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维生素D3在眼部纤维化中的作用及其对青光眼小梁网的治疗潜力。

The role of Vitamin D3 in ocular fibrosis and its therapeutic potential for the glaucomatous trabecular meshwork.

作者信息

Morelli-Batters Alexander, Lamont Hannah C, Elghobashy Mirna, Masood Imran, Hill Lisa J

机构信息

School of Biomedical Sciences, Institute of Clinical Sciences, University of Birmingham, Birmingham, United Kingdom.

School of Chemical Engineering, Healthcare Technologies Institute, University of Birmingham, Birmingham, United Kingdom.

出版信息

Front Ophthalmol (Lausanne). 2022 Aug 1;2:897118. doi: 10.3389/fopht.2022.897118. eCollection 2022.

Abstract

Glaucoma is the leading cause of irreversible blindness globally. The most prevalent subtype, Primary Open Angle Glaucoma (POAG), is characterized by increased intraocular pressure (IOP), damage to the optic nerve head and irreversible visual loss. IOP increases aqueous humor (AqH) outflow is reduced through the trabecular meshwork (TM) and Schlemm's canal (SC). Increased outflow resistance is partly due to TM/SC dysregulation, including loss of normal trabecular meshwork cell (TMC) function, following increased levels of oxidative stress within TMC, dysregulated extracellular matrix (ECM) deposition and remodeling alongside alterations in TMC phenotype and apoptosis. Current widely available POAG treatments do not target the aberrant expression of ECM in the TM directly. As a result, most drug treatments can fail as the underlying pathological process continues unabated. Rho-kinase inhibitors have demonstrated the benefit of restoring TM/SC function, however there is a clear need to develop further treatment strategies that can target the underlying cellular processes which become dysregulated within the TMC during POAG pathogenesis. Vitamin D is suggested to be beneficial in alleviating the symptoms of fibrosis and inflammation in soft tissues. It has important functions in many major organ systems, including regulation of calcium, phosphate and parathyroid hormone. Evidence suggests that Vitamin D3 modulates ECM turnover through the conventional TGFβ-SMAD signaling, which is associated with the development of POAG. The link between Vitamin D3, inflammation and fibrosis within ocular tissues will be discussed and the potential roles of Vitamin D3 in the management of POAG patients will be explored within this review.

摘要

青光眼是全球不可逆性失明的主要原因。最常见的亚型,原发性开角型青光眼(POAG),其特征是眼压(IOP)升高、视神经乳头受损和不可逆的视力丧失。眼压升高是由于房水(AqH)通过小梁网(TM)和施莱姆管(SC)的流出减少。流出阻力增加部分是由于TM/SC调节异常,包括正常小梁网细胞(TMC)功能丧失,这是在TMC内氧化应激水平升高、细胞外基质(ECM)沉积和重塑失调以及TMC表型和凋亡改变之后发生的。目前广泛可用的POAG治疗方法并未直接针对TM中ECM的异常表达。因此,随着潜在的病理过程持续未减,大多数药物治疗可能会失败。Rho激酶抑制剂已证明可恢复TM/SC功能,但显然需要开发进一步的治疗策略,以针对POAG发病机制中TMC内失调的潜在细胞过程。维生素D被认为有助于减轻软组织中的纤维化和炎症症状。它在许多主要器官系统中具有重要功能,包括调节钙、磷和甲状旁腺激素。有证据表明维生素D3通过传统的TGFβ-SMAD信号传导调节ECM周转,这与POAG的发展有关。本文将讨论维生素D3、眼组织内炎症和纤维化之间的联系,并探讨维生素D3在POAG患者管理中的潜在作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7208/11182265/b1120a82e151/fopht-02-897118-g001.jpg

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