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Dănilă AI, Ghenciu LA, Stoicescu ER, Bolintineanu SL, Iacob R, Săndesc MA, Faur AC. Aldose Reductase as a Key Target in the Prevention and Treatment of Diabetic Retinopathy: A Comprehensive Review. Biomedicines 2024; 12:747. [PMID: 38672103 PMCID: PMC11047946 DOI: 10.3390/biomedicines12040747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Revised: 03/24/2024] [Accepted: 03/26/2024] [Indexed: 04/28/2024] Open
Abstract
The escalating global prevalence of diabetes mellitus (DM) over the past two decades has led to a persistent high incidence of diabetic retinopathy (DR), necessitating screening for early symptoms and proper treatment. Effective management of DR aims to decrease vision impairment by controlling modifiable risk factors including hypertension, obesity, and dyslipidemia. Moreover, systemic medications and plant-based therapy show promise in advancing DR treatment. One of the key mechanisms related to DR pathogenesis is the polyol pathway, through which aldose reductase (AR) catalyzes the conversion of glucose to sorbitol within various tissues, including the retina, lens, ciliary body and iris. Elevated glucose levels activate AR, leading to osmotic stress, advanced glycation end-product formation, and oxidative damage. This further implies chronic inflammation, vascular permeability, and angiogenesis. Our comprehensive narrative review describes the therapeutic potential of aldose reductase inhibitors in treating DR, where both synthetic and natural inhibitors have been studied in recent decades. Our synthesis aims to guide future research and clinical interventions in DR management.
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Affiliation(s)
- Alexandra-Ioana Dănilă
- Department of Anatomy and Embriology, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania; (A.-I.D.); (S.L.B.); (R.I.); (A.C.F.)
| | - Laura Andreea Ghenciu
- Department of Functional Sciences, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
| | - Emil Robert Stoicescu
- Doctoral School, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania;
- Field of Applied Engineering Sciences, Specialization Statistical Methods and Techniques in Health and Clinical Research, Faculty of Mechanics, ‘Politehnica’ University Timisoara, Mihai Viteazul Boulevard No. 1, 300222 Timisoara, Romania
- Department of Radiology and Medical Imaging, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
- Research Center for Pharmaco-Toxicological Evaluations, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
| | - Sorin Lucian Bolintineanu
- Department of Anatomy and Embriology, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania; (A.-I.D.); (S.L.B.); (R.I.); (A.C.F.)
| | - Roxana Iacob
- Department of Anatomy and Embriology, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania; (A.-I.D.); (S.L.B.); (R.I.); (A.C.F.)
- Doctoral School, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania;
- Field of Applied Engineering Sciences, Specialization Statistical Methods and Techniques in Health and Clinical Research, Faculty of Mechanics, ‘Politehnica’ University Timisoara, Mihai Viteazul Boulevard No. 1, 300222 Timisoara, Romania
| | - Mihai-Alexandru Săndesc
- Department of Orthopedics and Traumatology, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania;
| | - Alexandra Corina Faur
- Department of Anatomy and Embriology, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania; (A.-I.D.); (S.L.B.); (R.I.); (A.C.F.)
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Sharma DS, Singh SK, Thakur D, K.R A, Khursheed R, Wadhwa S. Current Strategies and Future Perspective for the Effective Treatment of Diabetic Retinopathy. CURRENT DRUG THERAPY 2020. [DOI: 10.2174/1574885514666191007101007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Diabetes Retinopathy (DR) is one of the main complications due to diabetes. DR will
damage the retinal capillaries and block them, which causes the loss of vision. Different drugs and
therapies are used for the treatment and prevention of the DR. The most commonly used treatment
is laser technology and combination therapy, along with some drugs. But these drugs possess side
effects in the form of cataract, glaucoma, and complete blindness of the eye. The main strategy to
overcome In DR, medicines with minimum side effects or maximum therapeutic effects are used.
This article emphasizes the current strategy used for the treatment of DR with allopathic as well as
herbal drugs.
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Affiliation(s)
- Deep Shikha Sharma
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, India
| | - Sachin Kumar Singh
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, India
| | - Divya Thakur
- Department of Pharmaceutical Sciences and Drug Research, Punjabi University, Patiala, Punjab, India
| | - Arya K.R
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, India
| | - Rubiya Khursheed
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, India
| | - Sheetu Wadhwa
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, India
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PPARα Agonist Oral Therapy in Diabetic Retinopathy. Biomedicines 2020; 8:biomedicines8100433. [PMID: 33086679 PMCID: PMC7589723 DOI: 10.3390/biomedicines8100433] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 10/13/2020] [Accepted: 10/15/2020] [Indexed: 12/12/2022] Open
Abstract
Diabetic retinopathy (DR) is an eye condition that develops after chronically poorly-managed diabetes, and is presently the main cause for blindness on a global scale. Current treatments for DR such as laser photocoagulation, topical injection of corticosteroids, intravitreal injection of anti-vascular endothelial growth factor (VEGF) agents and vitreoretinal surgery are only applicable at the late stages of DR and there are possibilities of significant adverse effects. Moreover, the forms of treatment available for DR are highly invasive to the eyes. Safer and more effective pharmacological treatments are required for DR treatment, in particular at an early stage. In this review, we cover recently investigated promising oral pharmacotherapies, the methods of which are safer, easier to use, patient-friendly and pain-free, in clinical studies. We especially focus on peroxisome proliferator-activator receptor alpha (PPARα) agonists in which experimental evidence suggests PPARα activation may be closely related to the attenuation of vascular damages, including lipid-induced toxicity, inflammation, an excess of free radical generation, endothelial dysfunction and angiogenesis. Furthermore, oral administration of selective peroxisome proliferator-activated receptor alpha modulator (SPPARMα) agonists may induce hepatic fibroblast growth factor 21 expression, indirectly resulting in retinal protection in animal studies. Our review will enable more comprehensive approaches for understanding protective roles of PPARα for the prevention of DR development.
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Rezzola S, Loda A, Corsini M, Semeraro F, Annese T, Presta M, Ribatti D. Angiogenesis-Inflammation Cross Talk in Diabetic Retinopathy: Novel Insights From the Chick Embryo Chorioallantoic Membrane/Human Vitreous Platform. Front Immunol 2020; 11:581288. [PMID: 33117388 PMCID: PMC7552803 DOI: 10.3389/fimmu.2020.581288] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 08/27/2020] [Indexed: 12/11/2022] Open
Abstract
Pathological angiogenesis of the retina is a key component of irreversible causes of blindness, as observed in proliferative diabetic retinopathy (PDR). The pathogenesis of PDR is complex and involves vascular, inflammatory, and neuronal mechanisms. Several structural and molecular alterations associated to PDR are related to the presence of inflammation that appears to play a non-redundant role in the neovascular response that characterizes the retina of PDR patients. Vascular endothelial growth factor (VEGF) blockers have evolved over time for the treatment of retinal neovascularization. However, several limitations to anti-VEGF interventions exist. Indeed, the production of other angiogenic factors and pro-inflammatory mediators may nullify and/or cause resistance to anti-VEGF therapies. Thus, appropriate experimental models are crucial for dissecting the mechanisms leading to retinal neovascularization and for the discovery of more efficacious anti-angiogenic/anti-inflammatory therapies for PDR patients. This review focuses on the tight cross talk between angiogenesis and inflammation during PDR and describe how the chick embryo chorioallantoic membrane (CAM) assay may represent a cost-effective and rapid in vivo tool for the study of the relationship between neovascular and inflammatory responses elicited by the vitreous humor of PDR patients and for the screening of novel therapeutic agents.
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Affiliation(s)
- Sara Rezzola
- Department of Molecular and Translational Medicine, School of Medicine, University of Brescia, Brescia, Italy
| | - Alessandra Loda
- Department of Molecular and Translational Medicine, School of Medicine, University of Brescia, Brescia, Italy
| | - Michela Corsini
- Department of Molecular and Translational Medicine, School of Medicine, University of Brescia, Brescia, Italy
| | - Francesco Semeraro
- Eye Clinic, Department of Neurological and Vision Sciences, University of Brescia, Brescia, Italy
| | - Tiziana Annese
- Department of Basic Medical Sciences, Neurosciences, and Sensory Organs, University of Bari Medical School, Bari, Italy
| | - Marco Presta
- Department of Molecular and Translational Medicine, School of Medicine, University of Brescia, Brescia, Italy.,Italian Consortium for Biotechnology (CIB), Unit of Brescia, Brescia, Italy
| | - Domenico Ribatti
- Department of Basic Medical Sciences, Neurosciences, and Sensory Organs, University of Bari Medical School, Bari, Italy
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Solanki A, Bhatt LK, Johnston TP, Prabhavalkar KS. Targeting Matrix Metalloproteinases for Diabetic Retinopathy: The Way Ahead? Curr Protein Pept Sci 2019; 20:324-333. [DOI: 10.2174/1389203719666180914093109] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 08/15/2018] [Accepted: 08/29/2018] [Indexed: 12/21/2022]
Abstract
Diabetic retinopathy (DR) is a severe sight-threatening complication of diabetes. It causes
progressive damage to the retina and is the most common cause of vision impairment and blindness
among diabetic patients. DR develops as a result of various changes in the ocular environment. Such
changes include accelerated mitochondrial dysfunction, apoptosis, reactive oxygen species production,
and formation of acellular capillaries. Matrix metalloproteinases (MMPs) are one of the major culprits in
causing DR. Under physiological conditions, MMPs cause remodeling of the extracellular matrix in the
retina, while under pathological conditions, they induce retinal cell apoptosis. This review focuses on
the roles of various MMPs, primarily MMP-2 and MMP-9 in DR and also their participation in oxidative
stress, mitochondrial dysfunction, and apoptosis, along with their involvement in various signaling
pathways. This review also underscores different strategies to inhibit MMPs, thus suggesting that MMPs
may represent a putative therapeutic target in the treatment of DR.
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Affiliation(s)
- Ankita Solanki
- Department of Pharmacology, SVKM's Dr. Bhanuben Nanavati College of Pharmacy, Vile Parle (W), Mumbai, India
| | - Lokesh K. Bhatt
- Department of Pharmacology, SVKM's Dr. Bhanuben Nanavati College of Pharmacy, Vile Parle (W), Mumbai, India
| | - Thomas P. Johnston
- Division of Pharmaceutical Sciences, University of Missouri-Kansas City, Kansas City, MO, United States
| | - Kedar S. Prabhavalkar
- Department of Pharmacology, SVKM's Dr. Bhanuben Nanavati College of Pharmacy, Vile Parle (W), Mumbai, India
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Endothelial Microparticles Act as Novel Diagnostic and Therapeutic Biomarkers of Diabetes and Its Complications: A Literature Review. BIOMED RESEARCH INTERNATIONAL 2016; 2016:9802026. [PMID: 27803933 PMCID: PMC5075589 DOI: 10.1155/2016/9802026] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 08/28/2016] [Accepted: 09/19/2016] [Indexed: 02/06/2023]
Abstract
Diabetes mellitus- (DM-) related vascular diseases attract increased attention due to their high morbidity and mortality. The incidence of obesity, atherosclerosis, coronary heart disease, hypertension, and dyslipidemia is significantly higher in DM patients, with an earlier onset and faster progression compared with non-DM patients. DM-related vascular diseases including macrovascular and microvascular complications are characterized by endothelial dysfunction. Therefore, a better understanding of the etiology and mechanisms of endothelial dysfunction is important for the diagnosis and treatment of DM. Endothelial microparticles (EMPs) are new diagnostic and therapeutic targets and biomarkers in DM-related vascular disease. Circulating EMPs containing biologically active substances act as intercellular signals under physiological and pathological conditions. They serve as biological markers of altered vascular endothelium and reflect the pathological progression and diminished endothelial function of blood vessels. Recent evidence suggests that the plasma level of EMPs is significantly higher in DM patients than in healthy population and is significantly correlated with DM-related complications. These observations have prompted speculation that EMPs play a crucial role in the pathophysiology of DM. This review summarizes the known and potential roles of EMPs in the diagnosis, staging, treatment, and clinical prognosis of DM and related vascular diseases.
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Novel Strategies for the Improvement of Stem Cells' Transplantation in Degenerative Retinal Diseases. Stem Cells Int 2016; 2016:1236721. [PMID: 27293444 PMCID: PMC4887645 DOI: 10.1155/2016/1236721] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 04/17/2016] [Accepted: 05/03/2016] [Indexed: 12/20/2022] Open
Abstract
Currently, there is no cure for the permanent vision loss caused by degenerative retinal diseases. One of the novel therapeutic strategies aims at the development of stem cells (SCs) based neuroprotective and regenerative medicine. The main sources of SCs for the treatment of retinal diseases are the embryo, the bone marrow, the region of neuronal genesis, and the eye. The success of transplantation depends on the origin of cells, the route of administration, the local microenvironment, and the proper combinative formula of growth factors. The feasibility of SCs based therapies for degenerative retinal diseases was proved in the preclinical setting. However, their translation into the clinical realm is limited by various factors: the immunogenicity of the cells, the stability of the cell phenotype, the predilection of SCs to form tumors in situ, the abnormality of the microenvironment, and the association of a synaptic rewiring. To improve SCs based therapies, nanotechnology offers a smart delivery system for biomolecules, such as growth factors for SCs implantation and differentiation into retinal progenitors. This review explores the main advances in the field of retinal transplantology and applications of nanotechnology in the treatment of retinal diseases, discusses the challenges, and suggests new therapeutic approaches in retinal transplantation.
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Zhou J, Shen X, Lu Q, Zhang M. Thioredoxin-Interacting Protein (TXNIP) Suppresses Expression of Glutamine Synthetase by Inducing Oxidative Stress in Retinal Muller Glia Under Diabetic Conditions. Med Sci Monit 2016; 22:1460-6. [PMID: 27131835 PMCID: PMC4915319 DOI: 10.12659/msm.895916] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 11/12/2015] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Diabetic retinopathy (DR) is a progressive neurodegenerative disease with early-stage symptoms such as dysfunction of Muller cells, which leads to ganglion cell death. Its pathogenesis is probably associated with oxidative stress and a recently discovered protein, thioredoxin-interacting protein (TXNIP). MATERIAL AND METHODS To explore the role of TXNIP in DR, we cultured Muller cells under diabetic conditions, and then used immunohistochemistry, Western blot, and RT-PCR to detect the expression level of TXNIP under diabetic conditions. We demonstrated the expression level of glutamine synthetase (GS) when TXNIP was inhibited. To explore the potential pathway of TXNIP-induced cell damage in DR, we confirmed the role of IL-1β under diabetic conditions. RESULTS Diabetes induces TXNIP expressions at mRNA levels, but shows the opposite effect on GS. IL-1β plays an important role in this pathway. Azaserine effectively increased the expression of GS via attenuating the expression of TXNIP. CONCLUSIONS This study demonstrates the role of TXNIP and its mechanism in DR, provides a possible treatment for DR, and lays a new theoretical foundation for the clinical treatment of DR and other diabetic microvascular changes.
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Affiliation(s)
- Jia Zhou
- Department of Ophthalmology, Rui Jin Hospital, LuWan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
| | - Xi Shen
- Department of Ophthalmology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
| | - Qiong Lu
- Department of Ophthalmology, Rui Jin Hospital, LuWan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
| | - Min Zhang
- Department of Ophthalmology, Rui Jin Hospital, LuWan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
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Cai X, McGinnis JF. Diabetic Retinopathy: Animal Models, Therapies, and Perspectives. J Diabetes Res 2016; 2016:3789217. [PMID: 26881246 PMCID: PMC4736804 DOI: 10.1155/2016/3789217] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 12/06/2015] [Indexed: 12/12/2022] Open
Abstract
Diabetic retinopathy (DR) is one of the major complications of diabetes. Although great efforts have been made to uncover the mechanisms underlying the pathology of DR, the exact causes of DR remain largely unknown. Because of multifactor involvement in DR etiology, currently no effective therapeutic treatments for DR are available. In this paper, we review the pathology of DR, commonly used animal models, and novel therapeutic approaches. Perspectives and future directions for DR treatment are discussed.
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Affiliation(s)
- Xue Cai
- Department of Ophthalmology, Dean McGee Eye Institute, Oklahoma University Health Sciences Center, Oklahoma City, OK 73104, USA
- *Xue Cai: and
| | - James F. McGinnis
- Department of Ophthalmology, Dean McGee Eye Institute, Oklahoma University Health Sciences Center, Oklahoma City, OK 73104, USA
- Department of Cell Biology, Oklahoma University Health Sciences Center, Oklahoma City, OK 73104, USA
- Oklahoma Center for Neuroscience, Oklahoma University Health Sciences Center, Oklahoma City, OK 73104, USA
- *James F. McGinnis:
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Zhao H, Zhang J, Yu J. HMGB-1 as a Potential Target for the Treatment of Diabetic Retinopathy. Med Sci Monit 2015; 21:3062-7. [PMID: 26454330 PMCID: PMC4604733 DOI: 10.12659/msm.894453] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background Diabetic retinopathy (DR) is one of the most important complications of diabetes mellitus (DM) and is the leading cause of blindness in diabetic patients. Recent studies showed that as important inflammatory mediators, high mobility group box 1 (HMGB-1) is associated with diabetic peripheral neuropathy and can participate in the occurrence and development of DR. This study explored HMGB-1 as a therapeutic target for DR treatment through observing its role in retinal ganglion cells (GRCs) in a high glucose environment. Material/Methods RGCs were randomly divided into 3 groups: the normal control group, the high glucose group, and the siRNA HMGB-1 group. Real-time PCR was used to detect HMGB-1 mRNA expression. ELISA was used to test HMGB-1 protein expression in the supernatant. MTT assay was performed to determine cell proliferation. Real-time PCR and Western blotting were used to analyze TLR4 and NF-κB expression. Results HMGB-1 mRNA was up-regulated (P=0.015) and protein secretion increased (P=0.022) in the high glucose environment. RGCs survival decreased (P=0.026), while TLR4 and NF-κB mRNA (P=0.009 and P=0.017, respectively) and protein expression increased significantly (P=0.041 and P=0.024, respectively). SiRNA HMGB-1 transfection obviously inhibited HMGB-1 mRNA expression (P=0.032), reduced HMGB-1 secretion (P=0.012), and decreased TLR4 and NF-κB mRNA (P=0.033 and P=0.024, respectively) and protein expression (P=0.032; P=0.027, respectively). Compared with the high glucose group, the RGCs survival rate increased significantly (P=0.037). Conclusions As a therapeutic target, HMGB-1 can inhibit inflammation and promote RGCs survival to delay DR progress through the HMGB-1-TLR4-NF-κB signaling pathway.
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Affiliation(s)
- Hailan Zhao
- Department of Ophthalmology, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, China (mainland)
| | - Jingzhuang Zhang
- Department of Ophthalmology, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, China (mainland)
| | - Jie Yu
- Department of Ophthalmology, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, China (mainland)
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Alam NM, Mills WC, Wong AA, Douglas RM, Szeto HH, Prusky GT. A mitochondrial therapeutic reverses visual decline in mouse models of diabetes. Dis Model Mech 2015; 8:701-10. [PMID: 26035391 PMCID: PMC4486862 DOI: 10.1242/dmm.020248] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 04/19/2015] [Indexed: 12/21/2022] Open
Abstract
Diabetic retinopathy is characterized by progressive vision loss and the advancement of retinal micoraneurysms, edema and angiogenesis. Unfortunately, managing glycemia or targeting vascular complications with anti-vascular endothelial growth factor agents has shown only limited efficacy in treating the deterioration of vision in diabetic retinopathy. In light of growing evidence that mitochondrial dysfunction is an independent pathophysiology of diabetes and diabetic retinopathy, we investigated whether selectively targeting and improving mitochondrial dysfunction is a viable treatment for visual decline in diabetes. Measures of spatial visual behavior, blood glucose, bodyweight and optical clarity were made in mouse models of diabetes. Treatment groups were administered MTP-131, a water-soluble tetrapeptide that selectively targets mitochondrial cardiolipin and promotes efficient electron transfer, either systemically or in eye drops. Progressive visual decline emerged in untreated animals before the overt symptoms of metabolic and ophthalmic abnormalities were manifest, but with time, visual dysfunction was accompanied by compromised glucose clearance, and elevated blood glucose and bodyweight. MTP-131 treatment reversed the visual decline without improving glycemic control or reducing bodyweight. These data provide evidence that visuomotor decline is an early complication of diabetes. They also indicate that selectively treating mitochondrial dysfunction with MTP-131 has the potential to remediate the visual dysfunction and to complement existing treatments for diabetic retinopathy. Summary: Visual decline in mouse models of diabetes is reversed, independently of treating other disease symptoms, by treatment with MTP-131, a water-soluble peptide that selectively targets cardiolipin and improves mitochondrial bioenergetics.
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Affiliation(s)
- Nazia M Alam
- Department of Physiology and Biophysics, Weill Cornell Medical College, New York, NY, USA Burke Medical Research Institute, White Plains, NY, USA
| | - William C Mills
- Research Program in Mitochondrial Therapeutics, Department of Pharmacology, Weill Cornell Medical College, New York, NY, USA
| | - Aimee A Wong
- Burke Medical Research Institute, White Plains, NY, USA
| | - Robert M Douglas
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Hazel H Szeto
- Research Program in Mitochondrial Therapeutics, Department of Pharmacology, Weill Cornell Medical College, New York, NY, USA
| | - Glen T Prusky
- Department of Physiology and Biophysics, Weill Cornell Medical College, New York, NY, USA Burke Medical Research Institute, White Plains, NY, USA
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Abstract
One of the major complications in patients with diabetes is diabetic retinopathy (DR), a leading cause of blindness worldwide. It causes visual impairment and finally blindness, a result of long-term accumulated damage to the small blood vessels in the retina. It takes several years before any clinical symptoms of retinopathy appear in diabetic patients. Consequently, glycemic control, blood pressure and lipid-lowering therapy have all shown benefits in reducing the incidence and progression of DR. A number of hyperglycemia-induced metabolic stresses have been implicated in the pathophysiology of DR. The microvasculature of the retina responds to hyperglycemia through a number of biochemical changes, including the activation of protein kinase C (PKC), increased advanced glycation end-products (AGEs) formation, polyol pathway and oxidative stress. There is an accumulating body of evidence indicating that inflammation and neurodegeneration play an important role in the pathogenesis of DR.
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Affiliation(s)
- Haseeb Ahsan
- Department of Biochemistry, Faculty of Dentistry, Jamia Millia Islamia, Okhla, New Delhi 110025, India.
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Wang Y, Yuan Y, Jiang H. Serum and vitreous levels of visfatin in patients with diabetic retinopathy. Med Sci Monit 2014; 20:2729-32. [PMID: 25524991 PMCID: PMC4280054 DOI: 10.12659/msm.891292] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Background Angiogenesis plays an important role in the mechanism of diabetic retinopathy (DR). Visfatin, a recently identified adipokine, is thought to possess an angiogenic effect. The aim of our study was to investigate serum and vitreous levels of visfatin in patients with proliferative diabetic retinopathy (PDR) and non-PDR (NPDR). Material/Methods A total of 280 diabetic patients (124 without DR, 56 with NPDR, and 100 with PDR) and 78 control subjects were enrolled in this study. Serum and vitreous levels of visfatin were measured by enzyme-linked immunosorbent assay (ELISA). Results Serum and vitreous visfatin levels in PDR patients were significantly elevated compared with those in the other 3 groups. NPDR patients showed elevated vitreous visfatin levels compared with patients without DR. However, no significant differences in serum visfatin levels were found between NPDR patients and patients without DR. In addition, control subjects had significantly lower levels of serum and vitreous visfatin compared with diabetic patients without DR, NPDR patients, and PDR patients. Conclusions Serum and vitreous visfatin levels are associated with the presence and severity of DR.
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Affiliation(s)
- Yongqiang Wang
- Department of Ophthalmology , Ji'nan Military General Hospital, Ji'nan, Shandong, China (mainland)
| | - Ye Yuan
- Department of Ophthalmology, Ji'nan Military General Hospital, Ji'nan, Shandong, China (mainland)
| | - Hua Jiang
- Department of Ophthalmology, Ji'nan Military General Hospital, Ji'nan, Shandong, China (mainland)
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14
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Ola MS. Effect of hyperglycemia on insulin receptor signaling in the cultured retinal Müller glial cells. Biochem Biophys Res Commun 2014; 444:264-9. [DOI: 10.1016/j.bbrc.2014.01.052] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Accepted: 01/15/2014] [Indexed: 12/16/2022]
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