Pinilla Isabel, Maneu Victoria, Campello Laura, Fernández-Sánchez Laura, Martínez-Gil Natalia, Kutsyr Oksana, Sánchez-Sáez Xavier, Sánchez-Castillo Carla, Lax Pedro, Cuenca Nicolás
Aragón Health Research Institute (IIS Aragón), 50009 Zaragoza, Spain.
Department of Ophthalmology, Lozano Blesa, University Hospital, 50009 Zaragoza, Spain.
Antioxidants (Basel). 2022 May 30;11(6):1086. doi: 10.3390/antiox11061086.
Inherited retinal dystrophies (IRDs) are a large group of genetically and clinically heterogeneous diseases characterized by the progressive degeneration of the retina, ultimately leading to loss of visual function. Oxidative stress and inflammation play fundamental roles in the physiopathology of these diseases. Photoreceptor cell death induces an inflammatory state in the retina. The activation of several molecular pathways triggers different cellular responses to injury, including the activation of microglia to eliminate debris and recruit inflammatory cells from circulation. Therapeutical options for IRDs are currently limited, although a small number of patients have been successfully treated by gene therapy. Many other therapeutic strategies are being pursued to mitigate the deleterious effects of IRDs associated with oxidative metabolism and/or inflammation, including inhibiting reactive oxygen species' accumulation and inflammatory responses, and blocking autophagy. Several compounds are being tested in clinical trials, generating great expectations for their implementation. The present review discusses the main death mechanisms that occur in IRDs and the latest therapies that are under investigation.
遗传性视网膜营养不良(IRDs)是一大类具有遗传和临床异质性的疾病,其特征是视网膜进行性退化,最终导致视觉功能丧失。氧化应激和炎症在这些疾病的病理生理过程中起着重要作用。光感受器细胞死亡会在视网膜中引发炎症状态。多种分子途径的激活会触发细胞对损伤的不同反应,包括小胶质细胞的激活以清除碎片并从循环中募集炎症细胞。目前,IRDs的治疗选择有限,尽管少数患者已通过基因治疗成功治愈。正在探索许多其他治疗策略来减轻与氧化代谢和/或炎症相关的IRDs的有害影响,包括抑制活性氧的积累和炎症反应,以及阻断自噬。几种化合物正在临床试验中进行测试,人们对它们的应用寄予厚望。本综述讨论了IRDs中发生的主要死亡机制以及正在研究的最新疗法。