Inflammation and diabetic retinal microvascular complications

Abstract

Diabetic retinopathy (DR) is one of the most common complications of diabetes and is a leading cause of blindness in people of the working age in Western countries. A major pathology of DR is microvascular complications such as non-perfused vessels, microaneurysms, dot/blot hemorrhages, cotton-wool spots, venous beading, vascular loops, vascular leakage and neovascularization. Multiple mechanisms are involved in these alternations. This review will focus on the role of inflammation in diabetic retinal microvascular complications and discuss the potential therapies by targeting inflammation.

Angiogenic Factors and Cytokines in Diabetic Retinopathy

“…Numerous mechanisms have been hypothesized to explain the appearance of low-grade chronic inflammation in the diabetic retina (reviewed in [29,163]). These include: a direct effect of hyperglycemia, dyslipidemia, oxidative stress due to high glucose, advanced glycation end products, hypertension, and ER stress.…”

Bowman lecture on the role of inflammation in degenerative disease of the eye

“…48 Previously, the capillary occlusion in DR was attributed to the hypercoagulability of diabetes (also a criteria of the Metabolic Syndrome 40 ) and low fibrinolytic activity of diabetic plasma. In 1990, Schroder et al 49 demonstrated that activated leucocytes were the major contributors to capillary occlusion in alloxan diabetic rats, and this has been confirmed in many models (see review in Zhang et al 41 ). Diabetic patients also have increased adhesiveness of leucocytes, including T cells.…”

“…For a number of years now, the role of inflammation specifically in DR has been recognised, 41 particularly recent studies on the role of bone marrow-derived monocyte/macrophages. 42,43 Clinical features of DR and correlation with experimental models…”

Critical Role of the CXCL10/C-X-C Chemokine Receptor 3 Axis in Promoting Leukocyte Recruitment and Neuronal Injury during Traumatic Optic Neuropathy Induced by Optic Nerve Crush

“…4 Inflammation is the body's defense system against infection, injury, and stress and is a critical component of wound healing. 5 Circulating blood leukocytes that migrate to sites of tissue injury and infection are the key players in inflammation by eliminating the primary inflammatory trigger and contributing to tissue repair. 6 Nevertheless, it has been well established that excessive or uncontrolled inflammation can cause enhanced tissue injury and diseases by the following mechanisms: receptor-induced activation of programed cell death processes, the clogging and rupture of blood and lymphatic vessels, and/or production of toxic molecules, such as reactive oxygen species.…”