Challa Pratap, Arnold John J
Duke University, Ophthalmology , 2351 Erwin Road, Durham 27710 , USA
Expert Opin Investig Drugs. 2014 Jan;23(1):81-95. doi: 10.1517/13543784.2013.840288. Epub 2013 Oct 7.
Primary open-angle glaucoma (POAG) is a leading cause for worldwide blindness and is characterized by progressive optic nerve damage. The etiology of POAG is unknown, but elevated intraocular pressure (IOP) and advanced age have been identified as risk factors. IOP reduction is the only known treatment for glaucoma. Recently, drugs that inhibit rho-associated protein kinase (ROCK) have been studied in animals and people for their ability to lower IOP and potentially treat POAG. ROCK inhibitors lower IOP through a trabecular mechanism and may represent a new therapeutic paradigm for the treatment of POAG.
Exploring the place that ROCK inhibitors may occupy in our treatment of POAG requires a thorough understanding of pathophysiology and treatment. This article summarizes current research on the incidence, proposed etiologies and mechanisms of action for this drug class. ROCK inhibitor research is presented and considered in light of the current standard of pharmacologic care.
ROCK inhibitors alter the cell shape and extracellular matrix (ECM) of the trabecular meshwork. Preclinical studies demonstrate that these drugs have the potential to become a new therapy for glaucoma. However, ROCK inhibitors can affect multiple cell types, and their utility can be proven only after clinical studies in patients.
原发性开角型青光眼（POAG）是全球失明的主要原因，其特征为进行性视神经损伤。POAG的病因尚不清楚，但眼压升高（IOP）和高龄已被确定为危险因素。降低眼压是目前已知的青光眼治疗方法。最近，抑制Rho相关蛋白激酶（ROCK）的药物已在动物和人体中进行研究，因其具有降低眼压及潜在治疗POAG的能力。ROCK抑制剂通过小梁机制降低眼压，可能代表了一种治疗POAG的新治疗模式。
探索ROCK抑制剂在POAG治疗中可能占据的地位需要深入了解其病理生理学和治疗方法。本文总结了关于此类药物的发病率、提出的病因及作用机制的当前研究。根据当前药物治疗标准对ROCK抑制剂的研究进行了介绍和考量。
ROCK抑制剂可改变小梁网的细胞形态和细胞外基质（ECM）。临床前研究表明，这些药物有可能成为青光眼的一种新疗法。然而，ROCK抑制剂可影响多种细胞类型，只有在患者中进行临床研究后才能证明其效用。
