Modulation of Diabetic Retinopathy Pathophysiology by Natural Medicines Through PPAR-γ-related Pharmacology

Overview

Journal Br J Pharmacol

Publisher Wiley

Specialty Pharmacology

Date 2011 Apr 13

PMID 21480863

Citations 23

Authors

Min K Song

Basil D Roufogalis

Tom H W Huang

Affiliations

Soon will be listed here.

Abstract

Diabetic retinopathy (DR) is one of the most common microvascular complications of diabetes and remains a major cause of preventable blindness among adults at working age. DR involves an abnormal pathology of major retinal cells, including retinal pigment epithelium, microaneurysms, inter-retinal oedema, haemorrhage, exudates (hard exudates) and intraocular neovascularization. The biochemical mechanisms associated with hyperglycaemic-induced DR are through multifactorial processes. Peroxisome proliferator-activated receptor-γ (PPAR-γ) plays an important role in the pathogenesis of DR by inhibiting diabetes-induced retinal leukostasis and leakage. Despite DR causing eventual blindness, only a few visual or ophthalmic symptoms are observed until visual loss develops. Therefore, early medical interventions and prevention are the current management strategies. Laser photocoagulation therapy is the most common treatment. However, this therapy may cause retinal damage and scarring. Herbal and traditional natural medicines may provide an alternative to prevent or delay the progression of DR. This review provides an analysis of the therapeutic potential of herbal and traditional natural medicines or their active components for the slowdown of progression of DR and their possible mechanism through the PPAR-γ pathway.

Citing Articles

Natural remedies proposed for the management of diabetic retinopathy (DR): diabetic complications.

Khidr E, Morad N, Hatem S, El-Dessouki A, Mohamed A, El-Shiekh R Naunyn Schmiedebergs Arch Pharmacol. 2025; .

PMID: 39954069 DOI: 10.1007/s00210-025-03866-w.

Diosgenin, a Natural Steroidal Sapogenin, Alleviates the Progression of Diabetic Retinopathy in Diabetic Mice.

Liao W, Huang C, Wang H, Lei Y, Lin H, Huang Y In Vivo. 2023; 37(2):661-666.

PMID: 36881067 PMC: 10026653. DOI: 10.21873/invivo.13126.

Inhibition of Aldose Reductase by Novel Phytocompounds: A Heuristic Approach to Treating Diabetic Retinopathy.

Julius A, Renuka R, Hopper W, Babu Raghu P, Rajendran S, Srinivasan S Evid Based Complement Alternat Med. 2022; 2022:9624118.

PMID: 35356240 PMC: 8959960. DOI: 10.1155/2022/9624118.

Exploring the Pharmacological Mechanism of Liuwei Dihuang Decoction for Diabetic Retinopathy: A Systematic Biological Strategy-Based Research.

Yuan M, He Q, Long Z, Zhu X, Xiang W, Wu Y Evid Based Complement Alternat Med. 2021; 2021:5544518.

PMID: 34394383 PMC: 8356007. DOI: 10.1155/2021/5544518.

Association between gene polymorphisms and diabetic retinopathy risk: a meta-analysis.

Li X, Jiang G, Cheng S, Song Y, Deng C, Niu Y Aging (Albany NY). 2021; 13(4):5136-5149.

PMID: 33535175 PMC: 7950267. DOI: 10.18632/aging.202433.

References

Gerry J, Pascual G . Narrowing in on cardiovascular disease: the atheroprotective role of peroxisome proliferator-activated receptor gamma. Trends Cardiovasc Med. 2008; 18(2):39-44. DOI: 10.1016/j.tcm.2007.12.001. View

Williams R, Airey M, Baxter H, Forrester J, Kennedy-Martin T, Girach A . Epidemiology of diabetic retinopathy and macular oedema: a systematic review. Eye (Lond). 2004; 18(10):963-83. DOI: 10.1038/sj.eye.6701476. View

Shen L, Child A, Weber G, Folkman J, Aiello L . Rosiglitazone and delayed onset of proliferative diabetic retinopathy. Arch Ophthalmol. 2008; 126(6):793-9. DOI: 10.1001/archopht.126.6.793. View

Asgary S, Naderi G, Zadegan N, Vakili R . The inhibitory effects of pure flavonoids on in vitro protein glycosylation. J Herb Pharmacother. 2004; 2(2):47-55. View

Kimoto K, Nakatsuka K, Matsuo N, Yoshioka H . p38 MAPK mediates the expression of type I collagen induced by TGF-beta 2 in human retinal pigment epithelial cells ARPE-19. Invest Ophthalmol Vis Sci. 2004; 45(7):2431-7. DOI: 10.1167/iovs.03-1276. View

Hammes H, Strodter D, Weiss A, Bretzel R, Federlin K, Brownlee M . Secondary intervention with aminoguanidine retards the progression of diabetic retinopathy in the rat model. Diabetologia. 1995; 38(6):656-60. DOI: 10.1007/BF00401835. View

Wong A, Gasic-Milenkovic J, Schinzel R, Wiesinger H, Riederer P, Munch G . Anti-inflammatory antioxidants attenuate the expression of inducible nitric oxide synthase mediated by advanced glycation endproducts in murine microglia. Eur J Neurosci. 2002; 14(12):1961-7. DOI: 10.1046/j.0953-816x.2001.01820.x. View

Ren Y, Sun C, Sun Y, Tan H, Wu Y, Cui B . PPAR gamma protects cardiomyocytes against oxidative stress and apoptosis via Bcl-2 upregulation. Vascul Pharmacol. 2009; 51(2-3):169-74. DOI: 10.1016/j.vph.2009.06.004. View

Reilly C, Oates J, Sudian J, Crosby M, Halushka P, Gilkeson G . Prostaglandin J(2) inhibition of mesangial cell iNOS expression. Clin Immunol. 2001; 98(3):337-45. DOI: 10.1006/clim.2000.4985. View

10.

Baker M, Chen X, Cao X, Kaufman D . Expression of a dominant negative inhibitor of NF-kappaB protects MIN6 beta-cells from cytokine-induced apoptosis. J Surg Res. 2001; 97(2):117-22. DOI: 10.1006/jsre.2001.6121. View

11.

Siebenlist U, Franzoso G, Brown K . Structure, regulation and function of NF-kappa B. Annu Rev Cell Biol. 1994; 10:405-55. DOI: 10.1146/annurev.cb.10.110194.002201. View

12.

ELVIN-LEWIS M . Should we be concerned about herbal remedies. J Ethnopharmacol. 2001; 75(2-3):141-64. DOI: 10.1016/s0378-8741(00)00394-9. View

13.

Fong D, Aiello L, Ferris 3rd F, Klein R . Diabetic retinopathy. Diabetes Care. 2004; 27(10):2540-53. DOI: 10.2337/diacare.27.10.2540. View

14.

Baeuerle P, Henkel T . Function and activation of NF-kappa B in the immune system. Annu Rev Immunol. 1994; 12:141-79. DOI: 10.1146/annurev.iy.12.040194.001041. View

15.

Kim E, Kwon K, Koo B, Han M, Song M, Song E . Activation of peroxisome proliferator-activated receptor-gamma protects pancreatic beta-cells from cytokine-induced cytotoxicity via NF kappaB pathway. Int J Biochem Cell Biol. 2007; 39(6):1260-75. DOI: 10.1016/j.biocel.2007.04.005. View

16.

Kamei A, Hisada T, Iwata S . The evaluation of therapeutic efficacy of hachimi-jio-gan (traditional Chinese medicine) to rat galactosemic cataract. J Ocul Pharmacol. 1987; 3(3):239-48. DOI: 10.1089/jop.1987.3.239. View

17.

Rosen E, Spiegelman B . PPARgamma : a nuclear regulator of metabolism, differentiation, and cell growth. J Biol Chem. 2001; 276(41):37731-4. DOI: 10.1074/jbc.R100034200. View

18.

Joussen A, Poulaki V, Mitsiades N, Kirchhof B, Koizumi K, Dohmen S . Nonsteroidal anti-inflammatory drugs prevent early diabetic retinopathy via TNF-alpha suppression. FASEB J. 2002; 16(3):438-40. DOI: 10.1096/fj.01-0707fje. View

19.

Sharma K, Bhatia R, Kumar V . Role of the indigenous drug saptamrita lauha in hemorrhagic retinopathies. Ann Ophthalmol. 1992; 24(1):5-8. View

20.

Wang Y, Zhao H, Sheng X, Gambino P, Costello B, Bojanowski K . Protective effect of Fructus Lycii polysaccharides against time and hyperthermia-induced damage in cultured seminiferous epithelium. J Ethnopharmacol. 2002; 82(2-3):169-75. DOI: 10.1016/s0378-8741(02)00169-1. View