Bioenergetic-based neuroprotection and glaucoma.
Primary open-angle glaucoma (POAG) is a pressure-sensitive optic neuropathy which results in the death of retinal ganglion cells and causes associated loss of vision. Presently, the only accepted treatment strategy is to lower the intraocular pressure; however, for some patients this is insufficient to prevent progressive disease. Although the pathogenesis of POAG remains unclear, there is considerable evidence that energy failure at the optic nerve head may be involved. Neuroprotection, a strategy which directly enhances the survival of neurons, is desirable, but remains clinically elusive. One particular form of neuroprotection involves the notion of enhancing the energy supply of neurons. These 'bioenergetic' methods of neuroprotection have proven successful in animal models of other neurodegenerative diseases and conditions, including Parkinson's disease, Huntington's disease, amyotrophic lateral sclerosis and traumatic brain injury, but have been relatively unexplored in glaucoma models. This review focuses on some of the potential approaches for bioenergetic neuroprotection in the retina, including increasing the energy buffering capacity of damaged cells, decreasing the permeability of the mitochondrial membrane pore and free radical scavenging.
Schober
Michael S
MS
South Australian Institute of Ophthalmology, Adelaide, South Australia, Australia. michael.schober@imvs.sa.gov.au
Chidlow
Glyn
G
Wood
John Pm
JP
Casson
Robert J
RJ
D000818:Animals; D002118:Calcium / Q000378:metabolism; D016923:Cell Death; D004734:Energy Metabolism / Q000187:drug effects*; D016166:Free Radical Scavengers / Q000627:therapeutic use; D005901:Glaucoma / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control*; D005947:Glucose / Q000378:metabolism; D006801:Humans; D019344:Lactic Acid / Q000378:metabolism; D033681:Mitochondrial Membrane Transport Proteins / Q000378:metabolism; D000083162:Mitochondrial Permeability Transition Pore; D018696:Neuroprotective Agents / Q000627:therapeutic use*; D018384:Oxidative Stress; D012160:Retina / Q000378:metabolism*; D012165:Retinal Ganglion Cells
D016166:Free Radical Scavengers; D033681:Mitochondrial Membrane Transport Proteins; D000083162:Mitochondrial Permeability Transition Pore; D018696:Neuroprotective Agents; D019344:Lactic Acid; D005947:Glucose; D002118:Calcium