Neurodegeneration:An early event of diabetic retinopathy
Neurodegeneration:An early event of diabetic retinopathy作者机构：Diabetes and Metabolism Research Unit.Institut de Recerca Hospital Universitari Vall D'HebronUniversitat Autònoma de Barcelona CIBER for Diabetes and Associated Metabolic Diseases(CIBERDEMInstituto de Salut CarlosⅢ)
出 版 物：《World Journal of Diabetes》 (世界糖尿病杂志（英文版）（电子版）)
年 卷 期：2010年第1卷第2期
页 面：57-64页
学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 100212[医学-眼科学] 10[医学]
基 金：Supported by Grants from the Ministerio de Cienciae Innovacion,No.SAF2009-07408 CIBER de Diabetesy Enfermedades Metabólicas Asociadas and Generaltitat de Catalunya,No. 2009SGR739
主 题：Diabetic retinopathy Angiotensin II Erythropoietin Glutamate Retinal neurodegeneration Neuropeptides Pigment epithelial derived factor Somatostatin
摘 要：Diabetic retinopathy(DR) has been classically considered to be a microcirculatory disease of the retina caused by the deleterious metabolic effects of hyperglycemia per se and the metabolic pathways triggered by ***,retinal neurodegeneration is already present before any microcirculatory abnormalities can be detected in ophthalmoscopic *** other words,retinal neurodegeneration is an early event in the pathogenesis of DR which predates and participates in the microcirculatory abnormalities that occur in ***,the study of the mechanisms that lead to neurodegeneration will be essential to identify new therapeutic targets in the early stages of *** levels of glutamate and the overexpression of the renin-angiotensin-system play an essential role in the neurodegenerative process that occurs in diabetic *** neuroprotective factors,pigment epithelial derived factor,somatostatin and erythropoietin seem to be the most relevant and these will be considered in this ***,it should be noted that the balance between neurotoxic and neuroprotective factors rather than levels of neurotoxic factors alone will determine the presence or absence of retinal neurodegeneration in the diabetic *** strategies,based on either the delivery of neuroprotective agents or the blockade of neurotoxic factors,are currently being tested in experimental models and in clinical pilot *** these novel therapies will eventually supplement or prevent the need for laser photocoagulation or vitrectomy awaits the results of additional clinical research.
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