中药单体干预糖尿病视网膜神经退行性变的研究进展

Research progress in the intervention of Chinese herb monomers on diabetic retinal neurodegeneration

糖尿病视网膜病变(DR)传统意义上被认为是视网膜的单纯微血管疾病,目前主流疗法仍然只关注其晚期血管病变并发症和单一分子靶点-血管内皮生长因子(VEGF)。然而现在研究正转向一个更全面的观点,即DR是神经血管单元(NVU)损伤引起的一类神经血管性疾病。在DR早期阶段,糖尿病视网膜神经退行性变(DRN)占主导地位,可能先于微血管异常发生,且神经元细胞的凋亡可进一步导致微血管损伤和血-视网膜屏障(BRB)破坏。因此在早期DR中开发新的治疗策略来预防或逆转DRN是有意义的,然而目前尚没有针对DRN的药物被批准用于临床。近年来研究中药对视网膜保护作用已成为热点,且主要研究集中在中药单体。本文综述了具有代表性的中药单体在DRN中的研究现状,以期为DR的早期治疗与新药研发提供参考。

English_abstract Diabetic retinopathy(DR)has been traditionally considered a purely microvascular disease in the retina.Currently,mainstream therapies focus only on advanced vascular complications and a single molecular target-vascular endothelial growth factor(VEGF).However,the research is shifting towards a more comprehensive view that DR is a neurovascular disease caused by neurovascular unit(NVU)injury.In the early stage of DR,diabetic retinal neurodegeneration(DRN)dominates and may precede the retinal microvascular abnormalities.Moreover,neuronal apoptosis can further lead to microvascular injury and blood-retinal barrier(BRB)disruption.Therefore,it makes sense to develop new therapeutic strategies to prevent or reverse DRN.However,no drug targeting DRN has been approved for clinical use.In recent years,it has become a trend to study the protective effect of traditional Chinese medicine on the retina.The primary research focuses on Chinese herb monomers.This article reviews the research status of representative monomers in DRN to provide references for the early treatment of DR and development of new drugs.