Skopiński Piotr, Radomska-Leśniewska Dorota Magdalena, Izdebska Justyna, Kamińska Anna, Kupis Magdalena, Kubiak Aleksander Jan, Samelska Katarzyna
Department of Histology and Embryology, Medical University of Warsaw, Warsaw, Poland.
SPKSO Ophthalmic University Hospital, Warsaw, Poland.
Cent Eur J Immunol. 2021;46(1):105-110. doi: 10.5114/ceji.2021.104329. Epub 2021 Mar 11.
Glaucoma is the neurodegenerative disease of retinal ganglion cells. The main risk factor for glaucoma is increased intraocular pressure. The processes leading to cell death due to presence of the injury factor comprise multiple molecular mechanisms, as well as the immunological response. The knowledge of immunological mechanisms occurring in glaucomatous degeneration makes it possible to introduce glaucoma treatment modulating the cellular degradation. The glaucoma treatment of the future will make it possible not only to lower the intraocular pressure, but also to moderate the intracellular mechanisms in order to prevent retinal cell degeneration. Citicoline is a drug modulating glutamate excitotoxicity that is already in use. Rho kinase inhibitors were found to stimulate neurite growth and axon regeneration apart from lowering intraocular pressure. The complementary action of brimonidine is to increase neurotrophic factor (NTF) concentrations and inhibit glutamate toxicity. Immunomodulatory therapies with antibodies and gene therapies show promising effects in the current studies. The supplementation of NTFs prevents glaucomatous damage. Resveratrol and other antioxidants inhibit reactive oxygen species formation. Cell transplantation of stem cells, Schwann cells and nerve extracts was reported to be successful so far. Our review presents the most promising new strategies of neuroprotection and immunomodulation in glaucoma.
青光眼是视网膜神经节细胞的神经退行性疾病。青光眼的主要危险因素是眼压升高。由于损伤因素的存在导致细胞死亡的过程包括多种分子机制以及免疫反应。了解青光眼性退变中发生的免疫机制使得引入调节细胞降解的青光眼治疗成为可能。未来的青光眼治疗不仅能够降低眼压，还能够调节细胞内机制以防止视网膜细胞退变。胞磷胆碱是一种已在使用的调节谷氨酸兴奋性毒性的药物。除了降低眼压外，发现 Rho 激酶抑制剂还能刺激神经突生长和轴突再生。溴莫尼定的补充作用是增加神经营养因子（NTF）浓度并抑制谷氨酸毒性。在当前研究中，抗体免疫调节疗法和基因疗法显示出有前景的效果。补充 NTF 可预防青光眼性损伤。白藜芦醇和其他抗氧化剂可抑制活性氧的形成。迄今为止，干细胞、雪旺细胞和神经提取物的细胞移植已被报道取得成功。我们的综述介绍了青光眼神经保护和免疫调节最有前景的新策略。
