青光眼视神经保护性药物的选择

The option of neuroprotective therapeutics for glaucoma

作为最常见的视神经退行性疾病,青光眼是导致不可逆性致盲性眼病的第二大病因.诱发视网膜神经节细胞（RGC）凋亡的主要因素有神经营养因子的剥夺、谷氨酸的毒性作用等.目前,针对青光眼视神经损伤的保护主要以药物治疗为主,有三类药物可供选择,即化学药物、重组蛋白类药物以及小分子生物肽类药物.小分子生物肽类药物兼具重组蛋白类药物活性大、特异性强、毒副作用小等特点以及化学药物免疫原性弱、生产成本低等优点,而有望成为未来青光眼视神经保护药物的重要选择.本文对不同类型的青光眼视神经保护药物加以综述,以期为之后的基础研究和临床治疗提供参考.

Glaucoma is the second common cause of irreversible blindness worldwide associated with a progressive neurodegenerative disease of retinal ganglion cells （RGC）.The major hypothetical mechanisms of the apoptosis of RGCs includes deprivation of neurotrophic factors,excitotoxicity mediated by the interaction of glutamate with NMDAR.This article reviewed current development of three kinds of neuroprotective drugs for glaucoma management such as small-molecule therapeutics,recombinant therapeutic proteins and small-molecule bioactive peptides.Particularly,small peptides,which show high target specificity,high potency and low toxicity compared with small molecules,possession of the advantages of low immunogenicity and high cost-effectiveness over recombinant therapeutics,may become most important choice for neuroprotection against glaucoma of next generation.