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Non-Traditional Systemic Treatments for Diabetic Retinopathy: An 
 Evidence-Based Review

View Article: PubMed Central - PubMed

ABSTRACT

The rapid escalation in the global prevalence diabetes, with more than 30% being afflicted with diabetic retinopathy (DR), means it is likely that associated vision-threatening conditions will also rise substantially. This means that new therapeutic approaches need to be found that go beyond the current standards of diabetic care, and which are effective in the early stages of the disease. In recent decades several new pharmacological agents have been investigated for their effectiveness in preventing the appearance and progression of DR or in reversing DR; some with limited success while others appear promising. This up-to-date critical review of non-traditional systemic treatments for DR is based on the published evidence in MEDLINE spanning 1980-December 2014. It discusses a number of therapeutic options, paying particular attention to the mechanisms of action and the clinical evidence for the use of renin-angiotensin system blockade, fenofibrate and calcium dobesilate monohydrate in DR.

No MeSH data available.


Related in: MedlinePlus

Renin-Angiotensin-System activation in the pathogenesis of diabetic retinopathy. RAS activation leads to AT-Rs activation (mainly AT1-R) which trigger essential pathways involved in the pathogenesis of DR such as inflammation, oxidative stress, neurodegeneration, AGEs formation, leucostasis (which is crucial for the release of proinflammatory cytokines and the breakdown of the BRB) and angiogenesis. Abbreviations: AGE, Advanced glycation end-product; Angiotensin II, Angiotensin type II; AT1-R, Angiotensin II type 1 receptor; AT2-R, Angiotensin II type 2 receptor; BRB, Blood-retinal barrier; BM, Basement membrane; RAS, Renin-Angiotensin System; VEGF, Vascular endothelial growth factor.
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Figure 3: Renin-Angiotensin-System activation in the pathogenesis of diabetic retinopathy. RAS activation leads to AT-Rs activation (mainly AT1-R) which trigger essential pathways involved in the pathogenesis of DR such as inflammation, oxidative stress, neurodegeneration, AGEs formation, leucostasis (which is crucial for the release of proinflammatory cytokines and the breakdown of the BRB) and angiogenesis. Abbreviations: AGE, Advanced glycation end-product; Angiotensin II, Angiotensin type II; AT1-R, Angiotensin II type 1 receptor; AT2-R, Angiotensin II type 2 receptor; BRB, Blood-retinal barrier; BM, Basement membrane; RAS, Renin-Angiotensin System; VEGF, Vascular endothelial growth factor.


Non-Traditional Systemic Treatments for Diabetic Retinopathy: An 
 Evidence-Based Review
Renin-Angiotensin-System activation in the pathogenesis of diabetic retinopathy. RAS activation leads to AT-Rs activation (mainly AT1-R) which trigger essential pathways involved in the pathogenesis of DR such as inflammation, oxidative stress, neurodegeneration, AGEs formation, leucostasis (which is crucial for the release of proinflammatory cytokines and the breakdown of the BRB) and angiogenesis. Abbreviations: AGE, Advanced glycation end-product; Angiotensin II, Angiotensin type II; AT1-R, Angiotensin II type 1 receptor; AT2-R, Angiotensin II type 2 receptor; BRB, Blood-retinal barrier; BM, Basement membrane; RAS, Renin-Angiotensin System; VEGF, Vascular endothelial growth factor.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4997935&req=5

Figure 3: Renin-Angiotensin-System activation in the pathogenesis of diabetic retinopathy. RAS activation leads to AT-Rs activation (mainly AT1-R) which trigger essential pathways involved in the pathogenesis of DR such as inflammation, oxidative stress, neurodegeneration, AGEs formation, leucostasis (which is crucial for the release of proinflammatory cytokines and the breakdown of the BRB) and angiogenesis. Abbreviations: AGE, Advanced glycation end-product; Angiotensin II, Angiotensin type II; AT1-R, Angiotensin II type 1 receptor; AT2-R, Angiotensin II type 2 receptor; BRB, Blood-retinal barrier; BM, Basement membrane; RAS, Renin-Angiotensin System; VEGF, Vascular endothelial growth factor.

View Article: PubMed Central - PubMed

ABSTRACT

The rapid escalation in the global prevalence diabetes, with more than 30% being afflicted with diabetic retinopathy (DR), means it is likely that associated vision-threatening conditions will also rise substantially. This means that new therapeutic approaches need to be found that go beyond the current standards of diabetic care, and which are effective in the early stages of the disease. In recent decades several new pharmacological agents have been investigated for their effectiveness in preventing the appearance and progression of DR or in reversing DR; some with limited success while others appear promising. This up-to-date critical review of non-traditional systemic treatments for DR is based on the published evidence in MEDLINE spanning 1980-December 2014. It discusses a number of therapeutic options, paying particular attention to the mechanisms of action and the clinical evidence for the use of renin-angiotensin system blockade, fenofibrate and calcium dobesilate monohydrate in DR.

No MeSH data available.


Related in: MedlinePlus