Diabetic Retinopathy: Important Biochemical Alterations and the Main Treatment Strategies.

Autor: ValdezGuerrero AS; Laboratory for Research in Applied Biochemistry, Section of Postgraduate Studies and Research, Department of Basic Disciplinary Training, Higher School of Medicine, National Polytechnic Institute, Mexico City, Mexico., Quintana-Pérez JC; Laboratory for Research in Applied Biochemistry, Section of Postgraduate Studies and Research, Department of Basic Disciplinary Training, Higher School of Medicine, National Polytechnic Institute, Mexico City, Mexico., Arellano-Mendoza MG; Research Laboratory in Chronic Degenerative Diseases, Section of Postgraduate Studies and Research, Higher School of Medicine, National Polytechnic Institute, Mexico City, Mexico., Castañeda-Ibarra FJ; Laboratory for Research in Applied Biochemistry, Section of Postgraduate Studies and Research, Department of Basic Disciplinary Training, Higher School of Medicine, National Polytechnic Institute, Mexico City, Mexico., Tamay-Cach F; Laboratory for Research in Applied Biochemistry, Section of Postgraduate Studies and Research, Department of Basic Disciplinary Training, Higher School of Medicine, National Polytechnic Institute, Mexico City, Mexico. Electronic address: ftamay@ipn.mx., Alemán-González-Duhart D; Department of Basic Interdisciplinary Training, Interdisciplinary Center for Health Sciences-Santo Tomás Unit, National Polytechnic Institute, Mexico City, Mexico. Electronic address: dianaagd@hotmail.com.
Jazyk: angličtina
Zdroj: Canadian journal of diabetes [Can J Diabetes] 2021 Aug; Vol. 45 (6), pp. 504-511. Date of Electronic Publication: 2020 Oct 21.
DOI: 10.1016/j.jcjd.2020.10.009
Abstrakt: Diabetes mellitus (DM) is a chronic metabolic disorder characterized by impaired glucose homeostasis, insulin resistance and hyperglycemia. Among its serious multisystemic complications is diabetic retinopathy (DR), which develops slowly and often insidiously. This disorder-the most common cause of vision loss in working-age adults-is characterized by functional and morphological changes in the retina. It results from the exacerbation of ischemic and inflammatory conditions prompted by alterations in the blood vessels, such as the development of leukostasis, thickening of the basement membrane, retinal neovascularization and fibrovascular tissue formation at the vitreoretinal interface. The pathogenic alterations are usually triggered at the biochemical level, involving a greater activity in 4 pathways: the polyol pathway, the hexosamine pathway, the formation of advanced glycation end-products and the activation of protein kinase C isoforms. When acting together, these pathways give rise to increased levels of reactive oxygen species and decreased levels of endogenous antioxidant agents, thus generating oxidative stress. All current therapies are aimed at the later stages of DR, and their application implies side effects. One possible strategy for preventing the complications of DM is to counteract the elevated superoxide production stemming from a high level of blood glucose. Accordingly, some treatments are under study for their capacity to reduce vascular leakage and avoid retinal ischemia, retinal neovascularization and macular edema. The present review summarizes the biochemical aspects of DR and the main approaches for treating it.
(Copyright © 2020 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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