title: Effects of soluble CD14 and cytokine levels on diabetic macular edema and visual acuity.
abstract: OBJECTIVE
  The pathogenesis of diabetic retinopathy has been suggested to be associated with ocular inflammation. Macrophages and monocytes that infiltrate the eye are known to express CD14. After shedding from the membrane-bound CD14, soluble CD14 (sCD14) is released, which could potentially activate inflammatory signaling. In this study, the authors investigated ocular fluid and serum levels of vascular endothelial growth factor (VEGF), sCD14, and other inflammatory cytokines in patients with diabetic macular edema (DME). Furthermore, the authors determined any potential correlation between these factors and visual acuity.
  
  
  METHODS
  Vitreous fluid, aqueous humor, and serum samples from 14 eyes with DME and 24 control eyes were investigated. Soluble CD14, interleukin 8, interferon-inducible protein 10, monocyte chemotactic protein 1, monokine induced by interferon γ, and VEGF were measured simultaneously by FACSCalibur flow cytometer. Visual acuity was measured in all patients with DME before surgery, with the assessors being blinded to the patients' diagnoses.
  
  
  RESULTS
  All factors were significantly elevated in vitreous fluid of DME eyes. Soluble CD14 and VEGF levels in vitreous fluid and aqueous humor were significantly higher in patients with DME than in nondiabetic controls (P < 0.05). In patients with DME, vitreous and aqueous humor concentrations of sCD14 correlated significantly. In these patients, vitreous fluid concentration of sCD14 correlated significantly with that of VEGF or interleukin 8 or monocyte chemotactic protein 1. In addition, there was a significant positive correlation between preoperative visual acuity and intraocular sCD14 concentrations.
  
  
  CONCLUSIONS
  Soluble CD14 may act as key regulator of VEGF production and contribute to the pathogenesis of diabetic retinopathy.
authors.affiliation: Department of Ophthalmology, Tokyo Medical University, Tokyo, Japan. kazuhikouma@me.com
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Umazume
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Usui
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Wakabayashi
authors.forename: Yoko
authors.initials: Y
authors.lastname: Okunuki
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kezuka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Goto
mesh_terms: D000368:Aged; D001082:Aqueous Humor / Q000378:metabolism / Q000382:microbiology; D015415:Biomarkers / Q000378:metabolism; D016207:Cytokines / Q000378:metabolism*; D003930:Diabetic Retinopathy / Q000150:complications / Q000378:metabolism*; D005260:Female; D006801:Humans; D018950:Lipopolysaccharide Receptors / Q000378:metabolism*; D008269:Macular Edema / Q000378:metabolism* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism*; D014792:Visual Acuity / Q000502:physiology; D014822:Vitreous Body / Q000378:metabolism
chemical_list: D015415:Biomarkers; D016207:Cytokines; D018950:Lipopolysaccharide Receptors; D042461:Vascular Endothelial Growth Factor A