ArticleDiabetologia2023
Cholesterol crystal formation is a unifying pathogenic mechanism in the development of diabetic retinopathy.
Article in Diabetologia, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 22 citations in OpenAlex.
- Cholesterol crystal formation and embolism in the central nervous system and their potential role in Alzheimer's disease.American heart journal plus : cardiology research and practice · 2026Article
- Outcomes of Diabetes Management with Continuous Glucose Monitoring Technology.Archives of internal medicine research · 2026Article
- Retinal phenotype of APOB100 transgenic mice on a Western diet with human-like hyperlipidemia and cholesterol crystals in the retina and choroid.Lab animal · 2026Article
- Combined proteomics and metabolomics analyses revealed molecular signatures associated with proliferative diabetic retinopathy.Scientific reports · 2026Article
- Cholesterol-containing lipid crystals can directly stiffen the rat steatotic liver before fibrosis.Proceedings of the National Academy of Sciences of the United States of America · 2026Article
- Understanding the link between lipid and ocular disorders for effective therapy.Archives of medical science : AMS · 2026Article
- Artificial Intelligence in Diabetic Retinopathy and Diabetic Macular Edema: A Narrative Review.Bioengineering (Basel, Switzerland) · 2025Review
- Proliferative diabetic retinopathy subtypes defined by immune defense and endothelial mitochondrial dysfunction.Signal transduction and targeted therapy · 2025Article
- Cholesterol crystals in the pathogenesis of atherosclerosis.Nature reviews. Cardiology · 2025Review
- The role of cholesterol crystals and ocular crystal emboli in retinal pathology.American heart journal plus : cardiology research and practice · 2024Article
- Statins as a risk factor for diabetic retinopathy: a Mendelian randomization and cross-sectional observational study.Journal of translational medicine · 2024 · on this mapObservational
- Cholesterol crystals induce mechanical trauma, inflammation, and neo-vascularization in solid cancers as in atherosclerosis.American heart journal plus : cardiology research and practice · 2023Article
- Quantitative characterizations of the cholesterol-related pathways in the retina and brain of hamsters.Journal of lipid research · 2023Article
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Authors and funding
13 authors at 4 institutions in 1 country.
Funding
Abstract
aims/hypothesisHyper-reflective crystalline deposits found in retinal lesions have been suggested to predict the progression of diabetic retinopathy, but the nature of these structures remains unknown.
methodsScanning electron microscopy and immunohistochemistry were used to identify cholesterol crystals (CCs) in human donor, pig and mouse tissue. The effects of CCs were analysed in bovine retinal endothelial cells in vitro and in db/db mice in vivo using quantitative RT-PCR, bulk RNA sequencing, and cell death and permeability assays. Cholesterol homeostasis was determined using
resultsWe identified hyper-reflective crystalline deposits in human diabetic retina as CCs. Similarly, CCs were found in the retina of a diabetic mouse model and a high-cholesterol diet-fed pig model. Cell culture studies demonstrated that treatment of retinal cells with CCs can recapitulate all major pathogenic mechanisms leading to diabetic retinopathy, including inflammation, cell death and breakdown of the blood-retinal barrier. Fibrates, statins and α-cyclodextrin effectively dissolved CCs present in in vitro models of diabetic retinopathy, and prevented CC-induced endothelial pathology. Treatment of a diabetic mouse model with α-cyclodextrin reduced cholesterol levels and CC formation in the retina, and prevented diabetic retinopathy. CONCLUSIONS/
interpretationWe established that cholesterol accumulation and CC formation are a unifying pathogenic mechanism in the development of diabetic retinopathy.
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