Department of Ophthalmology, College of Medicine, King Saud University, KAUH, Riyadh, KSA.
J Diabetes Complications. 2012 Jan-Feb;26(1):56-64. doi: 10.1016/j.jdiacomp.2011.11.004. Epub 2012 Jan 5.
One of the major complications in patients with diabetes is diabetic retinopathy (DR), a leading cause of blindness worldwide. It takes several years before any clinical signs of retinopathy appear in diabetic patients, which gives an ample opportunity for scientists to uncover biochemical and molecular mechanism implicated early in the development and progression of the disease. During the past few decades, research progress has been made in investigating the pathophysiology of the disease; however, due to nonavailability of human retinal samples at different stages of the disease and also due to lack of a proper animal model of DR, the exact molecular mechanism has not been elucidated, making therapeutic a difficult task. In this review article, we have discussed a number of diabetes-induced metabolites such as glucose, lipids, amino acids, and other related factors and molecules that are implicated in the pathophysiology of the DR. Furthermore, we have highlighted neurodegeneration and regulation of neurotrophic factors, being recognized as early events that may be involved in the pathology of the disease in the course of DR. An understanding of the biochemical and molecular changes especially early in the diabetic retina may lead to new and effective therapies towards prevention and amelioration of DR, which is important for the millions of individuals who already have or are likely to develop the disease before a cure becomes available.
糖尿病患者的主要并发症之一是糖尿病视网膜病变（DR），它是全球致盲的主要原因之一。糖尿病患者在出现任何视网膜病变的临床迹象之前，需要几年的时间，这为科学家们提供了充分的机会来揭示疾病早期发展和进展中涉及的生化和分子机制。在过去的几十年中，研究人员在研究疾病的病理生理学方面取得了进展；然而，由于无法获得不同疾病阶段的人类视网膜样本，也由于缺乏适当的 DR 动物模型，确切的分子机制尚未阐明，使得治疗变得困难。在这篇综述文章中，我们讨论了一些糖尿病诱导的代谢物，如葡萄糖、脂质、氨基酸和其他相关因素和分子，它们与 DR 的病理生理学有关。此外，我们强调了神经退行性变和神经营养因子的调节，它们被认为是可能参与 DR 病理过程的早期事件。对糖尿病视网膜中早期生化和分子变化的理解可能会导致针对 DR 的预防和改善的新的有效治疗方法，这对于已经患有或可能在治愈方法出现之前患上这种疾病的数百万人来说非常重要。
