老年性黄斑变性中异常的脂质代谢和补体激活。

IF 5 2区 医学 Q1 OPHTHALMOLOGY Investigative ophthalmology & visual science Pub Date : 2024-10-01 DOI:10.1167/iovs.65.12.20
Siao Tang, Jiaqi Yang, Bingqing Xiao, Yani Wang, Yiou Lei, Dongwei Lai, Qinghua Qiu
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引用次数: 0

摘要

老年性黄斑变性(AMD)是导致全球老年人视力严重受损和失明的主要原因。作为一种多因素疾病,AMD 的发病机制受遗传、环境和年龄相关因素的影响,其中脂质代谢异常和补体系统失调起着关键作用。本综述深入探讨了在理解这两种关键途径之间错综复杂的相互作用方面取得的最新进展,重点介绍了它们通过慢性炎症、色素沉着的形成和视网膜色素上皮细胞功能障碍对疾病进展所起的作用。重要的是,新出现的证据表明,脂质状况失调,尤其是高密度脂蛋白水平的改变、氧化脂质沉积和细胞内脂褐质的积累,是加剧补体激活的因素,并随后扩大了 AMD 的组织损伤。此外,遗传学研究揭示了老年性黄斑变性与脂质转运和补体调节相关的特定基因之间的重要关联,从而揭示了疾病的易感性和潜在机制。本综述进一步探讨了这些发现的临床意义,主张采用一种新的治疗方法,将脂质代谢调节剂与补体抑制剂结合起来。通过同时靶向这些途径,双靶向方法有望显著改善 AMD 患者的预后,预示着 AMD 管理和治疗的新前景。
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Aberrant Lipid Metabolism and Complement Activation in Age-Related Macular Degeneration.

Age-related macular degeneration (AMD) stands as a leading cause of severe visual impairment and blindness among the elderly globally. As a multifactorial disease, AMD's pathogenesis is influenced by genetic, environmental, and age-related factors, with lipid metabolism abnormalities and complement system dysregulation playing critical roles. This review delves into recent advancements in understanding the intricate interaction between these two crucial pathways, highlighting their contribution to the disease's progression through chronic inflammation, drusen formation, and retinal pigment epithelium dysfunction. Importantly, emerging evidence points to dysregulated lipid profiles, particularly alterations in high-density lipoprotein levels, oxidized lipid deposits, and intracellular lipofuscin accumulation, as exacerbating factors that enhance complement activation and subsequently amplify tissue damage in AMD. Furthermore, genetic studies have revealed significant associations between AMD and specific genes involved in lipid transport and complement regulation, shedding light on disease susceptibility and underlying mechanisms. The review further explores the clinical implications of these findings, advocating for a novel therapeutic approach that integrates lipid metabolism modulators with complement inhibitors. By concurrently targeting these pathways, the dual-targeted approach holds promise in significantly improving outcomes for AMD patients, heralding a new horizon in AMD management and treatment.

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来源期刊
CiteScore
6.90
自引率
4.50%
发文量
339
审稿时长
1 months
期刊介绍: Investigative Ophthalmology & Visual Science (IOVS), published as ready online, is a peer-reviewed academic journal of the Association for Research in Vision and Ophthalmology (ARVO). IOVS features original research, mostly pertaining to clinical and laboratory ophthalmology and vision research in general.
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