白藜芦醇治疗糖尿病视网膜病变的药理作用及其机制研究进展

Research Progress on Pharmacological Effect and Mechanism of Resveratrol in the Treatment of Diabetic Retinopathy

白藜芦醇是一种广泛存在的植物抗毒素,在调节代谢,炎症反应,氧化应激,等过程中起到有益的作用。近年来,有关白藜芦醇用于糖尿病视网膜病变的研究逐渐增多。白藜芦醇能缓解糖尿病视网膜病变中视网膜血管和神经损害。在视网膜色素细胞中,白藜芦醇作用于SIRT1和AMPK,减少活性氧,下调血管内皮生长因子,影响血管内皮生长因子和血管内皮生长因子受体的相互作用。白藜芦醇也能影响NF-κB,调控炎症反应,抑制Caspase-3的表达,减少视网膜中色素细胞,血管内皮细胞,感光细胞,Müller细胞以及神经节细胞的凋亡。白藜芦醇有望成为未来糖尿病视网膜病变的补充治疗手段之一,但目前仍然缺乏严谨的临床证据,有关白藜芦醇的生物利用度和副作用也仍在探究之中。

Resveratrol, as a natural phytoalexin ubiquitous in plants, plays a beneficial role in the regulation of inflammation, oxidative stress, and metabolism. The studies about the effects of resveratrol on diabetic retinopathy have been increasing. Resveratrol might ameliorate vasculopathy and neuropathy in the progression of diabetic retinopathy. The role of resveratrol in the regulation of SIRT1 and AMPK in retinal pigment epithelium has been expounded. Preliminary studies have revealed that resveratrol reduces reactive oxygen species, down-regulates the expression of vascular endothelial growth factor(VEGF) and interferes with the binding of VEGF to its receptor on endothelial cells. Meanwhile, resveratrol might regulate inflammatory response via NF-κB,down-regulate the expression of caspase-3,and reduce the apoptosis of retinal pigment epithelium, endothelial cells, photoreceptors, Müller cells, and retinal ganglion cells in the development of diabetic retinopathy. Resveratrol may become one of the supplemental therapies for diabetic retinopathy in the future, which, however, needs to be fully elucidated via a well-designed randomized controlled clinical trial. Furthermore, the bioavailability and side effects of resveratrol should be considered.