Dynamic cytokine profiles across the progression of Type 1 diabetes mellitus are associated with diabetic retinopathy development

Abstract

El estudio analizó 48 citocinas circulantes y alteraciones retinianas mediante OCT y OCTA en 74 pacientes con DM1 de distinta duración y 23 controles sanos. En las fases iniciales de la DM1 se observaron niveles elevados de citocinas proinflamatorias, especialmente IL-1β, TNF-α, IL-2Rα e IL-8. Algunas de estas alteraciones persistieron en fases posteriores y se asociaron con adelgazamiento retiniano, aumento de la zona avascular foveal y neovascularización. Los resultados sugieren que determinados perfiles de citocinas podrían actuar como biomarcadores precoces de retinopatía diabética y contribuir a su prevención y seguimiento.

Type 1 diabetes mellitus (T1DM) is an autoimmune disease characterized by chronic inflammation that contributes to diabetic complications such as diabetic retinopathy (DR). This cross-sectional observational study aimed to characterize circulating cytokine profiles across different stages of T1DM and assess their association with early retinal alterations. 74 individuals with T1DM were categorized according to disease duration: <3 months (A), ≥ 3 months to ≤ 1 year (B), ≥ 1 to < 5 years (C) ≥ 5 years (D). 23 subjects were included as healthy controls (H). 48 serum cytokines were quantified using a standardized human cytokine assay. Retinal morphology and vascular parameters were assessed through OCT and OCTA images. Early-staged patients (A) showed elevated concentrations of IL-1β, TNF-α, IL2-Ra and IL-8, compared to controls (H). IL-8 remained increased in group C, alongside with higher Eotaxin, IL-12(p70) and IL-17 and anti-inflammatory cytokines IL-4 and LIF. Retinal thinning and enlarged foveal avascular and neovascularization areas correlated with these cytokine patterns. Distinct inflammatory cytokine profiles characterize T1DM progression and correlate with early events-associated to DR indicators, supporting their potential as immunological biomarkers and aiding in the prevention and management of T1DM and its specific complications such as DR.