Therapeutic approach in non‐proliferative diabetic retinopathy using antioxidant supplementation

• Published in: Acta ophthalmologica (Oxford, England) Vol. 100; no. S275
• Main Authors: Campos‐Borges, Helena Cristina, Pinazo‐Duran, Maria Dolores, Andres‐Blasco, Irene, Garcia‐Medina, Jose Javier, Zanon‐Moreno, Vicente, Gallego‐Martinez, Alex, Salgado‐Borges, Jose Manuel, Duarte, Lilianne, Prudêncio, Cristina
• Format: Journal Article
• Language: English
• Published: Malden Wiley Subscription Services, Inc 01.12.2022
• Subjects: Antioxidants; Diabetes mellitus; Diabetic retinopathy; Fatty acids; Matrix metalloproteinase; Metalloproteinase; Oxidants; Oxidative stress; Prophylaxis; Reactive oxygen species; Retinopathy; Signal transduction; Statistical analysis; Thiobarbituric acid; Vitamin B12
• ISSN: 1755-375X; 1755-3768
• DOI: 10.1111/j.1755-3768.2022.0218

Purpose: Overproduction of reactive oxygen species (ROS) leads to eye damage and causes effects of ROS signalling pathways. In this work, we evaluated oxidative stress (OS) biomarkers and the effects of a daily supplementation regimen containing antioxidants and essential fatty acids (A/ω3) in type 2 diabetic eyes (T2DM). Methods: This is a case–control study involving 480 participants, divided into 2 groups: (1) T2DM patients (n = 287) with (+)/without (−) non‐proliferative diabetic retinopathy (NPDR) and (2) controls (CG; n = 194)). Participants were randomly assigned to a daily pill of A/ω3. Patients were followed‐up for 38 months, allowing to outline patient characteristics, NPDR status, and classical and emerging blood parameters, including OS markers (candidate products and genes). Statistical analysis was performed using the SPSS 24.0 program. Results: Significantly higher levels of circulating pro‐oxidants (p = 0.001) and lower levels of antioxidants (p = 0.0001) were detected in patients with T2DM versus CG. Plasma malondialdehyde/thiobarbituric acid reactive species were significantly higher (MDA/TBARS; p = 0.006) and lower antioxidant load, based on the total antioxidant capacity of plasma (TAC; p = 0.042) and vitamins B12 (p = 0.05) and C (p = 020) levels were found inT2DM + NPDR versus T2DM‐NPDR. Overexpression of the matrix metalloproteinase‐9 (MMP‐9) gene was found in T2DM + NPDR versus T2DM‐NPDR and in GC (p = 0.021). It is important to note that the therapeutic regime with A/ω3 supplementation in all groups proved to be beneficial, particularly in the group of patients with diabetic retinopathy (DR). Conclusions: This study stresses the need for new strategies to increase the antioxidant load, as in the case of the A/ω3 supplementation regime, which can serve as a dietary prophylaxis and adjunctive intervention for better ophthalmic care in patients at risk of associated blindness to DR.