Factors angiogènics en la retinopatia diabètica proliferativa

Authors

  • Marta Garcia-Ramírez
  • Cristina Hernández
  • Esther Carrasco
  • Rafael Simó Canonge

Abstract

Diabetic retinopathy is the leading cause of legal blindness among working-aged individuals. Neuroretinal damage, thickening of the capillary basement membrane and a loss of pericytes and endothelial cells are among the earliest histological features. Neovascularization, the hallmark of proliferative diabetic retinopathy (PDR), occurs in the advanced stages and is the main cause of blindness in type 1 diabetes. Macular edema is another retinal complication of diabetes that is responsible for a major part of vision loss, particularly in type 2 diabetes. Vascular leakage, as a consequence of a breakdown in the blood retinal barrier, is the main event involved in its pathogenesis. Apart from controlling blood glucose and blood pressure, laser photocoagulation treatment is the only tool in the current armamentarium against diabetic retinopathy progression. Therefore, new pharmacological treatments, based on an understanding of the patho-physiological mechanisms of diabetic retinopathy, have been developed in recent years. There is mounting evidence to suggest that angiogenic factors play a crucial role in PDR development, with vascular endothelial growth factor (VEGF) being the most relevant. Other growth factors or cytokines, such as insulin-like growth factor I (IGF-1), hepatocyte growth factor (HGF), basic fibroblast growth factor (b-FGF), platelet derived growth factor (PDGF), pro-inflammatory cytokines and angiopoietins, are also involved in the pathogenesis of PDR.

Published

2007-12-28