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Neurodegeneration and Neuroprotection in Diabetic Retinopathy
Department of Biochemistry, Faculty of Science, King Saud University, Riyadh 11415, Saudi Arabia
* Author to whom correspondence should be addressed.
Received: 29 September 2012; in revised form: 12 January 2013 / Accepted: 17 January 2013 / Published: 28 January 2013
Abstract: Diabetic retinopathy is widely considered to be a neurovascular disease. This is in contrast to its previous identity as solely a vascular disease. Early in the disease progression of diabetes, the major cells in the neuronal component of the retina consist of retinal ganglion cells and glial cells, both of which have been found to be compromised. A number of retinal function tests also indicated a functional deficit in diabetic retina, which further supports dysfunction of neuronal cells. As an endocrinological disorder, diabetes alters metabolism both systemically and locally in several body organs, including the retina. A growing body of evidences indicates increased levels of excitotoxic metabolites, including glutamate, branched chain amino acids and homocysteine in cases of diabetic retinopathy. Also present, early in the disease, are decreased levels of folic acid and vitamin-B12, which are potential metabolites capable of damaging neurons. These altered levels of metabolites are found to activate several metabolic pathways, leading to increases in oxidative stress and decreases in the level of neurotrophic factors. As a consequence, they may damage retinal neurons in diabetic patients. In this review, we have discussed those potential excitotoxic metabolites and their implications in neuronal damage. Possible therapeutic targets to protect neurons are also discussed. However, further research is needed to understand the exact molecular mechanism of neurodegeneration so that effective neuroprotection strategies can be developed. By protecting retinal neurons early in diabetic retinopathy cases, damage of retinal vessels can be protected, thereby helping to ameliorate the progression of diabetic retinopathy, a leading cause of blindness worldwide.
Keywords: diabetic retinopathy; drugs; neurodegeneration; retina; oxidative stress; glutamate
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MDPI and ACS Style
Ola, M.S.; Nawaz, M.I.; Khan, H.A.; Alhomida, A.S. Neurodegeneration and Neuroprotection in Diabetic Retinopathy. Int. J. Mol. Sci. 2013, 14, 2559-2572.
Ola MS, Nawaz MI, Khan HA, Alhomida AS. Neurodegeneration and Neuroprotection in Diabetic Retinopathy. International Journal of Molecular Sciences. 2013; 14(2):2559-2572.
Ola, Mohammad S.; Nawaz, Mohd I.; Khan, Haseeb A.; Alhomida, Abdullah S. 2013. "Neurodegeneration and Neuroprotection in Diabetic Retinopathy." Int. J. Mol. Sci. 14, no. 2: 2559-2572.