Kąpa Maria, Koryciarz Iga, Kustosik Natalia, Jurowski Piotr, Pniakowska Zofia
Department of Ophthalmology and Vision Rehabilitation, Medical University of Lodz, 90-549 Lodz, Poland.
Optegra Eye Clinic, 90-127 Lodz, Poland.
J Clin Med. 2025 Jan 21;14(3):683. doi: 10.3390/jcm14030683.
This narrative review focuses on innovative treatment approaches to diabetic retinopathy to meet the urgent demand for advancements in managing both the early and late stages of the disease. Recent studies highlight the potential of adipose stem cells and their secreted factors in mitigating the retinal complications of diabetes, with promising results in improving visual acuity and reducing inflammation and angiogenesis in diabetic retinopathy. However, caution is warranted regarding the safety and long-term therapeutic effects of adipose stem cells transplantation. Bone marrow mesenchymal stem cells can also mitigate retinal damage in diabetic retinopathy. Studies demonstrate that bone marrow mesenchymal stem cells-derived exosomes can suppress the Wnt/β-catenin pathway, reducing oxidative stress, inflammation, and angiogenesis in the diabetic retina, offering promise for future diabetic retinopathy treatments. Nanotechnology has the ability to precisely target the retina and minimize systemic side effects. Nanoparticles and nanocarriers offer improved bioavailability, sustained release of therapeutics, and potential for synergistic effects. They can be a new way of effective treatment and prevention of diabetic retinopathy. Activation and modulation of PPARα as a means for diabetic retinopathy treatment has been widely investigated in recent years and demonstrated promising effects in clinical trials. PPARα activation turned out to be a promising therapeutic method for treating dyslipidemia, inflammation, and insulin sensitivity. The combination of PPARα modulators with small molecules offers an interesting perspective for retinal diseases' therapy.
本叙述性综述聚焦于糖尿病视网膜病变的创新治疗方法，以满足在该疾病早期和晚期管理方面取得进展的迫切需求。近期研究强调了脂肪干细胞及其分泌因子在减轻糖尿病视网膜并发症方面的潜力，在改善糖尿病视网膜病变患者的视力、减轻炎症和抑制血管生成方面取得了有前景的结果。然而，对于脂肪干细胞移植的安全性和长期治疗效果仍需谨慎。骨髓间充质干细胞也可减轻糖尿病视网膜病变中的视网膜损伤。研究表明，骨髓间充质干细胞衍生的外泌体可抑制Wnt/β-连环蛋白信号通路，减轻糖尿病视网膜中的氧化应激、炎症和血管生成，为未来糖尿病视网膜病变的治疗带来希望。纳米技术能够精准靶向视网膜并将全身副作用降至最低。纳米颗粒和纳米载体具有更高的生物利用度、治疗药物的持续释放以及产生协同效应的潜力。它们可能成为有效治疗和预防糖尿病视网膜病变的新途径。近年来，作为糖尿病视网膜病变治疗手段的过氧化物酶体增殖物激活受体α（PPARα）的激活和调节已得到广泛研究，并在临床试验中显示出有前景的效果。PPARα激活被证明是治疗血脂异常、炎症和胰岛素敏感性的一种有前景的治疗方法。PPARα调节剂与小分子的联合应用为视网膜疾病的治疗提供了一个有趣的视角。
