葛根素对糖尿病视网膜病变损伤的保护作用及机制研究进展

Research progress on the protective effect and mechanism of puerarin on diabetic retinopathy

在世界范围内,糖尿病(DM)是最常见的慢性消耗性疾病,且患病率和发病率逐年上升,严重影响患者生活质量,尤其是糖尿病并发症——糖尿病视网膜病变(DR)可引起的视力下降甚至丧失,使生活质量直线下降,因此研究DR的发病机制及有效治疗迫在眉睫。葛根是一种多年生豆科植物野葛或干葛藤的干燥根,也叫葛根黄酮,为临床常用中药,其根中主要含有异黄酮类、葛根苷ABC、三萜类、生物碱等,具有舒张心脑血管平滑肌,改善微循环的作用。目前,葛根已经广泛应用于心脑血管疾病、骨质坏死、DM及其并发症、神经退行性疾病、子宫内膜异位症以及肿瘤疾病的治疗。目前的研究表明,葛根素(Pue)可通过抑制视网膜新生血管形成、改善缺血缺氧、降低糖尿病糖基化终末产物水平、提高胰岛素生长因子(IGF)表达及降低肿瘤坏死因子-α(TNF-α)表达、降低血管内皮生长因子(VEGF)的表达水平、减少视网膜神经细胞凋亡、抑制核苷酸结合寡聚化结构域样受体蛋白3(NOD-like receptor protein 3,NLRP3)炎性通路及抑制铁死亡等途径对视网膜进行保护。本文就葛根素对糖尿病视网膜病变损伤的保护作用及机制做一综述,为葛根素的进一步开发利用提供参考。

Increasing prevalence and incidence of diabetes mellitus(DM)-the most common chronic consumptive disease worldwide-has a devastating impact on people’s daily lives,particularly through the deterioration or complete loss of vision brought on by diabetic retinopathy(DR).Therefore,it is imperative to investigate the pathogenesis and effective treatment of DR.Meanwhile,Pueraria lobata is the extensively used dried root of kudzu or dried kudzu,also known as Pueraria flavonoids.Moreover,its roots are primarily composed of isoflavones,Pueroside ABC,triterpenes,and alkaloids,which can calm cardio-cerebrovascular smooth muscle and enhance microcirculation.Currently,it is widely employed for the treatment of cardio-cerebrovascular diseases,osteonecrosis,DM and its complications,neurodegenerative disorders,endometriosis and tumor diseases.Inhibiting retinal neovascularization,alleviating ischemia and hypoxia,decreasing advanced glycation end products in diabetes,raising insulin-like growth factor(IGF)expression while decreasing tumor necrosis factor-α(TNF-a)expression,decreasing vascular endothelial growth factor(VEGF)expression,reducing retinal nerve cell death,inhibiting the NOD-like receptor protein 3(NLRP3)inflammatory pathway and inhibiting ferroptosis are all mechanisms by which puerarin(Pue)has been found to protect the retina in recent studies.Thus,this article summarizes the current comprehension of the mechanism and protective effect of Pue on diabetic retina,serving as a guidepost for its future development and application.