糖尿病视网膜病变中一氧化氮与氧化应激的相关性

Correlation between nitric oxide and oxidative stress in diabetic retinopathy

糖尿病视网膜病变(DR)作为一种糖尿病常见的微血管并发症,其主要病理特征为毛细血管闭塞、微小动脉瘤和新生血管形成,其发病机制尚未完全明了,现有的临床治疗方法尚无法根治DR,因此对DR发病机制的研究仍然是热点和难点。目前研究认为氧化应激反应是DR发生和发展的重要机制之一,其促进过量活性氧化产物的产生,诱导视网膜细胞功能障碍和细胞凋亡。高血糖刺激下视网膜中不同来源的一氧化氮(NO)水平失衡也对DR中的毛细血管损伤、血-视网膜屏障破坏和新生血管形成等病理改变起到不可忽视的作用,同时NO与氧化应激反应产生的氧化物相互作用,进一步加重DR中视网膜损伤,导致视网膜形态异常及功能障碍,最终导致患者不可逆性盲。本文从DR的病理生理变化、DR与氧化应激、DR与NO以及NO在氧化应激中的作用4个方面阐述NO及氧化应激在DR发病机制中的研究现状。

Diabetic retinopathy(DR)is a common microvascular complication of diabetes mellitus,with capillary occlusion,microaneurysms,and neovascularization as main pathological features,and its pathogenesis has not been fully understood.The existing clinical treatment can not cure DR,therefore,the study of the pathogenesis of DR is still a hot topic and difficult problem.Current studies have suggested that oxidative stress response is one of the important mechanisms for the development of DR,which promotes the production of excessive reactive oxygen species to induce retinal cell dysfunction and apoptosis.Imbalance of levels of nitric oxide(NO)from different types of sources in the retina under hyperglycemic stimulation also plays an important role in pathological changes,such as capillary damage,blood-retinal barrier disruption and neovascularization in DR.At the same time,NO interacts with oxides produced by oxidative stress to promote further retinal damage in DR,leading to retinal morphology abnormality and dysfunction,which ultimately cause irreversible blindness in patients.Research status of NO and oxidative stress in the pathogenesis of DR from pathophysiological changes of DR,DR and oxidative stress,DR and NO,and the role of NO in oxidative stress were reviewed in this article.