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Diabetic retinopathy (DR) is a kind of common vascular complications in diabetes and one of the leading causes of irreversible blindness.It is characterized by leaky retinal vasculature, neovascularization and fiber membrane proliferation.Although there are various DR treatments, most of them aim at middle and late stage of the disease and have limited efficacy.Therefore, early diagnosis and precise treatment of DR are important.In recent years, the research of biomarkers related to DR has developed rapidly, which plays an important role in the risk assessment and early intervention of the disease.Nowadays, classic biomarkers such as HbA1c have been widely used in clinical practice.With the further study on DR, inflammatory biomarkers and angiogenesis-related biomarkers have been found to be closely related to the occurrence and development of the disease.At the same time, with the progress of modern technology, advanced equipment have built a broad platform for the exploration of DR biomarkers.Omics biomarkers, imaging biomarkers and artificial intelligence have become the focus of research and made important contributions to the early treatment of DR.This article summarized the key progress related to the DR biomarkers research to provide new clinical strategies in the efficient prevention, control and treatment of DR.
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Objective:To investigate the protein expression changes of human umbilical cord mesenchymal stem cells (hUCMSCs) modified with pigment epithelium-derived factor ( PEDF) gene mediated by lentivirus. Methods:The hUCMSCs were divided into the control group and experimental group.Cells in the control group were normal hUCMSCs and the cells in experimental group were hUCMSCs with PEDF modification.The proteins from the two groups were collected and processed by FASP method.Samples were fractionated by liquid chromatography and analyzed by tandem mass spectrometry, and SWATH mode was applied.Differential protein analysis, Gene Ontology (GO) analysis and Reactome pathway enrichment analysis were performed. Results:A total of 5 361 quantified proteins were detected in this experiment, of which 432 proteins were differentially expressed (fold change>1.5, P<0.05). There were 219 of the 432 proteins up-regulated, including serpin family F member 1 (SERPINF1) (PEDF), DEAD-box helicase 59 (DDX59) and thrombospondin 1 (THBS1), etc., whereas 213 proteins were down-regulated, including collagen type Ⅰ alpha 1 (COL1A1), COL18A1, etc.GO analysis indicated that the differential proteins were mainly involved in fibrinolysis, extracellular structure organization, regulation of transporter activity, biosynthetic process of secondary alcohol and cholesterol, coenzyme metabolic process and regulation of peptidase activity, etc.Reactome pathway analysis showed that the differential proteins were mostly involved in regulation of insulin like growth factor (IGF) transport and uptake by IGF binding protein, post-translational protein phosphorylation, extracellular matrix organization, metabolism of steroids. Conclusions:After gene modification with PEDF mediated by lentivirus, the expression of many proteins in hUCMSCs were changed. PEDF gene modification can alter the structure of extracellular matrix and regulate the expression of proteins associated with cell proliferation, self-renewal and multipotency.
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INTRODUCTION@#Patients with chronic diseases face difficulties when navigating the healthcare system. Using the Healthcare System Hassles Questionnaire (HSHQ) developed by Parchman et al, this study aimed to explore the degree of hassles faced by patients in primary care in Singapore and identify the characteristics associated with greater hassles.@*METHODS@#A cross-sectional study was conducted on patients with chronic diseases at Hougang Polyclinic, Singapore, using the interviewer-administered HSHQ. The mean HSHQ score was compared with that reported by Parchman et al. The associations between the number of chronic diseases, demographic variables and healthcare hassles were assessed using multivariate linear logistic regression analysis.@*RESULTS@#In total, 217 outpatients aged 21 years and above were enrolled. Their overall mean HSHQ score (4.77 ± 6.18) was significantly lower than that of patients in the study by Parchman et al (15.94 ± 14.23, p < 0.001). Patients with five or more chronic diseases scored 3.38 (95% confidence interval [CI] 0.11-6.65, p = 0.043) points higher than those with one chronic disease did. With each increasing year of age, the mean HSHQ score decreased by 0.17 (95% CI -0.26 to -0.08, p = 0.001) points. Patients with polytechnic/diploma/university education and higher scored 2.65 (95% CI 0.19-5.11, p = 0.035) points higher than those with primary education and lower did.@*CONCLUSION@#Patients in our population reported less hassles than those in the study by Parchman et al did. Increasing age and lower education level were associated with less hassles. Further analysis of the types of chronic diseases may yield new information about the association of healthcare hassles with the number and types of chronic diseases.