糖尿病早期视网膜神经变性研究新进展  

Advances in early diabetic neuroretinopathy

作　　者：魏凡 彭立[1] 谢青[1] Wei Fan;Peng Li;Xie Qing(Department of Ophthalmology,Central South University Xiangya School of Medicine Affiliated Haikou Hospital,Haikou 570208,Hainan Province,China)

机构地区：[1]中南大学湘雅医学院附属海口医院眼科,海南省海口市570208

出　　处：《国际眼科杂志》2025年第1期76-81,共6页International Eye Science

基　　金：外国专家项目-海南省国际科技合作人才与交流项目(No.G20230607013E);海南省重点研发-社会发展项目(No.ZDYF2020110);海南省自然科学基金青年基金项目(No.821QN1005)。

摘　　要：糖尿病视网膜病变(DR)是由慢性高血糖引起的晚期微神经血管并发症,可导致血-视网膜屏障受损和视网膜功能障碍。近年来研究发现,糖尿病视网膜神经变性(DN)可能是糖尿病的视网膜改变最早事件之一,主要表现包括:新诊断糖尿病患者的视网膜电图反应缺陷;发病初期,小胶质细胞和Müller细胞在几周内自我激活并激活相关蛋白;神经递质(如DOPA/GABA)活性降低,损害神经节信号传递;早期线粒体功能障碍,如Drp1-Fis1持续裂变及mtDNA甲基化和碱基错配之间的潜在串扰等。探讨糖尿病早期视网膜神经变性的分子基础对于理解DN的发病机制及早期治疗至关重要。文章总结糖尿病早期视网膜感光功能及神经胶质细胞、神经递质、线粒体和其他因子的病理变化及机制,旨在为研究DN早期机制及靶向治疗提供理论依据。Diabetic retinopathy(DR) is a late-stage peripheral micro-neurovascular complication of chronic hyperglycemia,leading to blood-retinal barrier impairment and retinal dysfunction.Recent studies have found that diabetic neuroretinopathy(DN) may be one of the earliest events in diabetic retinal alterations.The main features include defective electroretinographic responses in newly diagnosed patients,early self-activation of microglia and Müller cells,reduced activity of neurotransmitters(e.g.,DOPA/GABA),and early mitochondrial dysfunction,such as persistent Drp1-Fis1 fission and mtDNA methylation mismatches.Understanding the molecular basis of DN is essential for elucidating its pathogenesis and developing early treatments.This review summarizes pathological changes and mechanisms of retinal function,glial cells,neurotransmitters,mitochondria,and other factors in early diabetes mellitus,in order to provide a theoretical foundation for investigating early DN mechanisms and developing targeted therapies.

关 键 词：糖尿病视网膜病变 糖尿病视网膜神经变性 视网膜电图 线粒体自噬 神经胶质细胞 多巴胺 

分 类 号：R587.2[医药卫生—内分泌] R774.1[医药卫生—内科学]