Burggraaf-Sánchez de Las Matas Raquel, Torres-Cuevas Isabel, Millán Iván, Desco María Del Carmen, Oblaré-Delgado Candela, Asensi Miguel, Mena-Mollá Salvador, Oger Camille, Galano Jean-Marie, Durand Thierry, Ortega Ángel Luis
Hospital of Sagunto, Ramón y Cajal Av. s/n, 46520 Sagunto, Spain.
Department of Physiology, Faculty of Pharmacy, University of Valencia, Vicente Andrés Estellés Av. s/n, 46100 Burjassot, Spain.
Antioxidants (Basel). 2025 Feb 20;14(3):244. doi: 10.3390/antiox14030244.
Chronic hyperglycemia is a major driver of neurovascular damage in diabetic retinopathy (DR), a leading cause of preventable blindness in adults. DR progression is often undetected until its advanced stages, with oxidative stress recognized as a primary contributor. In diabetes, oxidative stress disrupts retinal cellular balance, damaging proteins, DNA, and lipids, and triggering photoreceptor degeneration. Pterostilbene (Pter), a polyphenol with antioxidant properties, has demonstrated protective effects in DR animal models and was assessed in a pilot clinical study. DR patients treated with 250 mg/day of oral Pter showed a reduction in the development of retinal vascular alterations characteristic of the disease. Urinary analyses confirmed Pter's role in reducing the lipid peroxidation of polyunsaturated fatty acids (PUFAs), including arachidonic and adrenic acids, indicators of oxidative damage in DR. Pter also improved the GSH/GSSG ratio, reflecting a restored redox balance. However, after six months without treatment, retinal damage indicators reappeared, highlighting the importance of sustained intervention. These findings suggest that Pter may help slow the progression of DR by protecting against oxidative stress and highlight the importance of implementing antioxidant therapies from the diagnosis of diabetes, although its long-term impact and the development of consistent biomarkers deserve more research to optimize DR management.
慢性高血糖是糖尿病视网膜病变（DR）神经血管损伤的主要驱动因素，DR是成年人可预防失明的主要原因。DR进展在晚期之前通常难以察觉，氧化应激被认为是主要促成因素。在糖尿病中，氧化应激破坏视网膜细胞平衡，损害蛋白质、DNA和脂质，并引发光感受器退化。紫檀芪（Pter）是一种具有抗氧化特性的多酚，已在DR动物模型中显示出保护作用，并在一项初步临床研究中进行了评估。接受每日250毫克口服紫檀芪治疗的DR患者，其视网膜血管病变的发展有所减少，而这种病变是该疾病的特征。尿液分析证实了紫檀芪在减少多不饱和脂肪酸（PUFA）脂质过氧化中的作用，包括花生四烯酸和肾上腺酸，这些都是DR氧化损伤的指标。紫檀芪还改善了谷胱甘肽/氧化型谷胱甘肽（GSH/GSSG）比值，反映了氧化还原平衡的恢复。然而，在未经治疗六个月后，视网膜损伤指标再次出现，凸显了持续干预的重要性。这些发现表明，紫檀芪可能通过抵御氧化应激帮助减缓DR的进展，并突出了从糖尿病诊断时就实施抗氧化治疗的重要性，尽管其长期影响和一致生物标志物的开发值得更多研究以优化DR管理。
