醛糖还原酶抑制剂与糖尿病慢性并发症

Aldose reductase inhibitors and chronic diabetic complication

高血糖使醛糖还原酶过度激活,引起组织中山梨醇积聚,与高血糖等因素共同促进糖尿病并发症的发生发展。研究显示醛糖还原酶抑制剂可抑制山梨醇途径,通过抗氧化应激和炎症、抑制细胞凋亡、改善微循环障碍和能量代谢等延缓和治疗糖尿病并发症。醛糖还原酶抑制剂依帕司他在糖尿病微血管病变如周围神经病变、自主神经病变、肾脏疾病和视网膜病变研究中有良好作用,尤其在糖尿病周围神经病变、视网膜病变治疗中有循证医学证据,为美国糖尿病学会和中国糖尿病神经病变诊治规范的推荐药物。醛糖还原酶抑制剂新药开发给糖尿病慢性并发症防治带来新希望。

Over activation of aldose reductase which leads to accumulation of sorbitol in the tissues is considered to play an important role in the genesis and development of chronic diabetic complications along with hyperglycemia. Aldose reductase inhibitor （ARI） can inhibit sorbitol pathway by decreasing unsuitable activation of oxidative stress, in{lammation and apoptosis and improving microeirculation functions and energy metabolic in vivo and vitro experiments. Epalrestat, a constant ARI, provided a clinical role of preventing and treating diabetic micro-vessel complications such as perineuropathy, neuropathy and retinopathy from evident-based medicine. ARIs are recommended as treatment for perineuropathy by American Diabetes Association and by ＂Diabetic Neuropathy Diagnosis and Treatment Guideline in China＂. ARIs will play important roles for prevention and cure of chronic diabetic complications in the future.