Figueiredo Inês, Farinha Cláudia, Barreto Patrícia, Coimbra Rita, Pereira Pedro, Marques João Pedro, Pires Isabel, Cachulo Maria Luz, Silva Rufino
Ophthalmology Department, Unidade Local de Saúde Coimbra, 3004-561 Coimbra, Portugal.
AIBILI-Association for Innovation and Biomedical Research on Light and Image, 3000-548 Coimbra, Portugal.
Nutrients. 2024 Nov 28;16(23):4124. doi: 10.3390/nu16234124.
Age-related macular degeneration (AMD) is a leading cause of vision loss in older individuals, driven by a multifactorial etiology involving genetic, environmental, and dietary factors. Nutritional genomics, which studies gene-nutrient interactions, has emerged as a promising field for AMD prevention and management. Genetic predispositions, such as variants in , , , , and oxidative stress pathways, significantly affect the risk and progression of AMD. This narrative review synthesizes findings from randomized controlled trials and recent advances in nutritional genomics research. It examines the interplay between genetic predispositions and dietary interventions, exploring how personalized nutritional strategies can optimize AMD management. The AREDS and AREDS2 trials demonstrated that supplements, including vitamins C, E, zinc, copper, lutein, and zeaxanthin, can reduce the progression to advanced AMD. Nutritional interventions tailored to genetic profiles show promise: risk alleles may enhance zinc supplementation's anti-inflammatory effects, while variants influence the response to omega-3 fatty acids. Adjusting carotenoid intake, such as lutein and zeaxanthin, based on genetic susceptibility exemplifies emerging precision nutritional approaches. Ongoing research seeks to integrate nutrigenomic testing into clinical settings, enabling clinicians to tailor interventions to individual genetic profiles. Further studies are needed to assess the long-term effects of personalized interventions, investigate additional genetic variants, and develop tools for clinical implementation of nutrigenomics. Advancing these strategies holds the potential to improve patient outcomes, optimize AMD management, and pave the way for precision nutrition in ophthalmology.
年龄相关性黄斑变性（AMD）是老年人视力丧失的主要原因，其病因是多因素的，涉及遗传、环境和饮食因素。营养基因组学研究基因与营养素的相互作用，已成为预防和管理AMD的一个有前景的领域。遗传易感性，如 、 、 、 和氧化应激途径中的变异，会显著影响AMD的风险和进展。本叙述性综述综合了随机对照试验的结果以及营养基因组学研究的最新进展。它研究了遗传易感性与饮食干预之间的相互作用，探讨了个性化营养策略如何优化AMD的管理。年龄相关性眼病研究（AREDS）和年龄相关性眼病研究2（AREDS2）试验表明，包括维生素C、E、锌、铜、叶黄素和玉米黄质在内的补充剂可以减少进展为晚期AMD的风险。根据基因特征定制的营养干预措施显示出前景： 风险等位基因可能增强锌补充剂的抗炎作用，而 变异会影响对ω-3脂肪酸的反应。根据遗传易感性调整类胡萝卜素的摄入量，如叶黄素和玉米黄质，是新兴的精准营养方法的一个例子。正在进行的研究试图将营养基因组检测整合到临床环境中，使临床医生能够根据个体基因特征定制干预措施。需要进一步的研究来评估个性化干预措施的长期效果，研究更多的基因变异，并开发营养基因组学临床应用的工具。推进这些策略有可能改善患者的治疗效果，优化AMD的管理，并为眼科精准营养铺平道路。
