This study assessed the effect of a systemic oral treatment with antioxidants (AOs) in preretinopathic diabetes (PRD) patients, through the evaluation of oxidative stress in plasma and changes in the full-field electroretinogram (ERG).
Methods:
Thirty-two PRD subjects with good metabolic control were recruited. Patients were randomized in two groups, one of which received oral AO treatment with α-lipoic acid at 400 mg/day in association with genistein and vitamins, whereas the other group received a placebo. Free radicals and the AO barrier were evaluated in plasma with the Free Radical Analytical System 4 instrument (H&D srl, Parma, Italy), and the same day the electrophysiological response was measured by ERG. These analyses were performed at enrollment and after 30 days of treatment.
Results:
Statistically significant increases of plasma AO levels and ERG oscillatory potential values were observed in the group treated with AO, but not in the control group.
Conclusions:
Results of this preliminary study suggest that an oral treatment with AOs in PRD subjects may have a protective effect on retinal cells, as detected by ERG analysis, through the strengthening of the plasma AO barrier.
Get full access to this article
View all access options for this article.
References
1.
AliTK, El-RemessyAB. Diabetic retinopathy: current management and experimental therapeutic targets. Pharmacotherapy, 2009; 29:182–192.
2.
PhippsJA, FletcherEA, VingrysAJ. Paired-flash identification of rod and cone dysfunction in the diabetic rat. Invest Ophthalmol Vis Sci, 2004; 45:4592–4600.
3.
HancockHA, KraftTW. Oscillatory potential analysis and ERGs of normal and diabetic rats. Invest Ophthalmol Vis Sci, 2004; 45:1002–1008.
4.
StittAW, LiYM, GardinerTA, BucalaR, ArcherDB, VlassaraH. Advanced glycation end products (AGEs) co-localize with AGE receptors in the retinal vasculature of diabetic and of AGE-infused rats. Am J Pathol, 1997; 150:523–531.
5.
StittAW. The role of advanced glycation in the pathogenesis of diabetic retinopathy. Exp Mol Pathol, 2003; 75:95–108.
6.
Madsen-BouterseSA, KowluruRA. Oxidative stress and diabetic retinopathy: pathophysiological mechanisms and treatment perspectives. Rev Endocr Metab Disord, 2008; 9:315–327.
GohS-Y, CooperME. The role of advanced glycation end products in progression and complications of diabetes. J Clin Endocrinol Metab, 2008; 93:1143–1152.
WhitingPH, KalansooriyaA, HolbrookI, HaddadF, JenningsPE. The relationship between chronic glycaemic control and oxidative stress in type 2 diabetes mellitus. Br J Biomed Sci, 2008; 65:1–4.
LinJ, BierhausA, BugertP, DietrichN, FengY, Vom HagenF, NawrothP, BrownleeM, HammesHP. Effect of R-alpha-lipoic acid on experimental diabetic retinopathy. Diabetologia, 2006; 49:1089–1096.
13.
IorioEL, CarratelliM, D'AmicantonioT. Oxidative stress and diseases. ADI Magazine, 2006; 4:399–404.
14.
IorioEL, CinquantaL, PisanoRA. Diagnostic algorithm to manage oxidative stress. Aust J Cosmet Surg, 2006; 2:26–30.
15.
GarelnabiMO, BrownWV, LeNA. Evaluation of a novel colorimetric assay for free oxygen radicals as marker of oxidative stress. Clin Biochem, 2008; 41:1250–1254.
YaoD, VlessidisAG, EvmiridisNP. Monitoring reactive oxygen species in vivo using microdialysis sampling and chemiluminescence detection as an alternative global method for determination of total antioxidant capacity. Anal Chim Acta, 2002; 467:133–144.
HafforAS. Obstructive sleep apnea in elevated cardiac output patients: hypercapnea-induced hypoapnea. J Med Sci, 2004; 4:170–175.
20.
HafforAS, Al-JohanyAM. Effect of heat stress, hypoxia, hypoxia-hyperoxia on free radical production in mice, Mus musculus. J Med Sci, 2005; 5:89–94.
21.
MarmorMF, FultonAB, HolderGE, MiyakeY, BrigellM, BachM. Standard for clinical electroretinography (2008 update)Doc Ophthalmol, 2009; 118:69–77.
22.
KeoghRJ, DunlopME, LarkinsRG. Effect of inhibition of aldose reductase on glucose flux diacylglycerol formation, protein kinase C, and phospholipase A2 activation. Metabolism, 1997; 46:41–47.
23.
DegenhardtTP, ThorpeSR, BaynesJW. Chemical modification of proteins by methylglyoxal. Cell Mol Biol, 1998; 44:1139–1145.
24.
YamagishiS, UedaS, MatsuiT, NakamuraK, OkudaS. Role of advanced glycation end products (AGEs) and oxidative stress in diabetic retinopathy. Curr Pharmacol Des, 2008; 14:962–968.
25.
RussellJW, GolovoyD, VincentAM, MahendruP, OlzmannJA, MentzerA, FeldmanEL. High glucose-induced oxidative stress and mitochondrial dysfunction in neurons. FASEB J, 2002; 16:1738–1748.
26.
MohammadG, KowluruRA. Matrix metalloproteinase-2 in the development of diabetic retinopathy and mitochondrial dysfunction. Lab Invest, 2010; 90:1365–1372.
27.
EngermanRL, KernTS. Progression of incipient diabetic retinopathy during good glycemic control. Diabetes, 1987; 36:808–812.
28.
YamagishiS, TakeuchiM, InagakiY, NakamuraK, ImaizumiT. Role of advanced glycation end products (AGEs) and their receptor (RAGE) in the pathogenesis of diabetic microangiopathy. Int J Clin Pharmacol Res, 2003; 23:129–134.
29.
Adamiec-MroczekJ, Oficjalska-MlynczakJ. Assessment of selected adhesion molecule and proinflammatory cytokine levels in the vitreous body of patients with type 2 diabetes—role of the inflammatory-immune process in the pathogenesis of proliferative diabetic retinopathy. Graefes Arch Clin Exp Ophthalmol, 2008; 246:1665–1670.
30.
Lopes de JesusCC, AtallahAN, ValenteO, Moça TrevisaniVF. Vitamin C and superoxide dismutase (SOD) for diabetic retinopathy. Cochrane Database Syst Rev, 2008; 1:CD006695.
31.
ToshihikoO, YojiK. Protective role of antioxidative food factors in oxidative stress caused by hyperglycemia. Ann N Y Acad Sci, 2006; 1043:440–451.
32.
ArdenGB, HamiltonAM, Wilson-HoltJ, RyanS, YudkinJS, KurtzA. Pattern electroretinograms become abnormal when background diabetic retinopathy deteriorates to a preproliferative stage: possible use as a screening test. Br J Ophthalmol, 1986; 70:330–335.
33.
LuuCD, SzentalJA, LeeSY, LavanyaR, WongTY. Correlation between retinal oscillatory potentials and retinal vascular caliber in type 2 diabetes. Invest Ophthalmol Vis Sci, 2010; 51:482–486.
34.
KawasakiK. [Preretinopathic changes in the oscillatory potential in diabetic retina: interpretation and significance]Nihon Ganka Gak Zasshi, 1998; 102:813–836.
35.
TyrbergM, PonjavicV, Lövestam-AdrianM. Multifocal electroretinogram (mfERG) in patients with diabetes mellitus and an enlarged foveal avascular zone (FAZ)Doc Ophthalmol, 2008; 117:185–189.
