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13/03/2019

Demonstrate for the first time in humans that the application of neuroprotective eye drops is useful in the treatment of diabetic retinopathy

eurocondor_884

13/03/2019

It is the first evidence in humans that eye drops can reach the retina and modulate the action of neurons, which will be a change in the therapeutic strategy.

The EUROCONDOR European project, led by Dr. Rafael Simó, head of the http://en.vhir.org/portal1/grup-equip.asp?s=recerca&contentid=186789 Research Group on Diabetes and Metabolism at the Vall d'Hebron Research Institute (VHIR), has shown that the administration of neuroprotective eye drops is effective in treating diabetic retinopathy, since medication manages to reach the retina and act on the neurons avoiding its degeneration. This is the first study that demonstrates the effectiveness of an eye drop for diabetic retinopathy in humans, since until now it has only been possible in trials with rodents. This discovery will make it possible to treat the disease in the initial stages without having to wait for advanced stages and aggressive treatments. The results of the clinical trial are published in http://diabetes.diabetesjournals.org/content/early/2018/10/25/db18-0682 Diabetes magazine.Diabetic retinopathy is an eye disease caused by the deterioration of blood vessels that irrigate the retina and affects people who suffer from diabetes, mainly those who do not have good glycemic control. Approximately 30% of diabetic patients have some degree of diabetic retinopathy and this complication of diabetes continues to be the main cause of blindness in the working-age population in developed countries. Recently, the group led by Dr. Rafael Simó has made important contributions in studying the origin of this devastating complication of diabetes. Perhaps the most relevant has been the demonstration that before the presence of microvascular involvement is detected in the ophthalmological examination, there is already an affectation of the neurons in the retina, and that is a neurodegenerative process that at the same time it will contribute to microvascular involvement. In fact, the American Diabetes Association already defines diabetic retinopathy as a neurovascular disease.The EUROCONDOR project has been financed with 6 million euros from the 7th Framework Program of the European Union. Led by the Diabetes and Metabolism Research group of the VHIR, belonging to the CIBER of Diabetes and Metabolic Associated Diseases (CIBERDEM), has had the participation of 17 hospitals, universities and research centers in 8 European countries and the biopharmaceutical company BCN Peptides.The main objective of the study was to evaluate whether the topical administration of two neuroprotective medications could prevent or stop retinal neurodegeneration in type 2 diabetic patients. As a secondary objective they considered the evaluation of safety and the potential impact in the development or progression of diabetic retinopathy in terms of microvascular pathology.450 patients between 45 and 75 years of age with diabetes for 5 years or more were randomized to three groups of treatment with eye drops: placebo, brimonidine and somatostatin. The study lasted 2 years.The researchers demonstrated that "in those patients with neurodegeneration of the retina, eye drops with neuroprotective agents are effective in stopping the progression of neurodegeneration, that is, the death of retinal neurons," explains Dr. Rafael Simó, head of the Diabetes and Metabolism research group of the VHIR.As a result of this discovery, Dr. Simó emphasizes "the importance of the early detection of neurodegeneration of the retina in patients with type 2 diabetes for whom the neuroprotective treatment with collisions could be beneficial." Advantages of topical administrationCompared with intravitreal injections, the administration of drugs by topic way reduces the side effects, is much more comfortable for the patient and facilitates therapeutic adherence.The EUROCONDOR project has opened a new era in the treatment of diabetic retinopathy and other diseases that affect the retina. "To demonstrate for the first time in humans that the eye drops can reach the retina and modulate the action of the neurons will suppose a change in the therapeutic strategy of the initial stages of the disease", affirms the Dr. Simó.On the other hand, within the EUROCONDOR project, the study of the mechanisms by which somatostatin exercises its neuroprotective action has also been addressed.The Diabetes and Metabolism research group of the VHIR is working in the following step: the dual drugs, at the same time neuro and vascular protectors, is the case of GLP-1, which can stabilize the blood vessels of the eye and prevent the involvement vascular caused by diabetes.

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