ophthalmologyОфтальмологияOphthalmology in Russia1816-50952500-0845Ophthalmology10.18008/1816-5095-2023-3-384-389ophthalmology-2161Research ArticleОБЗОРЫREVIEWSСовременные представления о молекулярных механизмах возрастных изменений хрусталикаCurrent Concepts of Molecular Mechanisms of Age-Related Changes in Eye LensКиселеваТ. Н.KiselevaT. N.

Киселева Татьяна Николаевна, доктор медицинских наук, профессор, начальник отдела ультразвуковых исследований

ул. Садовая-Черногрязская, 14/19, Москва 105062

Kiseleva Tatiana N., MD, Professor, head of Ultrasound diagnostic department

Sadovaya-Chernogryazskaya str., 14/19, Moscow, 105062

ЗайцевМ. С.ZaitsevM. S.

Зайцев Максим Сергеевич, кандидат медицинских наук, научный сотрудник

ул. Садовая-Черногрязская, 14/19, Москва 105062

Maksim S. Zaitsev, PhD, research officer

Sadovaya-Chernogryazskaya str., 14/19, Moscow, 105062

ФГБУ «Научно-исследовательский центр глазных болезней им. Гельмгольца»РоссияHelmholtz National Medical Research Center of Eye DiseasesRussian Federation202329092023203384389Copyright © Киселева Т.Н., Зайцев М.С., 20232023Киселева Т.Н., Зайцев М.С.Kiseleva T.N., Zaitsev M.S.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/2161

Возрастная катаракта — одна из частых причин снижения и потери зрения у пожилых лиц в мире, которая по данным ВОЗ составляет 47,8 % от общего числа заболеваний глаз у лиц старше 50 лет. Несмотря на появление новых технологий хирургии катаракты, оперативное лечение является непростой задачей из-за его стоимости и растущего числа пациентов. Обзор литературы посвящен современным представлениям о патогенезе и молекулярных механизмах возникновения возрастной катаракты. Рассматриваются три основные теории катарактогенеза: окислительный стресс, воздействие хиноидных соединений, образующихся в результате нарушения метаболизма ароматических аминокислот, и активация фермента альдоредуктазы с последующим накоплением сорбитола, образованием активных форм кислорода (АФК), дисфункцией натрий-калиевого (Na+/K+) насоса и нарушением кальциевого баланса, что приводит к гибели эпителиальных клеток хрусталика. Теории патогенеза возрастной катаракты связаны между собой и базируются на явлении возрастных изменений метаболизма белков (большинство ядерных α-кристаллинов нерастворимы), глюкозы (неферментативное гликозилирование белков), липидного обмена, активности ферментов и потери мембранного потенциала клеток (увеличение содержания в клетке Na+ и Ca2+ и уменьшение уровня К+). Образование высокомолекулярных белковых комплексов, ковалентно связанных дисульфидными связями, — ключевое звено всех представленных теорий возникновения возрастных изменений хрусталика. На основе знаний о молекулярных механизмах катарактогенеза ведется поиск и разработка патогенетически ориентированных медикаментозных способов коррекции возрастных изменений хрусталика. В обзоре представлены основные результаты экспериментальных и клинических исследований, демонстрирующих выраженное антикаратактальное влияние раствора Пиреноксина 0,005 %.

Age-related cataract is the leading cause of vision loss in old people worldwide. According to the World Health Organization it accounts for 47.8 % of the total number of ocular pathologies in people over 50 years old. Despite the rapid development of cataract surgery technology, surgery remains a challenge due to its cost and the increasing number of patients. Literature review is devoted to current concepts of pathogenesis and molecular mechanisms of age-related changes in eye lens. There are the three main theories of cataractogenesis: oxidative stress; the impact of quinoid substances, which are formed due to the impairment of aromatic amino acid metabolism and the activation of aldo reductase enzyme with subsequent accumulation of sorbitol, reactive oxygen species (ROS) generation, dysfunction of Na+/K+ channels and calcium deregulation causing lens epithelial cells apoptosis. Theories of pathogenesis are linked and based on the development of age-related changes in protein metabolism (the majority of nuclear α-crystallins are insoluble), glucose metabolism (non-enzymatic glycosylation of proteins), lipid metabolism, enzyme activity and the loss of membrane potential of cells ( the increase of Na+ and Ca2+ level and the decrease of K+ level). Key element of all theories of age-related changes in eye lens is the aggregation of high molecular weight proteins covalent-bonded of disulfide linkages. Based on molecular mechanisms of cataractogenesis, the development of pathogenetically oriented medical methods of correction of the age-related changes in lens is carried on. This review provides information on results of experimental and clinical studies which demonstrate the anti-cataract effect of Pirenoxine 0, 005 %.

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