Norman MacAlister Gregg Lecture. The pathogenesis of diabetic retinopathy.
Diabetic retinopathy remains a major cause of loss of vision. The Diabetes Control and Complications Trial (DCCT) has implicated hyperglycaemia as a probable major direct causative factor in the pathogenesis of diabetic retinopathy. There are several plausible mechanisms by which high glucose concentrations could lead to the functional and later structural changes characterising diabetic retinopathy. These include increased activity of the aldose reductase pathway, increase de novo synthesis of diacylglycerol from glucose, causing protein kinase C activation, increased non-enzymatic glycation and increased oxidative damage. The demonstration of the potential roles of these pathways and the subsequent effects of growth factors in enhancing angiogenesis provide potential new approaches to the prevention and treatment of diabetic retinopathy.
Larkins
R G
RG
University of Melbourne, Department of Medicine, Royal Melbourne Hospital, Parkville, Victoria.
Dunlop
M E
ME
Johnson
E I
EI
D000449:Aldehyde Reductase / Q000502:physiology; D000818:Animals; D001786:Blood Glucose / Q000378:metabolism; D003930:Diabetic Retinopathy / Q000209:etiology* / Q000378:metabolism / Q000628:therapy; D017127:Glycation End Products, Advanced / Q000502:physiology; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000150:complications*; D012160:Retina / Q000473:pathology / Q000503:physiopathology
D001786:Blood Glucose; D017127:Glycation End Products, Advanced; D000449:Aldehyde Reductase