INFLUENCE OF FACTORS OF THE PROGRESSION OF DIABETIC RETINOPATHY ON THE CONTENT OF BLOOD SERUM CLUSTER OF DIFFERENTIATION CHEMOKINE CD54 IN THE OF PATIENTS WITH TYPE 2 DIABETES

Abstract

Background. An early critical step in the development of endothelial dysfunction and DR is the adhesion of leukocytes to endothelial cells, which is controlled and mediated by specific adhesion marker molecules CD54 (ICAM-1), CD106 (VCAM-1), P-selectin and E-selectin. However, the influence of DR progression factors on CD54 content in blood serum in patients with type 2 diabetes at different stages of DR is insufficiently covered in the literature. Aim: to assess the influence of factors of progression of diabetic retinopathy (age, gender, state of diabetes compensation) on the content of the CD54 in the blood serum of patients with type 2 diabetes at different stages of diabetic retinopathy. Material and methods. An open, one-center, one-moment selective observational study was conducted involving adult patients with type 2 diabetes and DR. The study was conducted in 82 patients with DR (148 eyes). Ophthalmological examination included visometry, perimetry, refractometry, tonometry, biomicroscopy, gonioscopy, ophthalmoscopy, optical coherence tomography. The concentration of the soluble form of CD54 in blood serum was determined by enzyme immunoassay. Statistical analysis included ANOVA and regression analysis. Differences were considered statistically significant if p<0.05. Results. A probable decrease in serum sICAM-1 concentration with increasing severity of DM in patients with HbA1c>7.5% was revealed, as well as a pronounced tendency to decrease the concentration of soluble CD54 in blood serum at the III stage of DM in patients with type 2 DM with HbA1c> 7,5%. During the progression of DR, a probable increase in the concentration of sICAM-1 at the II stage of DR when using insulin therapy. Conclusions. The concentration of soluble CD54 in blood serum in patients with HbA1c>7.5% as the stage of diabetic retinopathy increases probably decreases (p=0.05), and in patients on insulin therapy, the content of sICAM-1 in the II stage of diabetic retinopathy is probably higher than in patients, taking tableted hypoglycemic drugs (р=0.003).