Significance of assessing the inflammatory markers of vascular wall activation in age-related macular degeneration

Among the numerous pathogenetic factors of age-related macular degeneration (AMD), special attention has been recently paid to endothelial dysfunction (ED), since the vascular endothelium is an important internal component of the the hematoretinal barrier (IBRB) providing immunological homeostasis of the retina. The study of inflammatory endothelial activation markers seems relevant in terms of understanding the mechanisms of disease development, potentially contributing to the development of pathogenetic therapy at early and intermediate stages of AMD as well as secondary prevention of its complications. The aim of the present: study was to determine sICAM-1, sVCAM-1, sE-selectin, sP-selectin and MCP-1/CCL2 in blood serum (BS) and tear fluid (TF) of patients with initial (AREDS2) and intermediate (AREDS3) stages of AMD. The study was performed by flow cytometry (CBA) with BD FACS Canto II flow cytometer, USA), using a diagnostic panel based on compatible simplex Flow Cytomix^TM test systems (Bender Med System GmbH, Germany) to determine sICAM-1, sVCAM-1, sE-selectin, sP-selectin and MCP-1/CCL2 thus allowing their simultaneous detection followed by data processing in the FlowCytomix Pro v. 6.0 package (BenderMed Systems GmbH, Germany). We have revealed a tendency to increased serum sVCAM-1 in the AREDS3 group compared to the reference values. When studying tear fluid in the AREDS2 group, a significant increase in MCP-1, sE-selectin concentrations was found (p < 0.05), along with a tendency to increased local production of sICAM-1 and sP-selectin (p = 0.05) against normal levels. Significant shifts in the AREDS3 group concerned three 3 factors in tear fluid, i.e., sICAM-1, sE-selectin and sP-selectin, that exceeded control levels by 2.5, 5 and 2 times, respectively (p < 0.05). The obtained data are important because they presume a role of sICAM-1, sVCAM-1, sE-selectin, sP-selectin, MCP-1/CCL2 in pathogenesis of the disorder and allows us to suggest a compromised state of blood retinal barrier, thus requiring supplementation of AMD therapy with angioprotectives, antiinflammatory drugs, and needs further studies.

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