Liu Chun, Liu Xiaoqin, Duan Junguo
Eye School, Chengdu University of TCM, Chengdu 610075, China.
Clinical Medical School, Chengdu University of TCM, Chengdu 610075, China.
Pharmaceuticals (Basel). 2025 Apr 6;18(4):535. doi: 10.3390/ph18040535.
Age-related macular degeneration (AMD) is a leading cause of visual impairment and blindness in older adults. Its pathogenesis involves multiple factors, including aging, environmental influences, genetic predisposition, oxidative stress, metabolic dysfunction, and immune dysregulation. Currently, AMD treatment focuses primarily on wet AMD, managed through repeated intravitreal injections of anti-vascular endothelial growth factor (VEGF) therapies. While anti-VEGF agents represent a major breakthrough in wet AMD care, repeated injections may lead to incomplete responses or resistance in some patients, and carry a risk of progressive fibrosis. Artemisinin (ART) and its derivatives, originally developed as antimalarial drugs, exhibit a broad spectrum of pleiotropic activities beyond their established use, including anti-inflammatory, anti-angiogenic, antioxidant, anti-fibrotic, mitochondrial regulatory, lipid metabolic, and immunosuppressive effects. These properties position ART as a promising therapeutic candidate for AMD. A growing interest in ART-based therapies for AMD has emerged in recent years, with numerous studies demonstrating their potential benefits. However, no comprehensive review has systematically summarized the specific roles of ART and its derivatives in AMD pathogenesis and treatment. This paper aims to fill the knowledge gap by synthesizing the therapeutic efficacy and molecular mechanisms of ART and its derivatives in AMD, thereby providing a foundation for future investigations.
年龄相关性黄斑变性（AMD）是老年人视力损害和失明的主要原因。其发病机制涉及多种因素，包括衰老、环境影响、遗传易感性、氧化应激、代谢功能障碍和免疫失调。目前，AMD治疗主要集中在湿性AMD，通过反复玻璃体内注射抗血管内皮生长因子（VEGF）疗法进行管理。虽然抗VEGF药物是湿性AMD治疗的重大突破，但反复注射可能导致一些患者反应不完全或产生耐药性，并存在进行性纤维化的风险。青蒿素（ART）及其衍生物最初作为抗疟药物开发，除了既定用途外，还具有广泛的多效性活性，包括抗炎、抗血管生成、抗氧化、抗纤维化、线粒体调节、脂质代谢和免疫抑制作用。这些特性使青蒿素成为AMD有前景的治疗候选药物。近年来，基于青蒿素的AMD治疗方法越来越受到关注，许多研究证明了它们的潜在益处。然而，尚无全面综述系统总结青蒿素及其衍生物在AMD发病机制和治疗中的具体作用。本文旨在通过综合青蒿素及其衍生物在AMD中的治疗效果和分子机制来填补这一知识空白，从而为未来的研究提供基础。
