Department of Ophthalmology, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, China.
Department of Ophthalmology, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, China; State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong, China.
Med Hypotheses. 2014 May;82(5):636-8. doi: 10.1016/j.mehy.2014.02.030. Epub 2014 Mar 6.
Optic neuritis is a common disease in young adults, inducing apoptosis of retinal ganglion cells, which leads to varying degree of visual function damages, even blindness. As the standard treatment, methylprednisolone pulse therapy can only promote the recovery of visual acuity but not prevent retinal ganglion cell degeneration. It cannot help improve the ultimate visual outcome. Both inflammatory response and endogenous oxidative stress play crucial roles in the progression of optic neuritis. The combination of immunomodulatory and antioxidant is expected to improve the prognosis of the disease by preventing the apoptosis of retinal ganglion cells. Triterpenoids (oleanolic acid derived) were reported to have the dual capacity of simultaneously repressing production of pro-inflammatory mediators and exerting neuroprotective effects through induction of anti-oxidant genes in experimental optic neuritis. Gypenosides with an aglycone mainly of dammarane-type tetracyclic triterpenoids, also has the dual capacity of immune regulation and antioxidation. Both gypenosides and oleanolic acid were reported to have similar roles in hepatoprotection. Beside, gypenosides were reported to have the capacity of modulating the activation of immune cells and the expression of cytokines. In addition, gypenosides showed neuroprotective effect against oxidative injury in dopaminergic neurons and mouse model of Parkinson's disease. Accordingly, we propose that gypenosides have potential neuroprotective and immunomodulatory effects on optic neuritis through antioxidation and immune regulation. The application of gypenosides might prevent the apoptosis of retinal ganglion cells and improve the ultimate visual outcome in patients with optic neuritis.
视神经炎是一种常见于年轻人的疾病，可诱导视网膜神经节细胞发生细胞凋亡，导致不同程度的视觉功能损害，甚至失明。作为标准治疗方法，甲泼尼龙脉冲疗法只能促进视力恢复，而不能预防视网膜神经节细胞变性。它无助于改善最终的视觉预后。炎症反应和内源性氧化应激在视神经炎的进展中都起着关键作用。免疫调节和抗氧化的联合治疗有望通过防止视网膜神经节细胞凋亡来改善疾病的预后。三萜类（源于齐墩果酸）被报道具有同时抑制促炎介质产生和通过诱导抗氧化基因发挥神经保护作用的双重能力，在实验性视神经炎中。以达玛烷型四环三萜为主要苷元的绞股蓝苷具有免疫调节和抗氧化的双重能力。绞股蓝苷和齐墩果酸都被报道在保肝方面具有相似的作用。此外，绞股蓝苷被报道具有调节免疫细胞激活和细胞因子表达的能力。此外，绞股蓝苷对多巴胺能神经元和帕金森病小鼠模型的氧化损伤具有神经保护作用。因此，我们提出绞股蓝苷通过抗氧化和免疫调节对视神经炎具有潜在的神经保护和免疫调节作用。绞股蓝苷的应用可能防止视神经炎患者视网膜神经节细胞的凋亡，并改善最终的视觉预后。
