| 31. |
- Agardh, Elisabet, et al.
(författare)
-
A four-year follow-up study on the incidence of diabetic retinopathy in older onset diabetes mellitus
- 1994
-
Ingår i: Diabetic Medicine. - 1464-5491. ; 11:3, s. 273-278
-
Tidskriftsartikel (refereegranskat)abstract
- Out of 369 diabetic patients with an age at onset of diabetes > or = 30 years previously studied, 325 (88%) were included in an ophthalmological follow-up examination 4 years later. In patients treated with oral drugs at baseline, the incidence of any type of retinopathy was 30.8% and of severe retinopathy 5.7%. All patients who developed severe retinopathy received insulin during the follow-up period. At baseline, duration of diabetes, diastolic blood pressure, and signs of nephropathy (p < 0.05 in all cases) as well as degree of metabolic control (p < 0.01) differed between patients who developed retinopathy and those who did not. At follow-up, there were no longer any differences regarding degree of metabolic control and diastolic blood pressure. In patients treated with insulin at baseline, the incidence of any type of retinopathy was 41.0% and of severe retinopathy 16.1%. At baseline, duration of diabetes (p < 0.01), degree of metabolic control, and insulin dosage (p < 0.05 in both cases) differed between patients who developed retinopathy and those who did not. At follow-up, there was no longer any difference in insulin dosage.
|
|
| 32. |
- Agardh, Elisabet, et al.
(författare)
-
Diabetic retinopathy
- 2004
-
Ingår i: International textbook of diabetes mellitus. - Chichester, UK : John Wiley & Sons, Ltd. - 0471486558 ; , s. 1187-1187
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Diabetic retinopathy is the most common cause of blindness in the Western world in people aged 65 years or less. Intensive blood glucose control reduces the risk for development and progression of retinopathy. There is also a strong association between hypertension and retinopathy, and antihypertensive treatment seems to reduce the risk for both development and progression of retinopathy. The retinal vascular changes may vary from occasional hemorrhages and microaneurysms, to multiple hemorrhages and microaneurysms, prominent retinal thickening and exudates along blood vessels and in the macular region, new vessels, fibrosis, and retinal detachment. Sight-threatening lesions may well be present without disturbed visual function and visual outcome is dependent on timely treatments like laser photocoagulation and vitrectomy. Therefore, regular screening for diabetic retinopathy is of utmost importance. The molecular pathophysiology of diabetic retinopathy includes factors that initiate and promote the vascular disease like hyperglycemia, the polyol pathway, nonenzymatic glycation, oxidative stress, activation of protein kinase C, different growth factors, and vasoactive hormones. Several changes also take place in the retinal vasculature, which cause changed retinal blood flow and heterogeneity of its distribution, areas of nonperfusion and ischemia and hypoxia, which in turn leads to an increased production of vasoactive factors like vascular endothelial growth factor.
|
|
| 33. |
- Agardh, Elisabet, et al.
(författare)
-
Effects of inhibition of glycation and oxidative stress on the development of cataract and retinal vessel abnormalities in diabetic rats
- 2000
-
Ingår i: Current Eye Research. - 0271-3683. ; 21:1, s. 543-549
-
Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To study effects of inhibition of glycation, and oxidative stress on the development of cataract and retinal vessel abnormalities in diabetic rats. METHODS: Diabetes was induced in male Wistar rats with streptozocin (STZ; 60 mg/kg BW, i.p.). Diabetic as well as strain matched control rats were fed 1) a normal diet, 2) addition of aminoguanidine in the drinking water (0.5 g/l for diabetic rats and 1.0 g/l for control rats) or 3) probucol in the pellets (1% w/w). After 6 months, the number of acellular vessels, endothelial cells and pericytes were counted in trypsin digested retinal vessel preparations, and the total retinal tissue amount of glutathione (GSH) and cysteine was measured with HPLC. RESULTS: Cataract formation occurred after 13 weeks in diabetic animals compared with 17 weeks for those treated with aminoguanidine, and 16 weeks for those treated with probucol (p < 0.001 in both cases). Aminoguanidine inhibited the formation of acellular collapsed capillary strands, 9 (3-14) vs. 18 (12-262) (median, range) per quadrant in untreated diabetic rats (p = 0.004), while probucol did not have any effect. Neither aminoguanidine, nor probucol influenced the endothelial/pericyte ratio. Diabetes caused a reduction in the GSH/cysteine ratio (10.7 +/- 0.6 vs. 15.3 +/- 1. 5) (mean +/- SD; p < 0.001). Probucol partly restored this imbalance (p < 0.05) whereas aminoguanidine did not. CONCLUSIONS: The results indicate that cataract formation in diabetes involves both glycation and oxidative stress processes. The reduced formation of acellular collapsed capillary strands by aminoguanidine suggests a potential role for glycation in vascular damage. The positive effect of probucol on cysteine/GSH metabolism imbalance indicates that derangements of one of the retinal defense systems against oxidative stress can be normalized by antioxidants.
|
|
| 34. |
- Agardh, Elisabet, et al.
(författare)
-
Fetal growth is not associated with early onset of severe retinopathy in type 1 diabetes mellitus
- 2000
-
Ingår i: Diabetes Research and Clinical Practice. - 1872-8227. ; 48:1, s. 61-65
-
Tidskriftsartikel (refereegranskat)abstract
- Reduced fetal growth has been suggested as a possible risk factor for diabetic nephropathy. The aim of the present study was to examine whether there could be an association also with rapidly progressing severe retinopathy in younger type 1 diabetic patients. Maternal pregnancy, as well as birth parameters of 27 type 1 diabetic patients with severe retinopathy diagnosis at a median age of 25 years, were studied retrospectively. The control group consisted of 22 type 1 diabetic patients with mild background retinopathy and with similar age, age at onset, and duration of diabetes. Mothers of the subjects with severe retinopathy had a higher body mass index (P = 0.03) but similar age, blood pressure levels, and weight gain during pregnancy as those of the control group. All but four babies, two in each group, were born after 37 completed gestational weeks. There were no differences regarding birth weight or of relative birth weight corrected for gestational length. Head circumference, birth length, and placenta weight were similar. The results indicate that fetal growth is not a factor of major importance for the development of severe retinopathy in younger type 1 diabetic patients.
|
|
| 35. |
|
|
| 36. |
|
|
| 37. |
- Agardh, Elisabet, et al.
(författare)
-
Modifying a standard method allows simultaneous extraction of RNA and protein, enabling detection of enzymes in the rat retina with low expressions and protein levels
- 2006
-
Ingår i: Metabolism, Clinical and Experimental. - : Elsevier BV. - 1532-8600. ; 55:2, s. 168-174
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to evaluate messenger RNA and protein expression in limited amounts of tissue with low protein content. The Chomczynski method was used for simultaneous extraction of RNA, and protein was modified in the protein isolation step. Template mass and cycling time for the complementary DNA synthesis step of real-time reverse transcription-polymerase chain reaction (RT-PCR) for analysis of catalase, copper/zinc superoxide dismutase, manganese superoxide dismutase, the catalytic subunit of glutamylcysteine ligase, glutathione peroxidase 1, and the endogenous control cyclophilin B (CypB) were optimized before PCR. Polymerase chain reaction accuracy and efficacy were demonstrated by calculating the regression (R2) values of the separate amplification curves. Appropriate antibodies, blocking buffers, and running conditions were established for Western blot, and protein detection and multiplex assays with CypB were performed for each target. During the extraction procedure, the protein phase was dissolved in a modified washing buffer containing 0.1% sodium dodecyl sulfate, followed by ultrafiltration. Enzyme expression on real-time RT-PCR was accomplished with high reliability and reproducibility (R2, 0.990-0.999), and all enzymes except for glutathione peroxidase 1 were detectable in individual retinas on Western blot. Western blot multiplexing with CypB was possible for all targets. In conclusion, connecting gene expression directly to protein levels in the individual rat retina was possible by simultaneous extraction of RNA and protein. Real-time RT-PCR and Western blot allowed accurate detection of retinal protein expressions and levels.
|
|
| 38. |
- Agardh, Elisabet, et al.
(författare)
-
Normal eyes in type 1 diabetics stay normal after one year of treatment with continuous subcutaneous insulin pump
- 1986
-
Ingår i: Acta Ophthalmologica. - 0001-639X. ; 64:5, s. 530-532
-
Tidskriftsartikel (refereegranskat)abstract
- Seven patients with type 1 diabetes mellitus were restored to near normoglycaemia by treatment with continuous subcutaneous insulin infusion pumps (CSII). The patients were examined with ophthalmoscopy, fundus photography and fluorescein angiography before and one year after the start of CSII treatment. In addition, ophthalmoscopy was performed after 6 months of treatment. All 14 eyes were normal prior to the CSII treatment and none had developed any signs of retinopathy after 6 months or 1 year. It is concluded that metabolic control can be near normalized with CSII treatment without any risk for development of diabetic microangiopathy in type 1 diabetics with normal eyes.
|
|
| 39. |
- Agardh, Elisabet, et al.
(författare)
-
Putative risk factors associated with retinopathy in patients with diabetes diagnosed at or after 30 years of age
- 1989
-
Ingår i: Diabetic Medicine. - 1464-5491. ; 6:8, s. 724-727
-
Tidskriftsartikel (refereegranskat)abstract
- In a cross-sectional study of diabetic patients diagnosed at or after 30 years, and with different stages of retinopathy, factors such as duration of diabetes, treatment mode, metabolic control, blood pressure, and clinical signs of nephropathy were examined. The different stages of retinopathy used were absence of retinopathy, simplex, and severe retinopathy. Patients with simplex and severe retinopathy were older than those without retinopathy (p less than 0.001, and p less than 0.01, respectively). They also had a longer duration of diabetes (p less than 0.001), and were more often treated with insulin (p less than 0.001) and in larger doses (p less than 0.001). Their glycosylated haemoglobin levels were higher (p less than 0.01). Their systolic blood pressure was higher (p less than 0.01), but the diastolic blood pressure did not differ, and the number of patients treated for hypertension was similar in all groups. Albumin clearance was higher (p less than 0.01 and p less than 0.001), as were urinary albumin levels (p less than 0.001). The only variables that distinguished patients with simplex from those with severe retinopathy were albumin clearance (p less than 0.01) and urinary albumin levels (p less than 0.05).
|
|
| 40. |
- Agardh, Elisabet, et al.
(författare)
-
Retinal glial cell immunoreactivity and neuronal cell changes in rats with STZ-induced diabetes
- 2001
-
Ingår i: Current Eye Research. - : Informa UK Limited. - 0271-3683 .- 1460-2202. ; 23:4, s. 276-284
-
Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To study whether diabetes could influence glial cells, retinal neurons, and pigment epithelial cells and if so, to evaluate whether any changes could be influenced by aminoguanidine (AG) or probucol (PB). METHODS: Streptozocin (STZ)-induced diabetic male Wistar rats and age-matched control rats were fed a normal diet, addition of AG in the drinking water (0.5 g/l for diabetic and 1.0 g/l for control rats) or PB in the pellets (1 % w/w) for one or six months. Paraffin embedded retinal sections were incubated in the primary antibodies GFAP, calbindin, RPE65, and Hu, for glial, horizontal, pigment epithelial, and ganglion cells, respectively, and in fluorescent secondary antibodies. RESULTS: One month after STZ injection, GFAP immunoreactivity was sparse, but after six months it was prominent in glial cells in 5/5 diabetic and 1/7 control retinas (p = 0.015). Neither AG, nor PB influenced this immunoreactivity. Numbers of retinal pigment epithelial cells and cells in the ganglion cell layer, were similar at one and six months of diabetes. By time, the number of horizontal cells decreased (p < 0.001) and branching and numbers of their terminals were reduced (p < 0.001). CONCLUSION: Diabetes for six months resulted in increased glial cell immunoreactivity, and by age, horizontal cell numbers and branching of their terminals decreased, morphological patterns that were unaffected by AG or PB. The numbers of retinal pigment epithelial cells and cells in the ganglion cell layer were unaffected both by age and diabetes.
|
|
