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Патогенетические подходы к профилактике и лечению диабетической ретинопатии
Патогенетические подходы к профилактике и лечению диабетической ретинопатии
Кольчик О.В., Немирова С.В., Петрова К.С. Патогенетические подходы к профилактике и лечению диабетической ретинопатии. Consilium Medicum. 2017; 19 (4): 43–49.
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Аннотация
В связи с ростом распространенности сахарного диабета во всем мире растет и число пациентов с осложнениями. Диабетическая ретинопатия (ДР) имеется у 25–33% пациентов и, являясь ведущей причиной слепоты и слабовидения у лиц трудоспособного возраста, представляет собой острую проблему. Стандартные методы лечения ДР проводятся в основном уже на поздних стадиях и не всегда являются безопасными и успешными. Это заставляет искать новые подходы к решению данной проблемы и обратить внимание на профилактику поздних осложнений сахарного диабета. В статье обсуждаются патогенетические механизмы развития ДР и возможности снижения риска ее прогрессирования. Особое внимание уделяется применению препарата кальция добезилата, имеющего широкий спектр воздействия на звенья патогенеза ДР.
Ключевые слова: кальция добезилат, диабетическая ретинопатия.
Key words: calcium dobesilate, diabetic retinopathy.
Ключевые слова: кальция добезилат, диабетическая ретинопатия.
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Key words: calcium dobesilate, diabetic retinopathy.
Полный текст
Список литературы
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10. Olivarius N, Nielsen NV, Andreasen AH. Diabetic retinopathy in newly diagnosed middle-age dandle derly diabetic patients. Prevalence and interrelationship with microalbuminuria and triglycerides. Graefes Arch Clin Exp Ophthalmol 2001; 239 (9): 664–72.
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15. Xu J, Wei WB, Yuan MX et al. Prevalence and risk factors for diabetic retinopathy: the Beijing Communities Diabetes Study 6. Retina 2012; 32: 322–9.
16. Brownlee M. Biochemistry and molecular cell biology of diabetic complications. Nature 2001; 414: 813–20.
17. Tang J, Kern TS. Inflammation in diabetic retinopathy. Prog Retin Eye Res 2011; 30: 343–58.
18. Simo R, Ballarini S, Cunha-Vaz J et al. Non-traditional systemic treatments for diabetic retinopathy: an evidence-based review. Curr Med Chem 2015; 22: 2580–9.
19. Brunet J, Farine JC, Garay RP et al. Angioprotective action of calcium dobesilate against reactive oxygen species-induced capillary permeability in the rat. Eur J Pharmacol 1998; 358 (3): 213–20.
20. Adamis AP, Berman AJ. Immunological mechanisms in the pathogenesis of diabetic retinopathy. Semin Immunopathol 2008; 30 (2): 65–84.
21. Kern TS. Contributions of inflammatory processes to the development of the early stages of diabetic retinopathy. Exp Diabetes Res 2007; 2007: 95–103.
22. Barber AJ, Antonetti DA, Gardner TW. Altered expression of retinal occluding and glial fibrillary acidic protein in experimental diabetes. Invest Ophthalmol Vis Sci 2000; 4 (11): 3561–8.
23. Klaassen I, Hughes JM, Vogels IM et al. Altered expression of genes related to blood-retina barrier disruption in streptozotocin-induced diabetes. Exp Eye Res 2009; 89 (1): 4–15.
24. Miyamoto K, Khosrof S, Bursell SE et al. Prevention of leukostasis and vascular leakage in streptozotocin-induced diabetic retinopathy via intercellular adhesion molecule-1 inhibition. Proc Natl Acad Sci USA 1999; 96 (19): 10836–41.
25. Joussen AM, Poulaki V, Mitsiades N et al. Nonsteroidal anti-inflammatory drugs prevent early diabetic retinopathy via TNF-alpha suppression. FASEB J 2002; 16 (3): 438–40.
26. Leal EC, Martins J, Voabil P et al. Calcium dobesilate inhibits the alterations in tight junction proteins and leukocyte adhesion to retinal endothelial cells induced by diabetes. Diabetes 2010; 59 (10): 2637–45.
27. Lozovskaia EL, Kaplunskii GD, Sapezhinskii II. Superoxide dismutase activity and photosensitizing properties of 2.5-dihydroxybenzolsulfonate. Biofizika 1990; 35 (6): 912–16.
28. Brunet J, Farine JC, Garay RP et al. In vitro antioxidant properties of calcium dobesilate. Fund Clin Pharmacol 1998;12 (2): 205–12.
29. Szabo ME, Haines D, Garay E et al. Antioxidant properties of calcium dobesilate in ischemic reperfused diabetic rat retina. Eur J Pharmacol 2001; 428 (2): 277–86.
30. Graber R, Farine JC, Fumagalli I et al. Calcium Dobesilate protects human peripheral blood mononuclear cells from oxidation and apoptosis. Apoptosis 1998; 3 (1): 41–9.
31. Nowak M, Wielkoszyski T, Marek B et al. Blood serum levels of vascular cell adhesion molecule (sVCAM-1), intercellular adhesion molecule (sICAM-1) and endothelial leucocyte adhesion molecule-1 (ELAM-1) in diabetic retinopathy. Clin Exp Med 2008; 8 (3): 159–64.
32. Clausen P, Jacobsen P, Rossing K et al. Plasma concentrations of VCAM-1 and ICAM-1 are elevated in patients with Type 1 diabetes mellitus with microalbuminuria and overt nephropathy. Diabet Med 2000; 17 (9): 644–9.
33. Schram MT, Stam F, de Jongh RT et al. The effect of calcium dobesilate on vascular endothelial function, blood pressure, and markers of oxidation in obese male smokers: a placebo- controlled randomized clinical trial. Atherosclerosis 2003; 170 (1): 59–72.
34. Aiello LM. Perspectives on diabetic retinopathy. Am J Ophthalmol 2003; 136 (1): 122–135.
35. Campochiaro PA, Hackett SF. Ocular neovascularization: a valuable model system. Oncogene 2003; 22 (429): 6537–48.
36. Angulo J, Peir C, Romacho T et al. Inhibition of vascular endothelial growth factor (VEGF)-induced endothelial proliferation, arterial relaxation, vascular permeability and angiogenesis by dobesilate. Eur J Pharmacol 2011; 667 (1–3): 153–9.
37. Yang E, Shim JS, Woo H-J et al. Aminopeptidase N/CD13 induces angiogenesis through interaction with a pro-angiogenic protein, galectin-3. Biochem Biophys Res Commun 2007; 363 (2): 336–41.
38. Rota R, Chiavaroli C, Garay RP et al. Reduction of retinal albumin leakage by the antioxidant calcium dobesilate in streptozotocin-diabetic rats. Eur J Pharmacol 2004: 495 (2–3): 217–24.
39. Michal M, Gotti C. Effect of calcium dobesilate on platelet function. Thrombosis Res 1988; 51 (6): 593–605.
40. Skovborg F, Nielsen AV, Schlichtkrull J et al. Blood-viscosity in diabetic patients. Lancet 1966; 1 (7429): 129–31.
41. McMillan D. Plasma protein changes, blood viscosity and diabetic microangiopathy. Diabetes 1976; 25 (2): 25–33.
42. Barras J, Graf C. Hyperviscosity in diabetic retinopathy treated with Doxium (calcium dobesilate). Vasa 1980; 9 (2): 161–4.
43. Ak G, Buyukberber S, Sevinc A et al. The relation between plasma endothelin-1 levels and metabolic control, risk factors, treatment modalities, and diabetic microangiopathy in patients with Type 2 diabetes mellitus. J Diabetes Complications 2001; 15 (3): 150–7.
44. Chou JC, Rollins SD, Ye M et al. Endothelin receptor-A antagonist attenuates retinal vascular and neuroretinal pathology in diabetic mice. Invest Ophthalmol Vis Sci 2014; 55: 2516–25.
45. Zhong H, Guo L. The plasma levels of endothelin in diabetic retinopathy and their changes after treatment with doxium. Hunan Yike Daxue Xuebao 1997; 22 (1): 56–8.
46. Leite EB, Mota MC, Faria de Abreu JR et al. Effect of calcium dobesilate on the blood-retinal barrier in early diabetic retinopathy. Int Ophthalmol 1990; 14: 81–8.
47. Ribeiro ML, Seres AI, Carneiro AM et al. Effect of calcium dobesilate on progression of early diabetic retinopathy: a randomised double-blind study. Graefes Arch Clin Exp Ophthalmol 2006; 244: 1591–600.
48. Cuevas P, Outeiriño LA, Angulo J et al. Chronic cystoid macular oedema treated with intravitreal dobesilate. BMJ Case Reports 2012; 2012.
49. Feghhi M, Farrahi F, Abbaspour M et al. Effect of adding oral calcium dobesilate to laser photocoagulation on the macular thickness in patients with diabetic macular edema: a randomized clinical trial. Adv Pharm Bull 2014; 4 (4): 375–8.
50. Zhang X, Liu W, Wu S et al. Calcium dobesilate for diabetic retinopathy: a systematic review and meta-analysis. China Life Sci 2015; 58: 101–7.
51. Ford JA, Lois N, Royle P et al. Current treatments diabetic macular edema: systematic review and meta-analysis. BMJ Open 3: e002269. DOI: 10.1136/bmjopen-2012-002269
52. ACCORD Study Group; ACCORD Eye Study Group; Chew EY, Ambrosius WT, Davis MD et al. Effects medical therapies retinopathy progression in type 2 diabetes. N Engl J Med 2010; 363 (3): 233–44. DOI: 10.1056/NEJMoa1001288
53. Cheung NI, Mitchell P, Wong TY. Diabetic retinopathy. Lancet 2010; 376 (9735): 124–136. DOI: 10.1016/S0140-6736(09)62124-3
54. Moshetova L.K., Vorob'eva I.V., Alekseev I.B., Mikhaleva L.G. Rezul'taty lecheniia antioksidantnymi i angioprotektornymi preparatami patsientov s diabeticheskoi retinopatiei i vozrastnoi makuliarnoi degeneratsiei pri sakharnom diabete 2-go tipa. Vestn. oftal'mologii. 2015; 3: 15–21. DOI: 0.17116/oftalma2015131315-21 [in Russian]
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2. Соловьева Г.А. Роль препарата Докси-хем в лечении диабетической ретинопатии. Клин. офтальмология. 2003; 4 (1): 43–5. / Solov'eva G.A. Rol' preparata Doksi-khem v lechenii diabeticheskoi retinopatii. Klin. oftal'mologiia. 2003; 4 (1): 43–5. [in Russian]
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6. UK Prospective Diabetes Study (UKPDS) Group: Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes (UKPDS 38). BMJ 1998; 317: 703–13.
7. Wilczynski M, Dziegielewski K. Glycaemic control and microvascular complications in a large cohort of Italian Type 1 diabetic out-patients. Klin Oczna 2005; 107 (10–12): 672–4.
8. Al-Till MI, Al-Bdour MD, Ajlouni KM. Prevalence of blindness and visual impairment among Jordanian diabetics. Eur J Ophthalmol 2005; 15 (1): 62–8.
9. Mensah E, Kohner E. Diagnosis and management of diabetic retinopathy. Topic Endocrinol 2002; 19: 14–8.
10. Olivarius N, Nielsen NV, Andreasen AH. Diabetic retinopathy in newly diagnosed middle-age dandle derly diabetic patients. Prevalence and interrelationship with microalbuminuria and triglycerides. Graefes Arch Clin Exp Ophthalmol 2001; 239 (9): 664–72.
11. International Diabetes Federation. IDF Diabetes Atlas, 6th ed. Brussels, Belgium: International Diabetes Federation, 2013.
12. Yau JWY, Rogers SL, Kawasaki R et al. Meta-Analysis for Eye Disease (META-EYE).
13. Study Group. Global prevalence and majority risk factors of diabetic retinopathy. Diabetes Care 2012; 35: 556–64.
14. Дедов И.И., Сунцов Ю.И., Кудрякова C.B. Экономические проблемы сахарного диабета в России. Сахарный диабет. 2000; 3: 56–8. / Dedov I.I., Suntsov Iu.I., Kudriakova C.B. Ekonomicheskie problemy sakharnogo diabeta v Rossii. Sakharnyi diabet. 2000; 3: 56–8. [in Russian]
15. Xu J, Wei WB, Yuan MX et al. Prevalence and risk factors for diabetic retinopathy: the Beijing Communities Diabetes Study 6. Retina 2012; 32: 322–9.
16. Brownlee M. Biochemistry and molecular cell biology of diabetic complications. Nature 2001; 414: 813–20.
17. Tang J, Kern TS. Inflammation in diabetic retinopathy. Prog Retin Eye Res 2011; 30: 343–58.
18. Simo R, Ballarini S, Cunha-Vaz J et al. Non-traditional systemic treatments for diabetic retinopathy: an evidence-based review. Curr Med Chem 2015; 22: 2580–9.
19. Brunet J, Farine JC, Garay RP et al. Angioprotective action of calcium dobesilate against reactive oxygen species-induced capillary permeability in the rat. Eur J Pharmacol 1998; 358 (3): 213–20.
20. Adamis AP, Berman AJ. Immunological mechanisms in the pathogenesis of diabetic retinopathy. Semin Immunopathol 2008; 30 (2): 65–84.
21. Kern TS. Contributions of inflammatory processes to the development of the early stages of diabetic retinopathy. Exp Diabetes Res 2007; 2007: 95–103.
22. Barber AJ, Antonetti DA, Gardner TW. Altered expression of retinal occluding and glial fibrillary acidic protein in experimental diabetes. Invest Ophthalmol Vis Sci 2000; 4 (11): 3561–8.
23. Klaassen I, Hughes JM, Vogels IM et al. Altered expression of genes related to blood-retina barrier disruption in streptozotocin-induced diabetes. Exp Eye Res 2009; 89 (1): 4–15.
24. Miyamoto K, Khosrof S, Bursell SE et al. Prevention of leukostasis and vascular leakage in streptozotocin-induced diabetic retinopathy via intercellular adhesion molecule-1 inhibition. Proc Natl Acad Sci USA 1999; 96 (19): 10836–41.
25. Joussen AM, Poulaki V, Mitsiades N et al. Nonsteroidal anti-inflammatory drugs prevent early diabetic retinopathy via TNF-alpha suppression. FASEB J 2002; 16 (3): 438–40.
26. Leal EC, Martins J, Voabil P et al. Calcium dobesilate inhibits the alterations in tight junction proteins and leukocyte adhesion to retinal endothelial cells induced by diabetes. Diabetes 2010; 59 (10): 2637–45.
27. Lozovskaia EL, Kaplunskii GD, Sapezhinskii II. Superoxide dismutase activity and photosensitizing properties of 2.5-dihydroxybenzolsulfonate. Biofizika 1990; 35 (6): 912–16.
28. Brunet J, Farine JC, Garay RP et al. In vitro antioxidant properties of calcium dobesilate. Fund Clin Pharmacol 1998;12 (2): 205–12.
29. Szabo ME, Haines D, Garay E et al. Antioxidant properties of calcium dobesilate in ischemic reperfused diabetic rat retina. Eur J Pharmacol 2001; 428 (2): 277–86.
30. Graber R, Farine JC, Fumagalli I et al. Calcium Dobesilate protects human peripheral blood mononuclear cells from oxidation and apoptosis. Apoptosis 1998; 3 (1): 41–9.
31. Nowak M, Wielkoszyski T, Marek B et al. Blood serum levels of vascular cell adhesion molecule (sVCAM-1), intercellular adhesion molecule (sICAM-1) and endothelial leucocyte adhesion molecule-1 (ELAM-1) in diabetic retinopathy. Clin Exp Med 2008; 8 (3): 159–64.
32. Clausen P, Jacobsen P, Rossing K et al. Plasma concentrations of VCAM-1 and ICAM-1 are elevated in patients with Type 1 diabetes mellitus with microalbuminuria and overt nephropathy. Diabet Med 2000; 17 (9): 644–9.
33. Schram MT, Stam F, de Jongh RT et al. The effect of calcium dobesilate on vascular endothelial function, blood pressure, and markers of oxidation in obese male smokers: a placebo- controlled randomized clinical trial. Atherosclerosis 2003; 170 (1): 59–72.
34. Aiello LM. Perspectives on diabetic retinopathy. Am J Ophthalmol 2003; 136 (1): 122–135.
35. Campochiaro PA, Hackett SF. Ocular neovascularization: a valuable model system. Oncogene 2003; 22 (429): 6537–48.
36. Angulo J, Peir C, Romacho T et al. Inhibition of vascular endothelial growth factor (VEGF)-induced endothelial proliferation, arterial relaxation, vascular permeability and angiogenesis by dobesilate. Eur J Pharmacol 2011; 667 (1–3): 153–9.
37. Yang E, Shim JS, Woo H-J et al. Aminopeptidase N/CD13 induces angiogenesis through interaction with a pro-angiogenic protein, galectin-3. Biochem Biophys Res Commun 2007; 363 (2): 336–41.
38. Rota R, Chiavaroli C, Garay RP et al. Reduction of retinal albumin leakage by the antioxidant calcium dobesilate in streptozotocin-diabetic rats. Eur J Pharmacol 2004: 495 (2–3): 217–24.
39. Michal M, Gotti C. Effect of calcium dobesilate on platelet function. Thrombosis Res 1988; 51 (6): 593–605.
40. Skovborg F, Nielsen AV, Schlichtkrull J et al. Blood-viscosity in diabetic patients. Lancet 1966; 1 (7429): 129–31.
41. McMillan D. Plasma protein changes, blood viscosity and diabetic microangiopathy. Diabetes 1976; 25 (2): 25–33.
42. Barras J, Graf C. Hyperviscosity in diabetic retinopathy treated with Doxium (calcium dobesilate). Vasa 1980; 9 (2): 161–4.
43. Ak G, Buyukberber S, Sevinc A et al. The relation between plasma endothelin-1 levels and metabolic control, risk factors, treatment modalities, and diabetic microangiopathy in patients with Type 2 diabetes mellitus. J Diabetes Complications 2001; 15 (3): 150–7.
44. Chou JC, Rollins SD, Ye M et al. Endothelin receptor-A antagonist attenuates retinal vascular and neuroretinal pathology in diabetic mice. Invest Ophthalmol Vis Sci 2014; 55: 2516–25.
45. Zhong H, Guo L. The plasma levels of endothelin in diabetic retinopathy and their changes after treatment with doxium. Hunan Yike Daxue Xuebao 1997; 22 (1): 56–8.
46. Leite EB, Mota MC, Faria de Abreu JR et al. Effect of calcium dobesilate on the blood-retinal barrier in early diabetic retinopathy. Int Ophthalmol 1990; 14: 81–8.
47. Ribeiro ML, Seres AI, Carneiro AM et al. Effect of calcium dobesilate on progression of early diabetic retinopathy: a randomised double-blind study. Graefes Arch Clin Exp Ophthalmol 2006; 244: 1591–600.
48. Cuevas P, Outeiriño LA, Angulo J et al. Chronic cystoid macular oedema treated with intravitreal dobesilate. BMJ Case Reports 2012; 2012.
49. Feghhi M, Farrahi F, Abbaspour M et al. Effect of adding oral calcium dobesilate to laser photocoagulation on the macular thickness in patients with diabetic macular edema: a randomized clinical trial. Adv Pharm Bull 2014; 4 (4): 375–8.
50. Zhang X, Liu W, Wu S et al. Calcium dobesilate for diabetic retinopathy: a systematic review and meta-analysis. China Life Sci 2015; 58: 101–7.
51. Ford JA, Lois N, Royle P et al. Current treatments diabetic macular edema: systematic review and meta-analysis. BMJ Open 3: e002269. DOI: 10.1136/bmjopen-2012-002269
52. ACCORD Study Group; ACCORD Eye Study Group; Chew EY, Ambrosius WT, Davis MD et al. Effects medical therapies retinopathy progression in type 2 diabetes. N Engl J Med 2010; 363 (3): 233–44. DOI: 10.1056/NEJMoa1001288
53. Cheung NI, Mitchell P, Wong TY. Diabetic retinopathy. Lancet 2010; 376 (9735): 124–136. DOI: 10.1016/S0140-6736(09)62124-3
54. Мошетова Л.К., Воробьева И.В., Алексеев И.Б., Михалева Л.Г. Результаты лечения антиоксидантными и ангиопротекторными препаратами пациентов с диабетической ретинопатией и возрастной макулярной дегенерацией при сахарном диабете 2-го типа. Вестн. офтальмологии. 2015; 3: 15–21. DOI: 0.17116/oftalma2015131315-21 / Moshetova L.K., Vorob'eva I.V., Alekseev I.B., Mikhaleva L.G. Rezul'taty lecheniia antioksidantnymi i angioprotektornymi preparatami patsientov s diabeticheskoi retinopatiei i vozrastnoi makuliarnoi degeneratsiei pri sakharnom diabete 2-go tipa. Vestn. oftal'mologii. 2015; 3: 15–21. DOI: 0.17116/oftalma2015131315-21 [in Russian]
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70. Yang W, Yu X, Zhang Q et al. Attenuation of streptozotocin-induced diabetic retinopathy with low molecular wight fucoidan via inhibition of vascular endothelium growth factor. Exp Eye Res 2013; 115: 96–105.
71. Lameynardie S, Chiavaroli C, Travo P et al. Inhibition of choroidal angiogenesis by calcium dobesilate in normal Wistar and diabetic GK rats. Eur J Pharmacol 2005; 510: 149–56.
72. Vojnikovic B. Hyperviscosity in whole blood, plasma, and aqueous humor decreased by doxium (calcium dobesilate) in diabetics with retinopathy and glaucoma: a double-blind controlled study. Ophthalmic Res 1984; 16: 150–62.
73. Guerrini M, Acciavatti A, Pieragalli D et al. A controlled open trial of CD in the treatment of rheological alterations in diabetes mellitus. Eur Rev Med Pharm Sci 1985; 7: 1–19.
74. Benarroch IS, Brodsky M, Rubinstein A et al. Treatment of blood hyperviscosity with calcium dobesilate in patients with diabetic retinopathy. Ophthalmic Res 1985; 17: 131–8.
75. Vinazzer H, Hachen HJ. Influence of calcium dobesilate (Doxium) on blood viscosity and coagulation parameters in diabetic retinopathy. Vasa 1987; 16: 190–2.
76. Vojnikovic B. Doxium (calcium dobesilate) reduces blood hyperviscosity and lowers elevated intraocular pressure in patients with diabetic retinopathy and glaucoma. Ophthalmic Res 1991; 23: 12–20.
77. Guerrini M, Pieragalli D, Acciavatti A et al. Calcium dobesilate, hemorheology, fibrinolysis and endothelium. New perspectives on the prevention of diabetic microangiopathy. Clinical pharmacological study. Clin Ter 1989; 129: 271–85.
78. Allain H, Ramelet AA, Polard E, Bentue-Ferrer D. Safety of calcium dobesilate in chronic venous disease, diabetic retinopathy and haemorrhoids. Drug Safety 2004; 27: 649–60.
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Авторы
О.В.Кольчик1, С.В.Немирова*2, К.С.Петрова2
1 ГБУЗ НО «Нижегородская областная клиническая больница им. Н.А.Семашко». 603126, Россия, Нижний Новгород, ул. Родионова, д. 190;
2 ФГБОУ ВО «Нижегородская государственная медицинская академия» Минздрава России. 603005, Россия, Нижний Новгород, пл. Минина и Пожарского, д. 10/1
*nemirova.info@gmail.com
1 Nizhny Novgorod Regional Clinical Psychiatric Hospital №1. 603126, Russian Federation, Nizhny Novgorod, ul. Rodionova, d. 190;
2 Nizhny Novgorod State Medical Academy of the Ministry of Health of the Russian Federation. 603005, Russian Federation, Nizhny Novgorod, pl. Minina i Pozharskogo, d. 10/1
*nemirova.info@gmail.com
1 ГБУЗ НО «Нижегородская областная клиническая больница им. Н.А.Семашко». 603126, Россия, Нижний Новгород, ул. Родионова, д. 190;
2 ФГБОУ ВО «Нижегородская государственная медицинская академия» Минздрава России. 603005, Россия, Нижний Новгород, пл. Минина и Пожарского, д. 10/1
*nemirova.info@gmail.com
________________________________________________
1 Nizhny Novgorod Regional Clinical Psychiatric Hospital №1. 603126, Russian Federation, Nizhny Novgorod, ul. Rodionova, d. 190;
2 Nizhny Novgorod State Medical Academy of the Ministry of Health of the Russian Federation. 603005, Russian Federation, Nizhny Novgorod, pl. Minina i Pozharskogo, d. 10/1
*nemirova.info@gmail.com
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