Role of studying the pathogenesis of retinopathy of prematurity in optimizing disease screening

Abstract

Background: The efficiency of treatment and prevention of retinopathy of prematurity (ROP) has improved. In addition, the development of a disease screening system to reduce the incidence of disability resulting from this pathology is important.

Aim: This study aimed to determine new laboratory criteria for screening and predicting the ROP course through in-depth investigation of the molecules participating in the pathogenesis of ROP.

Material and methods: A comprehensive clinical and experimental study was performed to assess the local and systemic levels of 49 cytokines with various biological effects, four monoamines, and angiotensin-II (AT-II) at different stages of the pathological process. In the clinical analysis, 165 preterm infants at risk of ROP development were examined. For the experimental part, the disease course of 145 Wistar infant rats in the developed model of experimental ROP was analyzed.

Results: Among cytokines, the seven most promising potential laboratory markers of ROP development and adverse course were as follows: MCP1 >95 pg/mL, IGF-II >140 pg/mL, TGFbeta1 <18000 pg/mL, and IGF-I <24 pg/mL in the blood serum of preterm infants before the first signs of ROP and VEGF-A >108 pg/mL, TGF-beta2 >100 pg/mL, and PDGF-BB >1800 pg/mL at ROP manifestation. Among monoamines, serotonin (<17.0 pg/mL) and L-DOPA indicated their prognostic value in the clinical and experimental settings. Moreover, a possible prognostic role of AT-II was found.

Conclusion: In this study, methods to improve the ROP screening system are outlined, but further work is necessary to assess the possibility of implementing the results in clinical practice

Keywords

retinopathy of prematurity / pathogenesis / screening

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