Dias Paula Basso, Messias-Reason Iara, Hokazono Kenzo, Nisihara Renato
Clinical Hospital, Federal University of Paraná, Curitiba, Brazil; Department of Ophthalmology, Clinical Hospital, Federal University of Paraná, Curitiba, Brazil.
Clinical Hospital, Federal University of Paraná, Curitiba, Brazil.
Immunol Lett. 2024 Jun;267:106863. doi: 10.1016/j.imlet.2024.106863. Epub 2024 May 4.
Diabetes mellitus (DM) is a chronic systemic disease characterized by a multifactorial nature, which may lead to several macro and microvascular complications. Diabetic retinopathy (DR) is one of the most severe microvascular complications of DM, which can result in permanent blindness. The mechanisms involved in the pathogenesis of DR are multiple and still poorly understood. Factors such as dysregulation of vascular regeneration, oxidative and hyperosmolar stress in addition to inflammatory processes have been associated with the pathogenesis of DR. Furthermore, compelling evidence shows that components of the immune system, including the complement system, play a relevant role in the development of the disease. Studies suggest that high concentrations of mannose-binding lectin (MBL), an essential component of the complement lectin pathway, may contribute to the development of DR in patients with DM. This review provides an update on the possible role of the complement system, specifically the lectin pathway, in the pathogenesis of DR and discusses the potential of MBL as a non-invasive biomarker for both, the presence and severity of DR, in addition to its potential as a therapeutic target for intervention strategies.
糖尿病（DM）是一种具有多因素性质的慢性全身性疾病，可能导致多种大血管和微血管并发症。糖尿病视网膜病变（DR）是DM最严重的微血管并发症之一，可导致永久性失明。DR发病机制涉及多种因素，目前仍了解不足。血管再生失调、氧化应激和高渗应激以及炎症过程等因素都与DR的发病机制有关。此外，有力证据表明，包括补体系统在内的免疫系统成分在该疾病的发展中起相关作用。研究表明，补体凝集素途径的重要成分——高浓度的甘露糖结合凝集素（MBL），可能促使DM患者发生DR。本综述提供了关于补体系统，特别是凝集素途径，在DR发病机制中可能作用的最新信息，并讨论了MBL作为DR存在和严重程度的非侵入性生物标志物的潜力，以及其作为干预策略治疗靶点的潜力。
