Abstract:
Glaucoma is the leading cause of irreversible blindness globally, with Primary open angle glaucoma (POAG) being the commonest subtype. POAG is characterized by an increase in intraocular pressure (IOP), leading to optic nerve damage and subsequent visual field defects. Despite the clinical burden this disease poses, current therapies aim to reduce IOP rather than targeting the underling pathogenesis. Although the pathogenesis of POAG is complex, the culprit for this increase in IOP resides in the aqueous humour (AH) outflow pathway; the trabecular meshwork (TM) and Schlemm\'s canal. Dysfunction in these tissues is due to inherent mitochondrial dysfunction, calcium influx sensitivity, increase in reactive oxygen species (ROS) production, TGFβ-2 induction, leading to a sustained inflammatory response. Magnesium is the second most common intracellular cation, and is a major co-factor in over 300 reactions, being highly conserved within energy-dependent organelles such as the mitochondria. Magnesium deficiency has been observed in POAG and is linked to inflammatory and fibrotic responses, as well as increased oxidative stress (OS). Magnesium supplementation been shown to reduce cellular ROS, alleviate mitochondrial dysregulation and has further antifibrotic and anti-inflammatory properties within ocular tissues, and other soft tissues prone to fibrosis, suggesting that magnesium can improve visual fields in patients with POAG. The link between magnesium deficiency and glaucoma pathogenesis as well as the potential role of magnesium supplementation in the management of patients with POAG will be explored within this review.
摘要:
青光眼是全球不可逆性失明的主要原因,原发性开角型青光眼(POAG)是最常见的亚型。POAG的特征是眼内压(IOP)升高,导致视神经损伤和随后的视野缺损。尽管这种疾病带来了临床负担,目前的治疗旨在降低IOP,而不是针对潜在的发病机制.尽管POAG的发病机制复杂,眼压增加的罪魁祸首在于房水(AH)流出途径;小梁网(TM)和Schlemm管。这些组织的功能障碍是由于固有的线粒体功能障碍,钙内流敏感性,增加活性氧(ROS)的产生,TGFβ-2诱导,导致持续的炎症反应。镁是第二常见的细胞内阳离子,是300多个反应的主要辅助因子,在线粒体等能量依赖性细胞器内高度保守。在POAG中观察到镁缺乏,并与炎症和纤维化反应有关。以及增加的氧化应激(OS)。镁补充剂被证明可以减少细胞ROS,减轻线粒体失调,并在眼组织内具有进一步的抗纤维化和抗炎特性,和其他容易纤维化的软组织,提示镁可以改善POAG患者的视野。在这篇综述中,将探讨镁缺乏与青光眼发病机理之间的联系以及镁补充在POAG患者管理中的潜在作用。