Title:Combinational Approaches Targeting Neurodegeneration, Oxidative Stress, and Inflammation in the Treatment of Diabetic Retinopathy
Volume: 22
Issue: 16
Author(s): Siddhi Dilip Chalke and Pravin Popatrao Kale*
Affiliation:
- Department of Pharmacology, SVKM’S Dr. Bhanuben Nanavati College of Pharmacy, Mumbai-400 056,India
Keywords:
Diabetic retinopathy, neurodegeneration, oxidative stress, inflammation, citicoline, duloxetine, angiopoietin-2 inhibitors.
Abstract: Diabetic Retinopathy (DR) is one of the most severe ocular problems of diabetes. It is a
microvascular complication that impairs the vision of diabetic individuals and can cause acquired
blindness. Currently, available treatment options like laser therapy, vitrectomy, intravitreal anti-vascular
endothelial growth factor (VEGF) agents, and glucocorticoids help to reduce vision loss at advanced
stages. In spite of the available therapies, patients with severe vision loss face difficulty in
achieving the normal vision. There is a need for the development of newer treatment strategies to
address the condition from the early stages. Multiple factors owing to complex pathophysiological
events are responsible for this long-term complication. Neurodegeneration, inflammation, and
oxidative stress are the three important factors associated with the development of DR. Oxidative
stress is a major contributor to the onset and progression of DR. Pathological events like retinal
neurodegeneration and inflammation damage the retina in the early stages of DR. Different combinations
of treatments targeting these pathological events are discussed in the present review. The
first combination discussed is citicoline and resveratrol and the second combination is duloxetine
and N-acetyl cysteine (NAC). These combinations may help in the early stages of DR. CD5-2, and
angiopoietin-2 inhibitors is the third combination and this combination may help to manage diabetic
macular edema. The main purpose of this article is to discuss the link between these pathologies
and the three combinational approaches with the objective of considerating newer therapeutic approaches
in research related to DR treatment.
