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Dănilă AI, Ghenciu LA, Stoicescu ER, Bolintineanu SL, Iacob R, Săndesc MA, Faur AC. Aldose Reductase as a Key Target in the Prevention and Treatment of Diabetic Retinopathy: A Comprehensive Review. Biomedicines 2024; 12:747. [PMID: 38672103 PMCID: PMC11047946 DOI: 10.3390/biomedicines12040747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Revised: 03/24/2024] [Accepted: 03/26/2024] [Indexed: 04/28/2024] Open
Abstract
The escalating global prevalence of diabetes mellitus (DM) over the past two decades has led to a persistent high incidence of diabetic retinopathy (DR), necessitating screening for early symptoms and proper treatment. Effective management of DR aims to decrease vision impairment by controlling modifiable risk factors including hypertension, obesity, and dyslipidemia. Moreover, systemic medications and plant-based therapy show promise in advancing DR treatment. One of the key mechanisms related to DR pathogenesis is the polyol pathway, through which aldose reductase (AR) catalyzes the conversion of glucose to sorbitol within various tissues, including the retina, lens, ciliary body and iris. Elevated glucose levels activate AR, leading to osmotic stress, advanced glycation end-product formation, and oxidative damage. This further implies chronic inflammation, vascular permeability, and angiogenesis. Our comprehensive narrative review describes the therapeutic potential of aldose reductase inhibitors in treating DR, where both synthetic and natural inhibitors have been studied in recent decades. Our synthesis aims to guide future research and clinical interventions in DR management.
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Affiliation(s)
- Alexandra-Ioana Dănilă
- Department of Anatomy and Embriology, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania; (A.-I.D.); (S.L.B.); (R.I.); (A.C.F.)
| | - Laura Andreea Ghenciu
- Department of Functional Sciences, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
| | - Emil Robert Stoicescu
- Doctoral School, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania;
- Field of Applied Engineering Sciences, Specialization Statistical Methods and Techniques in Health and Clinical Research, Faculty of Mechanics, ‘Politehnica’ University Timisoara, Mihai Viteazul Boulevard No. 1, 300222 Timisoara, Romania
- Department of Radiology and Medical Imaging, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
- Research Center for Pharmaco-Toxicological Evaluations, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
| | - Sorin Lucian Bolintineanu
- Department of Anatomy and Embriology, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania; (A.-I.D.); (S.L.B.); (R.I.); (A.C.F.)
| | - Roxana Iacob
- Department of Anatomy and Embriology, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania; (A.-I.D.); (S.L.B.); (R.I.); (A.C.F.)
- Doctoral School, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania;
- Field of Applied Engineering Sciences, Specialization Statistical Methods and Techniques in Health and Clinical Research, Faculty of Mechanics, ‘Politehnica’ University Timisoara, Mihai Viteazul Boulevard No. 1, 300222 Timisoara, Romania
| | - Mihai-Alexandru Săndesc
- Department of Orthopedics and Traumatology, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania;
| | - Alexandra Corina Faur
- Department of Anatomy and Embriology, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania; (A.-I.D.); (S.L.B.); (R.I.); (A.C.F.)
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Wang Z, Zhang N, Lin P, Xing Y, Yang N. Recent advances in the treatment and delivery system of diabetic retinopathy. Front Endocrinol (Lausanne) 2024; 15:1347864. [PMID: 38425757 PMCID: PMC10902204 DOI: 10.3389/fendo.2024.1347864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 01/23/2024] [Indexed: 03/02/2024] Open
Abstract
Diabetic retinopathy (DR) is a highly tissue-specific neurovascular complication of type 1 and type 2 diabetes mellitus and is among the leading causes of blindness worldwide. Pathophysiological changes in DR encompass neurodegeneration, inflammation, and oxidative stress. Current treatments for DR, including anti-vascular endothelial growth factor, steroids, laser photocoagulation, and vitrectomy have limitations and adverse reactions, necessitating the exploration of novel treatment strategies. This review aims to summarize the current pathophysiology, therapeutic approaches, and available drug-delivery methods for treating DR, and discuss their respective development potentials. Recent research indicates the efficacy of novel receptor inhibitors and agonists, such as aldose reductase inhibitors, angiotensin-converting enzyme inhibitors, peroxisome proliferator-activated receptor alpha agonists, and novel drugs in delaying DR. Furthermore, with continuous advancements in nanotechnology, a new form of drug delivery has been developed that can address certain limitations of clinical drug therapy, such as low solubility and poor penetration. This review serves as a theoretical foundation for future research on DR treatment. While highlighting promising therapeutic targets, it underscores the need for continuous exploration to enhance our understanding of DR pathogenesis. The limitations of current treatments and the potential for future advancements emphasize the importance of ongoing research in this field.
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Affiliation(s)
| | | | | | - Yiqiao Xing
- Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Ning Yang
- Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
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Leley SP, Ciulla TA, Bhatwadekar AD. Diabetic Retinopathy in the Aging Population: A Perspective of Pathogenesis and Treatment. Clin Interv Aging 2021; 16:1367-1378. [PMID: 34290499 PMCID: PMC8289197 DOI: 10.2147/cia.s297494] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 06/04/2021] [Indexed: 12/24/2022] Open
Abstract
The elderly population in the United States is projected to almost double by the year 2050. In addition, the numbers of diabetics are rising, along with its most common complication, diabetic retinopathy (DR). To effectively treat DR within the elderly population, it is essential first to consider the retinal changes that occur due to aging, such as decreased blood flow, retinal thinning, and microglial changes, and understand that these changes can render the retina more vulnerable to oxidative and ischemic damage. Given these considerations, as well as the pathogenesis of DR, specific pathways could play a heightened role in DR progression in elderly patients, such as the polyol pathway and the vascular endothelial growth factor (VEGF) axis. Current ocular treatments include intravitreal corticosteroids, intravitreal anti-VEGF agents, laser photocoagulation and surgical interventions, in addition to better control of underlying diabetes with an expanding range of systemic treatments. While using therapeutics, it is also essential to consider how pharmacokinetics and pharmacodynamics change with aging; oral drug absorption can decrease, and ocular drug metabolism might affect the dosing and delivery methods. Also, elderly patients may more likely be nonadherent to their medication regimen or appointments than younger patients, and undertreatment with anti-VEGF drugs often leads to suboptimal outcomes. With a rising number of elderly DR patients, understanding how aging affects disease progression, pharmacological metabolism, and adherence are crucial to ensuring that this population receives adequate care.
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Affiliation(s)
- Sameer P Leley
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - Thomas A Ciulla
- Department of Ophthalmology, Eugene and Marilyn Glick Eye Institute, Indiana University, Indianapolis, IN, USA
- Clearside Biomedical, Inc., Alpharetta, GA, USA
- Midwest Eye Institute, Indianapolis, IN, USA
| | - Ashay D Bhatwadekar
- Department of Ophthalmology, Eugene and Marilyn Glick Eye Institute, Indiana University, Indianapolis, IN, USA
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Kutlutürk Karagöz I, Allahverdiyev A, Bağırova M, Abamor EŞ, Dinparvar S. Current Approaches in Treatment of Diabetic Retinopathy and Future Perspectives. J Ocul Pharmacol Ther 2020; 36:487-496. [DOI: 10.1089/jop.2019.0137] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Affiliation(s)
- Işıl Kutlutürk Karagöz
- Depatment of Bioengineering, Yıldız Technical University, Istanbul, Turkey
- Department of Ophthalmology, Ümraniye Trn. And Rch. Hospital, Istanbul, Turkey
| | - Adil Allahverdiyev
- Depatment of Bioengineering, Yıldız Technical University, Istanbul, Turkey
| | - Melehat Bağırova
- Depatment of Bioengineering, Yıldız Technical University, Istanbul, Turkey
| | - Emrah Şefik Abamor
- Depatment of Bioengineering, Yıldız Technical University, Istanbul, Turkey
| | - Sahar Dinparvar
- Depatment of Bioengineering, Yıldız Technical University, Istanbul, Turkey
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Benlarbi‐Ben Khedher M, Hajri K, Dellaa A, Baccouche B, Hammoum I, Boudhrioua‐Mihoubi N, Dhifi W, Ben Chaouacha‐Chekir R. Astaxanthin inhibits aldose reductase activity in Psammomys obesus, a model of type 2 diabetes and diabetic retinopathy. Food Sci Nutr 2019; 7:3979-3985. [PMID: 31890176 PMCID: PMC6924305 DOI: 10.1002/fsn3.1259] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 09/19/2019] [Accepted: 09/23/2019] [Indexed: 12/28/2022] Open
Abstract
Astaxanthin (ATX) is a marine carotenoid known for its powerful antioxidant and neuroprotective properties. In this study, we investigated the in vitro and in vivo potential inhibitory effect of ATX on the aldose reductase (AR) activity, a key enzyme in the polyol pathway responsible for the pathogenesis of diabetic complications including diabetic retinopathy (DR). The gerbil Psammomys obesus (P. ob.), an animal model for type 2 diabetes and DR has been used. The erythrocyte and retinal AR activity of P. ob. individuals were, respectively, assessed monthly and at the 7th month during a 7-month hypercaloric diet (HD) using a NADPH oxidation method. Meanwhile, the body weight and blood glucose of the gerbils were monitored. After 7 months, P. ob. individuals were fed with ATX (4.8 mg/kg of body weight) once a day for 1 week. The results showed that the HD-fed animals developed significant obesity and hyperglycemia in comparison with controls. Erythrocyte AR activity showed a progressive and significant increase in the HD-fed group compared with controls. Retinal AR activity was higher in the 7-month HD-fed group compared with controls. Erythrocyte AR activity was markedly decreased after ATX-treatment in vitro and in vivo. These findings suggested that ATX inhibited the erythrocyte AR activity and could be used for DR prevention and/or early treatment.
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Affiliation(s)
- Maha Benlarbi‐Ben Khedher
- Laboratory of Physiopathology, Food and Biomolecules (PAB): LR17ES03The High Institute of Biotechnology of Sidi Thabet (ISBST)University of Manouba (UMA)Sidi ThabetTunisia
| | - Khouloud Hajri
- Laboratory of Physiopathology, Food and Biomolecules (PAB): LR17ES03The High Institute of Biotechnology of Sidi Thabet (ISBST)University of Manouba (UMA)Sidi ThabetTunisia
| | - Ahmed Dellaa
- Laboratory of Physiopathology, Food and Biomolecules (PAB): LR17ES03The High Institute of Biotechnology of Sidi Thabet (ISBST)University of Manouba (UMA)Sidi ThabetTunisia
| | - Basma Baccouche
- Laboratory of Physiopathology, Food and Biomolecules (PAB): LR17ES03The High Institute of Biotechnology of Sidi Thabet (ISBST)University of Manouba (UMA)Sidi ThabetTunisia
| | - Imane Hammoum
- Laboratory of Physiopathology, Food and Biomolecules (PAB): LR17ES03The High Institute of Biotechnology of Sidi Thabet (ISBST)University of Manouba (UMA)Sidi ThabetTunisia
| | - Nourhene Boudhrioua‐Mihoubi
- Laboratory of Physiopathology, Food and Biomolecules (PAB): LR17ES03The High Institute of Biotechnology of Sidi Thabet (ISBST)University of Manouba (UMA)Sidi ThabetTunisia
| | - Wissal Dhifi
- Laboratory of Physiopathology, Food and Biomolecules (PAB): LR17ES03The High Institute of Biotechnology of Sidi Thabet (ISBST)University of Manouba (UMA)Sidi ThabetTunisia
| | - Rafika Ben Chaouacha‐Chekir
- Laboratory of Physiopathology, Food and Biomolecules (PAB): LR17ES03The High Institute of Biotechnology of Sidi Thabet (ISBST)University of Manouba (UMA)Sidi ThabetTunisia
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Yamamura ET, Tsuzaki K, Kita S. A novel method of producing the key intermediate ASI-2 of ranirestat using a porcine liver esterase (PLE) substitute enzyme. Biosci Biotechnol Biochem 2019; 83:1124-1135. [PMID: 30782084 DOI: 10.1080/09168451.2019.1580139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
(R)-2-amino-2-ethoxycarbonylsuccinimide (ASI-2) is a key intermediate used in the pharmaceutical industry and is valuable for the industrial synthesis of ranirestat, which is a potent aldose reductase inhibitor. ASI-2 was synthesized in a process combining chemical synthesis and bioconversion. Bioconversion in this study is a key reaction, since optically active carboxylic acid derivative ((R)-1-ethyl hydrogen 3-benzyloxycarbonylamino-3-ethoxycarbonylsuccinate, Z-MME-AE) is synthesized from a prochiral ester, diethyl 2-benzyloxycarbonylamino-2-ethoxycarbonylsuccinate, Z-MDE-AE, at a theoretical yield of 100%. Upon screening for microorganisms that asymmetrically hydrolyze Z-MDE-AE, Bacillus thuringiensis NBRC13866 was found. A novel esterase EstBT that produces Z-MME-AE was purified from Bacillus thuringiensis NBRC13866 and was stably produced in Escherichia coli JM109 cells. Using EstBT rather than porcine liver esterase (PLE), ASI-2 was synthesized with a 17% higher total yield by a novel method, suggesting that the esterase EstBT is a PLE substitute enzyme and therefore, may be of interest for future industrial applications.
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Affiliation(s)
- Ei-Tora Yamamura
- a Technical Department , Kyowa Pharma Chemical Co., Ltd ., Takaoka , Japan
| | - Kazuya Tsuzaki
- a Technical Department , Kyowa Pharma Chemical Co., Ltd ., Takaoka , Japan
| | - Shinji Kita
- a Technical Department , Kyowa Pharma Chemical Co., Ltd ., Takaoka , Japan
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Tanaka Y, Takagi R, Ohta T, Sasase T, Kobayashi M, Toyoda F, Shimmura M, Kinoshita N, Takano H, Kakehashi A. Pathological Features of Diabetic Retinopathy in Spontaneously Diabetic Torii Fatty Rats. J Diabetes Res 2019; 2019:8724818. [PMID: 31637263 PMCID: PMC6766157 DOI: 10.1155/2019/8724818] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Accepted: 03/14/2019] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE The Spontaneously Diabetic Torii (SDT) fatty rat, established by introducing the fa allele (obesity gene) of the Zucker fatty rat into the SDT rat genome, is a new model of obese type 2 diabetes. We studied the pathologic features of diabetic retinopathy (DR) in this animal. METHODS The eyes of SDT fatty, SDT (controls), and Sprague Dawley (SD) rats (normal controls) were enucleated at 8, 16, 24, 32, and 40 weeks of age (n = 5-6 for each rat type at each age). The retinal thicknesses, numbers of retinal folds, and choroidal thicknesses were evaluated. Immunostaining for glial fibrillary acidic protein (GFAP) and vascular endothelial growth factor (VEGF) was performed. Quantitative analyses of the immunopositive regions were performed using a cell-counting algorithm. RESULTS The retinas tended to be thicker in the SDT fatty rats and SDT rats than in the SD rats; the choroids tended to be thicker in the SDT fatty rats than in the SD rats. The retinal folds in the SDT fatty rats developed earlier and were more severe than in the SDT rats. Quantitative analyses showed that the GFAP- and VEGF-positive regions in the retinas of the SDT fatty rats were significantly larger than those of the SDT rats. CONCLUSIONS SDT fatty rats developed more severe DR earlier than the SDT rats. The SDT fatty rats might be useful as a type 2 diabetes animal model to study DR.
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Affiliation(s)
- Yoshiaki Tanaka
- Department of Ophthalmology, Jichi Medical University, Saitama Medical Center, 1-847 Amanuma-cho, Omiya-ku, Saitama, Saitama 330-8503, Japan
| | - Rina Takagi
- Department of Ophthalmology, Jichi Medical University, Saitama Medical Center, 1-847 Amanuma-cho, Omiya-ku, Saitama, Saitama 330-8503, Japan
| | - Takeshi Ohta
- Biological/Pharmacological Research Laboratories, Central Pharmaceutical Research Institute, Japan Tobacco Inc., 1-1 Murasaki-cho, Takatsuki, Osaka 569-1125, Japan
| | - Tomohiko Sasase
- Biological/Pharmacological Research Laboratories, Central Pharmaceutical Research Institute, Japan Tobacco Inc., 1-1 Murasaki-cho, Takatsuki, Osaka 569-1125, Japan
| | - Mina Kobayashi
- Department of Ophthalmology, Jichi Medical University, Saitama Medical Center, 1-847 Amanuma-cho, Omiya-ku, Saitama, Saitama 330-8503, Japan
| | - Fumihiko Toyoda
- Toyoda Eye Clinic, 7-1-10, Kisicho, Urawa-ku, Saitama, Saitama, Japan
| | - Machiko Shimmura
- Department of Ophthalmology, Jichi Medical University, Saitama Medical Center, 1-847 Amanuma-cho, Omiya-ku, Saitama, Saitama 330-8503, Japan
| | - Nozomi Kinoshita
- Department of Ophthalmology, Jichi Medical University, Saitama Medical Center, 1-847 Amanuma-cho, Omiya-ku, Saitama, Saitama 330-8503, Japan
| | - Hiroko Takano
- Department of Ophthalmology, Jichi Medical University, Saitama Medical Center, 1-847 Amanuma-cho, Omiya-ku, Saitama, Saitama 330-8503, Japan
| | - Akihiro Kakehashi
- Department of Ophthalmology, Jichi Medical University, Saitama Medical Center, 1-847 Amanuma-cho, Omiya-ku, Saitama, Saitama 330-8503, Japan
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Hiramatsu N, Deguchi S, Yoshioka C, Otake H, Yamamoto N, Nagai N. Evaluation of Retinal Function in Streptozotocin-induced Diabetic Rats by Using the Electroretinography and Immunohistochemistry Methods. YAKUGAKU ZASSHI 2017; 137:1169-1175. [PMID: 28867704 DOI: 10.1248/yakushi.17-00115] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Streptozotocin-induced diabetic rat (STZ rat) was used in many studies for the diabetic mellitus. In this study, we demonstrated whether the electroretinograms (ERG) was changed in the retina of STZ rats. In addition, we investigated the histopathological alteration in the retina of STZ rats by using the immunological method. The 100 mg/kg of STZ was injected continuously for 2 d (100 mg/kg×2). The insulin level was decreased, and the glucose level was enhanced 14 d after the injection of STZ. Moreover, the levels of a-wave, b-wave and OP amplitude were decreased in the rat at 14 d after the injection of STZ. Although, the damage and apoptosis was not observed in the retinal ganglion cell of STZ rats by the immunological experiment using the phospho-H2A.X and cleaved caspase-3, the distance between cell and cell was increased in both of outer- and inner- nuclear (granule) layer in retina of STZ rats. In conclusion, we showed that the enhanced thickening in retina was caused by the injection of excessive STZ. The thickening in retina of STZ rats may lead to the dysfunction of retina, resulting in the decrease in ERG. These findings provide significant information that can be used in the design of a model of diabetic retinopathy.
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Affiliation(s)
- Noriko Hiramatsu
- Laboratory of Molecular Biology and Histochemistry, Joint Research Support Promotion Facility, Center for Research Promotion and Support, Fujita Health University
| | | | | | | | - Naoki Yamamoto
- Laboratory of Molecular Biology and Histochemistry, Joint Research Support Promotion Facility, Center for Research Promotion and Support, Fujita Health University
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Selvaraj K, Gowthamarajan K, Karri VVSR, Barauah UK, Ravisankar V, Jojo GM. Current treatment strategies and nanocarrier based approaches for the treatment and management of diabetic retinopathy. J Drug Target 2017; 25:386-405. [DOI: 10.1080/1061186x.2017.1280809] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Kousalya Selvaraj
- Department of Pharmaceutics, JSS College of Pharmacy, Ootacamund, JSS University, Mysuru, India
| | - Kuppusamy Gowthamarajan
- Department of Pharmaceutics, JSS College of Pharmacy, Ootacamund, JSS University, Mysuru, India
| | | | - Uday K. Barauah
- Department of Pharmaceutics, JSS College of Pharmacy, Ootacamund, JSS University, Mysuru, India
| | - Vanka Ravisankar
- Department of Pharmaceutics, JSS College of Pharmacy, Ootacamund, JSS University, Mysuru, India
| | - Gifty M. Jojo
- Department of Pharmaceutics, JSS College of Pharmacy, Ootacamund, JSS University, Mysuru, India
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Cammalleri M, Dal Monte M, Locri F, Marsili S, Lista L, De Rosa M, Pavone V, Rusciano D, Bagnoli P. Diabetic Retinopathy in the Spontaneously Diabetic Torii Rat: Pathogenetic Mechanisms and Preventive Efficacy of Inhibiting the Urokinase-Type Plasminogen Activator Receptor System. J Diabetes Res 2017; 2017:2904150. [PMID: 29464181 PMCID: PMC5804371 DOI: 10.1155/2017/2904150] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 10/20/2017] [Accepted: 11/13/2017] [Indexed: 12/26/2022] Open
Abstract
The spontaneously diabetic Torii (SDT) rat is of increasing preclinical interest because of its similarities to human type 2 diabetic retinopathy (DR). The system formed by urokinase-type plasminogen activator (uPA) and its receptor (uPAR) is a player in blood-retinal barrier (BRB) breakdown in DR. Here, we investigated whether in SDT rats, preventive administration of UPARANT, an inhibitor of the uPAR pathway, counteracts the retinal impairment in response to chronic hyperglycemia. Electroretinogram (ERG) monitoring was followed over time. Fluorescein-dextran microscopy, CD31 immunohistochemistry, quantitative PCR, ELISA, Evans blue perfusion, and Western blot were also used. UPARANT prevented ERG dysfunction, upregulation of vascular endothelial growth factor and fibroblast growth factor-2, BRB leakage, gliosis, and retinal cell death. The mechanisms underlying UPARANT benefits were studied comparing them with the acute streptozotocin (STZ) model in which UPARANT is known to inhibit DR signs. In SDT rats, but not in the STZ model, UPARANT downregulated the expression of uPAR and its membrane partners. In both models, UPARANT reduced the levels of transcription factors coupled to inflammation or inflammatory factors themselves. These findings may help to establish the uPAR system as putative target for the development of novel drugs that may prevent type 2 DR.
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Affiliation(s)
- Maurizio Cammalleri
- Department of Biology, University of Pisa, Via San Zeno 31, 56127 Pisa, Italy
| | - Massimo Dal Monte
- Department of Biology, University of Pisa, Via San Zeno 31, 56127 Pisa, Italy
| | - Filippo Locri
- Department of Biology, University of Pisa, Via San Zeno 31, 56127 Pisa, Italy
| | - Stefania Marsili
- Department of Biology, University of Pisa, Via San Zeno 31, 56127 Pisa, Italy
| | - Liliana Lista
- Department of Biology, University of Napoli Federico II, Complesso Universitario Monte Sant'Angelo, Via Cinthia, Edificio 7, 80126 Napoli, Italy
| | - Mario De Rosa
- Department of Experimental Medicine, Second University of Napoli, Via Santa Maria di Costantinopoli 16, 80138 Napoli, Italy
| | - Vincenzo Pavone
- Department of Biology, University of Napoli Federico II, Complesso Universitario Monte Sant'Angelo, Via Cinthia, Edificio 7, 80126 Napoli, Italy
| | - Dario Rusciano
- Sooft Fidia Pharma, Contrada Molino 17, 63833 Montegiorgio, Italy
| | - Paola Bagnoli
- Department of Biology, University of Pisa, Via San Zeno 31, 56127 Pisa, Italy
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11
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Retinal Neurodegeneration Associated With Peripheral Nerve Conduction and Autonomic Nerve Function in Diabetic Patients. Am J Ophthalmol 2016; 170:15-24. [PMID: 27381712 DOI: 10.1016/j.ajo.2016.06.038] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 06/08/2016] [Accepted: 06/25/2016] [Indexed: 01/23/2023]
Abstract
OBJECTIVE In this study, we evaluated the correlation of retinal thickness with peripheral nerve conduction and autonomic nerve function in diabetic patients. DESIGN Cross-sectional study. METHODS Medical records of 160 patients (mean age, 63.61 ± 12.52 years) with diabetes without diabetic retinopathy or mild nonproliferative diabetic retinopathy (NPDR) were reviewed. The mean retinal thickness of the parafoveal area and ganglion cell/inner plexiform layer (GC-IPL) thickness in 6 macular regions were measured using optical coherence tomography. Peripheral nerve conduction studies were conducted on peroneal and posterior tibial motor nerves and the sural sensory nerve. Five cardiovascular autonomic function tests were performed. We classified patients into groups by severity of peripheral neuropathy and autonomic dysfunction and analyzed the correlations with mean retinal thickness. RESULTS The mean retinal thickness of the parafovea was 315.05 ± 12.70 μm and mean macular GC-IPL thickness was 79.89 ± 4.70 μm. Macular GC-IPL thickness showed significant correlation with peripheral nerve conduction (no peripheral neuropathy vs definite peripheral neuropathy: 82.0 ± 4.8 μm vs 75.2 ± 3.8 μm, P < .001). GC-IPL thickness decreased with severity of autonomic nerve dysfunction (no/mild dysfunction vs severe dysfunction: 81.2 ± 6.6 μm vs 77.6 ± 5.9 μm, P = .005). There was no significant correlation between the retinal thickness of the parafovea and electrodiagnostic tests. CONCLUSION The decrease of GC-IPL thickness was positively correlated with both peripheral nerve conduction and autonomic nerve function in diabetic patients who presented with no diabetic retinopathy or mild NPDR.
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Toyoda F, Tanaka Y, Shimmura M, Kinoshita N, Takano H, Kakehashi A. Diabetic Retinal and Choroidal Edema in SDT Rats. J Diabetes Res 2016; 2016:2345141. [PMID: 26783535 PMCID: PMC4691483 DOI: 10.1155/2016/2345141] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Revised: 08/05/2015] [Accepted: 08/20/2015] [Indexed: 11/01/2022] Open
Abstract
We evaluated the features of diabetic retinal and choroidal edema in Spontaneously Diabetic Torii (SDT) rats. We measured the retinal and choroidal thicknesses in normal Sprague-Dawley (SD) rats (n = 9) and SDT rats (n = 8). The eyes were enucleated 40 weeks later after they were diagnosed with diabetes, and 4-micron sections were cut for conventional histopathologic studies. The mean retinal and choroidal thicknesses were significantly thicker in the SDT rats than in the normal SD rats. The choroidal thickness was correlated strongly with the retinal thickness in both rat models. Diabetic retinopathy (DR) and diabetic choroidopathy appeared as edema in the SDT rats. The retinal thickness was correlated strongly with the choroidal thickness in the SDT rats, which is an ideal animal model of both DR and choroidopathy.
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Affiliation(s)
- Fumihiko Toyoda
- Department of Ophthalmology, Jichi Medical University, Saitama Medical Center, 1-847 Amanuma-cho, Omiya-ku, Saitama, Saitama 330-8503, Japan
| | - Yoshiaki Tanaka
- Department of Ophthalmology, Jichi Medical University, Saitama Medical Center, 1-847 Amanuma-cho, Omiya-ku, Saitama, Saitama 330-8503, Japan
| | - Machiko Shimmura
- Department of Ophthalmology, Jichi Medical University, Saitama Medical Center, 1-847 Amanuma-cho, Omiya-ku, Saitama, Saitama 330-8503, Japan
| | - Nozomi Kinoshita
- Department of Ophthalmology, Jichi Medical University, Saitama Medical Center, 1-847 Amanuma-cho, Omiya-ku, Saitama, Saitama 330-8503, Japan
| | - Hiroko Takano
- Department of Ophthalmology, Jichi Medical University, Saitama Medical Center, 1-847 Amanuma-cho, Omiya-ku, Saitama, Saitama 330-8503, Japan
| | - Akihiro Kakehashi
- Department of Ophthalmology, Jichi Medical University, Saitama Medical Center, 1-847 Amanuma-cho, Omiya-ku, Saitama, Saitama 330-8503, Japan
- *Akihiro Kakehashi:
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