DR视网膜内皮功能失调的研究进展

Research progress of retinal endothelial dysfunction in diabetic retinopathy

糖尿病视网膜病变(DR)是糖尿病最常见的眼部并发症,是工作人群及中老年人视力减退甚至失明的主要原因之一。在糖尿病微血管系统中,视网膜血管功能障碍由多种因素引起,高血糖通过不同的机制损伤视网膜内皮细胞、增加血管通透性、破坏血-视网膜屏障,导致视网膜内皮功能失调。其中,过氧化物酶体增殖物激活受体-y破坏、氧化应激、炎症、晚期糖基化终产物及其受体增加及microRNA失调等多种病理因素均可引起视网膜血管内皮损伤,加速视网膜内皮功能失调,从而导致DR的发生发展。文章旨在对各种病理因素所致视网膜内皮功能失调的相关机制进行综述,以深化我们对该疾病分子及细胞层面机制的理解,了解DR治疗过程中的挑战,为DR的临床管理和治疗提供新思路和策略。

Diabetic retinopathy(DR),the most common ocular complication of diabetes,is one of the major causes of vision impairment and even blindness among the working population as well as middle-aged and elderly individuals.In the diabetic microvascular system,hyperglycemia damages retinal endothelial cells,enhances vascular permeability and disrupts the blood-retinal barrier through different mechanisms,all of which result in endothelial dysfunction.Retinal vascular dysfunction caused by multifactors,such as peroxisome proliferator-activated receptor-y disruption,oxidative stress,inflammation,increased advanced glycation end products and their receptors,and microRNA dysregulation can cause vascular endothelial damage,accelerate retinal endothelial dysfunction,lead to the progression of DR.Therefore,the available date and the contributors in the pathophysiology of DR are reviewed with a special emphasis on the retinal endothelial dysfunction,for a better understanding of the molecular cellular mechanism in the development of DR,to analyze the challenges in the treatment of DR and to provide new ideas and strategies for the clinical management and treatment of DR.