Zarnowski Tomasz, Tulidowicz-Bielak Maria, Zarnowska Iwona, Mitosek-Szewczyk Krystyna, Wnorowski Artur, Jozwiak Krzysztof, Gasior Maciej, Turski Waldemar A
Chair of Ophthalmology, Medical University, Lublin. Poland.
Department of Child Neurology, Medical University, Lublin. Poland.
Curr Med Chem. 2017;24(32):3547-3558. doi: 10.2174/0929867324666170509120257.
There is growing evidence of the involvement of the kynurenine metabolic pathway and the enhancement of kynurenic acid production in the neuroprotective effects of the ketogenic diet.
Here, we review evidence implicating kynurenic acid in the efficacy of ketogenic diet in eye diseases associated with neurodegeneration.
Ketogenic diet and ketone bodies that are elevated during exposure to the ketogenic diet each have a neuroprotective effect on retinal ganglion cells in a rat model of Nmethyl- D-aspartate induced neuronal damage. Chronic exposure to ketogenic diet also increases kynurenic acid concentrations in discrete rat brain structures. A non-selective glutamate receptor agonist, glutamate, also decreases the production of kynurenic acid in bovine retinal slices; this effect is attenuated by acetoacetate and β-hydroxybutyrate, two of three ketone bodies overproduced during ketogenic diet.
Whether ketogenic diet induced enhancement of kynurenic acid production would translate into a clinically significant improvement in certain eye diseases like glaucoma and retinal neurodegenerations awaits further experimental and clinical verification.
越来越多的证据表明，犬尿氨酸代谢途径的参与以及犬尿酸生成的增加在生酮饮食的神经保护作用中发挥作用。
在此，我们综述了犬尿酸与生酮饮食对与神经退行性变相关的眼部疾病疗效的证据。
生酮饮食以及在生酮饮食期间升高的酮体，在N-甲基-D-天冬氨酸诱导的神经元损伤大鼠模型中，对视网膜神经节细胞均具有神经保护作用。长期接触生酮饮食还会增加大鼠离散脑区的犬尿酸浓度。一种非选择性谷氨酸受体激动剂谷氨酸，也会降低牛视网膜切片中犬尿酸的生成；这种作用会被乙酰乙酸和β-羟基丁酸减弱，这两种物质是生酮饮食期间过量产生的三种酮体中的两种。
生酮饮食诱导的犬尿酸生成增加是否会转化为青光眼和视网膜神经退行性变等某些眼部疾病临床上的显著改善，还有待进一步的实验和临床验证。
