NEW YORK (Reuters Health) Apr 12 – Breakdown of the blood-retinal barrier causes the transient worsening of retinopathy associated with intensive insulin therapy. Investigators now report that the inhibition of vascular-endothelial growth factor (VEGF) expression may offer a therapeutic option for preventing further vision loss when patients begin intensive glucose control.
Using human retinal pigment epithelial (RPE) cells, Dr. Anthony P. Adamis, of the Massachusetts Eye and Ear Infirmary in Boston, and colleagues found that, while both hyperglycemia and insulin upregulate VEGF, they do so through different signaling pathways. Insulin, but not hyperglycemia, upregulates hypoxia-inducible factor-1-alpha (HIF-1-alpha), they report in the March issue of the Journal of Clinical Investigation.

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