Malepati Akanksha, Grant Maria B
UAB Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35233, USA.
Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham, Birmingham, AL 35233, USA.
Int J Mol Sci. 2025 Apr 22;26(9):3961. doi: 10.3390/ijms26093961.
Diabetes mellitus (DM) is a chronic metabolic disorder that results in hyperglycemia, leading to multiple microvascular and macrovascular complications, including significant ocular damage resulting in the development of diabetic retinopathy (DR) and diabetic macular edema (DME). Many factors contribute to the pathogenesis of DR and DME, including hyperglycemia-mediated vascular and neuronal abnormalities and local and systemic inflammation. Growth hormone (GH) and insulin-like growth factor-1 (IGF-1) have been implicated in the initiation and progression of DR and DME through a variety of mechanistic processes. In this review, we provide a comprehensive synopsis of the diverse roles and molecular pathways supporting IGF-1 in the pathogenesis of DR and DME, elucidating its range of effects from detrimental to protective, depending on the context and stage of disease. We further investigate the underlying inflammatory processes regulated by IGF-1 and examine how the interaction of IGF-1 with key signaling molecules influences these inflammatory mechanisms. Additionally, the potential of serum IGF-1 as a biomarker for the progression of DR and DME in clinical practice is discussed. Finally, we consider current therapeutic approaches for DR and DME in relation to IGF-1 and explore novel therapeutic targets and innovative delivery methods. By providing an in-depth understanding of IGF-1's role in the pathogenesis and progression of DR and DME, this review underscores the diagnostic utility of serum IGF-1 and puts forth new treatment strategies to improve the management of DR and DME.
糖尿病（DM）是一种慢性代谢紊乱疾病，会导致血糖升高，进而引发多种微血管和大血管并发症，包括严重的眼部损害，导致糖尿病视网膜病变（DR）和糖尿病性黄斑水肿（DME）的发生。许多因素促成了DR和DME的发病机制，包括高血糖介导的血管和神经元异常以及局部和全身炎症。生长激素（GH）和胰岛素样生长因子-1（IGF-1）通过多种机制参与了DR和DME的起始和进展过程。在本综述中，我们全面概述了支持IGF-1在DR和DME发病机制中的多种作用和分子途径，阐明了其根据疾病背景和阶段从有害到保护的一系列作用。我们进一步研究了由IGF-1调节的潜在炎症过程，并探讨了IGF-1与关键信号分子的相互作用如何影响这些炎症机制。此外，还讨论了血清IGF-1作为临床实践中DR和DME进展生物标志物的潜力。最后，我们考虑了当前针对DR和DME与IGF-1相关的治疗方法，并探索了新的治疗靶点和创新的给药方法。通过深入了解IGF-1在DR和DME发病机制和进展中的作用，本综述强调了血清IGF-1的诊断效用，并提出了新的治疗策略以改善DR和DME的管理。
