Purpose: The aim of this study was to determine the association between nucleotide-binding and oligomerization domain (NOD)-like receptors (NLRs) family, pyrin domain-containing 3 (NLRP3) inflammasome-induced inflammation and disease severity in diabetic retinopathy (DR). Methods: Blood samples were collected from 64 patients with diabetes (DR, 43; without DR, 21) and 25 healthy controls. The protein and mRNA expression levels of NLRP3 inflammasomes in peripheral blood mononuclear cells were determined using western blotting and quantitative real-time reverse transcription-PCR. A total of 82 vitreous samples were obtained from patients with DR (n = 60) and nondiabetic controls (n = 22). All patients were candidates for vitrectomy. Interleukin (IL)-1β and IL-18 in the peripheral blood mononuclear cell culture medium and vitreous fluid were detected by enzyme-linked immunosorbent assay (ELISA). Immunofluorescence staining for apoptosis-associated speck-like protein with a caspase recruitment domain (ASC) and NLRP3 was performed in fibrovascular membranes from 21 proliferative DR patients and 22 controls with idiopathic epiretinal membranes. Results: We observed increased gene and protein expression of NLRP3, ASC, and caspase-1 in peripheral blood mononuclear cells of adults with DR compared with that in normal controls. Furthermore, the elevated expressions of NLRP3 and ASC were observed in the fibrovascular membranes from 21 adults with proliferative DR when compared with the 22 controls. IL-1β and IL-18 in the peripheral blood mononuclear cells and vitreous fluid were elevated in the DR patients when compared with controls. Conclusions: These outcomes suggested that NLRP3 inflammasomes are upregulated in adults with DR and may play a key role in the pathogenesis and progression of DR.

With the high prevalence of type 2 diabetes, diabetic retinopathy (DR) has become a leading health problem worldwide. The pathogenesis of DR is complex and several vascular, inflammatory, and neuronal mechanisms are involved. The purpose of this study was to assess the levels of immune and inflammatory biomarkers in the aqueous humor of patients with different severities of DR and to analyze the correlations between Interleukin-6 (IL-6) and these biomarkers, and between IL-6 and the severity of the disease. Aqueous humor samples were obtained from 51 non-diabetic patients and 151 diabetic patients. Levels of 45 different cytokines, chemokines, and growth factors were measured using a multiplex bead immunoassay. IL-6, IL-8, Inducible Protein-10 (IP-10), leukemia inhibitory factor (LIF), hepatocyte growth factor (HGF) and vascular endothelial growth factor (VEGF)-A were significantly higher (p < 0.05) in the aqueous humor of the DR patients compared to the non-diabetic patients, while the concentrations of IL-1α, IL-4, IL-9, IL-21, IL-23, IL-27, IL-31, RANTES, interferon-α, growth regulated oncogene (GRO), and tumor necrosis factor (TNF)-α were significantly lower (p < 0.05) in the DR patients. The IL-6 levels increased as the severity of DR increased. In addition, the IL-6 level positively correlated with the IL-8, HGF and LIF levels, while negatively with the IL-31and GRO levels. These findings suggest that inflammation and immune response may contribute to the pathogenesis of DR, and these biomarkers may potentially be new therapeutic targets for DR.

Objective: To quantify T helper (Th)17 cells and determine interleukin (IL)-17A levels in peripheral blood mononuclear cell (PBMC) culture and vitreous fluid from patients with type 2 diabetes mellitus (T2DM) with diabetic retinopathy (DR). Methods: Th17 cell frequency and IL-17A concentrations in PBMCs from 60 patients with T2DM with DR, 30 without DR and 30 sex- and age-matched healthy individuals were measured by flow cytometry and enzyme-linked immunosorbent assay (ELISA), respectively. IL-17A levels in vitreous fluid from 31 eyes with proliferative DR and diabetic macular oedema (DR group) and 32 eyes with an epiretinal membrane and macular hole (control group) that underwent vitrectomy were also examined by ELISA. Results: Compared with the control group, the proportion of Th17 cells and IL-17A concentrations in PBMCs were significantly increased in patients without DR but decreased in those with DR. IL-17A concentrations and Th17 cell frequency in PBMCs tended to decrease with DR severity and were negatively correlated with body mass index, T2DM duration and glycated haemoglobin. Additionally, vitreous fluid IL-17A levels were significantly elevated in patients with DR compared with those of the control group. Conclusions: We conclude that disturbances in Th17 cells and IL-17A levels are possibly associated with DR.