小胶质细胞在糖尿病视网膜病变视网膜神经血管单元中的作用

Role of microglia in retinal neurovascular unit of diabetic retinopathy

糖尿病视网膜病变(DR)是工作年龄人群主要致盲眼病,血-视网膜屏障破坏是关键环节。近年研究显示,DR不再是单纯微血管病变,而是视网膜胶质细胞与神经退行性变、微血管病变的共同发展结果。DR病程早期视网膜神经血管单元(RNVU)中神经元的损伤可能早于血管内皮的变化,胶质细胞的激活加重血管屏障功能障碍。视网膜小胶质细胞是常驻视网膜的局部免疫细胞,参与长期高糖诱导的慢性炎症反应、高糖诱导其分泌多种炎症因子,破坏血-视网膜屏障结构、增加神经元凋亡、改变Müller细胞胶质化等,影响视网膜局部稳态平衡。RNVU作为一个单元结构研究,近年来受到越来越多的关注,本文将针对小胶质细胞在RNVU中的作用机制、研究进展进行综述。

Diabetic retinopathy(DR)represents the primary cause of blindness among the global working-age population,and the disruption of the blood-retinal barrier is a crucial factor.Research in recent years has elucidated that DR transcends the scope of a mere microvascular disorder into a complex interplay of retinal glial cells and neurodegeneration microvascular pathology.Neuronal damage may precede vascular endothelial changes in the retinal neurovascular unit(RNVU)in the early stage of DR,and glial cell activation further exacerbates vascular barrier dysfunction.Retinal microglia are immune cells that reside in the retina and are involved in chronic inflammatory responses induced by long-term exposure to high glucose levels.Microglia secrete various inflammatory factors in response to high glucose levels,which can lead to the destruction of the blood-retinal barrier structure,increased neuronal apoptosis,and altered gliosis of Muller cells,thus affecting the retina’s homeostatic balance.The RNVU has received increasing attention in recent years as a unitary structural study,and the mechanism of microglia in the RNVU and the progress of the study are reviewed.