Hypoglycemia accelerates the breakdown of the blood-retinal barrier. Science Translational Medicine published a study showing that it can hasten this breakdown.
The blood-retinal barrier is a physiological structure that maintains visual function by regulating the homeostasis of the microenvironment within the retina. Similar to the well-known blood-brain barrier, it prevents harmful chemicals, large molecules, bacteria, and inflammatory cells from entering the retinal tissue.
The researchers found that during hypoglycemia, a specific protein known as hypoxia-inducible factor (HIF) accumulates in certain retinal cells. To investigate the role of HIF, the researchers induced hypoglycemia in mice both with and without diabetes.
The experiment showed that diabetic mice had elevated HIF levels during hypoglycemia, which led to retinal vascular leakage and expedited the breakdown of the blood-retinal barrier. In contrast, non-diabetic mice did not show increased HIF levels.
The researchers further tested an experimental drug called 32- 134D, which inhibits the HIF protein. According to the researchers, HIF levels were reduced in diabetic mice that received injections of 32- 134D before hypoglycemia induction. This prevented vascular leakage and the breakdown of the blood-retinal barrier.
“The study may help explain why diabetic patients who are just starting on strict blood sugar control, a cornerstone of diabetes management, may experience worsening of diabetic eye disease,” stressed corresponding author Professor Akrit Sodhi.
He added that the study specifically demonstrated that treatments targeting HIF could help treat or prevent diabetic retinopathy.
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