Research Description
Diabetic macular edema (DME) is a sight-threatening complication of diabetes affecting 15% of the diabetic population (~21 million patients). Anti-VEGF (vascular endothelial cell growth factor) therapy is the standard treatment for DME requiring monthly injections of an anti-VEGF drug into the vitreous cavity. Despite the anti-VEGF therapy’s initial success, 1/3 of patients have limited or no response to anti-VEGEF therapy - with African American patients responding at much lower rate than white and Hispanic patients. Often it takes months and large numbers of injections until a non-responding patient is moved to another therapy putting a huge burden and stress on patients and the health care system. To date, physicians are unable to predict who will respond to anti-VEGF therapy. New findings indicate that the first month of anti-VEGF therapy might hold the key to identify patients who respond versus patients who do not non-respond to anti-VEGF therapy. The proposal will focus on obtaining a detailed picture of how anti-VEGF therapy affects individual diabetic patients with diverse ethnic backgrounds within the first months of treatment. The idea is that clinical tests and specific biomarkers found in the eye of diabetic patients at 1 months or earlier will allow a physician to select appropriate personalized treatment protocols early on in the disease, thus, vastly increasing the life quality of diabetic patients while significantly lowering health care costs.Research Profile
What area of diabetes research does your project cover? What role will this particular project play in preventing, treating and/or curing diabetes?This project covers the area of diabetic retinopathy, one of the most prominent complications of diabetes. Diabetic retinopathy affects vision in diabetic patients leading to potential blindness. 30 to 50% of patients with diabetic retinopathy do not respond adequately to standard treatment (multiple anti-VEGF injections into the eye per year). This project aims to identify this patient population early on in the course of standard therapy so that a patient based treatment plan can be developed to avoid unnecessary injections into the eye, thus, lowering the burden for patients.
If a person with diabetes were to ask you how your project will help them in the future, how would you respond?A significant number of patients with diabetes who develop diabetic retinopathy do not respond to standard care. The goal of this project is to identify these patients early on using standard clinical parameters and samples taken from the eye of individual patients. Analyses of these patient samples aim to provide new information about mediators (or sets of mediators) associated with the development of diabetic retinopathy. This will allow to better understand why subsets of patients do not respond to standard therapy and will hopefully encourage the development of new alternative therapies. The idea is that these tests/analyses of samples obtained from individual patients will become part of standard care in the future and will be the backbone for personalized treatment plans for patients with diabetic retinopathy. Such personalized treatment plans will provide better outcomes for patients and will avoid unnecessary burden to patients and to the healthcare system.
Why important for you, personally, to become involved in diabetes research? What role will this award play?My first contact with the field of diabetes was at the end of my postdoctoral time. I had the privilege to attend a meeting at which diabetic patients explained and outlined to the audience how much diabetes affects their health and overall life quality. After this meeting, I decided to devote my research to the field of diabetic retinopathy transferring my knowledge of chronic inflammation into the eye. I have since identified several inflammatory pathways underlying the development of diabetic retinopathy in animal models and cell culture systems of retinal cells. However, while doing all this research, I began to realize that it is difficult to translate the knowledge obtained in animal models and cell culture systems into meaningful benefits for patients with diabetic retinopathy. Thus, a couple of years ago, I made a conscious decision to move my research fully into human cell systems and started to expand into translational research. This award provides me with the great opportunity to fully transition into translational patient based research. It is a huge and exciting step in my career and will hopefully help me to identify new therapies and/or patient based treatment plans in the future that will benefit patients with diabetic retinopathy.
In what direction do you see the future of diabetes research going?The future of diabetes research will still be on the development of therapies that aim to treat/cure diabetes. However, it’s unclear to date, whether these potential drugs and therapies will also treat/cure complications of diabetes such as diabetic retinopathy. It has also become clear that individual patients respond very differently to drugs aimed to treat diabetic complications. There is no “one fits all therapy”. Thus the future of new therapies will lay in the development of patient specific treatment plans catered to individuals patients with diabetes and diabetic complications.