糖尿病網膜症のpigment epithelium-derived factorと血管内皮細胞増殖因子

Vitreous levels of pigment epithelium-derived factor and vascular endothelial growth factor in diabetic retinopathy

要約　糖尿病網膜症36眼につき，硝子体内のpigment epithelium-derived factor（PEDF）と血管内皮細胞増殖因子（VEGF）の濃度を測定した。症例の内訳は，増殖糖尿病網膜症32眼，非増殖糖尿病網膜症4眼であり，特発性黄斑円孔15眼を対照とした。PEDFとVEGFの濃度はELISAで測定した。対照群でPEDF値は1.62±0.23μg/ml，VEGF値は検出できなかった。増殖糖尿病網膜症のPEDFは平均0.84μg/mlと有意に低く（p＝0.017），VEGFは平均1,871pg/mlと有意に高かった（p＝0.026）。活動性が高い増殖糖尿病網膜症24眼のPEDFは平均0.76μg/mlとさらに低く，VEGFは平均2,341pg/mlとさらに高かった。PEDFには眼内血管新生阻害作用があるとされている。上記の結果は，高濃度のVEGFのみならず，低濃度のPEDFが網膜症の進展に関与している可能性を示している。

Abstract.　We measured the vitreous levels of pigment epithelium-derived factor（PEDF）and vascular endothelial growth factor（VEGF）in 36 eyes of diabetic retinopathy. The retinopathy was proliferative in 32 eyes and nonproliferative in 4 eyes. Another series of 15 eyes of idiopathic macular hole served as control. PEDF and VEGF were measured using an enzyme-linked immunosorbent assay（ELISA）. In the control group,PEDF averaged 1.62±0.23μg/ml and VEGF was undetectable. In proliferative diabetic retinopathy,PEDF averaged 0.84μg/ml which was significantly lower than in the control（p＝0.017）. VEGF averaged 1,871pg/ml which was significantly higher than in the control（p＝0.026）. In 24 eyes of active diabetic retinopathy,PEDF was decreased to an average of 0.76μg/ml and VEGF was increased to an average of 2,341pg/ml. PEDF has been claimed to be a potent inhibitor of intraocular angiogenesis. The present findings show that lower levels of PEDF as well as higher levels of VEGF may be involved in the progression of diabetic retinopathy.