炎症在糖尿病视网膜病变中的作用:发病机制及治疗策略

Role of inflammation in diabetic retinopathy:pathogenesis and treatment strategies

糖尿病视网膜病变(DR)被认为是一种慢性中低度炎症性(微炎症)疾病。炎症贯穿DR发病全过程,表现为全身及眼局部炎症生物标志物增加。在DR患者眼中,促炎介质增加,如白细胞介素(IL)-1β、IL-6和肿瘤坏死因子-α(TNF-α)等增加;炎症细胞活化并增多,如视网膜中活化的小胶质细胞、Müller细胞和单核巨噬细胞浸润等。此外,免疫细胞也参与了DR的发病,如循环T淋巴细胞参与白细胞瘀滞。这些研究结果表明DR具有慢性炎症的病因,多种炎症相关因素共同参与、互相影响,导致血-视网膜屏障破坏和神经元损伤,加重DR的进展。因此,个体化抗炎治疗在DR治疗中具有重要意义。

Diabetic retinopathy(DR)is considered to be a chronic medium-and low-grade inflammatory disease(microinflammation).Inflammation runs through the entire process of DR,manifesting as an increase in ocular and systemic inflammation biomarkers.In the eyes of DR patients,there is an increase in pro-inflammatory mediators,such as interleukin(IL)-1β,IL-6 and tumor necrosis factor-α,as well as activated and increased number of inflammatory cells,such as activated microglia,Müller cells in the retina,and infiltration of mononuclear macrophage.In addition,immunocytes are also involved in the pathogenesis of DR,such as the involvement of circulating T cells in leukostasis.These indicate that chronic inflammation is an inducing factor of DR,with multiple inflammation-related factors participating and influencing each other,leading to the destruction of the blood-retinal barrier and neuronal injury and exacerbating the development of DR.Therefore,personalized anti-inflammatory therapy is of great significance in the treatment of DR.