The Relationship between M1/M2 Macrophage Expression and the Severity of Diabetes Retinopathy

Nan HUO; Junbo ZHAO; Min WANG; Weiqiao AN; Cui CUI

doi:10.12259/j.issn.2095-610X.S20251113

Volume 46 Issue 11

Nov. 2025

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Nan HUO, Junbo ZHAO, Min WANG, Weiqiao AN, Cui CUI. The Relationship between M1/M2 Macrophage Expression and the Severity of Diabetes Retinopathy[J]. Journal of Kunming Medical University, 2025, 46(11): 100-106. doi: 10.12259/j.issn.2095-610X.S20251113

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Nan HUO, Junbo ZHAO, Min WANG, Weiqiao AN, Cui CUI. The Relationship between M1/M2 Macrophage Expression and the Severity of Diabetes Retinopathy[J]. Journal of Kunming Medical University, 2025, 46(11): 100-106. doi: 10.12259/j.issn.2095-610X.S20251113

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The Relationship between M1/M2 Macrophage Expression and the Severity of Diabetes Retinopathy

doi: 10.12259/j.issn.2095-610X.S20251113

1.
Department of Ophthalmology
2.
Department of Infectious Diseases
3.
Department of Geriatrics，Handan Central Hospital，Handan Hebei 056001，China

Received Date: 2025-04-16
Available Online: 2025-12-04
Publish Date: 2025-11-25

Abstract

Abstract

Objective To explore the relationship between the M1/M2 macrophages and severity of diabetic retinopathy （DR）. Methods This retrospective study included 42 patients with or without DR who had type 2 diabetes mellitus （T2DM） and 19 healthy individuals undergoing cataract intraocular surgery without systemic or ocular diseases from Handan Central Hospital between April 2022 and November 2023. Patients with T2DM were divided into three groups: diabetes mellitus with non-dominant diabetic retinopathy （T2DM non-DR group, n = 20）, mild and moderate non-proliferative diabetic retinopathy （NPDR）（n = 10） and severe NPDR/ proliferative diabetic retinopathy （PDR）（n = 12）. Peripheral blood and aqueous humor were obtained at surgery initiation. The levels of VEGF-A, IL-8, Elafin and TGF-β in the samples were analyzed using kits, and the ratio of M1 macrophages to M2 macrophages was analyzed by flow cytometry. Results Among patients with T2DM, there were significant differences in the duration of diabetes, insulin and metformin use among the three groups （P < 0.05）. Aqueous humor levels of VEGF-A, IL-8, Elafin, M1 ratio, M2 ratio and TGF-β of each group were significantly different （F = 17.40, 9.492, 4.792, 11.32, 5.768 and 20.38, all P < 0.01）. The levels of VEGF-A, IL-8, Elafin, M1 ratio, VD86 and TGF-β in severe NPDR/PDR group were significantly higher than those in healthy control group and T2DM non-DR group （P < 0.05）, and the levels of VEGF-A, IL-8 and Elafin in severe NPDR/PDR group were significantly higher than those in mild and moderate NPDR group （P < 0.05）. The levels of M1 proportion and TGF-β in aqueous humor of the mild to moderate NPDR group were significantly higher than those in healthy control group and T2DM non-DR group （P < 0.05）. The level of M1 in aqueous humor was positively correlated with the levels of M2, Elafin, TGF-β and VEGF-A （r = 0.260, 0.411, 0.726 and 0.304, all P < 0.05）, and the level of M2 was positively correlated with the levels of Elafin and TGF-β （r = 0.865, 0.552, all P < 0.01）. Conclusion The elevation of IL-8 and M1 macrophages in the aqueous humor may promote the occurrence of DR, while the increase of Elafin and M2 macrophages may be a compensatory regulation to chronic inflammation, which is involved in the regulation of local microvascular lesions and fibrosis.
- Diabetic retinopathy,
- Macrophage,
- Polarization,
- Fibrosis,
- Aqueous humor

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References(23)

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