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青光眼治疗中旧挑战的新解决方案:牛磺酸是一个值得考虑的选择吗?

New solutions for old challenges in glaucoma treatment: is taurine an option to consider?

作者信息

Iezhitsa Igor, Agarwal Renu

机构信息

School of Medicine, International Medical University, Kuala Lumpur, Malaysia; Volgograd State Medical University, Research Centre for Innovative Medicines, Volgograd, Russian Federation.

School of Medicine, International Medical University, Kuala Lumpur, Malaysia.

出版信息

Neural Regen Res. 2021 May;16(5):967-971. doi: 10.4103/1673-5374.297059.

Abstract

Glaucoma is a range of progressive optic neuropathies characterized by progressive retinal ganglion cell loss and visual field defects. It is recognized as a leading cause of irreversible blindness affecting more than 70 million people worldwide. Currently, reduction of intraocular pressure, a widely recognized risk factor for glaucoma development, is the only pharmacological strategy for slowing down retinal ganglion cell loss and disease progression. However, retinal ganglion cell death and visual field loss have been observed in normotensive glaucoma, suggesting that the disease process is partially independent of intraocular pressure. Taurine is one of the agents that have attracted attention of researchers recently. Taurine has been shown to be involved in multiple cellular functions, including a central role as a neurotransmitter, as a trophic factor in the central nervous system development, as an osmolyte, as a neuromodulator, and as a neuroprotectant. It also plays a role in the maintenance of the structural integrity of the membranes and in the regulation of calcium transport and homeostasis. Taurine is known to prevent N-methyl-D-aspartic acid-induced excitotoxic injury to retinal ganglion cells. A recently published study clearly demonstrated that taurine prevents retinal neuronal apoptosis both in vivo and in vitro. Protective effect of taurine may be attributed to direct inhibition of apoptosis, an activation of brain derived neurotrophic factor-related neuroprotective mechanisms and reduction of retinal oxidative and nitrosative stresses. Further studies are needed to fully explore the potential of taurine as a neuroprotective agent, so that it can be applied in clinical practice, particularly for the treatment of glaucoma. The objective of current review was to summarize recent evidence on neuroprotective properties of taurine in glaucoma.

摘要

青光眼是一系列进行性视神经病变,其特征为视网膜神经节细胞进行性丧失和视野缺损。它被认为是不可逆失明的主要原因,全球有超过7000万人受其影响。目前,降低眼压是一种广泛认可的青光眼发病危险因素,是减缓视网膜神经节细胞丧失和疾病进展的唯一药物治疗策略。然而,在眼压正常的青光眼中也观察到了视网膜神经节细胞死亡和视野丧失,这表明该疾病进程部分独立于眼压。牛磺酸是最近引起研究人员关注的药物之一。牛磺酸已被证明参与多种细胞功能,包括作为神经递质发挥核心作用、作为中枢神经系统发育中的营养因子、作为渗透质、作为神经调节剂以及作为神经保护剂。它还在维持膜的结构完整性以及调节钙转运和体内平衡方面发挥作用。已知牛磺酸可预防N-甲基-D-天冬氨酸诱导的视网膜神经节细胞兴奋性毒性损伤。最近发表的一项研究清楚地表明,牛磺酸在体内和体外均可预防视网膜神经元凋亡。牛磺酸的保护作用可能归因于直接抑制细胞凋亡、激活脑源性神经营养因子相关的神经保护机制以及降低视网膜氧化应激和亚硝化应激。需要进一步研究以充分探索牛磺酸作为神经保护剂的潜力,以便将其应用于临床实践,特别是用于青光眼的治疗。本综述的目的是总结牛磺酸在青光眼中神经保护特性的最新证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/751c/8178787/935a4c12e98c/NRR-16-967-g001.jpg

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