vascular endothelial growth factor

血管内皮生长因子
  • 文章类型: Journal Article
    本文概述了含有抗血管内皮生长因子的药物用于治疗年龄相关性黄斑变性的新生血管形式的治疗方案。目前,含有抗血管内皮生长因子的药物是这种慢性和进行性疾病的唯一有效治疗方法。在过去的二十年中,这种疾病的治疗方案已经从简单的稳定疾病的努力转变为最大程度地改善视敏度及其维持。改善患者的生活质量,减轻患者及其家属的治疗负担。替代给药方案取代了原来的固定给药方案的其他目标是给药方案的更大个性化。更好的耐心合作,节省财务成本,减轻应用中心的负担。年龄相关性黄斑变性,无论是干形式还是湿形式,代表着严重的健康和社会经济问题,由于这种疾病是最常见的原因之一严重和不可逆的中枢神经系统的视力障碍,在发达的工业化国家的50岁以上的人的一只或两只眼睛的实际失明的程度。最重要的问题是确保这种疾病的早期诊断,然后是快速和连续的治疗,并采用个性化的主动治疗方案,目的是稳定和改善解剖和功能结果。
    This article presents an overview of treatment regimens of drugs containing antivascular endothelial growth factor for the treatment of neovascular form of age-related macular degeneration. Currently, drugs containing antivascular endothelial growth factor are the only effective treatment for this chronic and progressive disease. The treatment regimens for this disease in the last two decades have seen a shift from a simple endeavor to stabilize the disease to achieving maximum improvement of visual acuity and its maintenance, with improvement of the patient\'s quality of life and a minimal treatment burden on patients and their families. Other goals of the alternative dosing regimens that have replaced the original fixed regimens were greater individualization of the dosing regimen, better patient cooperation, saving financial costs and reducing the burden on application centers. Age-related macular degeneration, whether dry form or wet form, represents a serious health and socioeconomic problem, as the disease is one of the most common causes of severe and irreversible central visual acuity disorders up to the degree of practical blindness of one or both eyes in people over 50 years of age in developed industrialized countries. The most important issue is to ensure early diagnosis of this disease, followed by prompt and continuous treatment with an individualized proactive treatment regimen, with the aim of stabilizing and improving anatomical and functional results.
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  • 文章类型: Journal Article
    由表皮生长因子受体(EGFR)酪氨酸激酶抑制剂(TKI)或免疫检查点抑制剂(ICI)引起的间质性肺病(ILD)或肺炎是非小细胞肺癌(NSCLC)治疗中的主要问题。添加血管内皮生长因子(VEGF)和VEGF受体(VEGFR)抑制剂是否可以降低药物诱导的ILD的发生率尚不清楚。我们在2009年1月至2023年10月的相关随机试验中进行了系统评价,以评估存在或不存在VEGF/VEGFR抑制剂时EGFR-TKIs或ICIs诱导的ILD的发生率。主要结果是全球所有患者和亚洲人ILD发生率的比值比。次要结果是全球所有患者和亚洲人的3级或更高ILD发生率的比值比(OR)。我们确定了13项随机研究,EGFR-TKI组中的一个子分析,ICI组的三项随机研究。在EGFR-TKI组中,使用VEGF/VEGFR抑制剂的任何级别的ILD发生率的OR为0.54(95%CI,0.32-0.90;p=0.02),这表明发病率显著低于无VEGF/VEGFR抑制剂。相反,使用VEGF/VEGFR抑制剂的≥3级ILD发生率的OR为1.00(95%CI,0.43-2.36;p=0.99).在ICI组的所有受试者中,使用VEGF/VEGFR抑制剂的任何级别ILD发生率的OR为0.78(95%CI,0.51-1.21;p=0.27).系统评价表明,在NSCLC患者中,添加VEGF/VEGFR抑制剂可以降低EGFR-TKI引起的任何级别的药物诱导ILD的发生率,但在≥3级时不能降低。由于可获得ILD数据的随机试验数量有限,ICIs诱导的ILD仍未确定。
    https://www.crd.约克。AC.uk/PROSPERO/display_record。php?RecordID=409534,标识符CRD42023409534。
    Interstitial lung disease (ILD) or pneumonitis caused by epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKI) or immune checkpoint inhibitors (ICI) is a major concern in the treatment of non-small cell lung cancer (NSCLC). Whether the addition of vascular endothelial growth factor (VEGF) and VEGF receptor (VEGFR) inhibitors can reduce the incidence of drug-induced ILD remains unclear. We conducted a systematic review to assess the incidence of ILD induced by EGFR-TKIs or ICIs in the presence or absence of VEGF/VEGFR inhibitors in relevant randomized trials between January 2009 and October 2023. The primary outcome was the odds ratio for the incidence of ILD in all patients worldwide and Asians. Secondary outcomes were the odds ratios (ORs) of the incidence at grade-3 or higher ILD in all patients worldwide and Asians. We identified 13 randomized studies, one sub-analysis in the EGFR-TKI group, and three randomized studies in the ICI group. In the EGFR-TKI group, the OR of ILD incidence at any grade with VEGF/VEGFR inhibitors was 0.54 (95% CI, 0.32-0.90; p = 0.02), which represented a significantly lower incidence than that without VEGF/VEGFR inhibitors. Contrarily, the OR of ILD incidence at grade ≥ 3 with VEGF/VEGFR inhibitors was 1.00 (95% CI, 0.43-2.36; p = 0.99). In all subjects in the ICI group, the OR of ILD incidence at any grade with VEGF/VEGFR inhibitors was 0.78 (95% CI, 0.51-1.21; p = 0.27). The systematic review demonstrated that the addition of VEGF/VEGFR inhibitors could reduce the incidence of drug-induced ILD at any grade caused by EGFR-TKI in patients with NSCLC but could not reduce that at grade ≥ 3. The ILD induced by ICIs remains undetermined owing to the limited number of randomized trials for which ILD data are available.
    UNASSIGNED: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=409534, identifier CRD42023409534.
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  • 文章类型: Journal Article
    背景:过早卵巢功能不全(POI)是指在40岁之前卵巢中卵母细胞的数量和/或质量急剧下降,是女性不孕的主要原因。POI的患病率逐年增加,并且趋于年轻。关于POI的病因及相关发病机制的研究还很有限。草药可以治疗许多妇科疾病。而草药在不孕症等生殖保健方面是有效的。近年来,已经发现细胞因子(CK)的免疫调节可以预防或干预POI,中药可以通过调节CK来治疗POI,以改善卵巢功能和生育能力。
    目的:本文就POI相关CK调控的分子机制进行综述,并报告了草药对POI的治疗效果,包括草药配方,单一草药,中药活性成分和针灸。本综述为POI的临床防治提供理论支持,为中药治疗POI的研究提供了新的思路。
    方法:我们收集了来自不同科学数据库的有关通过调节CK对POI的草药治疗作用的相关科学文章,包括PubMed,WebofScience,万方数据库,CNKI及其他出版物资源本评论中使用的搜索词包括,\'过早卵巢功能不全\',\'卵巢早衰(POF)\',\'不孕症\',\'草药\',\'针灸\',\'细胞因子\',\'白细胞介素(IL)\',“肿瘤坏死因子-α(TNF-α)”,\'干扰素-γ(IFN-γ)\',转化生长因子-β(TGF-β)血管内皮生长因子(VEGF)\'免疫\'和\'炎症\'。本文根据现有的实验和临床研究,对中药的治疗效果进行了总结和分析。
    结果:结果表明,草药通过CK(包括IL,TNF-α,INF-γ,VEGF,TGF-β等)和相关信号通路,调节生殖激素紊乱,减少卵巢炎症损伤,氧化应激,细胞凋亡和卵泡闭锁,改善卵巢病理损伤和卵巢储备功能。
    结论:这篇综述通过调节CK丰富了基于中药的POI治疗理论。应加强中药治疗POI的具体作用机制和临床研究,以促进中药在临床的应用,为POI的治疗提供新的思路和更好的选择。
    BACKGROUND: Premature ovarian insufficiency (POI) refers to a dramatic decrease in the number and/or quality of oocytes in the ovaries before the age of 40 years, and is a key cause of female infertility. The prevalence of POI has been increasing annually and tends to be younger. Researches on the etiology of POI and related pathogenesis are still very limited. Herbal medicine can treat many gynecological diseases. And herbal medicine is effective in reproductive health care such as infertility. In recent years, it has been found that immune modulation by cytokines (CK) can prevent or intervene in POI, and herbal medicine can treat POI by regulating CK to improve ovarian function and fertility.
    OBJECTIVE: This review presents an overview of the molecular mechanisms of regulation of POI related CK, and reports the therapeutic effect of herbal medicine on POI including herbal medicine formulas, single herbal medicine, herbal medicine active components and acupuncture. This review provides theoretical support for clinical prevention and treatment of POI, and provides new ideas for researches on herbal medicine treatment of POI.
    METHODS: We performed a collection of relevant scientific articles from different scientific databases regarding the therapeutic effect of herbal medicine on POI by regulating CK, including PubMed, Web of Science, Wanfang Database, CNKI and other publication resources. The search terms used in this review include, \'premature ovarian insufficiency\', \'premature ovarian failure (POF)\', \'infertility\', \'herbal medicine\', \'acupuncture\', \'cytokine\', \'interleukin (IL)\', \'tumor necrosis factor-α (TNF-α)\', \'interferon-γ (IFN-γ)\', \'transforming growth factor-β (TGF-β)\', \'vascular endothelial growth factor (VEGF)\', \'immune\' and \'inflammation\'. This review summarized and analyzed the therapeutic effect of herbal medicine according to the existing experimental and clinical researches.
    RESULTS: The results showed that herbal medicine treats POI through CK (including ILs, TNF-α, INF-γ, VEGF, TGF-β and others) and related signaling pathways, which regulates reproductive hormones disorder, reduces ovarian inflammatory damage, oxidative stress, apoptosis and follicular atresia, improves ovarian pathological damage and ovarian reserve function.
    CONCLUSIONS: This review enriches the theory of POI treatments based on herbal medicine by regulating CK. The specific mechanisms of action and clinical researches on the treatment of POI by herbal medicine should be strengthened in order to promote the application of herbal medicine in the clinic and provide new ideas and better choices for the treatment of POI.
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  • 文章类型: Journal Article
    目的:评价亚阈值微脉冲激光(SML)联合抗血管内皮生长因子(VEGF)治疗糖尿病性黄斑水肿(DME)的疗效。
    方法:MEDLINE,EMBASE,和Cochrane对照试验中央注册中心进行了系统的搜索,以比较抗VEGF与SML和抗VEGF单药治疗DME的研究。结果指标是最佳矫正视力(BCVA),黄斑中心厚度(CMT),和抗VEGF注射的数量。
    结果:共选择了8项研究,包括493只眼。四项研究是随机对照的,另外四个是回顾性的。Meta分析显示,BCVA差异无统计学意义(均差[MD]-0.04;95CI-0.09至0.01logMAR;P=0.13;)。抗VEGF伴SML组的CMT更薄(MD-11.08;95CI-21.04至-1.12µm;P=0.03);然而,这是由于一项研究的重量更高,敏感性和子类别分析不支持这一发现.抗VEGF注射次数在抗VEGF伴SML组中显著减少(MD-2.22;95CI-3.02至-1.42;P<0.0001)。
    结论:目前的证据表明,与抗VEGF单药治疗相比,在抗VEGF治疗中加入SML可以显着减少抗VEGF注射的数量,同时实现类似的BCVA和CMT。
    OBJECTIVE: To evaluate the effects of subthreshold micropulse laser (SML) in addition to anti-vascular endothelial growth factor (VEGF) therapy for diabetic macular edema (DME).
    METHODS: MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials were systematically searched for studies that compared anti-VEGF with SML and anti-VEGF monotherapy for DME. Outcome measures were best-corrected visual acuity (BCVA), central macular thickness (CMT), and the number of anti-VEGF injections.
    RESULTS: Eight studies including 493 eyes were selected. Four studies were randomized controlled, and the other four were retrospective. Meta-analysis showed that there was no significant difference in BCVA (mean difference [MD] -0.04; 95%CI -0.09 to 0.01 logMAR; P = 0.13;). CMT was thinner in the group of anti-VEGF with SML (MD -11.08; 95%CI -21.04 to -1.12 µm; P = 0.03); however, it was due to a single study that weighed higher, and the sensitivity and subcategory analyses did not support the finding. The number of anti-VEGF injections was significantly decreased in the group of anti-VEGF with SML (MD -2.22; 95%CI -3.02 to -1.42; P < 0.0001).
    CONCLUSIONS: Current evidence indicates that adding SML to anti-VEGF therapy could significantly reduce the number of anti-VEGF injections compared to anti-VEGF monotherapy, while achieve similar BCVA and CMT.
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  • 文章类型: Journal Article
    Diabetic foot ulcers are a common and severe complication of diabetes mellitus, and a risk factor for amputation. Because of the vessel insufficiency in diabetic foot ulcers (DFU), vascular endothelial growth factor (VEGF) that simulates angiogenesis is of interest to promote wound healing. This systematic review evaluates the last 16 years of in-vivo studies with VEGF stimulation as a treatment for DFU, developed based on the last published systematic article. A total of 961 articles were identified through databases in two phases. 947 articles were excluded by exclusion criteria, and four articles met our inclusion criteria and were included. The effects of VEGF on wound healing were analysed in all four studies. In three studies, the VEGF-treated wounds showed statistically faster healing than those not treated with VEGF. In one study, the VEGF-treated wounds revealed a positive trend toward faster healing. Furthermore, all four studies were in favor of using VEGF, but concluded that further research is needed. These studies showed a positive trend towards faster healing and was safe when using VEGF topically on humans. Furthermore, viral particles of VEGF seem to have a systematic effect when a dose exceeding 5.0 × 109 vp pr wound. Future research in using VEGF on DFU should focus on VEGF\'s relevant dosage, release rate, and specific mechanism. This review inspires further research, and a consistent study design is prerequisite such that results are more homogenic and comparable. Much effort is needed to translate the results into our clinical practice.
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  • 文章类型: Journal Article
    糖尿病性视网膜病变(DR)是全球视力障碍的主要原因,需要全面了解其血管和神经成分,以进行有效的治疗干预。虽然血管病理学已经确立,最近的证据表明在DR中具有神经退行性作用。血管内皮生长因子(VEGF),传统上涉及血管生成,已经成为具有神经保护潜力的关键人物。本系统综述对文献进行了评估,以阐明这方面的分子机制和临床意义。审查遵循系统审查和荟萃分析(PRISMA)指南的首选报告项目,涵盖跨多个数据库的全面搜索策略。三项体外研究符合纳入标准,突出了这个不断发展的领域有限的研究。研究结果表明VEGF对视网膜神经节细胞(RGCs)和视网膜神经元的神经保护作用,揭示潜在的治疗途径。然而,人们对抗VEGF治疗对RGC生存的影响表示担忧。该综述讨论了需要进一步研究来描述负责VEGF介导的神经保护的特定同工型和信号通路。血管生成和神经保护之间的微妙平衡对治疗发展提出了挑战。强调有针对性干预的重要性。尽管有局限性,这篇综述提供了关于VEGF与DR神经保护之间复杂关系的有价值的见解,为未来的研究和重新定义治疗策略铺平道路。
    Diabetic retinopathy (DR) is a leading cause of global visual impairment, necessitating a comprehensive understanding of its vascular and neural components for effective therapeutic interventions. While vascular pathology is well-established, recent evidence suggests a neurodegenerative role in DR. Vascular endothelial growth factor (VEGF), traditionally implicated in angiogenesis, has emerged as a key player with neuroprotective potential. This systematic review evaluates the literature to shed light on molecular mechanisms and clinical implications in this regard. The review adheres to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, encompassing a thorough search strategy across multiple databases. Three in vitro studies met the inclusion criteria, highlighting the limited research in this evolving field. Findings suggest VEGF\'s neuroprotective effects on retinal ganglion cells (RGCs) and retinal neurons, unveiling potential therapeutic avenues. However, concerns arise regarding anti-VEGF therapies\' impact on RGC survival. The review discusses the need for further research to delineate specific isoforms and signaling pathways responsible for VEGF-mediated neuroprotection. The delicate balance between angiogenesis and neuroprotection poses challenges in therapeutic development, emphasizing the importance of targeted interventions. Despite limitations, this review provides valuable insights into the intricate relationship between VEGF and neuroprotection in DR, paving the way for future investigations and redefining therapeutic strategies.
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  • 文章类型: Journal Article
    糖尿病视网膜病变(DR)是糖尿病最常见的微血管并发症,损害视网膜,导致失明。与2型糖尿病患者相比,1型糖尿病患者发生DR的风险更大。糖尿病性视网膜病变可分为两类:增殖性糖尿病性视网膜病变(PDR)和非增殖性糖尿病性视网膜病变(NPDR)。糖尿病视网膜病变的发生和进展有多种危险因素,比如高血压,肥胖,吸烟,糖尿病的持续时间,和遗传学。许多研究已经评估了DR患者血清中多种炎性趋化因子的水平,玻璃体,和水性流体。在糖尿病性视网膜病变中,玻璃体液显示血管生成因子如血小板衍生生长因子(PDGF)或血管内皮生长因子(VEGF)升高,或抗血管生成因子如色素上皮衍生因子(PEDF)降低.为了预防糖尿病性视网膜病变,更多的体力活动以及更少的久坐行为与DR的可能性降低有关。补充含有维生素(B1,B2,B6,B12,C,D,E,和l-甲基叶酸)和矿物质(锌)可以帮助减少或避免DR的爆发。建议仅激光光凝和抗血管内皮生长因子(Anti-VEGF)注射作为严重视网膜病变的有利疗法。当谈到治疗DR的VEGF水平,炎症,氧化应激,凋亡,和血管生成,中医有很好的前途。
    Diabetic retinopathy (DR) is the most common microvascular complication of diabetes that damages the retina, leading to blindness. People with type 1 diabetes are at greater risk of developing DR than people with type 2 diabetes. Diabetic retinopathy may be divided into two primary categories: proliferative diabetic retinopathy (PDR) and non-proliferative diabetic retinopathy (NPDR). There are multiple risk factors for the onset and progression of diabetic retinopathy, such as hypertension, obesity, smoking, duration of diabetes, and genetics. Numerous investigations have evaluated the levels of a wide range of inflammatory chemokines within DR patients\' serum, vitreous, and aqueous fluids. In diabetic retinopathy, the vitreous fluid exhibited rises in angiogenic factors like platelet-derived growth factor (PDGF) or vascular endothelial growth factor (VEGF) or declines in antiangiogenic factors like pigment epithelium-derived factor (PEDF). For prevention of diabetic retinopathy, more physical activity as well as less sedentary behavior were linked to a reduced likelihood of DR. Supplementing with nutraceuticals containing vitamins (B1, B2, B6, B12, C, D, E, and l-methyl folate) and mineral (zinc) can help decrease or avoid an outbreak of DR. Only laser photocoagulation and Anti-vascular endothelial growth factor (Anti-VEGF) injections are advised as favorable therapies in severe retinopathy. When it comes to treating DR\'s VEGF levels, inflammation, oxidative stress, apoptosis, and angiogenesis, traditional Chinese medicine (TCM) has an excellent future.
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  • 文章类型: Journal Article
    由于与其他恶性肿瘤相比,头颈部鳞状细胞癌的预后仍不令人满意,靶向特异性生物标志物的新疗法是一个非常有希望的新兴领域.已开发用于阻止肿瘤血管生成的一类特定药物是血管内皮生长因子-酪氨酸激酶抑制剂。由于目前的数据主要限于临床前和I/II期试验,这篇综述总结了这些药物在头颈部鳞状细胞癌中的当前和未来前景。特别是,这些药物与免疫治疗的组合是一个令人兴奋的领域,对于复发或转移性疾病的患者来说可能是一个有希望的选择。在最近的试验中得到了证明,例如免疫检查点抑制剂与lenvatinib和cabozantinib的组合。此外,在局部晚期疾病的术前使用这种联合治疗是另一个令人感兴趣的领域.
    As the prognosis for squamous cell carcinoma of the head and neck remains unsatisfactory when compared to other malignancies, novel therapies targeting specific biomarkers are a critical emerging area of great promise. One particular class of drugs that has been developed to impede tumor angiogenesis is vascular endothelial growth factor-tyrosine kinase inhibitors. As current data is primarily limited to preclinical and phase I/II trials, this review summarizes the current and future prospects of these agents in squamous cell carcinoma of the head and neck. In particular, the combination of these agents with immunotherapy is an exciting area that may be a promising option for patients with recurrent or metastatic disease, evidenced in recent trials such as the combination immune checkpoint inhibitors with lenvatinib and cabozantinib. In addition, the use of such combination therapy preoperatively in locally advanced disease is another area of interest.
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  • 文章类型: Meta-Analysis
    血管生成受损与老年人的认知能力下降有关。虽然运动与血管生成的增加广泛相关,老年人的相关机制尚不清楚.这里,为了更好地了解相关机制,我们对老年人运动与特定血管生成标志物之间的关系进行了系统综述和荟萃分析.MEDLINE,Embase,和CochraneCENTRAL在老年人(≥50岁)运动前后血液中血管生成标志物浓度的原始报告中进行了检索。使用亚组分析和荟萃回归研究异质性。在纳入审查的44篇文章中,38项被纳入5项标志物的荟萃分析:血管内皮生长因子(VEGF),e-选择素(CD62E),内皮抑素,成纤维细胞生长因子2和基质金属肽酶-9。VEGF水平较高(SMD[95CI]=0.18[0.03,0.34],CD62E水平较低(SMD[95CI]=-0.72[-1.42,-0.03],运动后p=0.04)。其他标记没有改变。虽然还需要更多的研究,血管生成标志物的变化可能有助于解释运动对老年人血管生成的有益影响。
    Impaired angiogenesis is associated with cognitive decline in older adults. While exercise has been broadly associated with increased angiogenesis, the relevant mechanisms in older adults are not clear. Here, we present a systematic review and meta-analysis on the relationship between exercise and specific blood angiogenesis markers in older adults to better understand the relevant mechanisms. MEDLINE, Embase, and Cochrane CENTRAL were searched for original reports of angiogenesis markers\' concentrations in blood before and after exercise in older adults (≥50 years). Heterogeneity was investigated using sub-group analyses and meta-regressions. Of the 44 articles included in the review, 38 were included in the meta-analyses for five markers: vascular endothelial growth factor (VEGF), e-selectin (CD62E), endostatin, fibroblast growth factor 2, and matrix metallopeptidase-9. VEGF levels were higher (SMD[95%CI]= 0.18[0.03, 0.34], and CD62E levels were lower (SMD[95%CI]= -0.72[-1.42, -0.03], p = 0.04) after exercise. No other markers were altered. Although more studies are needed, changes in angiogenesis markers may help explain the beneficial effects of exercise on angiogenesis in older adults.
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  • 文章类型: Journal Article
    糖尿病(DM)是当今日益严重的问题,糖尿病视网膜病变(DR)是其主要并发症。目前,DR诊断主要依靠胃镜检查;然而,新的生物标志物可以促进这一过程并使其广泛可用。在当前的审查中,我们深入研究了各种因素和机制在DR发展中的复杂作用,programming,预测,以及它们与潜在致病途径相关的治疗方法。具体来说,我们专注于晚期糖基化终产物,血管内皮生长因子(VEGF),不对称二甲基精氨酸,内皮素-1,以及在DR背景下由microRNAs(miRNAs)介导的表观遗传调控。
    Diabetes mellitus (DM) is a growing problem nowadays, and diabetic retinopathy (DR) is its predominant complication. Currently, DR diagnosis primarily relies on fundoscopic examination; however, novel biomarkers may facilitate that process and make it widely available. In this current review, we delve into the intricate roles of various factors and mechanisms in DR development, progression, prediction, and their association with therapeutic approaches linked to the underlying pathogenic pathways. Specifically, we focus on advanced glycation end products, vascular endothelial growth factor (VEGF), asymmetric dimethylarginine, endothelin-1, and the epigenetic regulation mediated by microRNAs (miRNAs) in the context of DR.
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