The role of fractalkine in the development of diabetic macular edema in patients with type 2 diabetes mellitus

Main Article Content

M.L. Kyryliuk
S.А. Suk
S.O. Rykov
S.Yu. Mogilevskyy


Background. Diabetic macular edema (DME) is a severe complication of type 2 diabetes mellitus (DM) and a leading cause of vision loss in the working age population of most developed countries. The gold standard for DME treatment should be based on a good control of glycemia along with control of lipids and renal function. However, despite the systemic metabolic control values being essential for patients with diabetic retinopathy, it has proven to be insufficient for DME if it appears. In these patients, additional measures are needed in order to avoid the subsequent loss of vision. The aim of the work was to assess the content of blood fractalkine in patients with type 2 DM and DME in conjunction with the indicators of the thickness of the macula layers. Materials and methods. The study involved 82 patients with type 2 DM (145 eyes), divided into 4 groups in accordance with the DME form. The average age of patients was 65.25 ± 10.85 years, the average duration of DM — 14.00 ± 7.05 years, the average level of HbA1c — 8.40 ± 1.58 %. Results. Using analysis of variance and regression analysis, methods for constructing logistic regression models, we have shown that fractalkine is not associated with the risk of not low values (> QI) of nerve fiber layer, ganglion cell layer, inner plexiform layer, central sector of macula, thickness of fovea. Conclusions. Fractalkine may be a promising new therapeutic method for the treatment of diabetic retinal diseases. DME tends to be a chronic disease, although spontaneous recovery is not uncommon. It is important to recognize that 35 % of patients with macular edema had spontaneous resolution after 6 months if untreated.

Article Details

How to Cite
Kyryliuk, M., S. Suk, S. Rykov, and S. Mogilevskyy. “The Role of Fractalkine in the Development of Diabetic Macular Edema in Patients With Type 2 Diabetes Mellitus”. INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine), vol. 15, no. 1, Apr. 2019, pp. 10-15, doi:10.22141/2224-0721.15.1.2019.158686.
Original Researches


Ciulla TA, Amador AG, Zinman B. Diabetic retinopathy and diabetic macular edema: pathophysiology, screening, and novel therapies. Diabetes Care. 2003 Sep;26(9):2653-64.

Simó R, Hernández C; European Consortium for the Early Treatment of Diabetic Retinopathy (EUROCONDOR). Neurodegeneration in the diabetic eye: new insights and therapeutic perspectives. Trends Endocrinol Metab. 2014 Jan;25(1):23-33. doi: 10.1016/j.tem.2013.09.005.

Antonetti DA, Klein R, Gardner WTh. Diabetic Retinopathy. N Engl J Med. 2012 Mar 29;366(13):1227-39. doi: 10.1056/NEJMra1005073.

Barber, AJ. A new view of diabetic retinopathy: A neurodegenerative disease of the eye. Prog Neuropsychopharmacol Biol Psychiatry. 2003 Apr;27(2):283-90. doi: 10.1016/S0278-5846(03)00023-X.

Gyurko R, Siqueira CC, Caldon N, Gao L, Kantarci A, Van Dyke TE. Chronic hyperglycemia predisposes to exaggerated inflammatory response and leukocyte dysfunction in Akita mice. J Immunol. 2006 Nov 15;177(10):7250-6.

Liang KJ, Lee JE, Wang YD, et al. Regulation of dynamic behavior of retinal microglia by CX3CR1 signaling. Invest Ophthalmol Vis Sci. 2009 Sep;50(9):4444-51. doi: 10.1167/iovs.08-3357.

Tang J, Kern TS. Inflammation in diabetic retinopathy. Prog Retin Eye Res. 2011 Sep;30(5):343-58. doi: 10.1016/j.preteyeres.2011.05.002.

Malachkova NV, Kyryliuk ML, Komarovska IV. Serum adiponectin levels in obese type 2 diabetic patients with diabetic retinopathy. J Ophthalmol (Ukraine). 2017;5:39-44. doi: 10.31288/oftalmolzh201753944.

Malachkova NV, Kyryliuk ML, Komarovska IV. Association between serum resistin level and diabetic retinopathy in obese patients with type 2 diabetes mellitus. J ophthalmol (Ukraine). 2017;4:9-13. doi: 10.31288/oftalmolzh20174913.

Imai T, Hieshima K, Haskell C, et al. Identification and molecular characterization of fractalkine receptor CX3CR1, which mediates both leukocyte migration and adhesion. Cell. 1997 Nov 14;91(4):521-30. doi: 10.1016/S0092-8674(00)80438-9.

Janeway C, Travers P, Walport M, Shlomchik MJ. Immunobiology: The immune system in health and disease. 6th ed. New York: Garland Science; 2005. 77-79 pp.

Cardona AE, Pioro EP, Sasse ME, et al. Control of microglial neurotoxicity by the fractalkine receptor. Nat Neurosci. 2006 Jul;9(7):917-24. doi: 10.1038/nn1715.

Mizutani N, Sakurai T, Shibata T, et al. Dose-dependent differential regulation of cytokine secretion from macrophages by Fractalkine. J Immunol. 2007 Dec 1;179(11):7478-87.

Cardona SM, Mendiola AS, Yang YC, Adkins SL, Torres V, Cardona AE. Disruption of Fractalkine Signaling Leads to Microglial Activation and Neuronal Damage in the Diabetic Retina. ASN Neuro. 2015 Oct 29;7(5). pii: 1759091415608204. doi: 10.1177/1759091415608204.

Shiraya T, Kato S, Araki F, Ueta T, Miyaji T, Yamaguchi T.Aqueous cytokine levels are associated with reduced macular thickness after intravitreal ranibizumab for diabetic macular edema. PLoS One. 2017 Mar 27;12(3):e0174340. doi: 10.1371/journal.pone.0174340.

AAO. Diabetic Retinopathy PPP - Updated 2017. Available from: Accessed: Dec 2017.

Altman DG, Machin D, Bryant TN, Gardner MJ, editors. Statistics with confidence. Confidence intervals and statistical guidelines. Bristol: BMJ Books; 2000. 240 p.

Jekel JF, Katz DL, Elmore JG, Wild DMG. Epidemiology, biostatistics, and preventive medicine. Philadelphia: Elsevier Health Sciences; 2007. 421 p.

Kanda Y. Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics. Bone Marrow Transplant. 2013 Mar;48(3):452-8. doi: 10.1038/bmt.2012.244.

Kravchun P, Kadykova O, Gabisoniya T. New markers of progression of chronic heart failure in patients with myocardial infarction, type 2 diabetes and obesity. Georgian Med News. 2015;(238):60-64.

Mendiola AS, Garza R, Cardona SM, et al. Fractalkine Signaling Attenuates Perivascular Clustering of Microglia and Fibrinogen Leakage during Systemic Inflammation in Mouse Models of Diabetic Retinopathy. Front Cell Neurosci. 2017 Jan 10;10:303. doi: 10.3389/fncel.2016.00303.

Most read articles by the same author(s)