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J Leukoc Biol. 2017 Oct;102(4):993-1001. doi: 10.1189/jlb.3RU0417-139. Epub 2017 Jul 19.

Is leukostasis a crucial step or epiphenomenon in the pathogenesis of diabetic retinopathy?

Author information

1
Department of Ophthalmology, Ocular Angiogenesis Group, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
2
Department of Medical Biology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; and.
3
Cellular Imaging Core Facility, Department of Medical Biology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
4
Department of Ophthalmology, Ocular Angiogenesis Group, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; r.schlingemann@amc.uva.nl.

Abstract

Leukostasis in the retinal microvasculature in animal model studies of diabetes is associated with the development of diabetes-like retinopathy. Therefore, it is generally assumed that adhesion of leukocytes is a central event inciting a chronic, low-grade form of inflammation that causes the vascular abnormalities that are specific for the early stages of diabetic retinopathy (DR), which culminate in diabetic macular edema, proliferative DR, and vision loss in humans. Here, we review the literature critically with respect to leukostasis and assess its pathologic consequences in the human diabetic retina. First, we review the pathologic processes that are known to be involved in the development of human DR. Then, we summarize experimental evidence for the role of leukostasis in the development of DR and the mechanisms involved in leukostasis in the retina. Based on our critical review, we conclude that leukostasis may be an epiphenomenon of the diabetic retinal milieu, rather than a crucial, specific step in the development of human DR.

KEYWORDS:

blood–retinal barrier; diabetic macula edema; inflammation

PMID:
28724696
DOI:
10.1189/jlb.3RU0417-139
[Indexed for MEDLINE]

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