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Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Sep 15, 2021; 12(9): 1442-1462
Published online Sep 15, 2021. doi: 10.4239/wjd.v12.i9.1442
Cellular targets in diabetic retinopathy therapy
María Lucía Rodríguez, Iván Millán, Ángel Luis Ortega
María Lucía Rodríguez, Ángel Luis Ortega, Department of Physiology, Faculty of Pharmacy, University of Valencia, Burjassot 46100, Valencia, Spain
Iván Millán, Neonatal Research Group, Health Research Institute La Fe, Valencia 46026, Valencia, Spain
Author contributions: Ortega AL was responsible for the conceptualization and edition of the manuscript; Rodríguez ML, Millán I and Ortega AL contributed to the literature review, writing and revision of the manuscript; All authors approved the final version.
Conflict-of-interest statement: The authors declare that they have no conflicting interests.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ángel Luis Ortega, PhD, Associate Professor, Department of Physiology, Faculty of Pharmacy, University of Valencia, Av. Vicente Andrés Estellés, s/n, Burjassot 46100, Valencia, Spain. angel.ortega@uv.es
Received: February 26, 2021
Peer-review started: February 26, 2021
First decision: April 20, 2021
Revised: May 8, 2021
Accepted: August 3, 2021
Article in press: August 3, 2021
Published online: September 15, 2021
Processing time: 192 Days and 21.1 Hours
Abstract

Despite the existence of treatment for diabetes, inadequate metabolic control triggers the appearance of chronic complications such as diabetic retinopathy. Diabetic retinopathy is considered a multifactorial disease of complex etiology in which oxidative stress and low chronic inflammation play essential roles. Chronic exposure to hyperglycemia triggers a loss of redox balance that is critical for the appearance of neuronal and vascular damage during the development and progression of the disease. Current therapies for the treatment of diabetic retinopathy are used in advanced stages of the disease and are unable to reverse the retinal damage induced by hyperglycemia. The lack of effective therapies without side effects means there is an urgent need to identify an early action capable of preventing the development of the disease and its pathophysiological consequences in order to avoid loss of vision associated with diabetic retinopathy. Therefore, in this review we propose different therapeutic targets related to the modulation of the redox and inflammatory status that, potentially, can prevent the development and progression of the disease.

Keywords: Diabetic retinopathy; Oxidative stress; Inflammation; Cellular target; Diabetic macular edema

Core Tip: The identification of potential therapeutic targets related to oxidative stress and low chronic inflammation induced in diabetic retinopathy (DR) may be crucial in developing therapeutic approaches for preventing the development of DR. Hence, we focus on the antioxidant role of nuclear factor erythroid 2-related factor 2, low and chronic inflammatory conditions developed in DR, modulation of lipid peroxidation, activation of glucagon-like peptide-1 receptor, the classical biochemical pathways altered under hyperglycemia, and epigenetic alterations.