RETINAL DISORDERS Plasma E-selectin levels can play a role in the development of diabetic retinopathy Márta Kasza 1 & J. Meleg 2 & J. Vardai 3 & B. Nagy Jr. 4 & E. Szalai 5 & J. Damjanovich 5 & A. Csutak 5 & B. Ujhelyi 5 & V. Nagy 5 Received: 1 March 2016 /Revised: 29 May 2016 /Accepted: 9 June 2016 # Springer-Verlag Berlin Heidelberg 2016 Abstract Purpose Diabetic retinopathy is one of the leading causes of blindness. There are several risk factors, such as the duration of diabetes or glycemic control of the patient; however, sev- eral biochemical factors also alter the process. Our aim was to investigate the role of soluble E-selectin in the formation of diabetic retinopathy. Patients and methods Fifty-seven patients (37 female and 20 male, aged 61.71 ± 12.31 years) and 14 healthy control subjects (ten female and four male, aged 63.06 ±10.46 years) were enrolled in the study. We measured the soluble E-selectin level in the plasma of patients by ELISA. All patients underwent careful ophthalmological examination, including ophthalmoscopy and color fundus photography, while diabetic retinopathy grading was per- formed in line with the 2012 classification of the American Academy of Ophthalmology (AAO). Results The soluble E-selectin level was significantly higher in patients with diabetes compared to controls (32.95 ng/ml vs. 26.55 ng/ml, p =0.03). Dividing patients into groups by the presence of retinopathy, the E-selectin level was also sig- nificantly higher in the retinopathy group (p < 0.05). When we examined diabetic patients by the severity of retinopathy (groups A, B, and C, by the guidelines of the AAO), however, we did not find any significant difference in soluble E-selectin levels, although it tended to be higher in group B. Conclusions An elevated E-selectin level can play a role in the development of diabetic retinopathy, but it does not seem to alter disease severity. However, glycemic control and the reduction of cardiovascular risk factors may also alter the level of E-selectin that might play a role in the prevention of dia- betic retinopathy. Keywords Diabetes mellitus . Diabetic retinopathy . Soluble E-selectin Introduction Besides age-related macular degeneration and glaucoma, dia- betic retinopathy is one of the leading causes of blindness in well-developed countries [1]. Diabetic retinopathy might ap- pear early, only a couple of years later than the diagnosis of diabetes. The main risk factors for diabetic retinopathy are the duration of diabetes and glycemic control of the disease [2, 3]. Severity of retinopathy is graded by the AAO based on visual acuity, ophthalmoscopic findings, and risk factors; there are no signs of retinopathy in group A, while group B refers to non-proliferative diabetic retinopathy (NPDR) that can be di- vided into mild, moderate, and severe stages, and group C refers to proliferative diabetic retinopathy [4]. Selectins are adhesion molecules that play an impor- tant role in regeneration after tissue damage or inflamma- tion, providing adhesion between leucocytes and vascular endothelial cells. There are three basic types of selectins: L-selectins are presented on the surface of leucocytes, P- selectins on thrombocytes, and E-selectins on the surface * Márta Kasza kaszam77@gmail.com 1 Medical Centre, Hungarian Defence Forces, 1134 BudapestRóbert Károly krt. 44, Hungary 2 Jósa András Hospital, Nyíregyháza, Hungary 3 Kenézy Gyula Hospital, Debrecen, Hungary 4 Department of Laboratory Medicine, University of Debrecen, Debrecen, Hungary 5 Department of Ophthalmology, University of Debrecen, Debrecen, Hungary Graefes Arch Clin Exp Ophthalmol DOI 10.1007/s00417-016-3411-1