Quiriconi Pialuisa, Hristov Vanco, Aburaya Mayu, Greferath Una, Jobling Andrew I, Fletcher Erica L
Department of Anatomy and Physiology, The University of Melbourne, Melbourne, VIC, Australia.
NPJ Metab Health Dis. 2024 Jun 3;2(1):7. doi: 10.1038/s44324-024-00009-2.
Diabetic retinopathy is a vision-threatening disease and remains the most feared complication for those living with diabetes. Historically, the disease has been considered primarily vascular in nature, based on clinically detectable vascular pathology. Nonetheless, it is now recognized that the retina undergoes a variety of cellular changes from the early onset of diabetes. In fact, one of the earliest changes to occur is a loss in vasoregulation, yet our understanding of the underlying mechanisms is lacking. Microglia, the resident immune cells of the central nervous system, perform a range of physiological, non-inflammatory functions to maintain retinal homeostasis which includes surveying the microenvironment to constantly monitor tissue health, neuronal surveillance to maintain synaptic integrity and vasoregulation, a recently discovered role that these cells additionally perform. The role of microglia in the development of diabetic retinopathy is well-established, centered around their contribution to inflammation which remains an integral component in disease pathogenesis, particularly in later stages of disease. However, recent findings reveal that early in the development of diabetes the vasoregulatory function of microglia is dysfunctional, leading to early vascular compromise. This review summarizes recent work to highlight how microglia are affected by diabetes and the implications of these changes in the development of diabetic retinopathy from pre-clinical to advanced stages of disease.
糖尿病视网膜病变是一种威胁视力的疾病，仍然是糖尿病患者最担心的并发症。从历史上看，基于临床上可检测到的血管病变，该疾病主要被认为本质上是血管性的。尽管如此，现在人们认识到，从糖尿病早期开始，视网膜就会发生各种细胞变化。事实上，最早出现的变化之一是血管调节功能丧失，但我们对其潜在机制仍缺乏了解。小胶质细胞是中枢神经系统的常驻免疫细胞，执行一系列生理、非炎症功能以维持视网膜内环境稳定，包括监测微环境以持续监测组织健康、进行神经元监测以维持突触完整性以及血管调节，这是这些细胞最近被发现的额外功能。小胶质细胞在糖尿病视网膜病变发展中的作用已得到充分证实，其核心在于它们对炎症的贡献，炎症仍然是疾病发病机制中不可或缺的组成部分，尤其是在疾病后期。然而，最近的研究结果表明，在糖尿病发展的早期，小胶质细胞的血管调节功能就出现了功能障碍，导致早期血管受损。这篇综述总结了最近的研究工作，以强调糖尿病如何影响小胶质细胞，以及这些变化在糖尿病视网膜病变从临床前期到疾病晚期发展过程中的意义。
