Abstract:
The escalating global prevalence of diabetes mellitus (DM) over the past two decades has led to a persistent high incidence of diabetic retinopathy (DR), necessitating screening for early symptoms and proper treatment. Effective management of DR aims to decrease vision impairment by controlling modifiable risk factors including hypertension, obesity, and dyslipidemia. Moreover, systemic medications and plant-based therapy show promise in advancing DR treatment. One of the key mechanisms related to DR pathogenesis is the polyol pathway, through which aldose reductase (AR) catalyzes the conversion of glucose to sorbitol within various tissues, including the retina, lens, ciliary body and iris. Elevated glucose levels activate AR, leading to osmotic stress, advanced glycation end-product formation, and oxidative damage. This further implies chronic inflammation, vascular permeability, and angiogenesis. Our comprehensive narrative review describes the therapeutic potential of aldose reductase inhibitors in treating DR, where both synthetic and natural inhibitors have been studied in recent decades. Our synthesis aims to guide future research and clinical interventions in DR management.
摘要:
在过去的二十年中,糖尿病(DM)的全球患病率不断上升,导致糖尿病视网膜病变(DR)的发病率持续居高不下。需要筛查早期症状和适当的治疗。DR的有效管理旨在通过控制包括高血压在内的可改变的危险因素来减少视力损害。肥胖,和血脂异常。此外,全身药物治疗和基于植物的治疗在推进DR治疗方面显示出前景.与DR发病相关的关键机制之一是多元醇途径,醛糖还原酶(AR)催化葡萄糖在各种组织内转化为山梨糖醇,包括视网膜,镜头,睫状体和虹膜。升高的葡萄糖水平激活AR,导致渗透应力,糖基化终产物的形成,和氧化损伤。这进一步意味着慢性炎症,血管通透性,和血管生成。我们全面的叙述综述描述了醛糖还原酶抑制剂在治疗DR中的治疗潜力,近几十年来一直在研究合成和天然抑制剂。我们的综合旨在指导未来DR管理的研究和临床干预。