Plasma Levels of IL-17, VEGF, and Adrenomedullin and S-Cone Dysfunction of the Retina in Children and Adolescents without Signs of Retinopathy and with Varied Duration of Diabetes
The study objective was to assess chosen biochemical parameters of blood and bioelectric function of the retina in patients with T1DM. The study group consisted of 41 patients with T1DM with no signs of diabetic retinopathy. The control group included 21 pediatric patients. We performed (1) S-cone ERG testing with retina response stimulation in both eyes at the luminance of 0.1, 0.2, and 0.5？(cd × s/m2) with the 440？nm blue flash and light application of the amber background (300？ph？cd/m2, 495？nm wavelength), (2) anthropometric measurements, (3) biochemical investigations: IL-17, VEGF, and ADM by the ELISA method. A comparison of the ERG results with biochemical investigations indicates a likely correlation between the worsening of retinal bioelectric function and VEGF levels growing with diabetes duration. We showed a negative correlation between ADM and HbA1c and described possible causes of ADM reduction observed in subgroup I. We demonstrated the presence of bioelectric retinal dysfunction already before the diagnosis of diabetic retinopathy, which provides new possibilities in the diagnosis of preclinical chronic complications of diabetes. The changes observed in the levels of IL-17, ADM, and VEGF suggest their involvement in the diabetic pathogenesis of eye diseases. 1. Introduction Due to the systemic character of diabetes, virtually any organ can become damaged. The vision system is one of the first body parts exhibiting microcomplications and dysfunction, which is an important issue in modern diabetology [1]. Over 90% of patients with type 1 diabetes (T1DM) of 15 years’ and longer duration show features of retinopathy, whereas in type 2 diabetes (T2DM) approximately 5% are affected at the time of diagnosis [1, 2]. The scale of the problem is extremely large, as among the 2.5 million of the Polish diabetic population, the number of cases with diabetic retinopathy is estimated at 600,000 [3]. Thanks to the dynamic progress in the development of diagnostic methods and the use of modern appliances, diabetes is known to affect all the anatomical structures of the eyeball [4]. Apart from vascular changes, diabetes may also cause neurophysiological lesions [5, 6]. Functional changes of retinal neurons are detected by electro physiological tests, being a noninvasive and highly objectivediagnostic tool. Quick detection of retinopathy and immediate implementation of appropriate treatment reduce individual and social expenses and improve life quality [7–9]. While preparing the project, we were aware of the necessity to distinguish risk groups at an early
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