Xie Liqing, Lin Wenjian
Department of Endocrinology, First Affiliated Hospital of Harbin Medical University, Harbin, China.
Front Immunol. 2025 Jul 7;16:1604315. doi: 10.3389/fimmu.2025.1604315. eCollection 2025.
Diabetic retinopathy, a prevalent microvascular complication of diabetes mellitus, is characterized by its increasing global prevalence and stands as the leading cause of visual impairment and blindness in adults. The pathogenesis of diabetic retinopathy involves multifactorial interactions, among which inflammatory responses play a pivotal role in disease progression. With the emergence of the "gut-retinal axis" concept, growing evidence has elucidated the intricate association between gut microbiota dysbiosis and the development of diabetic retinopathy. Studies have revealed significant differences in gut microbiota composition and diversity between patients with diabetic retinopathy and those without diabetic retinopathy. Dysbiosis of the gut microbiota compromises intestinal barrier integrity, thereby facilitating the translocation of intestinal metabolites into systemic circulation. This process may trigger the activation of systemic inflammatory responses, thus contributing to the pathogenesis and progression of diabetic retinopathy. This review examines the metabolic disturbances and systemic inflammatory responses induced by gut microbiota dysbiosis in diabetes, providing an in-depth analysis of how gut microbiota dysbiosis influences the inflammatory mechanisms underlying diabetic retinopathy. Furthermore, it summarizes the protective effects of anti-diabetic drugs on diabetic retinopathy by modulating the intestinal microenvironment, offering novel perspectives for the treatment of diabetic retinopathy.
糖尿病视网膜病变是糖尿病常见的微血管并发症，其全球患病率呈上升趋势，是成年人视力损害和失明的主要原因。糖尿病视网膜病变的发病机制涉及多因素相互作用，其中炎症反应在疾病进展中起关键作用。随着“肠-视网膜轴”概念的出现，越来越多的证据阐明了肠道微生物群失调与糖尿病视网膜病变发生发展之间的复杂关联。研究表明，糖尿病视网膜病变患者与非糖尿病视网膜病变患者的肠道微生物群组成和多样性存在显著差异。肠道微生物群失调会损害肠道屏障完整性，从而促进肠道代谢产物进入体循环。这一过程可能触发全身炎症反应的激活，进而导致糖尿病视网膜病变的发病和进展。本综述探讨了糖尿病中肠道微生物群失调引起的代谢紊乱和全身炎症反应，深入分析了肠道微生物群失调如何影响糖尿病视网膜病变的炎症机制。此外，还总结了抗糖尿病药物通过调节肠道微环境对糖尿病视网膜病变的保护作用，为糖尿病视网膜病变的治疗提供了新的视角。
