PLATELETS IN VITRO STUDY: NON-PROLIFERATIVE DIABETIC RETINOPATHY LABORATORY PROGRESSION PARAMETERS SEARCH
The causes of various microcirculatory disorders in diabetes mellitus (DM) are still under investigation.
Objective: to explore the features of platelet reactivity (Pl) in vitro with the progression of non-proliferative diabetic retinopathy (DR).
Material and methods. The study was prospective in nature and included 31 patients (31 eyes) with type 2 diabetes, in which, according to the results of clinical, instrumental examination and ETDRS classifi cation (19 patients, 19 eyes) with mild and (12 patients, 12 eyes) with moderate non-proliferative DR was detected. Ophthalmological examination was performed before treatment and included: anamnesis collection, visometry, pneumo-tonometry, auto kerato-refractometry, anterior segment slit-lamp exam, retinoscopy, using wide-angle lenses, optical coherence tomography, retinal photography. Platelets were isolated by centrifugation of peripheral blood citrate. To activate platelets agonists involved in the pathogenesis of diabetes the following was used: adenosine diphosphate, epinephrine, angiotensin-2, platelet activating factor and collagen. Platelet aggregation was analyzed on the ChronoLog (USA) spectrophotometer.
Results. Visual acuity decreases, retinal thickness and macular retinal volume in the central zone increases due to decompensation of type 2 diabetes and non-proliferative DR progression. Prothrombogenous phenotype of platelets with dominant functional activity of α2 adrenergic receptors is a characteristic for patients with non-proliferative DR. Moreover, in patients with mild non-proliferative DR two major Pl receptors’ clusters, which coincide for high α2-adrenergic and angiotensin receptor antagonists receptors activity, but differ in response to collagen (p <0.001) are revealed. There are two other platelet clusters, which differ in activity of angiotensin receptor antagonists and PAF receptor (p <0.001) in patients with moderate non-proliferative DR.
Conclusion. Recognition of differences of activity platelet clusters (receptor clustering) in the mild and moderate stages of non-proliferative DR has some practical value in the context of fi nding informative laboratory parameters of disease progression.
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