CIBERDEM (CIBER de Diabetes y Enfermedades Metabólicas Asociadas), Diabetes and Metabolism Research Unit, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autónoma de Barcelona, Barcelona, Spain.
Curr Med Chem. 2013;20(26):3251-7. doi: 10.2174/09298673113209990024.
Diabetic retinopathy (DR) has been classically considered to be a microcirculatory disease of the retina. However, there is growing evidence to suggest that retinal neurodegeneration is an early event in the pathogenesis of DR which participates in the microcirculatory abnormalities that occur in DR. Among the neuroprotective factors synthesized by the retina, somatostatin (SST) is one of the most relevant. In DR there is a downregulation of retinal expression of SST that is associated with retinal neurodegeneration. There is growing evidence suggesting that SST could play a key role in the main pathogenic mechanisms involved in the development of DR (neurodegeneration, neovascularization and vascular leackage). Recently, first evidence that the topical administration of SST prevents retinal neurodegeneration in streptozotozin- induced diabetic rats has been reported. Indeed, SST eye drops prevented b-wave abnormalities in the ERG which are considered sensitive indicators of DR. In addition, SST eye drops prevented, glial activation, apoptosis and the misbalance between proapoptotic and survival signalling caused by diabetes. Furthermore, SST eye drops reduce glutamate- induced excitotoxicity. Therefore, topical administration of SST could be contemplated as an appropriate therapeutic approach for DR. However, clinical trials will be needed to establish its exact position in the treatment of this devastating complication of diabetes. Diabetic retinopathy (DR) has been classically considered to be a microcirculatory disease of the retina. However, there is growing evidence to suggest that retinal neurodegeneration is an early event in the pathogenesis of DR which participates in the microcirculatory abnormalities that occur in DR [1]. The retina synthesizes neuroprotective factors which counteract the deleterious effects of neurotoxic factors involved in neurodegeneration. The loss of these neuroprotective factors or the reduction of their effectiveness is essential for the development of retinal neurodegeneration. Among the neuroprotective and neurotrophic factors somatostatin (SST) is one of the most relevant. The main aim of the present review is to provide experimental evidence supporting the promising therapeutical use of SST to prevent or arrest DR.
糖尿病性视网膜病变（DR）一直被认为是视网膜的微循环疾病。然而，越来越多的证据表明，视网膜神经退行性变是 DR 发病机制中的早期事件，它参与了 DR 中发生的微循环异常。在视网膜合成的神经保护因子中，生长抑素（SST）是最相关的一种。在 DR 中，视网膜 SST 的表达下调与视网膜神经退行性变有关。越来越多的证据表明，SST 可能在 DR 发展涉及的主要致病机制中发挥关键作用（神经退行性变、新生血管形成和血管渗漏）。最近，有证据表明 SST 的局部给药可预防链脲佐菌素诱导的糖尿病大鼠的视网膜神经退行性变。事实上，SST 眼药水预防了 ERG 中的 b 波异常，这被认为是 DR 的敏感指标。此外，SST 眼药水可预防糖尿病引起的胶质细胞激活、细胞凋亡以及促凋亡和存活信号之间的失衡。此外，SST 眼药水可减少谷氨酸诱导的兴奋性毒性。因此，SST 的局部给药可被视为 DR 的一种合适的治疗方法。然而，需要进行临床试验以确定其在治疗这种糖尿病严重并发症中的确切地位。
