Biomarkers in Diabetic Retinopathy.
Biomarkers in Diabetic Retinopathy.
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DOI：
10.1900/rds.2015.12.159
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发表时间：
2015-03-01
期刊：
影响因子：
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通讯作者：
Januszewski, Andrzej S
中科院分区：
文献类型：
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作者：
Jenkins, Alicia J;Joglekar, Mugdha V;Januszewski, Andrzej S
全球糖尿病流行与肥胖增加有关。这种巧合可能导致2型糖尿病患病率上升。1型糖尿病的发病率也有一个尚未解释的增加，这与肥胖无关。虽然改善的糖尿病护理大大改善了糖尿病的预后，但该疾病仍然是导致工作年龄成人发病失明的常见原因。糖尿病视网膜病变是糖尿病最常见的并发症；这是许多糖尿病患者非常害怕的。糖尿病视网膜病变的发生和发展有多种危险因素和标志物，但残余风险仍然存在。建议对糖尿病视网膜病变进行筛查，以促进早期发现和治疗。在临床实践中，糖尿病视网膜病变及其风险的常见生物标志物与视网膜血管的可视化以及血糖、血脂、血压、体重、吸烟和妊娠状况的测量有关。对糖尿病视网膜病变的新型生物标志物和介质（如与炎症和血管生成相关的生物标志物和介质）的更多了解，促进了其他治疗方法的发展，特别是针对晚期视网膜病变，包括眼内皮质类固醇和玻璃体内血管内皮生长因子抑制剂（“抗vegf”）药物。不幸的是，尽管有一系列的治疗方法(包括激光光凝、眼内类固醇和抗vegf药物，以及最近的口服非诺贝特（一种ppar - α激动剂降脂药物），许多糖尿病视网膜病变患者对目前的治疗方法反应不佳。因此，更有效的治疗糖尿病视网膜病变是必要的。新的分析技术，特别是与分子标记相关的技术，正在加速糖尿病视网膜病变研究的进展。鉴于糖尿病的发病率和流行率不断上升，以及卫生保健系统筛查和治疗糖尿病视网膜病变的能力有限，有必要可靠地识别和分类糖尿病患者。生物标志物可能有助于更好地了解糖尿病视网膜病变，并有助于开发新的治疗方法和新的临床策略，以防止糖尿病患者视力丧失。本文综述了生物标志物研究的关键方面，并重点介绍了与糖尿病视网膜病变相关的一些特异性生物标志物。
There is a global diabetes epidemic correlating with an increase in obesity. This coincidence may lead to a rise in the prevalence of type 2 diabetes. There is also an as yet unexplained increase in the incidence of type 1 diabetes, which is not related to adiposity. Whilst improved diabetes care has substantially improved diabetes outcomes, the disease remains a common cause of working age adult-onset blindness. Diabetic retinopathy is the most frequently occurring complication of diabetes; it is greatly feared by many diabetes patients. There are multiple risk factors and markers for the onset and progression of diabetic retinopathy, yet residual risk remains. Screening for diabetic retinopathy is recommended to facilitate early detection and treatment. Common biomarkers of diabetic retinopathy and its risk in clinical practice today relate to the visualization of the retinal vasculature and measures of glycemia, lipids, blood pressure, body weight, smoking, and pregnancy status. Greater knowledge of novel biomarkers and mediators of diabetic retinopathy, such as those related to inflammation and angiogenesis, has contributed to the development of additional therapeutics, in particular for late-stage retinopathy, including intra-ocular corticosteroids and intravitreal vascular endothelial growth factor inhibitors ('anti-VEGFs') agents. Unfortunately, in spite of a range of treatments (including laser photocoagulation, intraocular steroids, and anti-VEGF agents, and more recently oral fenofibrate, a PPAR-alpha agonist lipid-lowering drug), many patients with diabetic retinopathy do not respond well to current therapeutics. Therefore, more effective treatments for diabetic retinopathy are necessary. New analytical techniques, in particular those related to molecular markers, are accelerating progress in diabetic retinopathy research. Given the increasing incidence and prevalence of diabetes, and the limited capacity of healthcare systems to screen and treat diabetic retinopathy, there is need to reliably identify and triage people with diabetes. Biomarkers may facilitate a better understanding of diabetic retinopathy, and contribute to the development of novel treatments and new clinical strategies to prevent vision loss in people with diabetes. This article reviews key aspects related to biomarker research, and focuses on some specific biomarkers relevant to diabetic retinopathy.