title: Diabetic retinopathy: new therapeutic perspectives based on pathogenic mechanisms.
abstract: Diabetic retinopathy (DR) is the leading cause of visual impairment and preventable blindness and represents a significant socioeconomic cost for healthcare systems worldwide. In early stages of DR the only therapeutic strategy that physicians can offer is a tight control of the risk factors for DR (mainly blood glucose and blood pressure). The currently available treatments for DR are applicable only at advanced stages of the disease and are associated with significant adverse effects. Therefore, new treatments for the early stages of DR are needed. However, in early stages of DR invasive treatments such as intravitreal injections are too aggressive, and topical treatment seems to be an emerging route. In the present review, therapeutic strategies based on the main pathogenic mechanisms involved in the development of DR are reviewed. The main gap in the clinical setting is the treatment of early stages of DR and, therefore, this review emphasizes in this issue by giving an overview of potential druggable targets. By understanding of disease-specific pathogenic mechanisms, biological heterogeneity and progression patterns in early and advanced DR a more personalised approach to patient treatment will be implemented.
authors.affiliation: CIBERDEM (CIBER de Diabetes y Enfermedades Metabólicas Asociadas) and Diabetes and Metabolism Research Unit, Vall Hebron Institut de Recerca (VHIR), Universitat Autónoma de Barcelona, Pg. Vall d'Hebron 119-129, 08035, Barcelona, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Hernández
authors.affiliation: Servicio de Endocrinología y Nutrición, Hospital Universitario de Bellvitge, Universitat de Barcelona, L'Hospitalet del LLobregat, Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Simó-Servat
authors.affiliation: CIBERDEM (CIBER de Diabetes y Enfermedades Metabólicas Asociadas) and Diabetes and Metabolism Research Unit, Vall Hebron Institut de Recerca (VHIR), Universitat Autónoma de Barcelona, Pg. Vall d'Hebron 119-129, 08035, Barcelona, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Bogdanov
authors.affiliation: CIBERDEM (CIBER de Diabetes y Enfermedades Metabólicas Asociadas) and Diabetes and Metabolism Research Unit, Vall Hebron Institut de Recerca (VHIR), Universitat Autónoma de Barcelona, Pg. Vall d'Hebron 119-129, 08035, Barcelona, Spain. rafael.simo@vhir.org.
authors.forename: R
authors.identifier: http://orcid.org/0000-0003-0475-3096
authors.initials: R
authors.lastname: Simó
mesh_terms: D000818:Animals; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000378:metabolism* / Q000628:therapy*; D006801:Humans; D007004:Hypoglycemic Agents / Q000494:pharmacology / Q000627:therapeutic use; D008833:Microcirculation / Q000187:drug effects / Q000502:physiology; D019636:Neurodegenerative Diseases / Q000175:diagnosis / Q000378:metabolism / Q000628:therapy; D012307:Risk Factors
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents
keywords: Anti-inflammatory treatment; Diabetic retinopathy; Neuroprotection; New treatment approaches; Personalized medicine; Topical treatment