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CURRENT VIEW ON PATHOGENIC MECHANISMS OF DIABETIC RETINOPATHY
I.M. Mikheytseva
The Fialtov Institute of the Tissue Therapy of the National Academy of Medical Sciences of Ukraine, Odesa, Ukraine
DOI: https://doi.org/10.15407/fz69.03.106
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Abstract
Diabetes mellitus (DM) and its complications are an actual
problem of modern medicine. This pathology continues to
spread throughout the world like a non-infectious epidemic.
In this review new data about the role of different cellular
mechanisms in forming of diabetic retinopathy (DR), namely,
oxidative-nitrosative stress, mitochondrial dysfunction, neurodegeneration and inflammation. A new approach to DR pathogenesis is the primacy of the neurodegenerative changes in the
retina vs previously held views of the problem as а microvascular pathology of the eye only. At the moment, hyperglycemia
is considered as the main etiological factor of DR. Activation
of the oxidation of excess glucose triggers a cascade of reactions with the formation of oxidative and nitrosative stress.
Mitochondria are the most sensitive to oxidative-nitrosative
organelles in cells of the retina. Hyperglicemia-induced mitochondrial dysfunction, with cellular respiration disruption and
increased production of free radicals in neurons of the retina,
can promote their further degeneration and DR enhancing. Local inflammation in the retina, which is facilitated in DM, also
considered as a new component of DR pathogenesis. In this
case, the inflammatory cascade occurs at the molecular level
without clinical manifestations of inflammation. The review
provides analysis of modern literature data on this mechanism
involving in retinal complications of DM. It is emphasized,
that retinal inflammation in DM enhances neurodegeneration
and promote retinopathy.
Keywords:
diabetes mellitus, retina, oxidative-nitrosative stress, mitochondrial dysfunction, neurodegeneration, inflammation.
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