锌在糖皮质激素诱导性青光眼中的作用机制与治疗途径  

The role of Zinc in glucocorticoid-Induced glaucoma:mechanisms and therapeutic approaches

作　　者：刘灿瑛(综述) 李轶擎(审校)[1] LIU Canying;LI Yiqing(State Key Laboratory of Ophthalmology,Zhongshan Ophthalmic Center,Sun Yat-sen University,Guangdong Provincial Key Laboratory of Ophthalmology Visual Science,Guangzhou 510060,China)

机构地区：[1]中山大学中山眼科中心,眼病防治全国重点实验室,广东省眼科视觉科学重点实验室,广州510060

出　　处：《眼科学报》2024年第6期275-284,共10页Eye Science

基　　金：国家自然科学基金(81870657);广东省自然科学基金(2022A1515012168);广东省基础与应用基础研究基金(2024A1515013296);广州市科技计划项目(202201020492);眼科国家重点实验室开放研究基金(2023KF01)。

摘　　要：糖皮质激素(glucocorticoid,GC)由于其抗炎特性被广泛用于治疗眼部炎症,而GC诱导性青光眼(glucocorticoid-induced glaucoma,GIG)作为一种常见并发症,其发病机制长期受到关注。文章综述了锌在GIG中的关键作用及其调控机制,揭示了锌在青光眼发病机制中的重要角色。锌作为人体中含量第二丰富的过渡金属,对蛋白质结构、酶催化和细胞信号调节至关重要。GC对锌分布的调控作用在不同组织和细胞类型中表现出复杂性,影响锌的摄取和释放,进而参与青光眼的病理过程。锌通过影响小梁网细胞外基质(extracellular matrix,ECM)的降解和重塑,以及视网膜神经节细胞的存活和轴突再生,在GIG的发病机制中发挥着复杂的作用。文章同时介绍了体内锌调控的现有途径,包括补充锌和减少锌的策略,提供了潜在的治疗途径。未来的研究应深入探索锌在青光眼中的作用机制以及与GC的相互作用,评估锌补充或螯合在青光眼治疗中的安全性和有效性,以及开发新型锌递送和螯合系统,有助于全面揭示锌在青光眼中的作用及治疗潜力,以实现更加精准的防治方案,改善患者预后。Glucocorticoid(GC)is widely used in the treatment of ocular inflammation for its anti-inflammatory propery.However,glucocorticoid-induced glaucoma(GIG)is a common complication,and its pathogenesis has been extensively studied.This review summarizes the crucial role of zinc in GIG and its regulatory mechanisms,highlighting zinc's significant involvement in the pathogenesis of glaucoma.Zinc,the second most abundant transition metal in the human body,is essential for protein structure,enzyme catalysis,and cell signaling regulation.The effects of GC on zinc distribution vary across different tissues and cell types,affecting zinc uptake and release,which may contribute to the pathological processes of glaucoma.Zinc influences the degradation and remodeling of the trabecular meshwork extracellular matrix and the survival and axonal regeneration of retinal ganglion cells,playing complex roles in the pathogenesis of GIG.We discuss available strategies for regulating zinc in vivo,including zinc supplementation and reduction strategies,providing potential therapeutic approaches.Future research should explore the mechanisms of zinc's role in glaucoma and its interaction with glucocorticoids,evaluate the safety and efficacy of zinc supplementation or chelation in glaucoma treatment,and develop novel zinc delivery and chelation systems.These efforts will help fully elucidate the role of zinc in glaucoma and its therapeutic potential,enabling more precise prevention and treatment strategies to improve patient outcomes.

关 键 词：糖皮质激素 青光眼 锌 小梁网 视神经保护 

分 类 号：Q581[生物学—生物化学] Q577[医药卫生—眼科] R775.3[医药卫生—临床医学]