Metabolic pathways in context: mTOR signalling in the retina and optic nerve ‐ A review

Abstract

The mechanistic target of rapamycin (mTOR) signalling network plays a key role in growth and development, autophagy, metabolism, inflammation as well as ageing, and it is therefore important in ocular health and disease. mTOR dysregulation has been identified in a range of conditions, including age-related macular degeneration, diabetic retinopathy, retinitis pigmentosa, traumatic optic neuropathy and glaucoma. Experimental modulation of the pathway has contributed to the understanding of these diseases and offers the potential for new avenues of therapy. This review discusses the mTOR pathway and its role in health and in diseases of the retina and optic nerve.

Emerging therapies for common eye conditions

“…In the current climate of the COVID-19 pandemic that is restricting population and personal mobility, 1 the value of preventative measures and more effective and longer acting treatments has come to the forefront. The papers by Lim et al 2 and Yao et al 3 suggest new approaches to the management of cataract and different forms of retinopathy, respectively.…”

“…The mTOR inhibitor, sirolimus, has been the topic of intense research in the oncology community and its effects also studied in retinovascular disease with the latest results awaited. 3 This kinase occupies a key point of convergence of multiple cellular pathways, regulating the body's response to both activating and inhibitory factors. It possesses a broad spectrum of therapeutic actions, including the ability to limit inflammation, proliferation, angiogenesis, fibrosis, and hyperpermeability.…”

“…However, although many candidate drugs modulating the mTOR pathway have exciting therapeutic potential, they also have the potential for a wide range of adverse events due to the fact that mTOR regulates many aspects of systemic and ocular health and stress the importance of ongoing work in this field. 3 With greater understanding of ocular disease processes, comes advances in preventive and more effective treatments. It is hoped that further development of the emerging therapies such as those reviewed in this issue of Clinical and Experimental Ophthalmology will lead to more effective future approaches for major causes of blindness across the globe.…”

“…Yao et al 3 review how the mechanistic target of rapamycin (mTOR) pathway regulates many aspects of systemic and ocular health and disease in another article of the same issue of Clinical and Experimental Ophthalmology . They discuss the development of newer modulators of mTOR signalling that are likely to reveal further insights into the pathway altering our understanding of diseases of the retina and optic nerve.…”

“…They discuss the development of newer modulators of mTOR signalling that are likely to reveal further insights into the pathway altering our understanding of diseases of the retina and optic nerve. The mTOR inhibitor, sirolimus, has been the topic of intense research in the oncology community and its effects also studied in retinovascular disease with the latest results awaited 3 . This kinase occupies a key point of convergence of multiple cellular pathways, regulating the body's response to both activating and inhibitory factors.…”