The Pathogenesis and Therapeutic Approaches of Diabetic Neuropathy in the Retina
Article Name: The Pathogenesis and Therapeutic Approaches of Diabetic Neuropathy in the Retina
What are the takeaway points from this article?
Diabetic retinopathy (DR) is a major neurovascular complication of both type 1 and type 2 diabetes, and a leading cause of blindness in the world. It appears neurovascular units – the anatomical and functional interdependence of neurons, glial cells and vascular cells – become impaired even during early stages of diabetes. The impairment can be triggered by hyperglycemia due to increased glucose flux resulting in overproduction of reactive oxygen species (ROS) and advanced glycation-end products (AGEs). AGEs can fuel further ROS production which itself is associated with mitochondrial dysfunction, perturbations in the blood barrier function, and neuronal tissue homeostasis.
Neuronal cell death and axon degeneration are observed from the early phase of DR. These irreversible changes are directly related to vision reduction and are demonstrated to precede vascular abnormalities. Thus, to halt the progression of pathological changes, both neuroprotective and axonal regenerative treatments are required, such as, improving intrinsic survival and regenerative abilities while overcoming the inhibitory glial environment. However, owing to the complexity of the retinal disturbances, single agent treatment may not be sufficient.
In this article, the authors argue that even in the early stages of DR, multiple strategies for axonal protection and regeneration may be indicated and these should be considered prior to planning clinical trials. Hopefully, this review can predicate a new multimodal therapy for neuropathy of the diabetic retina.
Oshitari T. (2021). The Pathogenesis and Therapeutic Approaches of Diabetic Neuropathy in the Retina. International journal of molecular sciences, 22(16), 9050. https://doi.org/10.3390/ijms22169050
Date Published: August 22, 2021
Summary by: Neil Kamra