Müller细胞在糖尿病黄斑水肿中的作用及机制

Role and mechanism of Müller cells in diabetic macular edema

Müller细胞作为视网膜中一种特殊的放射状胶质细胞,贯穿整个视网膜,与视网膜中的神经元、微血管和突起相接触,对视网膜的结构和功能具有重要的保护作用。糖尿病视网膜病变(DR)是糖尿病患者主要的眼部并发症,在DR的进展中,糖尿病黄斑水肿(DME)是患者视力下降的主要原因。在DME的发生中,Müller细胞的形态和结构发生变化、胞体肿胀、空泡化程度加深、细胞凋亡增多以及细胞因子分泌异常等,对血-视网膜屏障(BRB)具有破坏作用,不仅增加了BRB的通透性,还加速了视网膜下液体的渗出。此外,Müller细胞也可使K+和水的转运调节发生紊乱,阻碍视网膜下间隙的液体吸收,进一步促进DME发生。但在DR早期,Müller细胞分泌的神经营养因子可为视网膜提供保护,减轻视网膜水肿,保护视网膜神经节细胞,提示Müller细胞可作为DME治疗的靶点。因此探讨Müller细胞在DME形成中的作用与机制,可为DME的治疗提供新策略。本文就Müller细胞在DME中的作用机制和在DME进展中的保护作用进行综述。

Müller cells,as the special radial glial cells in the retina,span the entire retina,contact with neurons,microvessels and processes in the retina and play a significant role in protecting retinal structure and function.Diabetic retinopathy(DR)is a major ocular complication of diabetic patients.In the progression of DR,diabetic macular edema(DME)is the main cause of vision loss.During the occurrence of DME,the morphological and structural changes of Müller cells including severer swelling and vacuolation of cell bodies,increased apoptosis,and abnormal secretion of cytokines,etc.damage the blood-retinal barrier(BRB),increase the permeability of BRB and accelerate the exudation of subretinal fluid.In addition,Müller cells can disrupt the regulation of K+and water transportation,obstruct the fluid absorption in the subretinal space and promote the formation of DME.However,in the early stage of DR,neurotrophic factors secreted by Müller cells can protect the retina by alleviating retinal edema and protecting optic ganglion cells,suggesting that Müller cells can be used as targets for DME treatment.Therefore,new strategies can be provided by fully exploring the role and mechanism of Müller cells in the formation of DME.In this paper,the mechanism of Müller cells in DME and its protective role in the progression of DME were reviewed.