Department of Ophthalmology, Eugene and Marilyn Glick Eye Institute , Indianapolis, IN, USA.
Indiana University School of Medicine. Indiana University , Indianapolis, IN, USA.
Expert Opin Investig Drugs. 2020 Dec;29(12):1431-1442. doi: 10.1080/13543784.2020.1842872. Epub 2020 Dec 2.
Circadian rhythm is a natural endogenous process occurring roughly every 24 hours. Circadian rhythm dysfunction is involved in diabetic retinopathy (DR) pathogenesis. Interestingly, there are investigational drugs that exhibit potential in the treatment of DR by targeting circadian rhythm dysfunction.
We performed a literature search in June 2020 using PubMed's Medical Subject Heading (MeSH) terms 'circadian clock,' 'circadian rhythms,' and 'diabetic retinopathy.' This article offers an overview of the physiology of the biological clock and clock regulatory genes and presents an examination of the retinal clock. It discusses the pathogenic mechanisms of DR and emphasizes how circadian rhythm dysfunction at structural, physiological, metabolic and cellular levels, plays a critical role in the development of DR. The latter part of the paper sheds light on those investigational drugs (such as melatonin, tasimelteon and metformin) which exhibit potential in the treatment of DR by the targeting of circadian rhythm dysfunction.
An enhanced understanding of circadian rhythm and its role in DR could offer therapeutic potential by targeting of circadian rhythm dysfunction.
昼夜节律是一种大约每 24 小时发生一次的自然内源性过程。昼夜节律失调与糖尿病视网膜病变（DR）的发病机制有关。有趣的是，有一些研究性药物通过靶向昼夜节律失调显示出治疗 DR 的潜力。
我们于 2020 年 6 月使用 PubMed 的医学主题词（MeSH）术语“生物钟”、“昼夜节律”和“糖尿病视网膜病变”进行了文献检索。本文概述了生物钟的生理学和时钟调节基因，并对视网膜时钟进行了检查。它讨论了 DR 的发病机制，并强调了结构、生理、代谢和细胞水平的昼夜节律失调如何在 DR 的发展中发挥关键作用。本文的后半部分介绍了一些研究性药物（如褪黑素、他司美琼和二甲双胍），它们通过靶向昼夜节律失调显示出治疗 DR 的潜力。
增强对昼夜节律及其在 DR 中的作用的理解，通过靶向昼夜节律失调，可能为治疗提供潜在的可能。
