Department of Ophthalmology, Princess Alexandra Eye Pavilion, Chalmers Street, Edinburgh, EH3 9HA, UK.
Sleep Med Rev. 2011 Apr;15(2):107-13. doi: 10.1016/j.smrv.2010.06.001. Epub 2010 Oct 30.
The process of photoentrainment, through the activation of photoreceptor transduction cascades, influences the circadian physiology of many life forms from primitive invertebrates to primates. In humans, a population of intrinsically photosensitive retinal ganglion cells (ipRGC's) is responsible for mediating the circadian rhythm and is susceptible to primary dysfunction affecting this cell population specifically, or disorders influencing light activation of retinal ganglion photoreceptors. The former may arise through cell depletion in conditions such as inherited or acquired optic neuropathies or conditions like Parkinson's disease which may alter retinal dopamine-mediated neurotransmission, and the latter, secondary to common causes of light transmission reduction associated with ageing and cataract. This review examines the current evidence linking ocular pathology and the resultant reduction in retinal phototransduction with circadian disturbances and sleep disorders, with downstream effects on our overall physiological integrity. As our understanding of the effects of light pathways on circadian biology develops, therapeutic modalities based upon the underlying pathophysiological processes are emerging, although the direct measurement, consequences and treatment of relative or absolute ipRGC dysfunction remain to be fully and clearly elucidated in man.
光生物反馈过程通过激活光感受器转导级联反应，影响从原始无脊椎动物到灵长类等多种生物的生理节律。在人类中，一群内在感光视网膜神经节细胞（ipRGC）负责介导生理节律，并且容易受到特定影响该细胞群体的原发性功能障碍或影响视网膜神经节光感受器光激活的疾病的影响。前者可能是由于遗传性或获得性视神经病变等情况下的细胞耗竭引起的，或者可能改变视网膜多巴胺介导的神经传递的帕金森病等情况引起的，后者则继发于与年龄相关的白内障和白内障相关的常见光传输减少的原因。本综述检查了与昼夜节律紊乱和睡眠障碍相关的眼部病理学和由此导致的视网膜光转导减少的现有证据，以及对我们整体生理完整性的下游影响。随着我们对光通路对生理节律生物学影响的理解的发展，基于潜在病理生理过程的治疗方法正在出现，尽管相对或绝对 ipRGC 功能障碍的直接测量、后果和治疗仍有待在人类中得到充分和明确的阐明。
