多不饱和脂肪酸在糖尿病视网膜病变炎症中的作用机制研究进展  

Research progress on the mechanisms of polyunsaturated fatty acids in inflammation of diabetic retinopathy

作　　者：刘晓欣 刘心怡 刘堃[1] Liu Xiaoxin;Liu Xinyi;Liu Kun(Department of Ophthalmology,Shanghai General Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200080,China)

机构地区：[1]上海交通大学医学院附属第一人民医院眼科,上海200080

出　　处：《中华眼底病杂志》2025年第4期317-323,共7页Chinese Journal of Ocular Fundus Diseases

基　　金：国家自然科学基金(8217040425);上海市科学技术委员会优秀学术带头人计划(21XD1402700)。

摘　　要：糖尿病视网膜病变(DR)是糖尿病(DM)最常见的并发症之一,其发病机制至今仍未被完全阐明。研究发现炎症是DR发生发展的关键因素之一。作为一组全身代谢性疾病,DM引发的多不饱和脂肪酸(PUFA)代谢紊乱与DR的炎症机制密切相关。近年来代谢组学研究发现,在DR患者不同阶段及DM动物模型中,上调的PUFA及其衍生物大部分为促炎介质,而下调的PUFA及其衍生物多为抗炎介质。在DR进展过程中,一部分PUFA可能通过抑制小胶质细胞活化、减少炎症蛋白表达、拮抗花生四烯酸的促炎作用、抑制炎症小体的激活和中性粒细胞的迁移等机制发挥抗炎作用;而另一部分PUFA则可能通过形成类花生酸介质、促进白细胞黏附和诱导氧化应激反应等机制发挥促炎作用。PUFA在DR的炎症机制中发挥着复杂的双重作用。深入理解这些机制不仅有助于阐明DR的发病过程,也为开发新的治疗策略提供了潜在的靶点。Diabetic retinopathy(DR)is one of the most common complications of diabetes mellitus(DM),and its pathogenesis remains incompletely understood.Research has identified inflammation as a key factor in the onset and progression of DR.As a group of systemic metabolic disorders,the dysregulation of polyunsaturated fatty acid(PUFA)metabolism induced by DM is closely related to the inflammatory mechanisms in DR.Recent metabolomic studies have revealed that in various stages of DR and in diabetic animal models,most upregulated PUFAs and their derivatives act as pro-inflammatory mediators,while downregulated PUFAs and their derivatives are predominantly anti-inflammatory.In the progression of DR,some PUFAs may exert anti-inflammatory effects by inhibiting microglial activation,reducing the expression of inflammatory proteins,antagonizing the pro-inflammatory effects of arachidonic acid,and suppressing the activation of inflammasomes and the migration of neutrophils.Conversely,other PUFAs may promote inflammation through mechanisms such as the formation of pro-inflammatory mediators resembling prostaglandins,facilitating leukocyte adhesion,and inducing oxidative stress responses.PUFAs play a complex dual role in the inflammatory mechanisms of DR.A deeper understanding of these mechanisms not only aids in elucidating the pathogenesis of DR but also provides potential targets for developing new therapeutic strategies.

关 键 词：糖尿病视网膜病变 代谢组学 炎症 多不饱和脂肪酸 综述 

分 类 号：R774.1[医药卫生—眼科]