Department of Surgical Sciences and Advanced Technologies "G. F. Ingrassia", Cannizzaro Hospital, University of Catania, 95126 Catania, Italy.
Complex Operative Unit of Ophtalmology, Cannizzaro Hospital, University of Catania, 95126 Catania, Italy.
Int J Mol Sci. 2023 Jan 6;24(2):1166. doi: 10.3390/ijms24021166.
The rate at which obesity is becoming an epidemic in many countries is alarming. Obese individuals have a high risk of developing elevated intraocular pressure and glaucoma. Additionally, glaucoma is a disease of epidemic proportions. It is characterized by neurodegeneration and neuroinflammation with optic neuropathy and the death of retinal ganglion cells (RGC). On the other hand, there is growing interest in microbiome dysbiosis, particularly in the gut, which has been widely acknowledged to play a prominent role in the etiology of metabolic illnesses such as obesity. Recently, studies have begun to highlight the fact that microbiome dysbiosis could play a critical role in the onset and progression of several neurodegenerative diseases, as well as in the development and progression of several ocular disorders. In obese individuals, gut microbiome dysbiosis can induce endotoxemia and systemic inflammation by causing intestinal barrier malfunction. As a result, bacteria and their metabolites could be delivered via the bloodstream or mesenteric lymphatic vessels to ocular regions at the level of the retina and optic nerve, causing tissue degeneration and neuroinflammation. Nowadays, there is preliminary evidence for the existence of brain and intraocular microbiomes. The altered microbiome of the gut could perturb the resident brain-ocular microbiome ecosystem which, in turn, could exacerbate the local inflammation. All these processes, finally, could lead to the death of RGC and neurodegeneration. The purpose of this literature review is to explore the recent evidence on the role of gut microbiome dysbiosis and related inflammation as common mechanisms underlying obesity and glaucoma.
肥胖在许多国家呈流行趋势，其发病率令人震惊。肥胖个体发生眼内压升高和青光眼的风险较高。此外，青光眼是一种流行程度极高的疾病。其特征是神经退行性变和神经炎症伴有视神经病变和视网膜神经节细胞（RGC）死亡。另一方面，人们对微生物组失调越来越感兴趣，特别是在肠道中，人们广泛认为肠道在肥胖等代谢疾病的病因中起着重要作用。最近的研究开始强调，微生物组失调可能在几种神经退行性疾病的发生和进展中，以及几种眼部疾病的发展和进展中发挥关键作用。在肥胖个体中，肠道微生物组失调可通过引起肠道屏障功能障碍导致内毒素血症和全身炎症。因此，细菌及其代谢物可通过血液或肠系膜淋巴途径输送到视网膜和视神经等眼部区域，导致组织退化和神经炎症。如今，已经有初步证据表明存在脑和眼内微生物组。肠道微生物组的改变可能会扰乱常驻的脑-眼微生物组生态系统，进而加剧局部炎症。所有这些过程最终可能导致 RGC 死亡和神经退行性变。本文综述的目的是探讨肠道微生物组失调和相关炎症作为肥胖和青光眼共同机制的最新证据。
