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糖尿病视网膜病变的药物治疗

Pharmacologic management of diabetic retinopathy.

作者信息

Uemura Akiyoshi

机构信息

Department of Retinal Vascular Biology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan.

出版信息

J Biochem. 2018 Jan 1;163(1):3-9. doi: 10.1093/jb/mvx057.

Abstract

Diabetic retinopathy (DR) is a leading cause of vision loss in working-age populations, primarily attributable to retinal vascular hyperpermeability, hypoperfusion, and neoangiogenesis. In the past decade, laser photocoagulation and surgical interventions to treat DR have been replaced by topical administrations of anti-vascular endothelial growth factor drugs and corticosteroids. Although these drugs have revolutionized clinical management of DR, their limited efficacy and adverse effects have raised an increasing demand for new drug development. Meanwhile, mouse retinas have been prevalently employed as an experimental model system for angiogenic research, which has greatly contributed to the understanding of general principles in vascular biology. Therefore, clinical ophthalmology and basic research have complimentarily accumulated invaluable information for DR drug discovery. This review highlights the current pharmacologic management of DR, the utility of experimental mouse retinal models, and the perspectives on new drugs targeting the angioepoitin-Tie2 signals.

摘要

糖尿病视网膜病变(DR)是工作年龄人群视力丧失的主要原因,主要归因于视网膜血管高通透性、灌注不足和新生血管形成。在过去十年中,用于治疗DR的激光光凝和手术干预已被局部应用抗血管内皮生长因子药物和皮质类固醇所取代。尽管这些药物彻底改变了DR的临床管理,但它们有限的疗效和不良反应引发了对新药研发的日益增长的需求。与此同时,小鼠视网膜已被广泛用作血管生成研究的实验模型系统,这极大地促进了对血管生物学一般原理的理解。因此,临床眼科和基础研究为DR药物发现互补性地积累了宝贵信息。本综述重点介绍了DR的当前药物管理、实验性小鼠视网膜模型的效用以及针对血管生成素-Tie2信号的新药前景。

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