Liu Jinfeng, Ma Andre K H, So Kwok Fai, Lee Vincent W H, Chiu Kin
Department of Ophthalmology, The University of Hong Kong, SAR, Hong Kong, China.
Harrow School, Harrow, UK.
Adv Ophthalmol Pract Res. 2022 May 5;2(2):100060. doi: 10.1016/j.aopr.2022.100060. eCollection 2022 Aug-Sep.
In the last two decades, electrical stimulation (ES) has been tested in patients with various eye diseases and shows great treatment potential in retinitis pigmentosa and optic neuropathy. However, the clinical application of ES in ophthalmology is currently limited. On the one hand, optimization and standardization of ES protocols is still an unmet need. On the other hand, poor understanding of the underlying mechanisms has hindered clinical exploitation.
Numerous experimental studies have been conducted to identify the treatment potential of ES in eye diseases and to explore the related cellular and molecular mechanisms. In this review, we summarized the in vitro and in vivo evidence related to cellular and tissue response to ES in eye diseases. We highlighted several pathways that may be utilized by ES to impose its effects on the diseased retina.
Therapeutic effect of ES in retinal degenerative diseases might through preventing neuronal apoptosis, promoting neuronal regeneration, increasing neurotrophic factors production in Müller cells, inhibiting microglial activation, enhancing retinal blood flow, and modulating brain plasticity. Future studies are suggested to analyse changes in specific retinal cells for optimizing the treatment parameters and choosing the best fit ES delivery method in target diseases.
在过去二十年中,电刺激(ES)已在患有各种眼部疾病的患者中进行了测试,并在色素性视网膜炎和视神经病变中显示出巨大的治疗潜力。然而,ES在眼科的临床应用目前受到限制。一方面,ES方案的优化和标准化仍然是未满足的需求。另一方面,对潜在机制的了解不足阻碍了临床应用。
已经进行了大量实验研究,以确定ES在眼部疾病中的治疗潜力,并探索相关的细胞和分子机制。在本综述中,我们总结了与眼部疾病中ES的细胞和组织反应相关的体外和体内证据。我们强调了ES可能用于对患病视网膜施加其作用的几种途径。
ES在视网膜退行性疾病中的治疗作用可能是通过预防神经元凋亡、促进神经元再生、增加穆勒细胞中神经营养因子的产生、抑制小胶质细胞活化、增强视网膜血流以及调节脑可塑性来实现的。建议未来的研究分析特定视网膜细胞的变化,以优化治疗参数并在目标疾病中选择最合适的ES递送方法。