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Pro-permeability Factors in Diabetic Macular Edema; the Diabetic Macular Edema Treated With Ozurdex Trial.
Campochiaro, PA, Hafiz, G, Mir, TA, Scott, AW, Zimmer-Galler, I, Shah, SM, Wenick, AS, Brady, CJ, Han, I, He, L, et al
American journal of ophthalmology. 2016;:13-23
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Abstract
PURPOSE The Diabetic Macular Edema Treated with Ozurdex (DMEO) Trial measured aqueous pro-permeability factors (PPFs) in diabetic macular edema (DME) patients before and after injection of dexamethasone implant or vascular endothelial growth factor (VEGF)-neutralizing protein and correlated changes in levels with changes in excess foveal thickness (EFT) to identify potential PPFs contributing to DME. DESIGN Prospective, randomized crossover clinical trial. METHODS Twenty DME patients randomized to dexamethasone implant or VEGF-neutralizing protein had aqueous taps and spectral-domain optical coherence tomography (SDOCT) at baseline and every 4 weeks for 28 weeks. Aqueous levels of 55 vasoactive proteins were measured with protein array. Crossover at week 16 provided changes in protein levels after each intervention in all 20 patients. RESULTS After dexamethasone implant there was significant correlation between changes in levels of 13 vasoactive proteins with changes in EFT, including 3 known PPFs: angiopoietin-2 (r = 0.40, P = .001), hepatocyte growth factor (HGF; r = 0.31, P = .02), and endocrine gland-VEGF (EG-VEGF, r = 0.43, P < .001). Reduction of prolactin, insulin-like growth factor binding protein-3, and matrix metalloproteinase-9 correlated with edema reduction after injection of a VEGF-neutralizing protein as well as dexamethasone implant, suggesting their modulation is likely secondary to changes in edema rather than causative. CONCLUSIONS Correlation of edema reduction with reduction in the PPFs angiopoietin-2, HGF, and EG-VEGF provides potential insight into the multifactorial molecular mechanism by which dexamethasone implants reduce edema and suggest that additional study is needed to investigate the contributions of these 3 factors to chronic DME.
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[Effects of Xianling Gubao capsules for the treatment of bone loss induced by glucocorticoid].
Wu, JJ, Wen, LP, Wu, YG, Shen, Q, Han, Y
Zhongguo gu shang = China journal of orthopaedics and traumatology. 2009;(3):193-5
Abstract
OBJECTIVE To study the clinical effects of Xianling Gubao capsules for the treatment of glucocorticoid-induced osteoporosis. METHODS From 2005.6 to 2007.8, 50 patients with primary glomerulonephritis treated with glucocorticoids were divided into two groups randomly. The treatment group were dealed with Xianling Gubao capsules and the control group with calcitriol and Caltrate D 600. TCM Synrdome integral before and after treatment were estimated. And the bone mineral density (BMD) of lumbar spine and femoral neek was measured by dual-energy X-ray absorptionm etry (DEXA). Osteo-calcin, intact parathyroidhormone (IPTH), urine excretion of calcium and phosphorus, serum calcium and phosphorus were detected before and after treatment, and adverse effects were investigated too. RESULTS TCM Synrdome integral in two groups decresed apparently (P<0.05), which decresed more apparently in the treatment group than that in control group (P<0.05). BMD of lumbar spine and femoral neek increased in two groups (P<0.05), but there were no statistical deferences between them (P>0.05). Serum osteocalcin after treatment reduced significantly in two groups (P<0.05) compared with pre-treatment,but there were no statistical deferences between the treatment and the control group (P>0.05). In the control group, serum calcium after treatment increased significantly (P<0.05), but there were no statistical deferences compared with the treatment group (P>0.05). There were no statistical deferences in intact parathyroidhormone, urine excretion of calcium and phosphorus, serum phosphorus in the treatment and the control group before and after therapy. CONCLUSION Both the treatment group and the control group have clinical effects in prevention and treatment of GC-induced osteoporosis, but the treatment group has more remarkable therapeutic effect and less adverse effects.