Inflammation is known to be involved in the progression of diabetic retinopathy. Follicular helper T cells (Tfh) play critical roles in the differentiation of long-live plasma cells and production of antibodies, whereas circulating CD4⁺CXCR5⁺ T cells may act as a counterpart to measure Tfh cell disorders. In this study, we investigated whether Tfh could be involved in the development of diabetic retinopathy (DR) by assessing circulating Tfh cells in peripheral blood. Data showed that serum levels of total IgG and IgA were both significantly increased in type 2 diabetes mellitus (T2DM) patients with proliferative diabetic retinopathy (PDR) than with non-PDR. Also, B cell activation and differentiation were both enhanced in T2DM patients with PDR. Little changes were detected in levels of Th1, Th2, and Th17 cells. As indicated by elevated serum levels and supernatant from cultured PBMC of IL-21, we found increased circulating Tfh cells in PDR patients with dysregulated subsets. This study suggests the involvement of circulating Tfh cells in DR and, in particular, the pathogenesis of PDR.

已知炎症与糖尿病视网膜病变的进展有关。滤泡辅助 T 细胞 (Tfh) 在长寿命浆细胞的分化和抗体的产生中起关键作用，而循环 CD4 ⁺ CXCR5 ⁺T 细胞可以作为测量 Tfh 细胞疾病的对应物。在这项研究中，我们通过评估外周血中的循环 Tfh 细胞来研究 Tfh 是否可能参与糖尿病视网膜病变 (DR) 的发展。数据显示，与非 PDR 相比，增殖性糖尿病视网膜病变 (PDR) 的 2 型糖尿病 (T2DM) 患者的血清总 IgG 和 IgA 水平均显着升高。此外，患有 PDR 的 T2DM 患者的 B 细胞活化和分化均得到增强。Th1、Th2 和 Th17 细胞的水平几乎没有检测到变化。如IL-21培养的PBMC的血清水平和上清液升高所示，我们发现PDR患者亚群失调的循环Tfh细胞增加。该研究表明循环 Tfh 细胞参与 DR，特别是 PDR 的发病机制。