The Significance of Vascular and Neural Apoptosis to the Pathology of Diabetic Retinopathy
The Significance of Vascular and Neural Apoptosis to the Pathology of Diabetic Retinopathy
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DOI：
10.1167/iovs.10-6293
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发表时间：
2011-02-01
影响因子：
4.4
通讯作者：
Abcouwer, Steven F.
中科院分区：
文献类型：
--
作者：
Barber, Alistair J.;Gardner, Thomas W.;Abcouwer, Steven F.
糖尿病视网膜病变最显著的特征是眼底检查明显的血管异常。也有强有力的证据表明，糖尿病导致视网膜中神经和血管细胞的凋亡。因此，有充分的理由将糖尿病视网膜病变定义为慢性神经血管变性的一种形式。与人类视网膜病变的逐渐发作一致，动物模型中的细胞损失率是隐性的，即使在不受控制的糖尿病中也是如此。这并不奇怪，因为持续的高细胞损失率而没有再生很快就会导致灾难性的组织破坏。持续细胞死亡的后果难以检测，甚至累积细胞损失的量化也需要艰苦的组织学和显微镜检查。这种细微的细胞损失提出了这种现象与糖尿病视网膜病变进展和最终视力丧失的相关性的问题。神经元功能可能在细胞凋亡之前受损，导致视力早期恶化。在这里，我们回顾了一些证据支持凋亡细胞死亡作为糖尿病视网膜病变的一个贡献机制，探讨了一些潜在的原因，并讨论了细胞凋亡和糖尿病视网膜病变的视觉功能丧失之间的潜在联系。（Invest Ophthalmol维斯科学。2011; 52：1156-1163）DOI：10.1167/iovs.10-6293
The most striking features of diabetic retinopathy are the vascular abnormalities that are apparent by fundus examination. There is also strong evidence that diabetes causes apoptosis of neural and vascular cells in the retina. Thus, there is good reason to define diabetic retinopathy as a form of chronic neurovascular degeneration. In keeping with the gradual onset of retinopathy in humans, the rate of cell loss in the animal models is insidious, even in uncontrolled diabetes. This is not surprising given that a sustained high rate of cell loss without regeneration would soon lead to catastrophic tissue destruction. The consequences of ongoing cell death are difficult to detect, and even the quantification of cumulative cell loss requires painstaking histology and microscopy. This subtle cell loss raises the issue of the relevance of the phenomenon to the progression of diabetic retinopathy and the ultimate loss of vision. Neuronal function may be compromised in advance of apoptosis, contributing to an early deterioration of vision. Here we review some of the evidence supporting apoptotic cell death as a contributing mechanism of diabetic retinopathy, explore some of the potential causes, and discuss the potential links between apoptosis and loss of visual function in diabetic retinopathy. (Invest Ophthalmol Vis Sci. 2011; 52:1156-1163) DOI:10.1167/iovs.10-6293