Identification of ethanolamine as a biomarker and therapeutic potential for diabetic retinopathy in glucose well-controlled diabetic patients

Diabetic retinopathy (DR) is the leading cause of blindness in the working-age population, and there are no diagnostic biomarkers and intervention methods for DR developed from glucose well-controlled diabetic patients (GW-DR) to date. Here, we established a prospective cohort of 2126 diabetic Chinese adults (DM) including1134 subjects without ocular diseases at baseline. After 2-year follow-up, 42 participants (21 new-onset GW-DR and 21 matched control) with HbA1c persistently less than 7% were enrolled to profile the serum metabolic features of GW-DR through targeted metabolomics. Among different levels of metabolites, the lower level of ethanolamine with an AUC of 0.954 was significantly associated with early-stage GW-DR risk compared to HbA1c with a 0.506 AUC. Moreover, ethanolamine attenuated diabetic retinal inflammation in STZ-induced diabetic rats with inactivating microglia and DAG-PKC pathway remodeling. In conclusion, ethanolamine, as a potential metabolic biomarker for early diagnosis of GW-DR, may provide a biomarker-based treatment for DR prevention. We then performed gene expression profiling analysis using data obtained from RNA-seq of 4 different cells at two time points. Overall design: Comparative gene expression profiling analysis of RNA-seq data for BV2 cells stimulated by hypoxia with or without 100µM ethanolamine and control