Eisma Jessica H, Dulle Jennifer E, Fort Patrice E
Jessica H Eisma, Jennifer E Dulle, Patrice E Fort, Departments of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, MI 48105, United States.
World J Diabetes. 2015 Mar 15;6(2):312-20. doi: 10.4239/wjd.v6.i2.312.
According to the American Diabetes Association, diabetes was the seventh leading cause of death, and diabetic retinopathy the leading cause of blindness in working age adults in the United States in 2010. Diabetes is characterized by hyperglycemia associated with either hypoinsulinemia or insulin resistance, and over time, this chronic metabolic condition may lead to various complications including kidney failure, heart attacks, and retinal degeneration. In order to better understand the molecular basis of this disease and its complications, animal models have been the primary approach used to investigate the effects of diabetes on various tissues or cell types of the body, including the retina. However, inherent to these animal models are critical limitations that make the insight gained from these models challenging to apply to the human pathology. These difficulties in translating the knowledge obtained from animal studies have led a growing number of research groups to explore the diabetes complications, especially diabetic retinopathy, on tissues from human donors. This review summarizes the data collected from diabetic patients at various stages of diabetic retinopathy and classifies the data based upon their relevance to the main aspects of diabetic retinopathy: retinal vasculature dysfunction, inflammation, and neurodegeneration. This review discusses the importance of those studies to discriminate and establish the relevance of the findings obtained from animal models but also the limitations of such approaches.
根据美国糖尿病协会的数据,2010年糖尿病是美国第七大主要死因,而糖尿病视网膜病变是美国工作年龄成年人失明的主要原因。糖尿病的特征是高血糖,伴有胰岛素分泌不足或胰岛素抵抗,随着时间的推移,这种慢性代谢状况可能导致各种并发症,包括肾衰竭、心脏病发作和视网膜变性。为了更好地理解这种疾病及其并发症的分子基础,动物模型一直是研究糖尿病对身体各种组织或细胞类型(包括视网膜)影响的主要方法。然而,这些动物模型存在关键局限性,使得从这些模型中获得的见解难以应用于人类病理学。将动物研究中获得的知识进行转化存在这些困难,导致越来越多的研究小组探索来自人类供体组织的糖尿病并发症,尤其是糖尿病视网膜病变。本综述总结了从糖尿病视网膜病变不同阶段的糖尿病患者收集的数据,并根据这些数据与糖尿病视网膜病变主要方面的相关性进行分类:视网膜血管系统功能障碍、炎症和神经退行性变。本综述讨论了这些研究对于区分和确定从动物模型中获得的研究结果的相关性的重要性,以及此类方法的局限性。