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The innate immune system in diabetic retinopathy.
Prog Retin Eye Res. 2021 Sep; 84:100940.PR

Abstract

The prevalence of diabetes has been rising steadily in the past half-century, along with the burden of its associated complications, including diabetic retinopathy (DR). DR is currently the most common cause of vision loss in working-age adults in the United States. Historically, DR has been diagnosed and classified clinically based on what is visible by fundoscopy; that is vasculature alterations. However, recent technological advances have confirmed pathology of the neuroretina prior to any detectable vascular changes. These, coupled with molecular studies, and the positive impact of anti-inflammatory therapeutics in DR patients have highlighted the central involvement of the innate immune system. Reminiscent of the systemic impact of diabetes, immune dysregulation has become increasingly identified as a key element of the pathophysiology of DR by interfering with normal homeostatic systems. This review uses the growing body of literature across various model systems to demonstrate the clear involvement of all three pillars of the immune system: immune-competent cells, mediators, and the complement system. It also demonstrates how the relative contribution of each of these requires more extensive analysis, including in human tissues over the continuum of disease progression. Finally, although this review demonstrates how the complex interactions of the immune system pose many more questions than answers, the intimately connected nature of the three pillars of the immune system may also point to possible new targets to reverse or even halt reverse retinopathy.

Authors+Show Affiliations

Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, 48105, USA. Electronic address: warrenp@med.umich.edu.Department of Immunology, Cleveland Clinic, Cleveland, OH, 44106, USA. Electronic address: linf2@ccf.org.Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, 48105, USA; Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI, 48105, USA. Electronic address: patricef@umich.edu.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

33429059

Citation

Pan, Warren W., et al. "The Innate Immune System in Diabetic Retinopathy." Progress in Retinal and Eye Research, vol. 84, 2021, p. 100940.
Pan WW, Lin F, Fort PE. The innate immune system in diabetic retinopathy. Prog Retin Eye Res. 2021;84:100940.
Pan, W. W., Lin, F., & Fort, P. E. (2021). The innate immune system in diabetic retinopathy. Progress in Retinal and Eye Research, 84, 100940. https://doi.org/10.1016/j.preteyeres.2021.100940
Pan WW, Lin F, Fort PE. The Innate Immune System in Diabetic Retinopathy. Prog Retin Eye Res. 2021;84:100940. PubMed PMID: 33429059.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The innate immune system in diabetic retinopathy. AU - Pan,Warren W, AU - Lin,Feng, AU - Fort,Patrice E, Y1 - 2021/01/08/ PY - 2020/10/16/received PY - 2020/12/24/revised PY - 2021/01/03/accepted PY - 2022/07/08/pmc-release PY - 2021/1/12/pubmed PY - 2021/1/12/medline PY - 2021/1/11/entrez KW - Complement system KW - Diabetic retinopathy KW - Innate immunity KW - Microglia and macroglia KW - Neurodegeneration KW - Neurovascular unit SP - 100940 EP - 100940 JF - Progress in retinal and eye research JO - Prog Retin Eye Res VL - 84 N2 - The prevalence of diabetes has been rising steadily in the past half-century, along with the burden of its associated complications, including diabetic retinopathy (DR). DR is currently the most common cause of vision loss in working-age adults in the United States. Historically, DR has been diagnosed and classified clinically based on what is visible by fundoscopy; that is vasculature alterations. However, recent technological advances have confirmed pathology of the neuroretina prior to any detectable vascular changes. These, coupled with molecular studies, and the positive impact of anti-inflammatory therapeutics in DR patients have highlighted the central involvement of the innate immune system. Reminiscent of the systemic impact of diabetes, immune dysregulation has become increasingly identified as a key element of the pathophysiology of DR by interfering with normal homeostatic systems. This review uses the growing body of literature across various model systems to demonstrate the clear involvement of all three pillars of the immune system: immune-competent cells, mediators, and the complement system. It also demonstrates how the relative contribution of each of these requires more extensive analysis, including in human tissues over the continuum of disease progression. Finally, although this review demonstrates how the complex interactions of the immune system pose many more questions than answers, the intimately connected nature of the three pillars of the immune system may also point to possible new targets to reverse or even halt reverse retinopathy. SN - 1873-1635 UR - https://www.unboundmedicine.com/medline/citation/33429059/The_innate_immune_system_in_diabetic_retinopathy. L2 - https://scite.ai/reports/33429059 DB - PRIME DP - Unbound Medicine ER -
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