF in the experimental group of early and mid-late PDR was not statistically significant(P>0.05),while the difference between MCP-1 was statistically significant(P< 0.05)4)Correlation analysis of uPA,uPAR,VEGF,and MCP-1 levels in serum.In the early stage of PDR,uPA and uPAR levels were positively correlated(r=0.451,p=0.012);In the middle and late stage of PDR,uPA and uPAR,uPA and MCP-1,uPAR and MCP-1 levels were positively correlated(r=0.754,P=0.000 、 r=0.667,P=0.002,r=0.712,P=0.001).5)Correlation analysis of uPA,uPAR,VEGF,and MCP-1 levels in vitreous humor.In the early stage of PDR,uPA and uPAR,uPA and VEGF,uPAR and VEGF levels in early PDR were positively correlated(r=0.420,P=0.021、r=0.480,P=0.007、r=0.433,P=0.017);In the middle and late stage of PDR,uPA and uPAR,uPAR and MCP-1 levels were positively correlated(r=0.512,=0.025、r=0.546,P=0.016).Conclusions:1)uPA/uPAR in intraocular fluid,uPAR sensitivity may be higher.uPA/uPAR may mainly involved in the process of neovascularization due to VEGF in the early stage of PDR,while in the middle and late stage of PDR,uPA/uPAR mainly involved in inflammatory mediators such as MCP-1 to promote inflammation.2)Serum cytokines may be disturbed by systemic factors,and serum uPA,uPAR,VEGF,and MCP-1 cannot yet be used as markers to suggest the progression of PDR disease. |
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