Clinicopathological Assessments of Brain-Derived Neurotrophic Factor BDNF Physiology in Diabetic Retinopathy: A Systematic Review
DOI:
https://doi.org/10.36283/ziun-pjmd14-2/063Keywords:
Brain-Derived Neurotrophic Factor, Diabetic Retinopathy, Retinal Neuroprotection, Biomarker, Diabetes Mellitus, Retinal InflammationAbstract
Background: Diabetic retinopathy (DR) was seen to be one of the most grievous complications of diabetes mellitus that caused gradual loss of vision. Brain-derived neurotrophic factor BDNF has also been drawn into focus as a molecule relevant to retinal health and neuroprotection as more information unfolds. This research aimed to evaluate the clinicopathological significance of BDNF in patients with diabetic retinopathy (DR), with particular reference to its diagnostic and therapeutic implications. It also aimed to compare the diagnostic potential of BDNF with other existing biomarkers and therapeutic applications with an emphasis on treatment outcomes.
Methods: The PRISMA guidelines were followed while conducting the systematic review and the databases for data extraction were PubMed, Scopus, and Web of Science. English language articles that were published in scientific peer-reviewed journals between January 2013 and April 2024 were included. Furthermore, this review included observational clinical studies and clinical research studies with diabetic patients from which the authors examined BDNF levels in retinopathy patients. Any study that contained non-diabetic retinal disease, reviews, reports, and studies with incomplete information were excluded. For proper comparison, BDNF expression patterns were systematically evaluated and compared between the DR stages. For the removal of biases and assessment of risks, the Cochrane risk of bias tool and Newcastle-Ottawa Scale were used by two independent reviewers.
Results: An initial search yielded 106 articles and 15 were selected after fulfilling the inclusion criteria. The current study found that the plasma BDNF levels were lower in the patients with DR stages 4 and 3 compared with stages 2 and healthy diabetic individuals. This reduction was strongly associated with worsening of retinal vascular permeability and inflammation as well as neuronal degeneration. There was converging data to show that higher BDNF levels were being linked to slower DR progression, and thus the neurotrophic factor could be protective.
Discussion: BDNF emerged as a potential biomarker for monitoring the progression of DR. Its lower levels were associated with increased retinal damage and inflammation. Modulation of BDNF expression was beneficial for treatment, it also highlighted its role in neuroprotection and disease progression. However, variations in study designs and measurement techniques limited consistency in results.
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