在更新糖尿病视网膜疾病的分期系统时考虑的基本和细胞机制的推理
M Elizabeth Hartnett1, Ward Fickweiler2,3,4, Anthony P Adamis4,5
1Department of Ophthalmology, Byers Eye Institute of Stanford University, Palo Alto, California.
Ophthalmology science
|July 15, 2024
概括
高血糖导致早期糖尿病视网膜疾病 (DRD) 病变. 本次审查确定了更新DRD分期和治疗的有希望的生物标志物和细胞机制,重点关注VEGFA和炎症途径等目标.
科学领域:
- 眼科和视觉科学 眼科和视觉科学
- 糖尿病学 糖尿病学
- 细胞和分子医学 细胞和分子医学
背景情况:
- 糖尿病视网膜疾病 (DRD) 是糖尿病患者视力丧失的主要原因.
- 高血糖是早期DRD病变的主要驱动因素.
- 目前的DRD分期系统需要更新,以整合基本的生物机制.
研究的目的:
- 审查关于DRD相关的基本和细胞机制的临床前和临床证据.
- 确定更新DRD分阶段系统的潜在目标.
- 为未来DRD的治疗干预和治疗策略提供信息.
主要方法:
- 由基本和细胞机制工作组 (BCM-WG) 进行的临床前和临床证据的全面审查.
- 根据证据网格,支持证据水平和对DRD的未来相关性,对确定目标的分类.
- 将40个已识别的目标分组成概念或将其作为具体候选人进行评估.
主要成果:
- 确定了VEGFA,氧酶增殖器激活受体-α通路,血卡利克林和血管蛋白2作为有前途的生物标志物.
- 这些生物标志物在DRD中显示出诊断,监测,预测,预后和药学动力学应用的潜力.
- 关键的研究概念包括炎症,氧化信号,血管保护,神经保护,菌体和营养物质/微生物群相互作用,所有这些都受到高血糖的调节.
结论:
- 确定了几个有前途的目标和细胞机制,可能被纳入更新的DRD分期系统.
- 虽然直接的整合是有限的,但对这些目标的持续研究至关重要.
- 这些努力可能会导致新的生物标志物和治疗点,最终有利于糖尿病患者.
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