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Genetic analysis of aldose reductase in diabetic complications
1Institute of Molecular Biology, and the Institute of Molecular Technology for Drug Discovery and Synthesis, The University of Hong Kong, Pokfulam, Hong Kong, China. smchung@hkucc.hku.hk
Abstract:
Diabetes Mellitus is an increasing concern, worldwide in terms of health. Long-term diabetes often leads to secondary diseases such as cataract, retinopathy, neuropathy, nephropathy, and cardiovascular diseases. The enzyme aldose reductase (AR) has been implicated in the pathogenesis of some of these diseases and inhibitors of AR (ARIs) were effective in preventing some of the diabetic complications in animal models. However, clinical trials of these drugs were disappointing, casting doubt on the role of AR in these diseases. This review focuses on the recent studies using transgenic and gene knockout mice to analyze the role of AR in diabetic cataract and neuropathy. These studies clearly demonstrated that AR is crucial to the pathogenesis of these diseases, and that the mechanism leading to diabetic cataract may be different from that which causes diabetic neuropathy. A number of studies showed that there is a correlation between AR gene markers and susceptibility to develop complications among diabetic patients, suggesting that AR is also involved in the pathogenesis of diabetic complications in human. Together, these genetic studies strongly indicate that AR is an important target for the prevention of diabetic complications in human. This may provide impetus to develop more effective ARIs and to conduct better-designed clinical trials for ARIs in the prevention and treatment of these diseases.
Insights
Aldose reductase (AR) plays a key role in diabetic complications like cataracts and neuropathy. Genetic studies in mice and humans confirm AR
Area of Science:
- Biochemistry
- Genetics
- Diabetology
Background:
- Diabetes Mellitus is a growing global health concern.
- Long-term diabetes can cause secondary conditions like cataracts and neuropathy.
- Aldose reductase (AR) has been linked to diabetic complications, but clinical trials for AR inhibitors (ARIs) have yielded disappointing results.
Purpose of the Study:
- To review recent genetic studies on the role of AR in diabetic cataract and neuropathy.
- To evaluate the significance of AR in the pathogenesis of diabetic complications in humans.
Main Methods:
- Analysis of studies using transgenic and gene knockout mice.
- Review of studies correlating AR gene markers with diabetic complication susceptibility in patients.
Main Results:
- Genetic studies in mice demonstrate AR's crucial role in diabetic cataract and neuropathy.
- Evidence suggests distinct mechanisms for AR's involvement in cataract versus neuropathy.
- Correlation between AR gene markers and human diabetic complication susceptibility indicates AR's role in human disease.
Conclusions:
- AR is a critical target for preventing diabetic complications in humans.
- These findings may encourage the development of more effective ARIs and improved clinical trial designs.