title: Role of altered coagulation-fibrinolytic system in the pathophysiology of diabetic retinopathy.
abstract: The implications of altered coagulation-fibrinolytic system in the pathophysiology of several vascular disorders, such as stroke and myocardial infarction, have been well researched upon and established. However, its role in the progression of diabetic retinopathy has not been explored much. Since a decade, it is known that hyperglycemia is associated with a hypercoagulated state and the various impairments it causes are well acknowledged as independent risk factors for the development of cardiovascular diseases. But recent studies suggest that the hypercoagulative state and diminished fibrinolytic responses might also alter retinal homeostasis and induce several deleterious molecular changes in retinal cells which aggravate the already existing hyperglycemia-induced pathological conditions and thereby lead to the progression of diabetic retinopathy. The major mediators of coagulation-fibrinolytic system whose concentration or activity get altered during hyperglycemia include fibrinogen, antithrombin-III (AT-III), plasminogen activator inhibitor-1 (PAI-1) and von Willebrand factor (vWF). Inhibiting the pathways by which these altered mediators get involved in the pathophysiology of diabetic retinopathy can serve as potential targets for the development of an adjuvant novel alternative therapy for diabetic retinopathy.
authors.affiliation: Department of Pharmacology, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India. Electronic address: tapanbehl31@gmail.com.
authors.forename: Tapan
authors.initials: T
authors.lastname: Behl
authors.affiliation: Department of Ocular Pharmacology, Dr. Rajendra Prasad Centre for Ophthalmic Science, AIIMS, New Delhi, India.
authors.forename: Thirumurthy
authors.initials: T
authors.lastname: Velpandian
authors.affiliation: Department of Pharmacology, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India.
authors.forename: Anita
authors.initials: A
authors.lastname: Kotwani
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D000818:Animals; D000925:Anticoagulants / Q000627:therapeutic use; D000990:Antithrombin III / Q000378:metabolism; D001777:Blood Coagulation / Q000187:drug effects; D001786:Blood Glucose / Q000378:metabolism; D003930:Diabetic Retinopathy / Q000097:blood* / Q000188:drug therapy / Q000503:physiopathology; D005340:Fibrinogen / Q000378:metabolism; D005342:Fibrinolysis / Q000187:drug effects; D006801:Humans; D009389:Neovascularization, Pathologic; D017395:Plasminogen Activator Inhibitor 1 / Q000378:metabolism; D015861:Retinal Neovascularization; D015398:Signal Transduction; D014841:von Willebrand Factor / Q000378:metabolism
chemical_list: D020533:Angiogenesis Inhibitors; D000925:Anticoagulants; D001786:Blood Glucose; D017395:Plasminogen Activator Inhibitor 1; C051321:SERPINE1 protein, human; D014841:von Willebrand Factor; D000990:Antithrombin III; D005340:Fibrinogen
keywords: Antithrombin-III (AT-III); Fibrinogen; Plasminogen activator inhibitor-1 (PAI-1); Thrombin; von Willebrand factor (vWF)