Gargiulo P, Giusti C, Pietrobono D, La Torre D, Diacono D, Tamburrano G
Endocrinology-Department of Clinical Science, University of Rome La Sapienza, Rome, Italy.
Dig Liver Dis. 2004 Feb;36 Suppl 1:S101-5. doi: 10.1016/j.dld.2003.11.016.
The role of somatostatin and growth hormone in eye diseases recently became a matter of interest because of its link with proliferative diabetic retinopathy. In diabetic patients the pathologic proliferation of blood vessels as a result of retinal ischemia is a major cause of blindness. The hypoxic portions of the retina release angiogenic factors, stimulating neovascularization. Somatostatin is a natural peptide hormone that affects the release of a number of other hormones, such as growth hormone, glucagon, insulin and gastrin. The somatostatin analog promises to be safe and effective treatment for severe diabetic retinopathy. This compound has been shown to block the local and systemic production of insulin-like growth factor 1 and growth hormone, which promote the angiogenesis and endothelial cell proliferation associated with proliferative retinopathy. Several studies have confirmed that using somatostatin analogs to block insulin-like growth factor 1 production is effective in reducing neovascularization and preventing disease progression to proliferative stage of diabetic retinopathy. Long-acting somatostatin analogs are currently being tested for the treatment of diabetic retinopathy. The development of somatostatin analogs with increased selectivity for receptor subtypes will provide improved outcomes in the management of patients with diabetic retinopathy.
由于生长抑素和生长激素与增殖性糖尿病视网膜病变有关，它们在眼部疾病中的作用最近成为了研究热点。在糖尿病患者中，视网膜缺血导致的血管病理性增殖是失明的主要原因。视网膜的缺氧部分会释放血管生成因子，刺激新血管形成。生长抑素是一种天然肽类激素，它会影响许多其他激素的释放，如生长激素、胰高血糖素、胰岛素和胃泌素。生长抑素类似物有望成为治疗严重糖尿病视网膜病变的安全有效方法。已证明这种化合物可阻断胰岛素样生长因子1和生长激素的局部及全身生成，而这两种物质会促进与增殖性视网膜病变相关的血管生成和内皮细胞增殖。多项研究证实，使用生长抑素类似物阻断胰岛素样生长因子1的生成可有效减少新血管形成，并防止疾病发展至糖尿病视网膜病变的增殖阶段。长效生长抑素类似物目前正在进行治疗糖尿病视网膜病变的试验。对受体亚型具有更高选择性的生长抑素类似物的研发，将为糖尿病视网膜病变患者的治疗带来更好的效果。
