Circulating antipericyte autoantibodies: a novel modifier of risk of progression of diabetic retinopathy?
BACKGROUND
Antipericyte autoantibodies (APAAs) are present in high frequency among diabetic subjects with and without nonproliferative retinopathy. This study aimed to determine whether progression of retinopathy in type 2 diabetes was associated with the same medical risk factors in APAA-positive subjects as in APAA-negative subjects.


METHODS
Type 2 diabetic patients with nonproliferative diabetic retinopathy at baseline were followed prospectively for 2 years monitoring progression of retinopathy. Thirty-eight (21.7%) of 175 patients had progression in Early Treatment Diabetic Retinopathy Study grade by > or =2 steps in at least 1 eye. Serum APAAs were detected by immunofluorescence on tissue-cultured bovine retinal pericytes.


RESULTS
Progression of retinopathy was associated with HbA(1c) level (P = 0.002), diabetes duration (P = 0.03), and albumin/creatinine ratio (P = 0.02) in APAA-negative subjects but not in APAA-positive subjects. The association between progression and APAAs was strongest in the upper quartile for HbA(1c) level (>8.0%), where 71.4% of patients negative for APAAs had progression of retinopathy while only 24.1% of patients positive for APAAs had progression (P = 0.007).


CONCLUSIONS
The results suggest that APAA presence is a modifier of risk of progression of retinopathy due to hyperglycemia and that it could be useful as a biochemical marker of risk of progression of diabetic retinopathy in type 2 diabetic patients with poor metabolic control.
Nayak
Ramesh C
RC
University of Arizona College of Medicine, Tucson, Arizona 85724, USA. nayak01@comcast.net
Lynch
Kristian
K
Gustavsson
Carin
C
Kwok
Michael G K
MG
Farthing-Nayak
Pamela J
PJ
Agardh
Carl-David
CD
Agardh
Elisabet
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001323:Autoantibodies / Q000097:blood*; D002851:Chromatography, High Pressure Liquid; D003924:Diabetes Mellitus, Type 2 / Q000276:immunology*; D003930:Diabetic Retinopathy / Q000276:immunology*; D018450:Disease Progression; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D020286:Pericytes / Q000276:immunology*; D011446:Prospective Studies; D015861:Retinal Neovascularization / Q000276:immunology; D012307:Risk Factors
D001323:Autoantibodies; D006442:Glycated Hemoglobin