Diabetic retinopathy and endothelin system: microangiopathy versus endothelial dysfunction

Area of Science:

• Endocrinology and Metabolism
• Vascular Biology
• Ophthalmology

Background:

• Diabetes is a global epidemic with significant microvascular complications.
• Endothelin is increasingly recognized for its role in diabetic pathogenesis, especially affecting capillary flow and retinopathy.
• Current reviews lack focus on the endothelin system as a therapeutic target for diabetic microangiopathy.

Purpose of the Study:

• To review evidence on the endothelin system's role in diabetic complications.
• To explore endothelin modulation as a therapeutic strategy for diabetes.
• To highlight endothelin as a potential early indicator of diabetic microangiopathy.

Main Methods:

• Review of experimental and clinical evidence.
• Discussion of therapeutic approaches targeting the endothelin system.
• Integration of advanced ophthalmological imaging (OCT angiography) with biochemical markers.

Main Results:

• Experimental and clinical data support endothelin system modulation in diabetes management.
• Inhibition of high endothelin levels shows promise in treating diabetic vasculopathy, particularly retinopathy.
• OCT angiography detects early retinal changes, which, combined with endothelin measurements, can improve early diagnosis.

Conclusions:

• The endothelin system presents a viable therapeutic target and early diagnostic marker for diabetic complications.
• Modulating endothelin levels may offer novel treatment avenues for diabetic retinopathy and other microvascular issues.
• Combining advanced imaging with endothelin monitoring can enhance early detection and management of diabetes-related vascular damage.