Marino Rachele, Sappington Rebecca, Feligioni Marco
Laboratory of Neuronal Cell Signaling, EBRI Rita Levi-Montalcini Foundation, Rome, Italy.
Department of Neurobiology and Anatomy, Wake Forest School of Medicine, Atrium Health Wake Forest Baptist Medical Center; Department of Ophthalmology, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Neural Regen Res. 2023 Dec;18(12):2619-2622. doi: 10.4103/1673-5374.373662.
Retinal dysfunction is the most common cause of vision loss in several retinal disorders. It has been estimated a great increase in these pathologies that are becoming more globally widespread and numerous over time, also supported by the life expectancy increment. Among different types of retinopathies, we can account some that share causes, symptoms, and treatment including diabetic retinopathy, age-related macular degeneration, glaucoma, and retinitis pigmentosa. Molecular changes, environmental factors, and genetic predisposition might be some of the main causes that drive retinal tissue to chronic inflammation and neurodegeneration in these retinopathies. The treatments available on the market contain compounds that efficiently ameliorate some of the important clinical features of these pathologies like stabilization of the intraocular pressure, reduction of eye inflammation, control of eye oxidative stress which are considered the major molecular mechanisms related to retinal dysfunction. Indeed, the most commonly used drugs are anti-inflammatories, such as corticosteroids, antioxidant, hypotonic molecules and natural neuroprotective compounds. Unfortunately, these drugs, which are fundamental to treating disease symptoms, are not capable to cure the pathologies and so they are not life-changing for patients. This review provided an overview of current treatments on the market, but more interestingly, wants to be a quick window on the new treatments that are now in clinical trials. Additionally, it has been here highlighted that the recent technical enhancement of the investigation methods to identify the various retinopathies causes might be used as a sort of "precise medicine" approach to tailor the identification of molecular pathways involved and potentially study a dedicated treatment for each patient. This approach includes the use of cutting-edge technologies like gene therapy and metabolomics.
视网膜功能障碍是几种视网膜疾病中导致视力丧失的最常见原因。据估计，随着时间的推移，这些疾病在全球范围内愈发普遍且数量不断增加，预期寿命的延长也对此起到了推动作用。在不同类型的视网膜病变中，我们可以列举出一些具有共同病因、症状和治疗方法的疾病，包括糖尿病性视网膜病变、年龄相关性黄斑变性、青光眼和色素性视网膜炎。分子变化、环境因素和遗传易感性可能是导致这些视网膜病变中视网膜组织发生慢性炎症和神经退行性变的一些主要原因。市面上现有的治疗方法包含一些化合物，这些化合物能够有效改善这些疾病的一些重要临床特征，如稳定眼压、减轻眼部炎症、控制眼部氧化应激，这些被认为是与视网膜功能障碍相关的主要分子机制。事实上，最常用的药物是抗炎药，如皮质类固醇、抗氧化剂、低渗分子和天然神经保护化合物。不幸的是，这些对治疗疾病症状至关重要的药物并不能治愈这些疾病，因此对患者来说并不能改变生活。本综述概述了市面上现有的治疗方法，但更有趣的是，它希望成为了解目前正在进行临床试验的新治疗方法的一个快速窗口。此外，这里还强调，最近用于识别各种视网膜病变病因的研究方法的技术进步，可能会被用作一种“精准医学”方法，以确定所涉及的分子途径，并有可能为每位患者研究专门的治疗方法。这种方法包括使用基因治疗和代谢组学等前沿技术。
