Objective To investigate the correlation between the level of interleukin-23(IL-23)and IL-17 and the re-sponsiveness of patients with diabetic macular edema(DME)to ranibizumab and relevant predictive significance.Methods A total of 249 DME patients who were admitted to the First Affiliated Hospital of Nanyang Medical College from September 2021 to June 2023 were included in this study.These patients were divided into the sensitive group(72 cases and 72 eyes)and the non-sensitive group(177 cases and 177 eyes)according to their responsiveness to ranibizumab treatment.The baseline glycated hemoglobin(HbA1c),best corrected visual acuity(BCVA),central macular thickness(CMT),as well as the IL-23 and IL-17 levels before treatment,1 month after treatment,and 3 months after treatment,were compared between the two groups.Besides,the correlation between the reduction rate of the IL-23 and IL-17 levels after 1 and 3 months of treatment and the responsiveness to ranibizumab was analyzed.Moreover,the impact of the reduction rate of the IL-23 and IL-17 levels after 1 month of treatment on the responsiveness to ranibizumab and its predictive value was as-sessed.Results The baseline HbA1c and BCVA in the non-sensitive group were higher than those in the sensitive group,while the baseline CMT in the non-sensitive group was lower than that in the sensitive group(all P＜0.05).The IL-23 and IL-17 levels after 1 month and 3 months of treatment in both groups were lower than those before treatment.The IL-23 and IL-17 levels in the non-sensitive group were higher than those in the sensitive group after 1 month and 3 months of treat-ment.The reduction rate of IL-23 and IL-17 levels after 1 month and 3 months of treatment in the non-sensitive group was lower than that in the sensitive group(all P＜0.05).The reduction rate of IL-23 and IL-17 levels after 1 month and 3 months of treatment was positively correlated with therapeutic responsiveness(both P＜0.05).Before calibration,Logistic regression analysis showed that HbA1c,baseline CMT,baseline BCVA,and the reduction rate of IL-23 and IL-17 levels after 1 month of treatment were all correlated with the responsiveness of DME patients to ranibizumab(all P＜0.05).After cali-bration,Logistic regression analysis showed that the reduction rate of IL-23 and IL-17 levels after 1 month of treatment was still correlated with the responsiveness of DME patients to ranibizumab(both P＜0.05).After 1 month of treatment,the AUC of the IL-23 reduction rate and the IL-17 reduction rate alone or their combination for predicting the responsiveness of DME patients to ranibizumab was 0.776,0.755,and 0.930,respectively,indicating a high predictive value of their combi-nation.Conclusion The responsiveness of DME patients to ranibizumab is related to the levels of IL-23 and IL-17.The combination of the reduction rate of serum IL-23 and IL-17 levels after 1 month of treatment exhibits a higher value for pre-dicting the responsiveness of DME patients to ranibizumab.

Objective To investigate the correlation between the level of interleukin-23(IL-23)and IL-17 and the re-sponsiveness of patients with diabetic macular edema(DME)to ranibizumab and relevant predictive significance.Methods A total of 249 DME patients who were admitted to the First Affiliated Hospital of Nanyang Medical College from September 2021 to June 2023 were included in this study.These patients were divided into the sensitive group(72 cases and 72 eyes)and the non-sensitive group(177 cases and 177 eyes)according to their responsiveness to ranibizumab treatment.The baseline glycated hemoglobin(HbA1c),best corrected visual acuity(BCVA),central macular thickness(CMT),as well as the IL-23 and IL-17 levels before treatment,1 month after treatment,and 3 months after treatment,were compared between the two groups.Besides,the correlation between the reduction rate of the IL-23 and IL-17 levels after 1 and 3 months of treatment and the responsiveness to ranibizumab was analyzed.Moreover,the impact of the reduction rate of the IL-23 and IL-17 levels after 1 month of treatment on the responsiveness to ranibizumab and its predictive value was as-sessed.Results The baseline HbA1c and BCVA in the non-sensitive group were higher than those in the sensitive group,while the baseline CMT in the non-sensitive group was lower than that in the sensitive group(all P＜0.05).The IL-23 and IL-17 levels after 1 month and 3 months of treatment in both groups were lower than those before treatment.The IL-23 and IL-17 levels in the non-sensitive group were higher than those in the sensitive group after 1 month and 3 months of treat-ment.The reduction rate of IL-23 and IL-17 levels after 1 month and 3 months of treatment in the non-sensitive group was lower than that in the sensitive group(all P＜0.05).The reduction rate of IL-23 and IL-17 levels after 1 month and 3 months of treatment was positively correlated with therapeutic responsiveness(both P＜0.05).Before calibration,Logistic regression analysis showed that HbA1c,baseline CMT,baseline BCVA,and the reduction rate of IL-23 and IL-17 levels after 1 month of treatment were all correlated with the responsiveness of DME patients to ranibizumab(all P＜0.05).After cali-bration,Logistic regression analysis showed that the reduction rate of IL-23 and IL-17 levels after 1 month of treatment was still correlated with the responsiveness of DME patients to ranibizumab(both P＜0.05).After 1 month of treatment,the AUC of the IL-23 reduction rate and the IL-17 reduction rate alone or their combination for predicting the responsiveness of DME patients to ranibizumab was 0.776,0.755,and 0.930,respectively,indicating a high predictive value of their combi-nation.Conclusion The responsiveness of DME patients to ranibizumab is related to the levels of IL-23 and IL-17.The combination of the reduction rate of serum IL-23 and IL-17 levels after 1 month of treatment exhibits a higher value for pre-dicting the responsiveness of DME patients to ranibizumab.