褪黑激素对糖尿病视网膜病变内皮细胞及周细胞的保护作用研究现状与进展

Protective effects of melatonin on endothelial cells and pericytes in diabetic retinopathy

玻璃体腔注射抗VEGF药物已逐渐成为治疗糖尿病视网膜病变(DR)的一线方案。但由于DR血视网膜屏障损伤所引发的糖尿病黄斑水肿(DME)对抗VEGF药物的敏感性较差,寻找可有效保护血管壁结构的补充药物或替代药物十分必要。褪黑激素是一种主要由松果体分泌的激素,可在人体内发挥调节生物节律、抗氧化应激、抗炎等多项功能。近年来,国内外研究表明,褪黑激素可在视网膜病变中通过多种机制改善神经细胞退行性变、保护血管结构。在对视网膜毛细血管结构的保护作用方面,褪黑激素可通过抗氧化应激、抗炎症、抑制细胞凋亡等途径改善早期DR内皮细胞及周细胞的损伤,保护血视网膜屏障结构的完整性,提示褪黑激素或可为DR尤其DME的防治提供新思路。

Intravitreal injection of anti-VEGF drugs has gradually become the first-line treatment for diabetic retinopathy(DR).However,diabetic macular edema(DME)caused by DR blood-retinal barrier damage is less sensitive to anti-VEGF drugs.Therefore,it is necessary to find supplementary drugs or alternative drugs that can effectively protect the structure of the blood vessel wall.Melatonin is a hormone mainly secreted by the pineal gland,which can play a number of functions in the human body such as regulating biological rhythms,scavenging free radicals,and anti-inflammatory.In recent years,studies have shown that melatonin can improve neuronal degeneration and protect blood vessel structure through multiple mechanisms in retinopathy.In terms of its protective effect on the retinal capillary structure,melatonin can improve the damage of early DR endothelial cells and pericytes through anti-oxidative stress,anti-inflammatory,and inhibiting cell apoptosis so as to protect the integrity of the blood-retinal barrier structure.It suggests that melatonin may provide new ideas for the prevention and treatment of DR,especially with DME.