Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China.
Front Endocrinol (Lausanne). 2024 Feb 15;15:1347864. doi: 10.3389/fendo.2024.1347864. eCollection 2024.
Diabetic retinopathy (DR) is a highly tissue-specific neurovascular complication of type 1 and type 2 diabetes mellitus and is among the leading causes of blindness worldwide. Pathophysiological changes in DR encompass neurodegeneration, inflammation, and oxidative stress. Current treatments for DR, including anti-vascular endothelial growth factor, steroids, laser photocoagulation, and vitrectomy have limitations and adverse reactions, necessitating the exploration of novel treatment strategies. This review aims to summarize the current pathophysiology, therapeutic approaches, and available drug-delivery methods for treating DR, and discuss their respective development potentials. Recent research indicates the efficacy of novel receptor inhibitors and agonists, such as aldose reductase inhibitors, angiotensin-converting enzyme inhibitors, peroxisome proliferator-activated receptor alpha agonists, and novel drugs in delaying DR. Furthermore, with continuous advancements in nanotechnology, a new form of drug delivery has been developed that can address certain limitations of clinical drug therapy, such as low solubility and poor penetration. This review serves as a theoretical foundation for future research on DR treatment. While highlighting promising therapeutic targets, it underscores the need for continuous exploration to enhance our understanding of DR pathogenesis. The limitations of current treatments and the potential for future advancements emphasize the importance of ongoing research in this field.
糖尿病视网膜病变(DR)是 1 型和 2 型糖尿病高度组织特异性的神经血管并发症,也是全球致盲的主要原因之一。DR 的病理生理变化包括神经退行性变、炎症和氧化应激。目前治疗 DR 的方法包括抗血管内皮生长因子、类固醇、激光光凝和玻璃体切除术,但这些方法存在局限性和不良反应,需要探索新的治疗策略。本综述旨在总结 DR 的当前病理生理学、治疗方法和现有的药物输送方法,并讨论它们各自的发展潜力。最近的研究表明,新型受体抑制剂和激动剂,如醛糖还原酶抑制剂、血管紧张素转换酶抑制剂、过氧化物酶体增殖物激活受体α激动剂和新型药物,在延缓 DR 方面具有疗效。此外,随着纳米技术的不断进步,一种新的药物输送形式已经被开发出来,可以解决临床药物治疗的某些局限性,如低溶解度和差的渗透性。本综述为 DR 治疗的未来研究提供了理论基础。在强调有前途的治疗靶点的同时,也强调了需要不断探索以加深我们对 DR 发病机制的理解。目前治疗方法的局限性和未来进展的潜力强调了该领域持续研究的重要性。