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Angiogenic Factors and Cytokines in Diabetic Retinopathy
1Ophthalmology and Visual Sciences, University of Michigan Medical School, Kellogg Eye Center, 1000 Wall Street, Ann Arbor, MI 48105, USA.
Abstract:
Diabetic retinopathy (DR) is a sight-threatening complication of both type-1 and type-2 diabetes. The recent success of treatments inhibiting the function of vascular endothelial growth factor (VEGF) demonstrates that specific targeting of a growth factor responsible for vascular permeability and growth is an effective means of treating DR-associated vascular dysfunction, edema and angiogenesis. This has stimulated research of alternative therapeutic targets involved in the control of retinal vascular function. However, additional treatment options and preventative measures are still needed and these require a greater understanding of the pathological mechanisms leading to the disturbance of retinal tissue homeostasis in DR. Although severe DR can be treated as a vascular disease, abundant data suggests that inflammation is also occurring in the diabetic retina.Thus, anti-inflammatory therapies may also be useful for treatment and prevention of DR. Herein, the evidence for altered expression of angiogenic factors and cytokines in DR is reviewed and possible mechanisms by which the expression of VEGF and cytokines may be increased in the diabetic retina are examined. In addition, the potential role for microglial activation in diabetic retinal neuroinflammation is explored.
Insights
Diabetic retinopathy (DR) involves vascular issues and inflammation. Targeting vascular endothelial growth factor (VEGF) and exploring anti-inflammatory therapies, including microglial activation, may offer new treatments for this diabetes complication.
Area of Science:
- Ophthalmology
- Diabetology
- Immunology
Background:
- Diabetic retinopathy (DR) is a major cause of vision loss in diabetes patients.
- Vascular endothelial growth factor (VEGF) inhibitors are effective but not a complete solution.
- Inflammation and neuroinflammation are increasingly recognized in DR pathogenesis.
Purpose of the Study:
- To review evidence on altered angiogenic factors and cytokines in DR.
- To examine mechanisms increasing VEGF and cytokine expression in diabetic retinas.
- To explore the role of microglial activation in diabetic retinal neuroinflammation.
Main Methods:
- Literature review of studies on DR pathogenesis.
- Analysis of altered expression of angiogenic factors and cytokines.
- Exploration of mechanisms driving VEGF and cytokine upregulation.
- Investigation into microglial activation in diabetic retinas.
Main Results:
- Evidence suggests increased expression of angiogenic factors and cytokines in DR.
- Potential mechanisms for increased VEGF and cytokine levels identified.
- Microglial activation implicated in diabetic retinal neuroinflammation.
Conclusions:
- Targeting VEGF and inflammation shows therapeutic promise for DR.
- Understanding neuroinflammation is crucial for developing new DR treatments.
- Further research into microglial roles could lead to novel preventative and therapeutic strategies.
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