在糖尿病视网膜病变管理中,揭开高级糖化终端产品作为新兴的治疗点
Sandeep Saxena1, Nibha Mishra1, Gemmy Cheung2
1Retina service, Department of Ophthalmology, King George's Medical University, Lucknow, India.
European journal of ophthalmology
|March 24, 2025
概括
糖尿病视网膜病变 (DR) 源于慢性高血糖损害视网膜神经血管单元. 针对高级糖化最终产品 (AGEs) 提供了新的治疗策略,以保护糖尿病患者的视力.
科学领域:
- 眼科医生 眼科 眼科
- 内分泌学 在内分泌学.
- 糖尿病学 糖尿病学
背景情况:
- 糖尿病,标志着高血糖,是一个日益增长的全球健康问题.
- 糖尿病视网膜病变 (DR) 是导致视力丧失的主要原因,与神经血管单元 (NVU) 损伤有关.
- 仅仅血红蛋白A1c (HbA1c) 无法完全预测DR风险;其他因素也参与其中.
研究的目的:
- 探索高级糖化最终产品 (AGEs) 在DR病变发生中的作用.
- 审查针对NVU保护AGE的治疗策略.
- 突出早期DR管理中的范式转变.
主要方法:
- 关于高血糖,AGE和DR的文献综述.
- 分析导致糖尿病NVU损伤的因素.
- 检查现有的和自然化合物作为抗AGE疗法.
主要成果:
- 慢性高血糖症通过AGE,炎症和氧化应激诱导NVU损伤.
- AGEs无可逆转地积累,大大导致DR和其他糖尿病并发症.
- 几种药物 (皮奥格利塔,ARB,ACE抑制剂,他类药物) 和天然化合物 (本福胺,肉) 显示出抗AGE的潜力.
结论:
- 针对AGE提供了一个有前途的治疗途径,可以在早期DR中保存NVU功能.
- 包括抗AGE策略在内的多方面的方法代表了DR管理的新方向.
- 需要进一步的研究来优化这些策略,以改善患者的治疗结果.
相关概念视频
Diabetes: Management and Pharmacotherapy
216
The therapy for diabetes aims to alleviate hyperglycemia-related symptoms, prevent acute metabolic decompensation, and reduce chronic end-organ complications. Glycemic control is evaluated through short-term (self-monitoring, continuous glucose monitoring) and long-term (A1c, fructosamine) metrics, enabling near real-time tracking of blood glucose levels and reflecting glycemic control over specific time frames.
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
216
Glucagon-like Receptor Agonists
277
Incretins include glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), which stimulate insulin secretion post-meals. In type 2 diabetes, GIP's efficacy is reduced, making GLP-1 a viable drug target. GIP originates from preproGIP.
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by...
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by...
277
Diabetes Mellitus: Type 2 and Gestational
2.1K
Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
2.1K
Dipeptidyl Peptidase 4 Inhibitors
146
Dipeptidyl peptidase 4 (DPP-4) is a serine protease widely distributed in the body. It's involved in the inactivation of GLP-1 and GIP hormones, which are crucial for insulin regulation. DPP-4 inhibitors, such as sitagliptin (Januvia), saxagliptin (Onglyza), linagliptin (Tradjenta), alogliptin (Nesina), and vildagliptin (Galvus), help increase the proportion of active GLP-1, enhancing insulin secretion. These inhibitors work by competitively binding to DPP-4. This binding causes a...
146
Oral Hypoglycemic Agents: Biguanides and Glitazones
144
Biguanides, particularly metformin (Glucophage), are insulin sensitizers that enhance glucose uptake, thereby reducing insulin resistance. Unlike sulfonylureas, metformin doesn't prompt insulin secretion, which helps to curb hypoglycemia risk. Metformin is beneficial in treating conditions like polycystic ovary syndrome due to its insulin-resistance reduction capability. The drug's primary action involves curtailing hepatic gluconeogenesis, a significant contributor to high blood...
144
Open Angle Glaucoma: Treatment
375
In open-angle glaucoma, the iridocorneal angle remains open, but the trabecular meshwork becomes stiff, slowing down the outflow of aqueous humor. This causes a buildup of aqueous humor in the anterior chamber, leading to a sudden increase in intraocular pressure. The treatment for open-angle glaucoma focuses on reducing the elevated intraocular pressure by either decreasing the secretion of aqueous humor or increasing its outflow.
Drugs such as carbonic anhydrase inhibitors, α2- and...
Drugs such as carbonic anhydrase inhibitors, α2- and...
375


