Modulation of diabetic retinopathy pathophysiology by natural medicines through PPAR‐γ‐related pharmacology

Abstract

Diabetic retinopathy (DR) is one of the most common microvascular complications of diabetes and remains a major cause of preventable blindness among adults at working age. DR involves an abnormal pathology of major retinal cells, including retinal pigment epithelium, microaneurysms, inter‐retinal oedema, haemorrhage, exudates (hard exudates) and intraocular neovascularization. The biochemical mechanisms associated with hyperglycaemic‐induced DR are through multifactorial processes. Peroxisome proliferator‐activated receptor‐γ (PPAR‐γ) plays an important role in the pathogenesis of DR by inhibiting diabetes‐induced retinal leukostasis and leakage. Despite DR causing eventual blindness, only a few visual or ophthalmic symptoms are observed until visual loss develops. Therefore, early medical interventions and prevention are the current management strategies. Laser photocoagulation therapy is the most common treatment. However, this therapy may cause retinal damage and scarring. Herbal and traditional natural medicines may provide an alternative to prevent or delay the progression of DR. This review provides an analysis of the therapeutic potential of herbal and traditional natural medicines or their active components for the slowdown of progression of DR and their possible mechanism through the PPAR‐γ pathway. LINKED ARTICLE This article is commented on by Costa and Ciccodicola, pp. 1–3 of this issue. To view this commentary visit http://dx.doi.org/10.1111/j.1476-5381.2011.01443.x

Targeting neovascularization in ischemic retinopathy: recent advances

“…PPARγ pathway was found to be involved in the attenuation of progression of DR by herbal and traditional natural medicines or their active components [169] and also in the antiangiogenic effect of the omega3-PUFAs on RNV in OIR independent of vascular endothelial growth factor [170]. Moreover, PPARγligands have been shown to inhibit VEGF-induced choroidal angiogenesis in vitro and CNV in vivo [171].…”

Acetyl-11-keto-β-boswellic acid reduces retinal angiogenesis in a mouse model of oxygen-induced retinopathy

“…In the last few years, an intense research activity has focused around the use of herbal and traditional natural medicines as an alternative for slowing down the progression of proliferative retinopathies (Song et al, 2012). Acetyl-11-keto-b-boswellic acid (AKBA) is one of the active principles present in boswellic acids derived from the plant Boswellia serrata, which have been used in Ayurvedic systems of medicine against a number of inflammatory diseases.…”

Diabetic Retinopathy and Laser Therapy in Rats: A Protein-Protein Interaction Network Analysis

“…DR involves an abnormal pathology of major retinal cells, including retinal pigment epithelium, inter-retinal edema, microaneurysms. 77 So involving the pathway in epithelial development such as columnar/cuboidal epithelial cell development is not unexpected. This process is involved in most of the mentioned characteristic features of RD and the introduced crucial proteins are attributed in regulation of this process.…”