本文提供了一个病例报告,并讨论了在接受光生物调制(PBM)的患者中联合施用植物化学物质引起的潜在神经修复的神经生物学。这改善了年龄相关性黄斑变性(AMD)过程中的解剖和临床异常。在联合治疗后,服用营养品和PBM的患者的视网膜组织有明显的改善,其年龄具有出色的视力,并且没有角膜内脏恶化。在诊断时存在。目前的治疗方法是量身定制的,基于翻译证据,改善自噬途径,这是AMD发病和进展的关键决定因素。事实上,用特定的光暴露模式与特定的植物化学物质相结合的治疗,可能通过恢复其神经生物学来协同改善视网膜的显微解剖结构。曝光的组合,在选择性波长下,通过摄入特定的植物化学物质来治疗AMD产生的效果在这里报告为“卢加诺方案”。这样的临床方案代表了由转化研究支持的“正在进行”发展。事实上,最近的证据表明,特定的植物化学物质,当联合给药时,可以促进视网膜内的解剖和功能完整性。这些又与特定波长产生的类似效应协同作用,当以特定时间间隔给药时。在分子水平上讨论了特定光与组合植物化学物质之间的协同作用,最近的数据表明这些治疗方法,当根据特定模式交付时,可能增强视网膜中的自噬。改善视网膜形态和视力,根据自噬在调节视网膜上皮完整性方面的关键作用,在本病例报告中观察到了彻底的讨论。尽管令人兴奋,与翻译证据一致,AMD期间疾病改善效应的临床报告具有病例报告的固有限制,这需要在大量患者中进行广泛验证。“卢加诺方案”的潜在有效性可能适用于其他类型的视网膜变性,自噬途径中的常见改变确实发生。因此,这种治疗方法可能会延伸到视网膜突触变性的常见晚期,在几种类型的视网膜退行性疾病中,适应不良的可塑性最终会收敛。
The present article presents a
case report and discusses the neurobiology underlying the potential neuro-repair induced by combined administration of phytochemicals in a patient undergoing photo-bio-modulation (PBM), which improves anatomical and clinical abnormalities in the course of age-related macular degeneration (AMD). After combined treatments the patient with nutraceuticals and PBM had noticeable improvement of retinal tissue with excellent vision for her age and no worsening of corneal guttae, which was present at the time of diagnosis. The present treatment was tailored, based on translational evidence, to improve the autophagy pathway, which is a key determinant in the onset and progression of AMD. In fact, treatment with specific patterns of light exposure combined with specific phytochemicals, may synergize in improving the microanatomy of the retina by restoring its neurobiology. The combination of light exposure, at selective wavelengths, with the effects produced by the intake of specific phytochemicals to treat AMD is reported here as \"Lugano Protocol\". Such a clinical protocol represents an \"in progress\" development backed up by translational research. In fact, recent evidence indicates that, specific phytochemicals, when administered in combination may promote anatomical and functional integrity within the retina. These in turn synergize with analogous effects produced by specific wavelengths, when administered at specific time intervals. The synergism between specific light and combined phytochemicals is discussed at molecular level, where recent data indicate how these treatments, when delivered according to specific patterns, may enhance autophagy in the retina. The improvement of retinal morphology and visual acuity, observed in this
case report is thoroughly discussed in the light of the key role of autophagy in regulating the integrity of the retinal epithelium. Despite exciting, and consistent with translational evidence, the clinical report of a disease modifying effect during AMD owns the inherent limit of a
case report, which requires wide validation in large number of patients. The potential effectiveness of \"Lugano protocol\" may apply to other types of retinal degenerations, where common alterations in the autophagy pathway do occur. Thus, such a therapeutic approach may extend to a common late stage of retinal trans-synaptic degeneration, where maladaptive plasticity during several types of retinal degenerative disorders eventually converge.