细胞因子在糖尿病黄斑水肿发病机制中的作用

The Role of Cytokines in the Pathogenesis of Diabetic Macular Edema

摘要: 糖尿病性黄斑水肿(Diabetic Macular Edema, DME)是糖尿病患者视力丧失的最常见原因，其产生机制复杂，主要是血–视网膜屏障被破坏，导致血管通透性增高所致。近年来，人们尝试通过各种方法治疗DME，包括激光光凝、类固醇曲安奈德和玻璃体切除术等多种治疗方式。然而，治疗效果并不理想，直到研究发现血管内皮生长因子(VEGF)在DME发病过程中的重要作用，DME的治疗有了里程碑式的进展。眼内抗VEGF药物在DME中疗效良好，使许多DME患者的视力得到提升。然而临床医生在工作中逐渐发现，部分患者对抗VEGF药物低应答甚至不应答，这表明可能有其他因素参与。现有研究显示，DME发病与炎症反应有关。本文对DME的发病机制中VEGF因子、炎症因子等细胞因子的作用进行概述，并描述了与细胞因子相关的新型药物。

Abstract: Diabetes macular edema (DME) is the most common cause of vision loss in diabetes patients. Its mechanism is complex, mainly due to the destruction of the blood retinal barrier, leading to in-creased vascular permeability. For many years, people have tried to treat DME by various methods, including laser photocoagulation, steroid triamcinolone acetonide and vitrectomy. However, the treatment effect was not ideal until the study found that vascular endothelial growth factor (VEGF) played an important role in the pathogenesis of DME, and the treatment of DME made a landmark progress. Intraocular anti-VEGF drugs have been shown to be effective in DME and have improved vision in many DME patients. Nevertheless, clinicians gradually find that some patients have low or no response to anti-VEGF drugs in their work, which indicates that other factors may be involved. Current research shows that inflammatory reaction plays an important role in the occurrence of DME. This article summarizes the role of cytokines such as VEGF and inflammatory factors in the pathogenesis of DME, and describes new drugs related to cytokines.