Department of Clinical Chemistry and Biochemistry, Medical University of Lodz, 90-419 Lodz, Poland.
Department of Ophthalmology, SPKSO Ophthalmic Hospital, Medical University of Warsaw, 03-709 Warsaw, Poland.
Int J Mol Sci. 2020 Jun 11;21(11):4171. doi: 10.3390/ijms21114171.
Glaucoma is a heterogenous, chronic, progressive group of eye diseases, which results in irreversible loss of vision. There are several types of glaucoma, whereas the primary open-angle glaucoma (POAG) constitutes the most common type of glaucoma, accounting for three-quarters of all glaucoma cases. The pathological mechanisms leading to POAG pathogenesis are multifactorial and still poorly understood, but it is commonly known that significantly elevated intraocular pressure (IOP) plays a crucial role in POAG pathogenesis. Besides, genetic predisposition and aggregation of abrogated proteins within the endoplasmic reticulum (ER) lumen and subsequent activation of the protein kinase RNA-like endoplasmic reticulum kinase (PERK)-dependent unfolded protein response (UPR) signaling pathway may also constitute important factors for POAG pathogenesis at the molecular level. Glaucoma is commonly known as a 'silent thief of sight', as it remains asymptomatic until later stages, and thus its diagnosis is frequently delayed. Thereby, detailed knowledge about the glaucoma pathophysiology is necessary to develop both biochemical and genetic tests to improve its early diagnosis as well as develop a novel, ground-breaking treatment strategy, as currently used medical therapies against glaucoma are limited and may evoke numerous adverse side-effects in patients.
青光眼是一组异质性、慢性、进行性眼病，可导致不可逆转的视力丧失。有几种类型的青光眼，而原发性开角型青光眼（POAG）是最常见的青光眼类型，占所有青光眼病例的四分之三。导致 POAG 发病机制的病理机制是多因素的，仍不完全清楚，但众所周知，眼内压（IOP）显著升高在 POAG 发病机制中起着关键作用。此外，内质网（ER）腔中截短蛋白的遗传倾向和聚集以及随后激活蛋白激酶 RNA 样内质网激酶（PERK）依赖性未折叠蛋白反应（UPR）信号通路也可能构成 POAG 发病机制的重要分子水平因素。青光眼通常被称为“视力的无声小偷”，因为它在晚期之前没有症状，因此其诊断经常被延误。因此，需要详细了解青光眼的病理生理学知识，以开发生化和遗传测试，以改善其早期诊断，并制定新的突破性治疗策略，因为目前用于治疗青光眼的医学疗法有限，并且可能在患者中引起许多不良反应。
