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Target Concepts:
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Query: UMLS:C0086543 (
cataract
)
29,165
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
With regard to diabetic retinopathy, in addition to the demonstration by the DCCT study that prevention is achieved by good metabolic control, our present knowledge on physiopathology leads us to imagine three types of possible therapeutic approach; inhibition of glucotoxicity, improvement of capillary flow, blockade of angiogenesis. 1) Inhibition of glucotoxicity Aldose reductase inhibitors can prevent
cataract
in diabetic or galactosemic rats. The effect of these drugs on retinopathy, evaluated in some clinical trials, remains controversial, suggesting a minor role. Aminoguanidine is an inhibitor of formation of advanced glycosylation end-products (AGE). This compound has been tested on a model of experimental retinopathy in rats. Parallel to the AGE decrease in retina, formation of microaneurysms and loss of endothelial cells in capillaries were delayed. Clinical tolerance allows human application and randomised trials will give further information on this potentially efficient drug. 2) Improvement of capillary flow This objective can be obtained by drugs inhibiting platelet aggregation or improving erythrocyte or leucocyte deformability. Clinical trials using such compounds were not very conclusive. 3) Blockade of angiogenesis Proliferation of new vessels is a rather severe stage of diabetic retinopathy. Angiogenesis is due to factors locally produced (as FGF, TGF and u-PA produced by anoxic tissues), systemic (IGF-1) or released by inflammatory reaction (IL1, TNF alpha and beta). One imagines usage of drugs which inhibit these factors and prevent angiogenesis. At the present time, two approaches have been used in proliferative retinopathy worsening despite panphotocoagulation; analogues of
somatostatin
and interferon alpha. The promissing results of these pilot studies have to be confirmed.(ABSTRACT TRUNCATED AT 250 WORDS)
...
PMID:[Outlook for the future in the treatment of diabetic retinopathy]. 752 51
Chronic overproduction of growth hormone and insulin-like growth factor 1 play an important role in the pathogenesis of diabetic retinopathy.
Somatostatin
receptors are the targets of
somatostatin
analogues such as octreotide in the treatment of diabetic retinopathy. Octreotide has shown promise as a safe and effective treatment for advanced diabetic retinopathy and diabetic macular edema. One important pathomechanism in the development of diabetic complications is the activation of protein kinase C induced by high glucose due to an increased diacylglycerol level. The development of a selective PKCss inhibitor enables a new therapeutic approach for the treatment of diabetic retinopathy. Ongoing prospective clinical studies are investigating if treatment with specific PKCss inhibitors can prevent the progression of diabetic retinopathy and diabetic macular edema. The intravitreal injection of triamcinolone acetonide leads to at least temporary improvement of the diffuse diabetic macular edema. Side effects are increase of intraocular pressure,
cataract
, and endophthalmitis.
...
PMID:[Pharmacological treatment of diabetic retinopathy]. 1559 46
Worldwide, ocular cataracts are a major cause of human blindness. A key goal of
cataract
-related research is to identify simple, cost-efficient but effective ways to prevent
cataract
formation or progression. Genistein is a naturally occurring dietary isoflavone with well-documented estrogenic, antioxidant, and protein tyrosine kinase inhibitor activity, which in turn modulates the activity of several enzymes involved in cell signaling and proliferation. Furthermore, many isoflavones have been shown to be potent inhibitors of aldose reductase, which is an important rate-limiting enzyme in the process of
cataract
induction in the metabolic disease galactosemia. In order to assess the potential for genistein to mitigate
cataract
formation, we have studied its effects in the animal model of dietary galactose-induced cataracts in adult male rats. Our experimental hypothesis was that dietary genistein would prevent or delay the progression of cataracts induced by high dietary intake of galactose. Our results show that the isoflavone genistein was not able to completely prevent galactose-induced
cataract
formation, but genistein did delay the progression of cataracts induced by dietary galactose. In addition, we found that dietary galactose decreased concentrations of serum
somatostatin
, while adding genistein decreased the serum glucose level but increased the serum testosterone level. As an initial inquiry into the mechanisms by which the partial protective effect of genistein could be mediated, we found that genistein increased the expression of connexin (Cx) 43 in the lens but did not affect the expression of soluble guanylyl cyclase (sGC) subunits. This finding suggests that the partial protective effect of genistein on
cataract
induction appears to be unrelated to sGC but may be mediated by enhanced expression of Cx43 and changed metabolic state.
...
PMID:Effect of the isoflavone genistein against galactose-induced cataracts in rats. 1720 92