Changes of plasma tPA and PAI activities in patients with diabetic retinopathy

To investigate the relationship between the diabetic retinopathy (DR) and the activity of plasma tissue plasminogen activator (tPA) and plasminogen activator inhibitor (PAI).

tPA and PAI activities were measured by chromatogenous substrate assay in plasma samples obtained from patients with and without diabetic retinopathy (n = 42). Retinopathy was determined by stereoscopic color fundus photographs graded according to a modification of Chinese National Fundus Disease Academic Meeting. And 21 sex-age matched normal people were as controls. This study was in a masked fashion.

1. tPA activity was lower and PAI activity was higher in all of diabetic patients than those in controls (P < 0.001); 2. tPA activity was lower and PAI activity was higher in proliferative DR (PDR) subgroup than those in non-DR (NDR) and background-DR (BDR) subgroups (P < 0.01, respectively); 3. there was no significant difference between BDR and NDR subgroups (P > 0.05); and 4. the results also suggested that the severity of DR and duration of diabetes were correlated negatively with the activity of tPA but positively with that of PAI (r = -0.564, -0.416, 0.671, 0.442; P < 0.01, respectively).

Reduced plasma tPA activity and enhanced PAI activity in diabetic patients, probably is one of the causes for thromboembolic diseases and are related to the severity of DR and duration of diabetes. Therefore, the change and imbalance between activities of plasma tPA and PAI might play a role in developing and progression of DR.