Pathogenesis of retinopathy of prematurity.
Pathogenesis of retinopathy of prematurity.
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DOI：
10.1016/s1084-2756(03)00119-2
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发表时间：
2003-12-01
期刊：
影响因子：
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通讯作者：
Smith, Lois E H
中科院分区：
文献类型：
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作者：
Smith, Lois E H
早产儿视网膜病变(ROP)是发达国家儿童失明的主要原因。ROP是一种两期疾病，在早产后视网膜血管生长延迟(I期)开始。发育中的视网膜血管不足会造成缺氧，从而加速刺激新血管和异常血管生长的因子的释放(第二阶段)。ROP的发生是因为氧调节和非氧调节因子的异常，这影响到疾病的两个阶段。血管内皮生长因子(VEGF)是一种重要的氧调节因子，如果抑制，会抑制正常的血管生长，如果抑制过多，则会促进视网膜新生血管的形成。胰岛素样生长因子(IGF-1)是一种重要的非氧调节生长因子。与血管内皮生长因子类似，低水平的IGF-1可阻止正常的血管生长(第一阶段)，较高水平的IGF-1可促进新生血管(第二阶段)。我们发现，发生ROP的早产儿与年龄匹配的无疾病的早产儿相比，血清IGF-1水平较低。IGF-1对正常的血管发育至关重要。低IGF-1预示ROP，而IGF-1恢复到正常水平可能会阻止ROP。
Retinopathy of prematurity (ROP) is a major cause of blindness in children in developed countries. ROP, a two-phase disease, is initiated with delayed retinal vascular growth after premature birth (phase I). Insufficient vascularization of the developing retina creates hypoxia, which precipitates the release of factors stimulating new and abnormal blood vessel growth (phase II). ROP develops because of abnormalities in both oxygen-regulated and non-oxygen-regulated factors, which affect both phases of the disease. Vascular endothelial growth factor (VEGF) is an important oxygen-regulated factor that, if suppressed, inhibits normal vessel growth, but in excess, precipitates retinal neovascularization. A critical non-oxygen-regulated growth factor is insulin-like growth factor (IGF-1). Similar to VEGF, low levels of IGF-1 prevent normal vessel growth (phase I), and higher levels allow neovascularization (phase II). We found that premature infants who develop ROP have low levels of serum IGF-1 compared with age-matched infants without disease. IGF-1 is critical to normal vascular development. Low IGF-1 predicts ROP, and restoration of IGF-1 to normal levels might prevent ROP.