Yu Fu-Shin, Yin Jia, Lee Patrick, Hwang Frank S, McDermott Mark
Department of Ophthalmology/Kresge Eye Institute, Wayne State University School of Medicine, Detroit, Michigan 48201, USA.
Expert Rev Ophthalmol. 2015;10(4):383-392. doi: 10.1586/17469899.2015.1049157. Epub 2015 Jun 26.
The cornea is the most densely innervated mammalian tissue. The sensory nerves are responsible for sensations of dryness, temperature, touch, and pain, and play important roles in the blink reflex, wound healing, and tear production. Many ocular and systemic diseases can adversely affect corneal sensory nerve and consequently impair their function. One of such systemic diseases is diabetes mellitus (DM) which causes sensory degeneration, neurotrophic keratopathy (DNK), and delayed wound healing. In this review, we summarize recent discoveries revealing mechanisms underlying the pathogenesis of DNK and the impairment of sensory nerve regeneration in post wound diabetic corneas in using animal model of human diabetes. Because it is generally believed that common mechanisms are operative in the pathogenesis of diabetic peripheral neuropathy in different tissues, the findings in the corneas have implications in in other tissues such as the skin, which often leads to foot ulceration and amputation in diabetic patients.
角膜是神经支配最密集的哺乳动物组织。感觉神经负责干燥、温度、触觉和疼痛等感觉,并在眨眼反射、伤口愈合和泪液分泌中发挥重要作用。许多眼部和全身性疾病会对角膜感觉神经产生不利影响,进而损害其功能。糖尿病(DM)就是这样一种全身性疾病,它会导致感觉退化、神经营养性角膜病变(DNK)以及伤口愈合延迟。在这篇综述中,我们总结了最近的发现,这些发现揭示了在使用人类糖尿病动物模型研究DNK发病机制以及糖尿病角膜伤口愈合后感觉神经再生受损的潜在机制。由于人们普遍认为不同组织中糖尿病周围神经病变的发病机制存在共同作用机制,因此角膜中的研究结果对皮肤等其他组织也有启示意义,而皮肤病变在糖尿病患者中常常导致足部溃疡和截肢。