The protective role of GLP-1 in neuro-ophthalmology.

Exploration of drug science Pub Date : 2023-01-01 Epub Date: 2023-08-28 DOI:10.37349/eds.2023.00015
Sohum Sheth, Aashay Patel, Marco Foreman, Mohammed Mumtaz, Akshay Reddy, Ramy Sharaf, Siddharth Sheth, Brandon Lucke-Wold
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Abstract

Despite recent advancements in the field of neuro-ophthalmology, the rising rates of neurological and ophthalmological conditions, mismatches between supply and demand of clinicians, and an aging population underscore the urgent need to explore new therapeutic approaches within the field. Glucagon-like peptide 1 receptor agonists (GLP-1RAs), traditionally used in the treatment of type 2 diabetes, are becoming increasingly appreciated for their diverse applications. Recently, GLP-1RAs have been approved for the treatment of obesity and recognized for their cardioprotective effects. Emerging evidence indicates some GLP-1RAs can cross the blood-brain barrier and may have neuroprotective effects. Therefore, this article aims to review the literature on the neurologic and neuro-ophthalmic role of glucagon-like peptide 1 (GLP-1). This article describes GLP-1 peptide characteristics and the mechanisms mediating its known role in increasing insulin, decreasing glucagon, delaying gastric emptying, and promoting satiety. This article identifies the sources and targets of GLP-1 in the brain and review the mechanisms which mediate its neuroprotective effects, as well as implications for Alzheimer's disease (AD) and Parkinson's disease (PD). Furthermore, the preclinical works which unravel the effects of GLP-1 in ocular dynamics and the preclinical literature regarding GLP-1RA use in the management of several neuro-ophthalmic conditions, including diabetic retinopathy (DR), glaucoma, and idiopathic intracranial hypertension (IIH) are discussed.

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GLP-1 在神经眼科中的保护作用。
尽管神经眼科领域近年来取得了长足的进步,但神经和眼科疾病的发病率不断上升、临床医生供需不匹配以及人口老龄化等问题都凸显了在该领域探索新治疗方法的迫切性。传统上用于治疗 2 型糖尿病的胰高血糖素样肽 1 受体激动剂(GLP-1RAs)因其用途广泛而日益受到重视。最近,GLP-1RAs 已被批准用于治疗肥胖症,其保护心脏的作用也得到了认可。新的证据表明,一些 GLP-1RAs 可以穿过血脑屏障,并可能具有神经保护作用。因此,本文旨在回顾有关胰高血糖素样肽 1(GLP-1)在神经和神经眼科方面作用的文献。本文介绍了 GLP-1 肽的特点及其在增加胰岛素、降低胰高血糖素、延迟胃排空和促进饱腹感方面的已知作用机制。本文确定了 GLP-1 在大脑中的来源和靶点,回顾了介导其神经保护作用的机制,以及对阿尔茨海默病(AD)和帕金森病(PD)的影响。此外,文章还讨论了揭示 GLP-1 对眼部动力学影响的临床前研究,以及有关 GLP-1RA 用于治疗糖尿病视网膜病变 (DR)、青光眼和特发性颅内高压 (IIH) 等几种神经眼科疾病的临床前文献。
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