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Insight into macular oedema treatment

Often, treatment against disease can be empirical. However, understanding the mode of action is central to improving efficacy and overcoming potential side effects.
Insight into macular oedema treatment
One of the complications of diabetes is retinopathy, a condition leading to macular swelling or oedema and vision loss. Glucocorticoids reduce macular oedema but their mechanism of action is unknown and can also have severe side effects, including cataract and glaucoma.

The primary objective of the EU-funded GLUCOMINERALORET (The gluco- and mineralo-corticoid pathways in retina: Molecular characterisation and therapeutic implication) project was to fill the gaps in fundamental knowledge of the glucocorticoid system and in diabetic macular oedema (DME) physiopathology. In this context, researchers investigated how diabetes can induce retinal deregulation and how it contributes to oedema. In addition, they set out to identify potential targets for DME treatment.

To identify the glucocorticoid cofactors and the dynamics of their interactions, researchers performed proteomic and genomic analyses on rat retina following in vivo administration of corticosterone. They compared their results with those obtained from rat models of early- and late-stage diabetes.

The analyses led to the identification of several protein and gene players and allowed researchers to establish a list of new potential therapeutic targets. Of particular interest were the molecules implicated in aqueous and ionic flows as they could explain the rapid effects of glucocorticoid treatment in patients with DME. In addition, they worked to improve on the side effects of glucocorticoids by highlighting the genes causing glaucoma or cataract.

Overall, the GLUCOMINERALORET study provided important molecular insight into the mode of action of glucocorticoids in reducing oedema. More importantly, it potentiated the therapeutic efficacy of glucocorticoids against DME.

Related information


Macular oedema, diabetes, retinopathy, glucocorticoids, cataract, glaucoma
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