ophthalmologyОфтальмологияOphthalmology in Russia1816-50952500-0845Ophthalmology10.18008/1816-5095-2022-3-557-564ophthalmology-1922Research ArticleКЛИНИЧЕСКИЕ И ЭКСПЕРИМЕНТАЛЬНЫЕ ИССЛЕДОВАНИЯCLINICAL & EXPERIMENTAL RESEARCHМаркеры пролиферативной диабетической ретинопатииMarkers of Proliferative Diabetic Retinopathyhttps://orcid.org/0000-0002-5636-2380БилецкаяВ. А.BiletskayaV. A.

аспирант,

ул. Миклухо-Маклая, 6, Москва, 117198

postgraduate,

Miklukho-Maklaya str., 6, Moscow, 117198

dr.biletskaya@mail.ruhttps://orcid.org/0000-0002-2998-3392ЛипатовД. В.LipatovD. V.

доктор медицинских наук, ул. Миклухо-Маклая, 6, Москва, 117198;

профессор, ул. Дмитрия Ульянова, 11, Москва, 117036

MD, Professor,

Miklukho-Maklaya str., 6, Moscow, 117198;

Dm. Ulyanova str., 11, Moscow, 117036

https://orcid.org/0000-0003-4557-7447СаяпинаИ. Ю.SayapinaI. Yu.

доктор медицинских наук, профессор,

ул. Горького, 95, Благовещенск, 675006

MD, Professor,

Gorky str., 95, Blagoveshchensk, 675006

https://orcid.org/0000-0002-9833-6236ФроловМ. А.FrolovM. A.

доктор медицинских наук, профессор,

ул. Миклухо-Маклая, 6, Москва, 117198

MD, Professor,

Miklukho-Maklaya str., 6, Moscow, 117198

https://orcid.org/0000-0003-2828-874XСургучВ. К.SurguchV. K.

кандидат медицинских наук, врач-офтальмолог,

ул. Дмитрия Ульянова, 11, Москва, 117036

PhD, ophthalmologist,

Dm. Ulyanova str., 11, Moscow, 117036

ФГАОУ ВО «Российский университет дружбы народов»РоссияRUDN UniversityRussian FederationФГАОУ ВО «Российский университет дружбы народов»; ФГБУ «Национальный медицинский исследовательский центр эндокринологии» Министерства здравоохранения Российской ФедерацииРоссияRUDN University; National Medical Research Center for EndocrinologyRussian FederationФГБОУ ВО «Амурская государственная медицинская академия» Министерства здравоохранения Российской ФедерацииРоссияAmur State Medical AcademyRussian FederationФГБУ «Национальный медицинский исследовательский центр эндокринологии» Министерства здравоохранения Российской ФедерацииРоссияNational Medical Research Center for EndocrinologyRussian Federation202206102022193557564Copyright © Билецкая В.А., Липатов Д.В., Саяпина И.Ю., Фролов М.А., Сургуч В.К., 20222022Билецкая В.А., Липатов Д.В., Саяпина И.Ю., Фролов М.А., Сургуч В.К.Biletskaya V.A., Lipatov D.V., Sayapina I.Y., Frolov M.A., Surguch V.K.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.ophthalmojournal.com/opht/article/view/1922

Заболеваемость сахарным диабетом (СД) неуклонно растет, и в настоящее время Всемирная организация здравоохранения (ВОЗ) характеризует эту ситуацию как эпидемию. Диабетическая ретинопатия (ДР) — одно из частых осложнений СД, а также одна из основных причин приобретенной необратимой потери зрения. Патогенез пролиферативной ДР на данный момент остается до конца не изученным, однако многие авторы задумываются о важной роли биологически значимых медиаторов этого процесса — цитокинов и факторов роста. Цитокины и факторы роста — белковые медиаторы, которые регулируют различные функции, как локально, так и системно. Они осуществляют жизненный цикл клеток, процесс пролиферации, участвуют в регуляции защитной воспалительной реакции организма, контролируют ангиогенез и другие механизмы. Доказано, что основными звеньями патогенеза ДР являются окислительный стресс, утолщение эндотелиальной базальной мембраны в капиллярах, потеря перицитов, конечные продукты гликирования и воспаление. В формировании новообразованных сосудов основную роль играет хориоретинальная гипоксия и ишемия. Новообразованные сосуды являются неполноценными (с тонкой стенкой, лишенной перицитов), их наличие часто приводит к геморрагиям, гипоксии, что, в свою очередь, замыкает патологический круг и вызывает выработку цитокинов и вазопролиферативных факторов. Частыми осложнениями ДР являются внутриглазные кровоизлияния, фиброз сетчатки и патологическое изменение задней гиалоидной мембраны, тракционная отслойка сетчатки и др. В представленном обзоре рассмотрены некоторые виды цитокинов и факторы роста и их роль в свете патогенеза пролиферативной ДР. Современные технологии позволяют проводить эффективные исследования интраокулярных жидкостей, исследовать содержимое биологически активных веществ как во влаге передней камеры глаза, так и в стекловидном теле. Для сужения круга обзора по затрагиваемой теме внимание сосредоточено на работах, в которых рассматривались различные локальные маркеры во внутриглазных жидкостях у пациентов с СД. Стоит отметить, что таких исследований немного, а результаты их зачастую существенно отличаются между собой. Этот факт является предметом для обсуждения и побуждает к дальнейшему изучению этой темы. 

The incidence of diabetes mellitus (DM) is steadily growing and today the World Health Organization (WHO) describes this situation as an epidemic. Diabetic retinopathy (DR) is one of the most common complications of DM, as well as one of the main causes of acquired irreversible vision loss. Nowadays the pathogenesis of proliferative DR remains completely unexplored, but many authors think about the important role of biologically significant mediators of this process cytokines and growth factors. Cytokines and growth factors are protein mediators that regulate various functions, both locally and systemically. They carry out the cells’ life cycle, the processes of proliferation, participate in the regulation of the protective inflammatory response of the body, control angiogenesis and other mechanisms. It is proved that the main links in the pathogenesis of DR are oxidative stress, thickening of the endothelial basement membrane in capillaries, loss of pericytes, end products of glycation and inflammation. Chorioretinal hypoxia and ischemia play a major role in the formation of newly formed vessels. Newly formed vessels are defective (with a thin wall devoid of pericytes), often lead to hemorrhages, hypoxia, which in turn closes the pathological circle and causes the production of cytokines and vasoproliferative factors. Frequent complications of DR are intraocular hemorrhages, retinal fibrosis and pathological changes in the posterior hyaloid membrane, traction retinal detachment, etc. This review examines some types of cytokines and growth factors and their role in the light in the pathogenesis of proliferative DR. Modern technologies make it possible to conduct effective studies of intraocular fluids to study the content of biologically active substances both in the moisture of the anterior chamber of the eye and in the vitreous body. To narrow the scope of the review on the subject attention is focused on the works that examined various markers locally in the intraocular fluids in patients with DM. It is worth noting that there are few such studies and their results often differ significantly from each other. This fact is a subject for discussion and encourages further study of this topic. 

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The authors declare that there are no conflicts of interest present.