Mechanistic investigations of diabetic ocular surface diseases

Abstract

With the global prevalence of diabetes mellitus over recent decades, more patients suffered from various diabetic complications, including diabetic ocular surface diseases that may seriously affect the quality of life and even vision sight. The major diabetic ocular surface diseases include diabetic keratopathy and dry eye. Diabetic keratopathy is characterized with the delayed corneal epithelial wound healing, reduced corneal nerve density, decreased corneal sensation and feeling of burning or dryness. Diabetic dry eye is manifested as the reduction of tear secretion accompanied with the ocular discomfort. The early clinical symptoms include dry eye and corneal nerve degeneration, suggesting the early diagnosis should be focused on the examination of confocal microscopy and dry eye symptoms. The pathogenesis of diabetic keratopathy involves the accumulation of advanced glycation end-products, impaired neurotrophic innervations and limbal stem cell function, and dysregulated growth factor signaling, and inflammation alterations. Diabetic dry eye may be associated with the abnormal mitochondrial metabolism of lacrimal gland caused by the overactivation of sympathetic nervous system. Considering the important roles of the dense innervations in the homeostatic maintenance of cornea and lacrimal gland, further studies on the neuroepithelial and neuroimmune interactions will reveal the predominant pathogenic mechanisms and develop the targeting intervention strategies of diabetic ocular surface complications.

Combined administration of gallic acid and glibenclamide mitigate systemic complication and histological changes in the cornea of diabetic rats induced with streptozotocin

“…Corneal sections of diabetic rats in previous studies 44 , 56 showed severe degenerative changes, such as edema, degradation of its collagen fibers, and corneal neovascularization, which are consistent with the findings of this study. Severe vascularization of acellular bowmans membrane, corneal edema and cornea fibrosis as obtained in the histology of the cornea of the diabetic group suggests that they were at risk of developing diabetic corneal complications.…”

The Role of SLIT3–ROBO4 Signaling in Endoplasmic Reticulum Stress–Induced Delayed Corneal Epithelial and Nerve Regeneration

“… 57 The cornea is the most densely innervated tissue of the body; after corneal injury, the regeneration of the local sensory nerves is regulated by numerous complex molecules. 19 , 20 Different AGMs have distinct effects on corneal nerve growth. For example, during early development, both Sema3A and SLIT2 are involved in preventing nerves from entering the corneal stroma.…”

Polysaccharide-Based Nanoparticles Equipped with Glucose Oxidase for In Vivo Insulin Delivery

“…According to the International Diabetes Federation’s survey, the worldwide population of individuals with diabetes is predicted to reach 650 million by 2040 . DM occurs because of insufficient insulin secretion or insulin resistance, which leads to the accumulation of glucose in the circulation. , When the blood glucose level exceeds the normal range (≥11.1 mmol/L), it causes hyperglycemia, and prolonged hyperglycemia can cause cardiovascular disease, ketoacidosis, stroke, renal failure, neuropathy, lower limb amputation, and retinopathy. − Hence, continuous control of the glucose level is key to treating patients with diabetes.…”