The APOE4 allele is associated with a decreased risk of retinopathy in type 2 diabetics.

BACKGROUND: Common polymorphisms within the apolipoprotein E (APOE) gene are suggested to be associated with the development of type 2 diabetes mellitus (T2DM), but the potential association with T2DM complications (nephropathy, neuropathy and retinopathy) remains unclear. We perform the case-control study to analyse the association between the APOE polymorphism and risk of T2DM and to analysed the potential relationship between the APOE and T2DM complications. METHODS AND RESULTS: APOE variants (rs429358 and rs7412) were genotyped by TaqMan assay in T2DM patients (N = 1274; N = 829 with complications including retinopathy, neuropathy and nephropathy status) and with PCR-RFLP in healthy nondiabetic controls (N = 2055). The comparison of subjects with genotypes associated with low plasma cholesterol (APOE2/E2 and APOE2/E3 carriers vs. others) did not show an association with T2DM (OR [95% CI] = 0.88 [0.71-1.08). The differences remained insignificant after adjusting for diabetes duration, sex and BMI. Carriers of at least one APOE4 allele (rs429358) are protected against T2DM related retinopathy (OR [95% CI] = 0.65 [0.42-0.99]. Protection against retinopathy is driven mostly by females (OR [95% CI] = 0.50 [0.25-0.99]); and remains significant (P = 0.044) after adjustment for diabetes duration and BMI. CONCLUSION: Common APOE polymorphism was not associated with T2DM in the Czech population. Yet, APOE4 allele revealed an association with retinopathy. In particular, female T2DM patients with at least one APOE4 allele exhibit lower prevalence of retinopathy in our study subjects.

Early worsening of diabetic retinopathy after simultaneous pancreas and kidney transplantation-Myth or reality?

Early worsening of diabetic retinopathy due to sudden glucose normalization is a feared complication of pancreas transplantation; however, its rate or severity has not been studied prospectively. We followed up 43 pancreas and kidney recipients for a composite endpoint comprising new need for laser therapy, newly diagnosed proliferation, macular edema, visual acuity worsening, and blindness over 12 months. Although 37% of patients met this primary endpoint, its severity was rather low. Mean central retinal thickness and proportion of patients with subclinical macular edema increased significantly, with spontaneous resolution in half of them. Visual acuity did not change. There was no significant difference in the absolute glycated hemoglobin (HbA1c) drop, age, and diabetes duration between the patients who met and those who did not meet the primary endpoint, but a higher proportion of patients with worsening had a recent history of laser treatment. Retinopathy remained stable in 62.8% of patients. In 26%, the visual acuity significantly improved. Although retinopathy worsening was documented in more than one-third of patients, its evolution was not related to the magnitude of metabolic change; rather, it corresponded to the expected natural course of retinopathy. Nonetheless, comprehensive ophthalmologic care should be a substantial component of the recipient management.

Micronization of Ibuprofen Particles Using Supercritical Fluid Technology.

Most of drugs are only slightly soluble in the circulatory system of the human body. This reduces the efficiency of their use and that is why new ways how to increase their solubility are investigated. One way to improve the solubility of the drug is to reduce its particle size. Conventional techniques such as crushing or grinding usually do not guarantee a narrow particle size distribution, which is required for pharmaceuticals. Application of supercritical fluids, especially of supercritical CO2, seems to be convenient method for the preparation of pharmaceuticals submicron particles or nanoparticles. The method enables the preparation of particles in a narrow size distribution and at the same time it does not leave any unwanted residues of solvents or other chemicals. The aim of this work is the micronization of ibuprofen particles using the supercritical fluid and characterization of formed products. The micronization of the particles was done using commercially available device Spe-ed SFE-4 in rapid expansion of supercritical solution mode. The applied temperatures and pressures were 308.15 K and 313.15 K and 200, 250 and 300 bar. The prepared particles were characterized using methods of X-ray diffraction, infrared spectroscopy, particle size distribution, scanning electron microscopy and tests of dissolution and permeability. Mean particles size was reduced from 180 µm (original ibuprofen) to 2.8-7.3 µm of the processed samples. The dissolution test confirmed better solubility and the permeability of newly formed particles improved.

[History of diagnosis and therapy of diabetic retinopathy]. / Historie diagnostiky a lécby diabetické retinopatie.

The article surveys the fascinating historical milestones of the diagnosis of diabetic retinopathy. In the context of the discovery then it represents some of the famous characters of ophthalmology and documents the evolution of diagnostics, conservative treatment, as well as laser and surgical therapy for this serious diseaseKey words: diabetic retinopathy - history - therapy.