Oorzaken van retinopathie
- Caldwell RB, Bartoli M, Behzadian MA, El-Remessy AE, Al-Shabrawey M, Platt DH, Liou GI, Caldwell RW Curr Drug Targets. 2005 Jun;6(4):511-24. Vascular endothelial growth factor and diabetic retinopathy: role of oxidative stress
Retinal neovascularization and macular edema are central features of diabetic retinopathy, a major cause of blindness in working age adults. [Abstract] - Crawford TN, Alfaro DV 3rd, Kerrison JB, Jablon EP. Curr Diabetes Rev. 2009 Feb;5(1):8-13. Diabetic retinopathy and angiogenesis
Two major retinal problems cause most of the diabetes-related vision loss: diabetic macular edema and complications from abnormal retinal blood vessel growth, angiogenesis. [Abstract] - From Wikipedia, the free encyclopedia Neovascularization
Neovascularization is the formation of functional microvascular networks with red blood cell perfusion. Neovascularization differs from angiogenesis in that angiogenesis is mainly characterized by the protrusion and outgrowth of capillary buds and sprouts from pre-existing blood vessels. [Article] - From Wikipedia, the free encyclopedia Edema
Edema or oedema formerly known as dropsy or hydropsy, is an abnormal accumulation of fluid beneath the skin or in one or more cavities of the body that produces swelling. [Article]
MICROANEURYSMS
- From Wikipedia, the free encyclopedia Aneurysm
An aneurysm or aneurism is a localized, blood-filled balloon-like bulge in the wall of a blood vessel. [Article] - Garner A. J R Soc Med. 1981 Jun;74(6):427-31. Developments in the pathology of diabetic retinopathy: a review
Clinically it is useful to recognize two grades of retinopathy in diabetes mellitus, background and proliferative. Background retinopathy is manifested by focal closure of retinal capillaries, microaneurysms and associated punctate haemorrhages, serous exudates and, occasionally, cotton-wool spots secondary to acute ischaemia. [Article] - From Wikipedia, the free encyclopedia Aneurysm
An aneurysm or aneurism is a localized, blood-filled balloon-like bulge in the wall of a blood vessel. [Article] - Sebag J, McMeel JW. Surv Ophthalmol. 1986 May-Jun;30(6):377-84. Diabetic retinopathy. Pathogenesis and the role of retina-derived growth factor in angiogenesis
Diabetic retinopathy results from a combination of systemic and ocular abnormalities. Vasodilation, basement membrane pathology, microaneurysms, abnormal blood flow and tissue oxygenation, connective tissue abnormalities, and retinal ischemia are all components of early diabetic retinopathy. The pathogenesis of neovascularization is discussed with respect to the effects of vasodilation, vascular leakage, vitreous changes, and retinal ischemia. [Abstract]
LEAKAGE
- Wilkinson-Berka JL Int J Biochem Cell Biol. 2006;38(5-6):752-65 Angiotensin and diabetic retinopathy
In diabetes, damage to the retina occurs in the vasculature, neurons and glia resulting in pathological angiogenesis, vascular leakage and a loss in retinal function. [Abstract] - Cunha-Vaz JG. Diabetes. 1983 May;32 Suppl 2:20-7. Studies on the pathophysiology of diabetic retinopathy. The blood-retinal barrier in diabetes
A review of the pathologic picture of diabetic retinopathy shows that available clinical methods of examination demonstrate the alteration of the blood-retinal barrier (leakage), microaneurysms, capillary closure, preferential channels, preretinal neovascularization and gross extravascular lesions. [Abstract] - Mohamed Q, Gillies MC, Wong TY. JAMA. 2007 Aug 22;298(8):902-16. Management of diabetic retinopathy: a systematic review
Forty-four studies (including 3 meta-analyses) met the inclusion criteria. Tight glycemic and blood pressure control reduces the incidence and progression of DR. [Article] - From Wikipedia, the free encyclopedia Glycated haemoglobin (HbA1c)
Glycated hemoglobin (glycosylated hemoglobin, hemoglobin A1c, HbA1c, A1C, or Hb1c; sometimes also HbA1c) is a form of hemoglobin which is measured primarily to identify the average plasma glucose concentration over prolonged periods of time. It is formed in a non-enzymatic glycation pathway by hemoglobin's exposure to plasma glucose. Normal levels of glucose produce a normal amount of glycated hemoglobin. As the average amount of plasma glucose increases, the fraction of glycated hemoglobin increases in a predictable way. This serves as a marker for average blood glucose levels over the previous months prior to the measurement. The 2010 American Diabetes Association Standards of Medical Care in Diabetes added the A1c ? 48 mmol/mol (?6.5%) as another criterion for the diagnosis of diabetes. In diabetes mellitus, higher amounts of glycated hemoglobin, indicating poorer control of blood glucose levels, have been associated with cardiovascular disease,nephropathy, and retinopathy. Monitoring the HbA1c in type-1 diabetic patients may improve treatment. [Article] - Klein R, Klein BE, Moss SE, Cruickshanks KJ. Arch Intern Med. 1994 Oct 10;154(19):2169-78. Relationship of hyperglycemia to the long-term incidence and progression of diabetic retinopathy
These data are compatible with the hypothesis that long-term control of hyperglycemia, as measured by glycosylated hemoglobin levels, is a significant risk factor for the long-term progression of diabetic retinopathy and that lower levels of glycosylated hemoglobin, even later in the course of diabetes, may modify the risk imposed by higher levels earlier in the course of disease in people with both younger- and older-onset diabetes. [Abstract] - Klein R, Klein BE, Moss SE, Davis MD, DeMets DL. JAMA. 1988 Nov 18;260(19):2864-71. Glycosylated hemoglobin predicts the incidence and progression of diabetic retinopathy
A positive relationship between incidence and progression of retinopathy and glycosylated hemoglobin remained after controlling for duration of diabetes, age, sex, and baseline retinopathy. These data suggest a strong and consistent relationship between hyperglycemia and incidence and progression of retinopathy. [Abstract]
INSTABIELE BLOEDSUIKER
- Saltro – Hb1Ac
De HbA1c-waarde geeft samen met het meten van de bloedglucosewaarde op verschillende tijdstippen een indicatie of de behandeling van diabetes optimaal verloopt. Afhankelijk van de situatie adviseren richtlijnen om de HbA1c-waarde iedere 2 tot 12 maanden te meten. [Article] - Stolar M. Am J Med. 2010 Mar;123(3 Suppl):S3-11. Glycemic control and complications in type 2 diabetes mellitus
Microvascular complications, including nephropathy, retinopathy, and neuropathy, are strongly related to hemoglobin A1c (HbA1c). However, vascular complications may progress in patients who have HbA1c <7.0% and may appear even in undiagnosed patients owing to transient increases in plasma glucose concentrations. [Abstract] - Ceriello A, Ihnat MA. Diabet Med. 2010 Aug;27(8):862-7. 'Glycaemic variability': a new therapeutic challenge in diabetes and the critical care setting
Much attention has been paid recently to the possibility that oscillating glucose may superimpose on glycated haemoglobin (HbA(1c)) in determining the risk for diabetes complications. Furthermore, recent evidence suggests that glucose variability, particularly if accompanied by frequent hypoglycaemic episodes, may adversely alter the prognosis of acutely ill patients. The production of free radicals, accompanied by an insufficient increase in intracellular antioxidant defences, seems to account for this phenomenon. In humans, studies also confirm that fluctuating glucose levels produce an increase in free radicals as well as endothelial dysfunction, and that these changes are greater than those produced by stable high glucose. Avoiding glucose fluctuations in diabetic patients and in critically ill patients seems to be an emerging therapeutic challenge. [Abstract] - Weber C, Schnell O. Diabetes Technol Ther. 2009 Oct;11(10):623-33. The assessment of glycemic variability and its impact on diabetes-related complications: an overview
There is a growing body of evidence that the sole use of hemoglobin A1c is insufficient to adequately reflect the metabolic situation of patients with diabetes mellitus. The risk of developing diabetes-related complications apparently not only depends on the long-term stability of glucose values, but also on the presence or occurrence of short-term glycemic peaks and nadirs lasting for minutes or hours during a day. This leads to the phenomenon of glycemic variability. This article reviews the existing evidence for the clinical relevance of short-term glucose variations and the currently available different means of measuring glycemic variability. [Abstract] - Nalysnyk L, Hernandez-Medina M, Krishnarajah G. Diabetes Obes Metab. 2010 Apr;12(4):288-98. Glycaemic variability and complications in patients with diabetes mellitus: evidence from a systematic review of the literature
Among type 2 DM studies, a significant positive association between glucose variability and the development or progression of diabetic retinopathy, cardiovascular events and mortality was reported in 9 of 10 studies. Based on this overview of the available evidence, there appears to be a signal suggesting that glucose variability, characterized by extreme glucose excursions, could be a predictor of diabetic complications, independent of HbA1c levels, in patients with type 2 DM. [Abstract] - Otto-Buczkowska E, Machnica L. Endokrynol Pol. 2010 Nov-Dec;61(6):700-3. Metabolic memory - the implications for diabetic complications
Large randomised studies have established that early intensive glycaemic control reduces the risk of diabetic complications. This phenomenon has recently been dubbed 'metabolic memory'. It has been suggested that early glycaemia normalisation can halt the hyperglycaemia-induced pathological processes associated with enhanced oxidative stress and glycation of cellular proteins and lipids. The phenomenon of metabolic memory suggests that early aggressive treatment and strict glycaemic control could prevent chronic diabetic complications. [Abstract] - Drzewoski J, Kasznicki J, Trojanowski Z. Pol Arch Med Wewn. 2009 Jul-Aug;119(7-8):493-500. The role of "metabolic memory" in the natural history of diabetes mellitus
There is growing evidence that early, intensive treatment of new-onset diabetes mellitus aimed at tight glucose control reduces the risk of micro- and macrovascular complications. Metabolic memory is a term used to describe beneficial effects of immediate intensive treatment of hyperglycemia and the observation that they are maintained for many years, regardless of glycemia in the later course of diabetes. This phenomenon was first observed in preclinical studies and was later confirmed in large clinical trials. It has been suggested that early glycemia normalization can halt hyperglycemia-induced pathological processes associated with enhanced oxidative stress and glycation of cellular proteins and lipids. The phenomenon of metabolic memory suggests that antioxidants and agents degrading advanced glycation end products in addition to strict hypoglycemic treatment can be used to prevent chronic diabetic complications. [Abstract] - Yam JC, Kwok AK Hong Kong Med J. 2007 Feb;13(1):46-60 Update on the treatment of diabetic retinopathy
Strict metabolic control and tight blood pressure control can significantly reduce the risk of developing retinopathy and its progression, but are difficult to achieve in clinical practice. [Article]
GLYCEMIC INDEX
- Chiu CJ, Taylor A. Prog Retin Eye Res. 2011 Jan;30(1):18-53. Dietary hyperglycemia, glycemic index and metabolic retinal diseases
The glycemic index (GI) indicates how fast blood glucose is raised after consuming a carbohydrate-containing food. Human metabolic studies indicate that GI is related to patho-physiological responses after meals. Compared with a low-GI meal, a high-GI meal is characterized with hyperglycemia during the early postprandial stage (0-2h) and a compensatory hyperlipidemia associated with counter-regulatory hormone responses during late postprandial stage (4-6h). Over the past three decades, several human health disorders have been related to GI. The strongest relationship suggests that consuming low-GI foods prevents diabetic complications. Diabetic retinopathy (DR) is a complication of diabetes. In this aspect, GI appears to be useful as a practical guideline to help diabetic people choose foods. [Abstract] - Johnson ST, Newton AS, Chopra M, Buckingham J, Huang TT, Franks PW, Jetha MM, Ball GD. BMC Pediatr. 2010 Dec 23;10:97. In search of quality evidence for lifestyle management and glycemic control in children and adolescents with type 2 diabetes: A systematic review
There is no high quality evidence to suggest lifestyle modification improves either short- or long-term glycemic control in children and youth with T2D. Additional research is clearly warranted to define optimal lifestyle behaviour strategies for young people with T2D. [Article] - Thomas DE, Elliott EJ. Br J Nutr. 2010 Sep;104(6):797-802. Epub 2010 Apr 27. The use of low-glycaemic index diets in diabetes control
Lowering the GI of the diet may contribute to improved glycaemic control in diabetes. [Abstract ] - Thomas D, Elliott EJ. Cochrane Database Syst Rev. 2009 Jan 21;(1):CD006296. Low glycaemic index, or low glycaemic load, diets for diabetes mellitus
A low-GI diet. can improve glycaemic control in diabetes without compromising hypoglycaemic events [Abstract] - NDF Richtlijnen en adviezen
Dit artikel kan alleen worden gedownload. Selecteer de link "NDF Voedingsrichtlijnen bij diabetes 2010". Zie tabel 2 :Gemiddelde aanbevolen hoeveelheid voedingsmiddelen per dag.[Overzicht]. [Overview] - Tabel van glycemische indexen
De glycemische index van een koolhydraat is een getal wat aangeeft hoe sterk de glucosespiegel in het bloed omhoog gaat na het eten van een voedingsmiddel. Hoe lager het getal hoe beter [Article] - Nationaalkompas: Diabetes mellitus samengevat
In 2007 hadden ruim 740.000 mensen diabetes mellitus (95%-betrouwbaarheidsinterval: 665.000 - 824.000) (jaarprevalentie op basis van huisartsenregistraties). Op 1 januari 2007 waren er 668.000 mensen met diabetes; in de loop van 2007 kwamen daar ongeveer 71.000 nieuwe patiënten met diabetes bij (95%-betrouwbaarheidsinterval: 57.000 - 90.000). [Article] - From Wikipedia, the free encyclopedia Free-radical theory
The free-radical theory of aging (FRTA) states that organisms age because cells accumulate free radical damage over time. A free radical is any atom or molecule that has a single unpaired electron in an outer shell. While a few free radicals such as melanin are not chemically reactive, most biologically-relevant free radicals are highly reactive. For most biological structures, free radical damage is closely associated with oxidative damage. Antioxidants are reducing agents, and limit oxidative damage to biological structures by passivating free radicals. [Article] - From Wikipedia, the free encyclopedia
Reactive oxygen species (ROS) are chemically reactive molecules containing oxygen. Examples include oxygen ionsand peroxides. Reactive oxygen species are highly reactive due to the presence of unpaired valence shell electrons. ROS form as a natural byproduct of the normal metabolism of oxygen and have important roles in cell signaling andhomeostasis. [Article] - From Wikipedia, the free encyclopedia Oxidative stress
Oxidative stress represents an imbalance between the production and manifestation of reactive oxygen species and a biological system's ability to readily detoxify the reactive intermediates or to repair the resulting damage. Disturbances in the normal redox state of tissues can cause toxic effects through the production of peroxides and free radicals that damage all components of the cell, including proteins, lipids, and DNA. Some reactive oxidative species can even act as messengers through a phenomenon called redox signaling. [Article] - Kowluru RA, Chan PS. Exp Diabetes Res. 2007;2007:43603. Oxidative stress and diabetic retinopathy
Oxygen metabolism is essential for sustaining aerobic life, and normal cellular homeostasis works on a fine balance between the formation and elimination of reactive oxygen species (ROS). Many diabetes-induced metabolic abnormalities are implicated in its development, and appear to be influenced by elevated oxidative stress; however the exact mechanism of its development remains elusive. Increased superoxide concentration is considered as a causal link between elevated glucose and the other metabolic abnormalities important in the pathogenesis of diabetic complications. [Article] - Madsen-Bouterse SA, Kowluru RA. Rev Endocr Metab Disord. 2008 Dec;9(4):315-27. Oxidative stress and diabetic retinopathy: pathophysiological mechanisms and treatment perspectives
Oxidative stress is considered as one of the crucial contributors in the pathogenesis of diabetic retinopathy, but oxidative stress appears to be highly interrelated with other biochemical imbalances that lead to structural and functional changes and accelerated loss of capillary cells in the retinal microvasculature and, ultimately, pathological evidence of the disease. [Abstract] - Kowluru RA. Antioxid Redox Signal. 2005 Nov-Dec;7(11-12):1581-87. Diabetic retinopathy: mitochondrial dysfunction and retinal capillary cell death
Oxidative stress is increased in the retina in diabetes; the levels of oxidatively modified DNA and nitrosylated proteins are elevated, and antioxidant defense enzymes are impaired. [Abstract] - Altomare E, Grattagliano I, Vendemaile G, Micelli-Ferrari T, Signorile A, Cardia L. Eur J Clin Invest. 1997 Feb;27(2):141-7. Oxidative protein damage in human diabetic eye: evidence of a retinal participation
Moreover, an increased formation of protein-bound free sulphydryls and carbonyl proteins, indices of oxidative damage to proteins, was noted in diabetic patients. All these parameters were shown to be altered particularly when diabetes was complicated with retinal alterations. Protein oxidation may, therefore, represent an important mechanism in the onset of eye complications in diabetic patients. [Abstract] - van Reyk DM, Gillies MC, Davies MJ. Redox Rep. 2003;8(4):187-92. The retina: oxidative stress and diabetes
A prominent and early feature of the retinopathy of diabetes mellitus is a diffuse increase in vascular permeability. As the disease develops, the development of frank macular oedema may result in vision loss. That reactive oxygen species production is likely to be elevated in the retina, and that certain regions of the retina are enriched in substrates for lipid peroxidation, may create an environment susceptible to oxidative damage. [Abstract] - Doly M, Droy-Lefaix MT, Braquet P EXS. 1992;62:299-307 Oxidative stress in diabetic retina
The authors then discuss the participation of oxygenated free radicals in the pathogenesis of diabetic retinopathy. In conclusion, the authors discuss the possible utilization of a free radical scavenger, such as EGb 761, in the prevention of the retinal impairment in diabetes. [Abstract] - Dandona P, Thusu K, Cook S, Snyder B, Makowski J, Armstrong D, Nicotera T. Lancet. 1996 Feb 17;347(8999):444-5. Oxidative damage to DNA in diabetes mellitus
IDDM and NIDDM patients showed greater oxidative damage to DNA, with increased generation of ROS, than controls. Such changes might contribute to accelerated aging and atherogenesis in diabetes and to the microangiopathic complications of the disease. [Abstract] - From Wikipedia, the free encyclopedia Mitochondrion
In cell biology, a mitochondrion (plural mitochondria) is a membrane-enclosed organelle found in most eukaryotic cells. These organelles range from 0.5 to 10 micrometers (?m) in diameter. Mitochondria are sometimes described as "cellular power plants" because they generate most of the cell's supply of adenosine triphosphate (ATP), used as a source of chemical energy. [Article] - Barot M, Gokulgandhi MR, Mitra AK. Curr Eye Res. 2011 Oct 6. Mitochondrial Dysfunction in Retinal Diseases
The mitochondrion is a vital intracellular organelle for retinal cell function and survival. There is growing confirmation to support an association between mitochondrial dysfunction and a number of retinal degenerations. This review highlights the role of mitochondrial dysfunction originating from oxidative stress in the etiology of retinal diseases including diabetic retinopathy, glaucoma and age-related macular degeneration (AMD). [Abstract] - Kowluru RA. Antioxid Redox Signal. 2005 Nov-Dec;7(11-12):1581-87. Diabetic retinopathy: mitochondrial dysfunction and retinal capillary cell death
Oxidative stress is increased in the retina in diabetes; the levels of oxidatively modified DNA and nitrosylated proteins are elevated, and antioxidant defense enzymes are impaired. The levels of superoxides are elevated in the retina, and the mitochondria become dysfunctional with proapoptotic protein, Bax, translocating from the cytosol into the mitochondria, and cytochrome c leaking out from the mitochondria. [Abstract] - Madsen-Bouterse SA, Mohammad G, Kanwar M, Kowluru RA. Antioxid Redox Signal. 2010 Sep 15;13(6):797-805. Role of mitochondrial DNA damage in the development of diabetic retinopathy, and the metabolic memory phenomenon associated with its progression
Diabetic retinopathy does not halt after hyperglycemia is terminated; the retina continues to experience increased oxidative stress, suggesting a memory phenomenon. Mitochondrial DNA (mtDNA) is highly sensitive to oxidative damage. Thus, mtDNA continues to be damaged even after PC is terminated. Although the retina tries to overcome mtDNA damage by inducing glycosylase, they remain deficient in the mitochondria with a compromised ETC system. The process is further exacerbated by subsequent increased mtDNA damage providing no relief to the retina from a continuous cycle of damage, and termination of hyperglycemia fails to arrest the progression of retinopathy. [Article] - Jarrett SG, Lin H, Godley BF, Boulton ME. Prog Retin Eye Res. 2008 Nov;27(6):596-607 Mitochondrial DNA damage and its potential role in retinal degeneration
Mitochondria are central to retinal cell function and survival. There is increasing evidence to support an association between mitochondrial dysfunction and a number of retinal pathologies including age-related macular degeneration (AMD), diabetic retinopathy and glaucoma. [Abstract] - From Wikipedia, the free encyclopedia Advanced glycation end-product
An advanced glycation end-product (AGE) is the result of a chain of chemical reactions after an initial glycation reaction. AGEs may be formed external to the body (exogenously) by heating (e.g., cooking); or inside the body (endogenously) through normal metabolism and aging. Under certain pathologic conditions (e.g., oxidative stress due to hyperglycemia in patients with diabetes), AGE formation can be increased beyond normal levels. AGEs are now known to play a role as proinflammatory mediators in gestational diabetes as well. Many cells in the body (for example, endothelial cells, smooth muscle, and cells of the immune system) from tissue such as lung, liver, kidney, and peripheral blood bear the Receptor for Advanced Glycation End-products (RAGE) that, when binding AGEs, contributes to age- and diabetes-related chronic inflammatory diseases such as atherosclerosis, asthma, arthritis, myocardial infarction, nephropathy, retinopathy, periodontitis and neuropathy. [Article] - From Wikipedia, the free encyclopedia Glycated hemoglobin
Glycated hemoglobin (hemoglobin A1c, HbA1c, A1C, or Hb1c; sometimes also HbA1c) is a form of hemoglobin that is measured primarily to identify the averageplasma glucose concentration over prolonged periods of time. It is formed in a non-enzymatic glycation pathway by hemoglobin's exposure to plasma glucose. Normal levels of glucose produce a normal amount of glycated hemoglobin. As the average amount of plasma glucose increases, the fraction of glycated hemoglobin increases in a predictable way. This serves as a marker for average blood glucose levels over the previous months prior to the measurement.. [Article] - Ahmed N. Diabetes Res Clin Pract. 2005 Jan;67(1):3-21. Advanced glycation endproducts--role in pathology of diabetic complications
Recent studies suggest that interaction of AGEs with RAGE alter intracellular signalling, gene expression, release of pro-inflammatory molecules and free radicals that contribute towards the pathology of diabetic complications. [Abstract] - Barbosa JH, Oliveira SL, Seara LT. Arq Bras Endocrinol Metabol. 2008 Aug;52(6):940-50. The role of advanced glycation end-products (AGEs) in the development of vascular diabetic complications
The advanced glycation end-products (AGEs) constitute a class of heterogeneous molecules formed by amino-carbonyl reactions of a non-enzymatic nature, which occur at an accelerated rate in the hyperglycemic state of diabetes. Considered important pathogenic mediators of diabetic complications, AGEs are capable of irreversibly modifying the chemical properties and functions of diverse biological structures. [Abstract] - Yamagishi S, Matsui T. Curr Pharm Biotechnol. 2011 Mar 1;12(3):362-8. Advanced glycation end products (AGEs), oxidative stress and diabetic retinopathy
Although various biochemical and hemodynamic pathways are implicated in the diabetic retinopathy, recent clinical study has substantiated the concept of 'metabolic memory', and suggested the active involvement of advanced glycation end products (AGEs) and oxidative stress in this sight-threatening disorder. [Abstract] - Stitt AW, Curtis TM. Pharmacol Rep. 2005;57 Suppl:156-68. Advanced glycation and retinal pathology during diabetes
Evidence now points towards a pathogenic role for advanced glycation in the initiation and progression of diabetic retinopathy and this review will examine the current state of knowledge of AGE-related pathology in the retina at a cellular and molecular level. [Article] - Yamagishi S, Ueda S, Matsui T, Nakamura K, Okuda S. Curr Pharm Des. 2008;14(10):962-8. Role of advanced glycation end products (AGEs) and oxidative stress in diabetic retinopathy
This article summarizes the role of AGEs and oxidative stress in the development and progression of diabetic retinopathy and the therapeutic interventions that could prevent this devastating disorder. [Abstract] - Stitt AW. Invest Ophthalmol Vis Sci. 2010 Oct;51(10):4867-74.
The pathogenesis of diabetic retinopathy is multifactorial, and a range of hyperglycemia-linked pathways have been implicated in the initiation and progression of this condition. This review concentrates on the formation of advanced glycation end products (AGEs) and the role they play in diabetic retinopathy. Perspective is provided on advanced glycation in the retina, the impact that this process has on retinal cell function, and how it relates to other pathogenic pathways. Emphasis is also placed the modulatory role of the receptor for AGEs (RAGE) and how its activation could evoke retinal inflammatory disease. [Article] - Baynes JW. Exp Gerontol. 2001 Sep;36(9):1527-37. The role of AGEs in aging: causation or correlation
Although AGEs in proteins are probably correlative, rather than causative, with respect to aging, they accumulate to high levels in tissues in age-related chronic diseases, such as atherosclerosis, diabetes, arthritis and neurodegenerative disease. Inhibition of AGE formation in these diseases may limit oxidative and inflammatory damage in tissues, retarding the progression of pathophysiology and improve the quality of life during aging. [Abstract] - From Wikipedia, the free encyclopedia Inflammation
Inflammation is part of the complex biological response of vasculartissues to harmful stimuli, such as pathogens, damaged cells, or irritants. Inflammation is a protective attempt by the organism to remove the injurious stimuli and to initiate the healing process. Atherosclerosis, formerly considered a bland lipid storage disease, actually involves an ongoing inflammatory response. Recent advances in basic science have established a fundamental role for inflammation in mediating all stages of this disease from initiation through progression and, ultimately, the thrombotic complications of atherosclerosis. [Article] - Zalesin KC, Franklin BA, Miller WM, Peterson ED, McCullough PA. Med Clin North Am. 2011 Sep;95(5):919-37. http://www.ncbi.nlm.nih.gov/pubmed/21855700
Obesity promotes a cascade of secondary pathologies including diabetes, insulin resistance, dyslipidemia, inflammation, thrombosis, hypertension, the metabolic syndrome, and OSA, which collectively heighten the risk for cardiovascular disease. [Abstract] - Donath MY, Shoelson SE. Nat Rev Immunol. 2011 Feb;11(2):98-107 Type 2 diabetes as an inflammatory disease
Together, these changes suggest that inflammation participates in the pathogenesis of T2D. [Abstract] - Williams MD, Nadler JL. Curr Diab Rep. 2007 Jun;7(3):242-8. Inflammatory mechanisms of diabetic complications
Activation of inflammatory processes may contribute to the development of type 2 diabetes mellitus. In addition, inflammation appears to be a major mechanism responsible for vascular damage leading to the clinically well-recognized complications of diabetes. [Abstract] - Williams MD, Nadler JL. Curr Diab Rep. 2007 Jun;7(3):242-8. Inflammatory mechanisms of diabetic complications
Emerging evidence also indicates that markers of inflammation are associated with the more severe forms of diabetic retinopathy. [Abstract] - Zhang W, Liu H, Rojas M, Caldwell RW, Caldwell RB Immunotherapy. 2011 May;3(5):609-28. Anti-inflammatory therapy for diabetic retinopathy
Studies have shown that DR has prominent features of chronic, subclinical inflammation. This article focuses on the role of inflammation in DR and summarizes the progress of studies of anti-inflammatory strategies for DR. [Abstract] - Hori S. Nihon Ganka Gakkai Zasshi. 2010 Mar;114(3):202-15; Strategy for treatment of diabetic retinopathy
These findings suggest that the inflammation lead to the complex pathology of retinopathy. Anti-inflammatory drugs need to be included in the therapeutic strategy. [Abstract] - Caldwell RB, Zhang W, Romero MJ, Caldwell RW. Brain Res Bull. 2010 Feb 15;81(2-3):303-9 Vascular dysfunction in retinopathy-an emerging role for arginase
Retinal neovascularization is a leading cause of visual disability. Retinal diseases involving neovascularization all follow the same progression, beginning with vascular inflammatory reactions and injury of the vascular endothelium and ending with neovascularization, fibrosis and retinal detachment. [Article] - Adamis AP, Berman AJ. Semin Immunopathol. 2008 Apr;30(2):65-84 Immunological mechanisms in the pathogenesis of diabetic retinopathy
There is an accumulating body of evidence that immunological mechanisms play a prominent role in the pathogenesis of diabetic retinopathy (DR), which is characterized by many features typical of inflammation. [Abstract] - From Wikipedia, the free encyclopedia Polyol pathway
Also called the sorbitol-aldose reductase pathway, the polyol pathway appears to be implicated in diabetic complications, especially in microvascular damage to the retina, kidney, and nerves. While most cells require the action of insulin for glucose to gain entry into the cell, the cells of the retina, kidney, and nervous tissues are insulin-independent, so glucose moves freely across the cell membrane, regardless of the action of insulin. Cells use glucose for energy; however, unused glucose enters the polyol pathway when aldose reductase reduces it to sorbitol. Sorbitol dehydrogenase can then oxidize sorbitol to fructose, which also produces NADH from NAD+. Hexokinase can return the molecule to the glycolysispathway by phosphorylating fructose to form fructose-6-phosphate. However, in uncontrolled diabetics that have high blood glucose - more than the glycolysispathway can handle - the reaction's mass balance ultimately favors the production of sorbitol. Sorbitol cannot cross cell membranes, and, when it accumulates, it produces osmotic stresses on cells by drawing water into the insulin-independent tissues. [Artcle] - Zamfir C. Oftalmologia. 2009;53(2):8-12. Biochemical mechanisms in the pathogeny of diabetic retinopathy
Hyperglycemia becomes pathogenic for specific cells through multiple biochemical mechanisms. First, we describe the activation of polyol pathway. Then, we discuss the intracellular production of advanced glycation end product precursors and the activation of protein kinase C system. Also, we talk about the increased hexosamine pathway activity. All of these mechanisms are initiated by the same phenomena, the hyperglycemia-induced mitochondrial production of superoxid which is equal with increased intracellular oxidative stress. [Abstract] - Lorenzi M. Exp Diabetes Res. 2007;2007:61038. The polyol pathway as a mechanism for diabetic retinopathy: attractive, elusive, and resilient
The polyol pathway is a two-step metabolic pathway in which glucose is reduced to sorbitol, which is then converted to fructose. It is one of the most attractive candidate mechanisms to explain, at least in part, the cellular toxicity of diabetic hyperglycemia because (i) it becomes active when intracellular glucose concentrations are elevated, (ii) the two enzymes are present in human tissues and organs that are sites of diabetic complications, and (iii) the products of the pathway and the altered balance of cofactors generate the types of cellular stress that occur at the sites of diabetic complications. This new knowledge has rekindled interest in a possible role of the polyol pathway in diabetic retinopathy and in methodological investigation that may prepare new clinical trials. [Article] - Cumbie BC, Hermayer KL. Vasc Health Risk Manag. 2007;3(6):823-32. Current concepts in targeted therapies for the pathophysiology of diabetic microvascular complications
Microvascular complications characterized by retinopathy, nephropathy, and neuropathy are highly prevalent among diabetics. Glycemic control has long been the mainstay for preventing progression of these complications; however, such control is not easily achieved. This review summarizes the specific pathogenic mechanisms of microvascular complications for which clinical therapies have been developed, including the polyol pathway, advanced glycation end products, protein kinase c, vascular epithelium growth factor, and the superoxide pathway. [Article] - Chung SS, Chung SK Curr Drug Targets. 2005 Jun;6(4):475-86. Aldose reductase in diabetic microvascular complications
In animal studies, there is strong evidence that aldose reductase, the first and rate-limiting enzyme of the polyol pathway that converts glucose to fructose, plays a key role in the pathogenesis of microvascular complications. However, clinical trials of the aldose reductase inhibitors were disappointing and several pharmaceutical companies had abandoned the development of this line of drugs. [Abstract] - Ishihara M, Yukimura Y, Aizawa T, Yamada T, Ohto K, Yoshizawa K. Diabetes Care. 1987 Jan-Feb;10(1):20-5. High blood pressure as risk factor in diabetic retinopathy development in NIDDM patients
The correlation between diabetic retinopathy and blood pressure was analyzed in 742 type II diabetic patients. Systolic and pulse blood pressures were significantly higher in the patients with retinopathy than in those without (mean systolic pressure 142 vs. 139 mmHg, P less than .01; mean pulse pressure 60.5 vs. 56.4 mmHg, P less than .001). [Abstract] - Janka HU, Ziegler AG, Valsania P, Warram JH, Krolewski AS. Diabete Metab. 1989;15(5 Pt 2):333-7. Impact of blood pressure on diabetic retinopathy
Recent epidemiologic, cross-sectional studies indicated a close relationship between elevated systolic blood pressure and diabetic retinopathy, particularly in NIDDM subjects. In IDDM patients, the association with diastolic blood pressure was more pronounced. In the few prospective studies with sufficient number of individuals and acceptable documentation of retinal changes, in addition to poor metabolic control elevated blood pressure emerged as one of the best predictors of the development of severe deterioration of diabetic eye disease. [Abstract] - Williams ME. Curr Diab Rep. 2011 Aug;11(4):323-9 The goal of blood pressure control for prevention of early diabetic microvascular complications
Lowering blood pressure may confer a benefit to diabetic microvascular complications comparable with glycemic control. Hypertension is causally related to kidney outcomes and is a risk factor for the development of diabetic retinopathy. [Abstract]
HYPERTENSIVE RETINOPATHY
- Bhargava M, Ikram MK, Wong TY. J Hum Hypertens. 2011 Apr 21. How does hypertension affect your eyes?
Hypertension has profound effects on various parts of the eye. Classically, elevated blood pressure results in a series of retinal microvascular changes called hypertensive retinopathy, comprising of generalized and focal retinal arteriolar narrowing, arteriovenous nicking, retinal hemorrhages, microaneurysms and, in severe cases, optic disc and macular edema. Studies have shown that mild hypertensive retinopathy signs are common and seen in nearly 10% of the general adult non-diabetic population. [Abstract] - Wong TY, McIntosh R. Br Med Bull. 2005 Sep 7;73-74:57-70 Hypertensive retinopathy signs as risk indicators of cardiovascular morbidity and mortality
Moderate hypertensive retinopathy signs, such as isolated microaneurysms, haemorrhages and cotton-wool spots, are strongly associated with subclinical cerebrovascular disease and predict incident clinical stroke, congestive heart failure and cardiovascular mortality, independent of blood pressure and other traditional risk factors. [Article] - From Wikipedia, the free encyclopedia Apolipoprotein A1
Apolipoprotein A-I is the major protein component of high density lipoprotein (HDL) in plasma. Chylomicrons secreted from the intestinal enterocyte also contain ApoA1 but it is quickly transferred to HDL in the bloodstream [3]. The protein promotes cholesterol efflux from tissues to the liver for excretion. [Article] - From Wikipedia, the free encyclopedia Apolipoprotein B
Apolipoprotein B (APOB or ApoB) is the primary apolipoprotein of low-density lipoproteins (LDL or "bad cholesterol"), which is responsible for carrying cholesterol to tissues. While it is unclear exactly what functional role APOB plays in LDL, it is the primary apolipoprotein component and is absolutely required for its formation. What is clear is that the APOB on the LDL particle acts as a ligand for LDL receptors in various cells throughout the body (i.e. less formally, APOB "unlocks" the doors to cells and thereby delivers cholesterol to them). [Article] - Deguchi Y, Maeno T, Saishin Y, Hori Y, Shiba T, Takahashi M. Jpn J Ophthalmol. 2011 Mar;55(2):128-31. Relevance of the serum apolipoprotein ratio to diabetic retinopathy
The apoB/A-1 ratio may contribute to PDR progression in patients with DR. High apoB and apoB/A-1 values may be related to PDR development. [Abstract] - Sasongko MB, Wong TY, Nguyen TT, Kawasaki R, Jenkins A, Shaw J, Wang JJ. Diabetes Care. 2011 Feb;34(2):474-9. Serum apolipoprotein AI and B are stronger biomarkers of diabetic retinopathy than traditional lipids
ApoAI and apoB and the apoB-to-apoAI ratio were significantly and independently associated with diabetic retinopathy and diabetic retinopathy severity and improved the ability to discriminate diabetic retinopathy by 8%. Serum apolipoprotein levels may therefore be stronger biomarkers of diabetic retinopathy than traditional lipid measures. [Article] - Walldius G, Jungner I. J Intern Med. 2006 May;259(5):493-519. The apoB/apoA-I ratio: a strong, new risk factor for cardiovascular disease and a target for lipid-lowering therapy--a review of the evidence
During the last several years interest has focused on the importance of the lipid-transporting apolipoproteins--apoB transports all potentially atherogenic very low-density lipoprotein (VLDL), intermediate-density lipoprotein (IDL) and LDL particles, and apoA-I transports and acts as the major antiatherogenic protein in the HDL particles. The evidence for the apoB/apoA-I ratio being a strong, new risk factor for cardiovascular (CV) disease. The results indicate that the apoB/apoA-I ratio is a simple, accurate and new risk factor for CV disease--the lower the apoB/apoA-I ratio, the lower is the risk. Guidelines should be developed in order to recognize the important clinical risk information embedded in the apoB/apoA-I ratio. [Article] - Irace C, Scarinci F, Scorcia V, Bruzzichessi D, Fiorentino R, Randazzo G, Scorcia G, Gnasso A. Br J Ophthalmol. 2011 Jan;95(1):94-8. Association among low whole blood viscosity, haematocrit, haemoglobin and diabetic retinopathy in subjects with type 2 diabetes
Haemoglobin, haematocrit and whole blood viscosity were significantly lower in subjects with retinopathy compared to subjects without retinopathy in both sexes. These variables significantly decreased with increasing severity of retinopathy. Results demonstrate the association among low viscosity, haemoglobin, haematocrit and diabetic retinopathy. [Article]
Pathology
NEOVASCULARIZATION AND EDEMAHyperglycemia
VERHOOGDE HbA1cOxidative Stress
Mitochondrial dysfunction
AGEs
Inflammation
Polyol Pathway
Kenmerken van diabetische retinopathy
High blood pressure
ApoB/A-1 ratio
Haematocrit
Behandeling
- Lee KW, Lip GY. QJM. 2003 Jul;96(7):465-80 The role of omega-3 fatty acids in the secondary prevention of cardiovascular disease
It has long been recognized from epidemiological studies that Greenland Eskimos have substantially reduced rates of acute myocardial infarction (MI) compared with Western controls. From these epidemiological observations, the benefits of fatty fish consumption have been explored in cell culture and animal studies, as well as randomized controlled trials investigating the cardioprotective effects of omega-3 fatty acids. Dietary omega-3 fatty acids seem to stabilize the myocardium electrically, resulting in reduced susceptibility to ventricular arrhythmias, thereby reducing the risk of sudden death. These fatty acids also have potent anti-inflammatory effects, and may also be antithrombotic and anti-atherogenic. Furthermore, the recent GISSI-Prevention study of 11 324 patients showed a marked decrease in risk of sudden cardiac death as well as a reduction in all-cause mortality in the group taking a highly purified form of omega-3 fatty acids, despite the use of other secondary prevention drugs, including beta-blockers and lipid-lowering therapy. The use of omega-3 fatty acids should be considered as part of a comprehensive secondary prevention strategy post-myocardial infarction. [Article] - Ishikawa Y, Yokoyama M, Saito Y, Matsuzaki M, Origasa H, Oikawa S, Sasaki J, Hishida H, Itakura H, Kita T, Kitabatake A, Nakaya N, Sakata T, Shimada K, Shirato K, Matsuzawa Y; Circ J. 2010 Jul;74(7):1451-7. Preventive effects of eicosapentaenoic acid on coronary artery disease in patients with peripheral artery disease
Subanalysis of the JELIS trial demonstrated that in patients with PAD the incidence of CAD was higher than in controls, and that EPA markedly reduced the occurrence of CAD in those patients. [Abstract] - Gezondheidsraad Richtlijnen goede voeding 2006
De hoeveelheid visolie vetzuren in de voeding zal daarentegen aanzienlijk moeten toenemen om te kunnen voldoen aan de voedingsnorm voor deze vetzuren van 450 mg per dag. Deze inname kan worden gerealiseerd door tweemaal per week een portie vis te gebruiken waarvan ten minste eenmaal een portie vette vis. [Article] - Itakura H, Yokoyama M, Matsuzaki M, Saito Y, Origasa H, Ishikawa Y, Oikawa S, Sasaki J, Hishida H, Kita T, Kitabatake A, Nakaya N, Sakata T, Shimada K, Shirato K, Matsuzawa Y; J Atheroscler Thromb. 2011;18(2):99-107 Relationships between plasma fatty acid composition and coronary artery disease
The higher plasma level of EPA (hazard ratio=0.83, p=0.049, in all participants and hazard ratio=0.71, p=0.018, in the EPA intervention group), but not of DHA, was inversely associated with the risk of major coronary events. [Article] - Harris WS, Von Schacky C. Prev Med. 2004 Jul;39(1):212-20. The Omega-3 Index: a new risk factor for death from coronary heart disease?
The Omega-3 Index was inversely associated with risk for CHD mortality. The Omega-3 Index may represent a novel, physiologically relevant, easily modified, independent, and graded risk factor for death from CHD that could have significant clinical utility. [Abstract]
DIABETISCHE RETINOPATHIE
- Dutot M, de la Tourrette V, Fagon R, Rat P. Nutr Metab (Lond). 2011 Jun 16;8:39. New approach to modulate retinal cellular toxic effects of high glucose using marine epa and dha
Marine formulations rich in omega-3 fatty acids represent a promising therapeutic approach for diabetic retinopathy. [Article] - SanGiovanni JP, Chew EY. Prog Retin Eye Res. 2005 Jan;24(1):87-138. The role of omega-3 long-chain polyunsaturated fatty acids in health and disease of the retina
Our general conclusion is that there is consistent evidence to suggest that omega-3 LCPUFAs may act in a protective role against ischemia-, light-, oxygen-, inflammatory-, and age-associated pathology of the vascular and neural retina. [Abstract] - Opreanu M, Lydic TA, Reid GE, McSorley KM, Esselman WJ, Busik JV. Invest Ophthalmol Vis Sci. 2010 Jun;51(6):3253-63. Inhibition of cytokine signaling in human retinal endothelial cells through downregulation of sphingomyelinases by docosahexaenoic acid
The authors have previously demonstrated that DHA inhibits cytokine-induced inflammation in human retinal endothelial cells (HRECs), the resident vasculature affected by diabetic retinopathy. However, the anti-inflammatory mechanism of docosahexaenoic acid (DHA) is still not well understood. This study provides a novel potential mechanism for the anti-inflammatory effect of DHA in HRECs. DHA downregulates the basal and cytokine-induced ASMase and NSMase expression and activity level in HRECs, and inhibition of sphingomyelinases in endothelial cells prevents cytokine-induced inflammatory response. [Article] - Connor KM, SanGiovanni JP, Lofqvist C, Aderman CM, Chen J, Higuchi A, Hong S, Pravda EA, Majchrzak S, Carper D, Hellstrom A, Kang JX, Chew EY, Salem N Jr, Serhan CN, Smith LE. Nat Med. 2007 Jul;13(7):868-73. Increased dietary intake of omega-3-polyunsaturated fatty acids reduces pathological retinal angiogenesis
These findings indicate that increasing the sources of omega-3-PUFA or their bioactive products reduces pathological angiogenesis. Western diets are often deficient in omega-3-PUFA, and premature infants lack the important transfer from the mother to the infant of omega-3-PUFA that normally occurs in the third trimester of pregnancy. Supplementing omega-3-PUFA intake may be of benefit in preventing retinopathy. [Abstract] - Hunt S. Ophthalmologe. 2007 Aug;104(8):727-9. [Increased dietary intake of omega-3-PUFA reduces pathological retinal angiogenesis
According to a recent publication in Nature Medicine an increased dietary intake of omega-3-polyunsaturated fatty acids (PUFA) may protect against the development and progression of retinal neovascularization. In a mouse model of oxygen-induced retinopathy the researchers were able to demonstrate that neonatal mice kept on a "Japanese diet" (i.e. rich in omega-3-PUFA) developed about 50% less retinal neovascularization as compared to mice kept on a "Western diet" (rich in omega-6-PUFA). [Abstract] - Kharbanda RK, Walton B, Allen M, Klein N, Hingorani AD, MacAllister RJ, Vallance P. Circulation. 2002 Jun 4;105(22):2600-4. Prevention of inflammation-induced endothelial dysfunction: a novel vasculo-protective action ofaspirin
Experimental inflammation produces endothelial dysfunction, which can be prevented by pretreatment with aspirin. [Article] - Ridker PM, Cushman M, Stampfer MJ, Tracy RP, Hennekens CH. N Engl J Med. 1997 Apr 3;336(14):973-9. Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men
The base-line plasma concentration of C-reactive protein predicts the risk of future myocardial infarction and stroke. Moreover, the reduction associated with the use of aspirin in the risk of a first myocardial infarction appears to be directly related to the level of C-reactive protein, raising the possibility that antiinflammatory agents may have clinical benefits in preventing cardiovascular disease. [Abstract]
DIABETIC RETINOPATHY
- Camargo EG, Gross JL, Weinert LS, Lavinsky J, Silveiro SP. Arq Bras Endocrinol Metabol. 2007 Apr;51(3):457-65. Low-dose aspirin in patients with diabete melitus: risks and benefits regarding macro and microvascular complications
Aspirin is recommended as cardiovascular disease prevention in patients with diabetes mellitus. Due to the increased risk of bleeding and because of the hypothesis that there could be a worsening of microvascular complications related to aspirin, there has been observed an important underutilization of the drug. However, it is now known that aspirin is not associated with a deleterious effect on diabetic retinopathy and there is evidence indicating that it also does not affect renal function with usual doses (150 mg/d). On the other hand, higher doses may prove necessary, since recent data suggest that diabetic patients present the so called "aspirin resistance". [Abstract] - Bergerhoff K, Clar C, Richter B. Endocrinol Metab Clin North Am. 2002 Sep;31(3):779-93. Aspirin in diabetic retinopathy. A systematic review
All trials showed that aspirin alone or in combination with dipyridamole neither lowered nor increased the risk of the development of diabetic retinopathy. The results suggest that there are no ocular contraindications to taking aspirin if required as part of a treatment for cardiovascular diseases or other medical indications. [Abstract]
DHA/EPA
VISOLIE EN HART EN VAATZIEKTENAspirin
ASPRIN – INFAMMATION- From Wikipedia, the free encyclopedia Benfotiamine
Benfotiamine is a synthetic S-acyl derivative of thiamine(vitamin B1). The primary use of this antioxidant is as an "anti-AGE" supplement. In a trial, benfotiamine lowered AGE by 40%. At high doses, benfotiamine was shown to be effective for the treatment of diabetic retinopathy, neuropathy, and nephropathy. [Article] - Stracke H, Lindemann A, Federlin K. Exp Clin Endocrinol Diabetes. 1996;104(4):311-6. A benfotiamine-vitamin B combination in treatment of diabetic polyneuropathy
In a double-blind, randomized, controlled study, the effectiveness of treatment with a combination of Benfotiamine (an Allithiamine, a lipid-soluble derivative of vitamin B1 with high bioavailability) . [Abstract] - Beltramo E, Berrone E, Tarallo S, Porta M. Acta Diabetol. 2008 Sep;45(3):131-41. Effects of thiamine and benfotiamine on intracellular glucose metabolism and relevance in the prevention of diabetic complications
Diabetes might be considered a thiamine-deficient state, if not in absolute terms at least relative to the increased requirements deriving from accelerated and amplified glucose metabolism in non-insulin dependent tissues that, like the vessel wall, are prone to complications. [Abstract]
AGEs
- Stirban A, Negrean M, Stratmann B, Gawlowski T, Horstmann T, Götting C, Kleesiek K, Mueller-Roesel M, Koschinsky T, Uribarri J, Vlassara H, Tschoepe D. Diabetes Care. 2006 Sep;29(9):2064-71. Benfotiamine prevents macro- and microvascular endothelial dysfunction and oxidative stress following a meal rich in advanced glycation end products in individuals with type 2 diabetes
Our study confirms micro- and macrovascular endothelial dysfunction accompanied by increased oxidative stress following a real-life, heat-processed, AGE-rich meal in individuals with type 2 diabetes and suggests benfotiamine as a potential treatment. [Article] - Cameron NE, Gibson TM, Nangle MR, Cotter MA. Ann N Y Acad Sci. 2005 Jun;1043:784-92. Inhibitors of advanced glycation end product formation and neurovascular dysfunction in experimental diabetes
Advanced glycation and lipoxidation end products (AGEs/ALEs) have been implicated in the pathogenesis of the major microvascular complications of diabetes mellitus: nephropathy, neuropathy, and retinopathy. Benfotiamine is a transketolase activator that directs these substrates to the pentose phosphate pathway, thus reducing tissue AGEs. [Abstract] - Du X, Edelstein D, Brownlee M. Diabetologia. 2008 Oct;51(10):1930-2. Oral benfotiamine plus alpha-lipoic acid normalises complication-causing pathways in type 1 diabetes
In the nine participants with type 1 diabetes, treatment had no effect on any of the three indicators used to assess hyperglycaemia. However, treatment with benfotiamine plus alpha-lipoic acid completely normalised increased AGE formation, reduced increased monocyte hexosamine-modified proteins by 40% and normalised the 70% decrease in prostacyclin synthase activity from 1,709 +/- 586 pg/ml 6-keto-prostaglandin F(1alpha) to 4,696 +/- 533 pg/ml. These results show that the previously demonstrated beneficial effects of these agents on complication-causing pathways in rodent models of diabetic complications also occur in humans with type 1 diabetes. [Abstract]
AGES – RETINOPATHY
- Balakumar P, Rohilla A, Krishan P, Solairaj P, Thangathirupathi A. Pharmacol Res. 2010 Jun;61(6):482-8 The multifaceted therapeutic potential of benfotiamine
AGEs exaggerate the status of oxidative stress in diabetes that may additionally contribute to functional changes in vascular tone control observed in diabetes. The anti-AGE property of benfotiamine certainly makes it effective for the treatment of diabetic neuropathy, nephropathy and retinopathy. Interestingly, few recent studies demonstrated additional non-AGE-dependent pharmacological actions of benfotiamine. [Abstract]
COMPLICATIONS
- Nawale RB, Mourya VK, Bhise SB. Indian J Biochem Biophys. 2006 Dec;43(6):337-44. Non-enzymatic glycation of proteins: a cause for complications in diabetes
Hyperglycemia in diabetes causes non-enzymatic glycation of free amino groups of proteins (of lysine residues) and leads to their structural and functional changes, resulting incomplications of the diabetes. [Abstract] - Hammes HP, Du X, Edelstein D, Taguchi T, Matsumura T, Ju Q, Lin J, Bierhaus A, Nawroth P, Hannak D, Neumaier M, Bergfeld R, Giardino I, Brownlee M. Nat Med. 2003 Mar;9(3):294-9. Benfotiamine blocks three major pathways of hyperglycemic damage and prevents experimental diabetic retinopathy
Three of the major biochemical pathways implicated in the pathogenesis of hyperglycemia induced vascular damage (the hexosamine pathway, the advanced glycation end product (AGE) formation pathway and the diacylglycerol (DAG)-protein kinase C (PKC) pathway) are activated by increased availability of the glycolytic metabolites glyceraldehyde-3-phosphate and fructose-6-phosphate. We have discovered that the lipid-soluble thiamine derivative benfotiamine can inhibit these three pathways, as well as hyperglycemia-associated NF-kappaB activation, by activating the pentose phosphate pathway enzyme transketolase, which converts glyceraldehyde-3-phosphate and fructose-6-phosphate into pentose-5-phosphates and other sugars. In retinas of diabetic animals, benfotiamine treatment inhibited these three pathways and NF-kappaB activation by activating transketolase, and also prevented experimental diabetic retinopathy. The ability of benfotiamine to inhibit three major pathways simultaneously might be clinically useful in preventing the development and progression of diabetic complications. [Abstract] - Thornalley PJ. Curr Diabetes Rev. 2005 Aug;1(3):287-98. The potential role of thiamine (vitamin B1) in diabetic complications
More immediately, given the emerging multiple benefits of thiamine repletion, even mild thiamine deficiency in diabetes should be avoided and thiamine supplementation to high dose should be considered as adjunct nutritional therapy to prevent dyslipidemia and the development of vascular complications in clinical diabetes. [Abstract]
NEPHROPATHY
- Diabetes Obes Metab. 2011 Jul;13(7):577-83. doi: 10.1111/j.1463-1326.2011.01384.x. Emerging role of thiamine therapy for prevention and treatment of early-stage diabetic nephropathy
Thiamine supplementation may prevent and reverse early-stage diabetic nephropathy. This probably occurs by correcting diabetes-linked increased clearance of thiamine, maintaining activity and expression of thiamine pyrophosphate-dependent enzymes that help counter the adverse effects of high glucose concentrations-particularly transketolase. Evidence from experimental and clinical studies suggests that metabolism and clearance of thiamine is disturbed in diabetes leading to tissue-specific thiamine deficiency in the kidney and other sites of development of vascular complications. [Abstract] - Jeganathan VS. Curr Pharm Biotechnol. 2011 Mar 1;12(3):392-5. The therapeutic implications of renin-angiotensin system blockade in diabetic retinopathy
Research has proven that blood pressure is an important modifiable risk factor for diabetic retinopathy and that lowering high blood pressure significantly reduces the development and progression of retinopathy in both type 1 and type 2 diabetic patients. [Abstract]
RETINOPATHY
- Clermont A, Bursell SE, Feener EP. J Hypertens Suppl. 2006 Mar;24(1):S73-80. Role of the angiotensin II type 1 receptor in the pathogenesis of diabetic retinopathy: effects of blood pressure control and beyond
Hypertension has been identified as a major risk factor for diabetic retinopathy and randomized clinical trials have shown that reduction of blood pressure using angiotensin converting enzyme (ACE) inhibitors reduces the progression of diabetic retinopathy. [Abstract] - Sjølie AK. Diabetes Res Clin Pract. 2007 May;76 Suppl 1:S31-9. Prospects for angiotensin receptor blockers in diabetic retinopathy
Several trials have suggested that ACE inhibitor therapy can inhibit progression of retinopathy. [Abstract] - Porta M, Maldari P, Mazzaglia F. Diabetes Obes Metab. 2011 Sep;13(9):784-90. doi: 10.1111/j.1463-1326.2011.01415.x. New approaches to the treatment of diabetic retinopathy
Results from recent clinical trials suggest a role for blockers of the renin-angiotensinsystem (angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers) and for fenofibrate in reducing progression and/or inducing regression of mild-to-moderate non-proliferative DR. [Abstract]
COMPLICATIES
- Cordonnier DJ, Zaoui P, Halimi S. Drugs. 2001;61(13):1883-92. Role of ACE inhibitors in patients with diabetes mellitus
Experimental and epidemiological data suggest that activation of the renin-angiotensin-aldosterone system plays an important role in increasing in the micro- and macrovascular complications in patients with diabetes mellitus. Not only are ACE inhibitors potent antihypertensive agents but there is a growing body of data indicating that also they have a specific 'organ-protective' effect. For the same degree of blood pressure control, compared with other antihypertensive agents, ACE inhibitors demonstrate function and tissue protection of considered organs. [Abstract] - Podar T, Tuomilehto J. Drugs. 2002;62(14):2007-12. The role of angiotensin converting enzyme inhibitors and angiotensin II receptor antagonists in the management of diabetic complications
Evidence suggests that ACE inhibitors can be advantageous for prevention and halting progression of both micro- and macrovascular complications in patients with diabetes mellitus. ACE inhibitors are useful antihypertensive agents in both type 1 and type 2 diabetes; however, ACE inhibitor therapy often needs to be supplemented with calcium channel antagonists, beta-blockers or diuretics to achieve good blood pressure control. ACE inhibitors are also indicated in non-hypertensive patients with type 1 and type 2 diabetes who have micro- or macroalbuminuria. The effect of ACE inhibitors in halting the development and progression of retinopathy and, potentially, neuropathy needs further proof in large-scale studies. More recently, angiotensin II receptor antagonists are emerging as drugs with the potential to be successfully included in the management of diabetic complications, especially when ACE inhibitors are not suitable because of adverse effects. [Abstract]
NEUROPATHY
- Malik RA, Williamson S, Abbott C, Carrington AL, Iqbal J, Schady W, Boulton AJ. Lancet. 1998 Dec 19-26;352(9145):1978-81. Effect of angiotensin-converting-enzyme (ACE) inhibitor trandolapril on human diabetic neuropathy: randomised double-blind controlled trial
The ACE inhibitor trandolapril may improve peripheral neuropathy in normotensive patients with diabetes. Larger clinical trials are needed to confirm these data before changes to clinical practice can be advocated. [Abstract]
INSULIN SENSITIVITY
- Pollare T. J Diabet Complications. 1990 Apr-Jun;4(2):75-8. Insulin sensitivity and blood lipids during antihypertensive treatment with special reference to ACE inhibition
ACE inhibitors may be the agents of choice because of their potential positive effects on insulin sensitivity and renal function, and their lack of severe adverse side-effects. [Abstract] - Scheen AJ. Rev Med Liege. 2002 Jul;57(7):449-52 Prevention of type II diabetes by inhibiting the renin-angiotensin system
Some studies suggested that inhibitors of angiotensin converting enzyme can improve insulin sensitivity. Interestingly enough, three clinical trials recently reported concordant results showing that the inhibition of the renin-angiotensin system significantly reduces the risk of developing type 2 diabetes in patients at high risk of vascular complications. [Abstract]
PREVENTION DIABETES
- Fonseca VA. J Clin Hypertens (Greenwich). 2006 Oct;8(10):713-20; Insulin resistance, diabetes, hypertension, and renin-angiotensin system inhibition: reducing risk for cardiovascular disease
Similarly, analysis of data from clinical trials of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers indicate that the use of these agents results in fewer cases of new-onset diabetes among patients with hypertension, when compared with other antihypertensive agents. [Article]
Benfotiamine
ACE remmer
HIGH BLOOD PRESSURE RISK FACTOR- Kowluru RA, Kennedy A. Expert Opin Investig Drugs. 2001 Sep;10(9):1665-76. Therapeutic potential of anti-oxidants and diabetic retinopathy
Oxidative stress is increased in the retina in diabetes. The possible sources of increased oxidative stress might include increased generation of free radicals or impaired anti-oxidant defence system. Dietary supplementation with anti-oxidants in animal models of diabetic retinopathy inhibits retinal metabolic abnormalities and retinal histopathology, suggesting that oxidative stress is associated with the development of retinopathy. The mechanism by which anti-oxidants inhibit retinopathy in diabetes warrants further investigation, but animal studies show that increasing the diversity of anti-oxidants provides significantly more protection than using any single anti-oxidant. Thus, supplementation with anti-oxidants represents an achievable adjunct therapy to help preserve vision in diabetic patients. [Abstract] - Kowluru RA, Tang J, Kern TS Diabetes. 2001 Aug;50(8):1938-42. Abnormalities of retinal metabolism in diabetes and experimental galactosemia. VII. Effect of long-term administration of antioxidants on the development of retinopathy
Thus, long-term administration of antioxidants can inhibit the development of the early stages of diabetic retinopathy, and the mechanism by which this action occurs warrants further investigation. Supplementation with antioxidants can offer an achievable and inexpensive adjunct therapy to help inhibit the development of retinopathy in diabetes. [Article] - Kowluru RA, Kennedy A. Expert Opin Investig Drugs. 2001 Sep;10(9):1665-76. Therapeutic potential of anti-oxidants and diabetic retinopathy
Thus, supplementation with anti-oxidants represents an achievable adjunct therapy to help preserve vision in diabetic patients. [Abstract] - Kowluru RA, Koppolu P. Free Radic Res. 2002 Sep;36(9):993-9. Diabetes-induced activation of caspase-3 in retina: effect of antioxidant therapy
Our results suggest that increased oxidative stress in diabetes is involved in the activation of retinal caspase-3 and apoptosis of endothelial cells and pericytes. Antioxidants might be inhibiting the development of diabetic retinopathy by inhibiting microvascular apoptosis. [Abstract]
PYCNOGENOL
- From Wikipedia, the free encyclopedia Proanthocyanidin
Proanthocyanidine (PAC), ook bekend als oligomerisch proanthocyanidine (OPC), pycnogenol, leukocyanidine of leucoanthocyanine is een groep van flavonoïden. Proanthocyanidine is een antioxidant[14] 20 keer sterker dan vitamine C en 50 keer sterker dan vitamine E[15]. Rode wijn bevat 180 milligram proanthocyanidine per liter, twintig keer meer dan witte wijn. [Article] - Spadea L, Balestrazzi E. Phytother Res. 2001 May;15(3):219-23. Treatment of vascular retinopathies with Pycnogenol
The results demonstrated a beneficial effect of Pycnogenol on the progression of retinopathy. The mechanism of action of Pycnogenol may be related to its free radical (FR) scavenging, anti-inflammatory and capillary protective activities. It has been suggested that Pycnogenol may bind to the blood vessel wall proteins and mucopolysaccharides and produce a capillary 'sealing' effect, leading to a reduced capillary permeability and oedema formation. [Abstract] - Kamuren ZT, McPeek CG, Sanders RA, Watkins JB 3rd. J Ocul Pharmacol Ther. 2006 Feb;22(1):10-8. Effects of low-carbohydrate diet and Pycnogenol treatment on retinal antioxidant enzymes in normal and diabetic rats
When diet was combined with Pinus maritima treatment, both retinal glutathione peroxidase and glutathione reductase activities increased, suggesting that a low-carbohydrate diet plus Pinus maritima may be an effective antioxidant and antihyperglycemic therapy, reducing the risk of diabetic retinopathy and cataract formation. [Abstract]
VITAMIN E
- Pazdro R, Burgess JR. Mech Ageing Dev. 2010 Apr;131(4):276-86. The role of vitamin E and oxidative stress in diabetes complications
Diabetes is a disease characterized by poor glycemic control for which risk of the type 2 form increases with age. A rise in blood glucose concentration causes increased oxidative stress which contributes to the development and progression of diabetes-associated complications. Studies have shown that primary antioxidants or genetic manipulation of antioxidant defenses can at least partially ameliorate this oxidative stress and consequentially, reduce severity of diabetic complications in animal models. The most compelling evidence for an effect of vitamin E in diabetes is on protection against lipid peroxidation, whereas effects on protein and DNA oxidation are less pronounced. [Abstract] - Bursell SE, Clermont AC, Aiello LP, Aiello LM, Schlossman DK, Feener EP, Laffel L, King GL. Diabetes Care. 1999 Aug;22(8):1245-51. High-dose vitamin E supplementation normalizes retinal blood flow and creatinine clearance in patients with type 1 diabetes
Oral vitamin E treatment appears to be effective in normalizing retinal hemodynamic abnormalities and improving renal function in type 1 diabetic patients of short disease duration without inducing a significant change in glycemic control. This suggests that vitamin E supplementation may provide an additional benefit in reducing the risks for developing diabetic retinopathy or nephropathy. [Article] - Bursell SE, King GL. Diabetes Res Clin Pract. 1999 Sep;45(2-3):169-82. Can protein kinase C inhibition and vitamin E prevent the development of diabetic vascular complications?
In addition high doses of vitamin E were shown to decrease the level of DAG and PKC induced by diabetes or hyperglycemia. Thus animal and clinical studies have shown that high doses of vitamin E treatment can apparently reverse some of the changes in the retinal and renal vessels. [Abstract]
LIPOIC ACID
- Lin J, Bierhaus A, Bugert P, Dietrich N, Feng Y, Vom Hagen F, Nawroth P, Brownlee M, Hammes HP. Diabetologia. 2006 May;49(5):1089-96. Effect of R-(+)-alpha-lipoic acid on experimental diabetic retinopathy
R-(+)-alpha-lipoic acid prevents microvascular damage through normalised pathways downstream of mitochondrial overproduction of ROS, and preserves pericyte coverage of retinal capillaries, which may provide additional endothelial protection. [Article] - Nebbioso M, Federici M, Rusciano D, Evangelista M, Pescosolido N. Diabetes Technol Ther. 2011 Nov 1 Oxidative Stress in Preretinopathic Diabetes Subjects and Antioxidants
Patients were randomized in two groups, one of which received oral AO treatment with ?-lipoic acid at 400?mg/day in association with genistein and vitamins, whereas the other group received a placebo. Conclusions: Results of this preliminary study suggest that an oral treatment with AOs in PRD subjects may have a protective effect on retinal cells, as detected by ERG analysis, through the strengthening of the plasma AO barrier. [Abstract] - Reljanovic M, Reichel G, Rett K, Lobisch M, Schuette K, Möller W, Tritschler HJ, Mehnert H Free Radic Res. 1999 Sep;31(3):171-9. Treatment of diabetic polyneuropathy with the antioxidant thioctic acid (alpha-lipoic acid): a two year multicenter randomized double-blind placebo-controlled trial (ALADIN II). Alpha Lipoic Acid in Diabetic Neuropathy
We conclude that in a subgroup of patients after exclusion of patients with excessive test variability throughout the trial, TA appeared to have a beneficial effect on several attributes of nerve conduction. [Abstract] - Jacob S, Ruus P, Hermann R, Tritschler HJ, Maerker E, Renn W, Augustin HJ, Dietze GJ, Rett K. Free Radic Biol Med. 1999 Aug;27(3-4):309-14. Oral administration of RAC-alpha-lipoic acid modulates insulin sensitivity in patients with type-2 diabetes mellitus: a placebo-controlled pilot trial
The results suggest that oral administration of alpha-lipoic acid can improve insulin sensitivity in patients with type-2 diabetes. The encouraging findings of this pilot trial need to be substantiated by further investigations. [Abstract]
Antioxidants
- From Wikipedia, the free encyclopedia Flavonoid
Flavonoids (both flavonols and flavanols) are most commonly known for their antioxidant activity. Additionally, at high experimental concentrations that would not exist in vivo, the antioxidant abilities of flavonoids in vitro are stronger than those of vitamin C and E. [Article] - From Wikipedia, the free encyclopedia Proanthocyanidin
Proanthocyanidin (PA or PAC), also known as procyanidin, oligomeric proanthocyanidin (OPC), leukocyanidin, leucoanthocyanin and condensed tannins, is a class of flavanols. Proanthocyanidins are essentially polymer chains of flavonoids such as flavan-3-ols (catechins). One was discovered in 1948 by Jacques Masquelier and called Vitamin P, although this name did not gain official category status and has since fallen out of usage. It was Masquelier who first developed techniques for the extraction of proanthocyanidins from certain plant species. [Article] - Majumdar S, Srirangam R. J Pharm Pharmacol. 2010 Aug;62(8):951-65. Potential of the bioflavonoids in the prevention/treatment of ocular disorders
Several pharmacological actions of the bioflavonoids may be useful in the prevention or treatment of ocular diseases responsible for vision loss such as diabetic retinopathy, macular degeneration and cataract. [Abstract]
PYCNOGENOL
- Maimoona A, Naeem I, Saddiqe Z, Jameel K. J Ethnopharmacol. 2011 Jan 27;133(2):261-77 A review on biological, nutraceutical and clinical aspects of French maritime pine bark extract
Bark extract of Pinus pinaster has a long history of ethnomedicinal use and is available commercially as herbal dietary supplement with proprietary name pycnogenol. It is used as a food supplement to overcome many degenerative disorders. Rohdewald (2002) wrote the first comprehensive review of extract highlighting its antioxidative nature and its role in different diseases. Later, Watson (2003) and Gulati (2005) in their reviews about cardiovascular health, described the extract as a best neutraceutical agent in this regard. [Abstract]
PYCNOGENOL - OEDEMA
- Spadea L, Balestrazzi E. Phytother Res. 2001 May;15(3):219-23. Treatment of vascular retinopathies with Pycnogenol
The results demonstrated a beneficial effect of Pycnogenol on the progression of retinopathy. It has been suggested that Pycnogenol may bind to the blood vessel wall proteins and mucopolysaccharides and produce a capillary 'sealing' effect, leading to a reduced capillary permeability and oedema formation. [Abstract] - Schönlau F, Rohdewald P. Int Ophthalmol. 2001;24(3):161-71. Pycnogenol for diabetic retinopathy. A review
All of these studies unequivocally showed that Pycnogenol retains progression of retinopathy and partly recovers visual acuity. Treatment efficacy of Pycnogenol was at least as good as that of calcium dobesilate. Pycnogenol was shown to improve capillary resistance and reduce leakages into the retina. Tolerance was generally very good and side effects were rare, mostly referring to gastric discomfort. In conclusion, treatment with Pycnogenol had a favourable outcome in the majority of the patients with diabetic retinopathy. [Abstract] - Steigerwalt R, Belcaro G, Cesarone MR, Di Renzo A, Grossi MG, Ricci A, Dugall M, Cacchio M, Schönlau F. J Ocul Pharmacol Ther. 2009 Dec;25(6):537-40. Pycnogenol improves microcirculation, retinal edema, and visual acuity in early diabetic retinopathy
Previous studies with Pycnogenol showed effectiveness for stopping progression of preproliferative stages of retinopathy. The aim of our study was to show protective effects of Pycnogenol in early stages of retinopathy, characterized by mild to moderate retinal edema in the absence of hemorrhages or hard exudates in the macula center. Pycnogenol taken at this early stage of retinopathy may enhance retinal blood circulation accompanied by regression of edema, which favorably improves vision of patients. [Abstract]
PYCNOGENOL - enlargements and neovascularization
- Li M, Ma YB, Gao HQ, Li BY, Cheng M, Xu L, Li XL, Li XH Chin Med J (Engl). 2008 Dec 20;121(24):2544-52. A novel approach of proteomics to study the mechanism of action of grape seed proanthocyanidin extracts on diabetic retinopathy in rats
GSPE significantly reduced the AGEs of diabetic rats (P < 0.05). Moreover, GSPE significantly suppressed the vascular lesions of central regions, decreased capillary enlargements and neovascularization, similar to those of the control rats under light microscope. [Article]
PYCNOGENOL - antihyperglycemic
- Kamuren ZT, McPeek CG, Sanders RA, Watkins JB 3rd. J Ocul Pharmacol Ther. 2006 Feb;22(1):10-8. Effects of low-carbohydrate diet and Pycnogenol treatment on retinal antioxidant enzymes in normal and diabetic rats
When diet was combined with Pinus maritima treatment, both retinal glutathione peroxidase and glutathione reductase activities increased, suggesting that a low-carbohydrate diet plus Pinus maritima may be an effective antioxidant and antihyperglycemic therapy, reducing the risk of diabetic retinopathy and cataract formation. [Abstract]
PYCNOGENOL - OTHER DISEASE
- Zibadi S, Rohdewald PJ, Park D, Watson RR. Nutr Res. 2008 May;28(5):315-20. Reduction of cardiovascular risk factors in subjects with type 2 diabetes by Pycnogenol supplementation
After 12 weeks of supplementation, Pycnogenol resulted in improved diabetes control, lowered CVD risk factors, and reduced antihypertensive medicine use vs controls. [Abstract] - Belcaro G, Cesarone MR, Errichi BM, Ledda A, Di Renzo A, Stuard S, Dugall M, Pellegrini L, Gizzi G, Rohdewald P, Ippolito E, Ricci A, Cacchio M, Cipollone G, Ruffini I, Fano F, Hosoi M. Clin Appl Thromb Hemost. 2006 Jul;12(3):318-23. Diabetic ulcers: microcirculatory improvement and faster healing with pycnogenol
The combined treatment group and oral only group had better microcirculation after the combined treatment. Combined local and systemic application of Pycnogenol may offer a new treatment of diabetic ulcers. Local treatment also speeds ulcer healing. [Abstract]
CALCIUM DOBESILATE
- From Wikipedia, the free encyclopedia Chronic venous insufficiency
Chronic venous insufficiency or CVI is a medical condition where the veins cannot pump enough oxygen-poor blood back to the heart. [Article] - Rabe E, Jaeger KA, Bulitta M, Pannier F. Phlebology. 2011;26(4):162-8. Calcium dobesilate in patients suffering from chronic venous insufficiency: a double-blind, placebo-controlled, clinical trial
Dobesilate reduces leg oedema and improves the symptoms of objectively diagnosed CVI, independent of the concomitant usage of compression stockings. [Abstract] - Ribeiro ML, Seres AI, Carneiro AM, Stur M, Zourdani A, Caillon P, Cunha-Vaz JG; DX-Retinopathy Study Group. Graefes Arch Clin Exp Ophthalmol. 2006 Dec;244(12):1591-600. Effect of calcium dobesilate on progression of early diabetic retinopathy: a randomised double-blind study
Calcium dobesilate 2 g daily for 2 years shows a significantly better activity than placebo on prevention of BRB disruption, independently of diabetes control. Tolerance was very good. [Abstract] - Allain H, Ramelet AA, Polard E, Bentué-Ferrer D. Drug Saf. 2004;27(9):649-60. Safety of calcium dobesilate in chronic venous disease, diabetic retinopathy and haemorrhoids
This review concludes that the risk of an adverse effect with calcium dobesilate 500-1500 mg/day is low and constant over time. [Abstract] - Benarroch IS, Brodsky M, Rubinstein A, Viggiano C, Salama EA. Ophthalmic Res. 1985;17(3):131-8. Treatment of blood hyperviscosity with calcium dobesilate in patients with diabetic retinopathy
These results indicate that calcium dobesilate, by restoring the integrity of the microvessels, and by lowering blood viscosity, could act favorably on the evolution of diabetic retinopathy. [Abstract] - Haritoglou C, Gerss J, Sauerland C, Kampik A, Ulbig MW; CALDIRET study group. Lancet. 2009 Apr 18;373(9672):1364-71. Effect of calcium dobesilate on occurrence of diabetic macular oedema (CALDIRET study): randomised, double-blind, placebo-controlled, multicentre trial
Calcium dobesilate did not reduce the risk of development of CSME. [Abstract]
. [Abstract]
Pycnogenol
BIOFLAVONOIDS- From Wikipedia, the free encyclopedia Isoflavones
Isoflavones comprise a class of organic compounds, often naturally occurring, related to the isoflavonoids. Many act as phytoestrogens in mammals. Being phytochemicals, they are able to be termed antioxidants because of their ability to trap singlet oxygen. [Article] - From Wikipedia, the free encyclopedia Genistein
Genistein is one of several known isoflavones. Isoflavones, such as genistein and daidzein, are found in a number of plants including lupin, fava beans, soybeans, kudzu, and psoralea being the primary food source. Besides functioning as antioxidant and anthelmintic, many isoflavones have been shown to interact with animal and human estrogen receptors, causing effects in the body similar to those caused by the hormone estrogen. [Article] - Ibrahim AS, El-Shishtawy MM, Peña A Jr, Liou GI Mol Vis. 2010 Oct 8;16:2033-42. Genistein attenuates retinal inflammation associated with diabetes by targeting of microglial activation
These findings show genistein to be effective in dampening diabetes-induced retinal inflammation by interfering with inflammatory signaling (ERK and P38 MAPKs) that occurs in activated microglia. This beneficial effect of genistein may represent a new intervention therapy to modulate early pathological pathways long before the occurrence of vision loss among diabetics. [Article] - Nakajima M, Cooney MJ, Tu AH, Chang KY, Cao J, Ando A, An GJ, Melia M, de Juan E Jr. Invest Ophthalmol Vis Sci. 2001 Aug;42(9):2110-4. Normalization of retinal vascular permeability in experimental diabetes with genistein
Long-term oral administration of genistein significantly inhibits retinal vascular leakage in experimentally induced diabetic rats. Tyrosine kinase inhibition may be a useful pharmacological approach for the treatment of diabetic-induced retinal vascular leakage. [Article]
MENOPAUSAL
- Oh HY, Kim SS, Chung HY, Yoon S. J Med Food. 2005 Spring;8(1):1-7. Isoflavone supplements exert hormonal and antioxidant effects in postmenopausal Korean women with diabetic retinopathy
There is growing evidence that soy isoflavones exert hormonal and antioxidant effects in postmenopausal women. These findings suggest that GCP supplementation may change the levels of some hormones and improve antioxidant status in postmenopausal Korean women with diabetic retinopathy. [Abstract] - Evans M, Elliott JG, Sharma P, Berman R, Guthrie N. Maturitas. 2011 Feb;68(2):189-96. The effect of synthetic genistein on menopause symptom management in healthy postmenopausal women: a multi-center, randomized, placebo-controlled study
The current study provides the first evidence that a single daily dose of 30 mg of synthetic genistein reduces hot flush frequency and duration. [Abstract] - Ferrari A. J Obstet Gynaecol Res. 2009 Dec;35(6):1083-90. Soy extract phytoestrogens with high dose of isoflavones for menopausal symptoms
In daily practice conditions, high doses of isoflavones, particularly genistein, can be used for the management of hot flushes in . [Abstract] - Marini H, Minutoli L, Polito F, Bitto A, Altavilla D, Atteritano M, Gaudio A, Mazzaferro S, Frisina A, Frisina N, Lubrano C, Bonaiuto M, D'Anna R, Cannata ML, Corrado F, Adamo EB, Wilson S, Squadrito F. Ann Intern Med. 2007 Jun 19;146(12):839-47 Effects of the phytoestrogen genistein on bone metabolism in osteopenic postmenopausal women: a randomized trial.
Twenty-four months of treatment with genistein has positive effects on BMD in osteopenic postmenopausal women. ClinicalTrials.gov registration number:. [Abstract]
PUERARIN
- Ren P, Hu H, Zhang R. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2000 Aug;20(8):574-6. Observation on efficacy of puerarin in treating diabetic retinopathy
Puerarin can reduce blood viscosity, improve microcirculation, and plays a positive therapeutic role in diabetic retinopathy. [Abstract] - Teng Y, Cui H, Yang M, Song H, Zhang Q, Su Y, Zheng J. Mol Biol Rep. 2009 May;36(5):1129-33. Protective effect of puerarin on diabetic retinopathy in rats
It was concluded that puerarin exerts significant protective effects against DR in rats, likely regulating angiogenesis factors expressions, and thus may be an effective and promising medicine for treatment of DR. [Abstract]
Genistein
ISOFLAVONES- Ellis JM, Folkers K, Minadeo M, VanBuskirk R, Xia LJ, Tamagawa H. Biochem Biophys Res Commun. 1991 Aug 30;179(1):615-9. A deficiency of vitamin B6 is a plausible molecular basis of the retinopathy of patients with diabetes mellitu
The absence of retinopathy in vitamin B6-treated diabetic patients over periods of 8 months - 28 years appears monumental. These observations are like discovery and constitute a basis for a new protocol to establish the apparent relationship of a deficiency of vitamin B6 as a molecular cause of diabetic neuropathy. [Abstract] - Stitt A, Gardiner TA, Alderson NL, Canning P, Frizzell N, Duffy N, Boyle C, Januszewski AS, Chachich M, Baynes JW, Thorpe SR. Diabetes. 2002 Sep;51(9):2826-32. The AGE inhibitor pyridoxamine inhibits development of retinopathy in experimental diabetes
These results indicate that the AGE/ALE inhibitor PM protected against a range of pathological changes in the diabetic retina and may be useful for treating diabetic retinopathy. [Article]
. [Abstract]
B6
NOG UITZOEKEN OF DEZE ONDERZOEKEN NUTTIG ZIJN
Wetenschappleijke onderbouwing van het retinopathie protocol
L-carnitine en retinopathie
ONDERSTAAND ONDERZOEK MOET WORDEN VERPLAATST NAAR BLS STABILISATIE, NEUROPATHIE EN AMD
Referenties chroom bij de behandeling van retinopathie
- The effects of inorganic chromium and brewer's yeast supplementation on glucose tolerance, serum lipids and drug dosage in individuals with type 2 diabetes, Bahijiri SM, Mira SA, Mufti AM, Ajabnoor MA, Department of Clinical Biochemistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
- Chromium: The Missing Mineral, by Thomas H. Maugh II, Los Angeles Times, October 20, 1992
- Chromium May Reduce Risk of Diabetes, NEW YORK (BW HealthWire), June 27, 1997
- Chromium picolinate increases membrane fluidity and rate of insulin internalization, Evans GW, Bowman TD, Department of Chemistry, Bemidji State University, MN 56601-269
- Chromium (III)-ion enhances the utilization of glucose in type-2 diabetes mellitus, Keszthelyi Z, Past T, Koltai K, Szabo L, Mozsik G, Pecsi Tudomanyegyetem, Altalanos Orvostudomanyi Kar, I. Belgyogyaszati Klinika, Pecs. gyula.mozsik@aok.pte.hu
- Nutritional factors influencing the glucose/insulin system: chromium, Anderson RA, Nutrient Requirements and Functions Laboratory, United States Department of Agriculture, Beltsville, Maryland 20705-2350, USA
- Antioxidant effects of chromium supplementation with type 2 diabetes mellitus and euglycemic subjects, Cheng HH, Lai MH, Hou WC, Huang CL, School of Nutrition and Health Sciences, Taipei Medical University, Taipei 110, Taiwan. chenghh@tmu.edu.tw
- Chromium and insulin resistance, Kleefstra N, Bilo HJ, Bakker SJ, Houweling ST, Isala Klinieken, locatie Weezenlanden, afd. Interne Geneeskunde, Postbus 10.500, 8000 GM Zwolle, kleefstra@langerhans.com
- A scientific review: the role of chromium in insulin resistance, PubMed - indexed for MEDLINE
Referenties alfa liponzuur bij de behandeling van retinopathie
- Alpha-lipoic acid: a multifunctional antioxidant that improves insulin sensitivity in patients with type 2 diabetes, Evans JL, Goldfine ID, Medical Research Institute, San Bruno, California 94066, USA. jevans@lipoic.com
- The sensory symptoms of diabetic polyneuropathy are improved with alpha-lipoic acid: the SYDNEY trial, Ametov AS, Barinov A, Dyck PJ, Hermann R, Kozlova N, Litchy WJ, Low PA, Nehrdich D, Novosadova M, O'Brien PC, Reljanovic M, Samigullin R, Schuette K, Strokov I, Tritschler HJ, Wessel K, Yakhno N, Ziegler D; SYDNEY Trial Study Group, Russian Medical Academy for Advanced Studies, Moscow, Russia
- The function of endogenous protective systems in patients with insulin-dependent diabetes mellitus and polyneuropathy: effect of antioxidant therapyStrokov IA, Manukhina EB, Bakhtina LY, Malyshev IY, Zoloev GK, Kazikhanova SI, Ametov AS, Department of Endocrinology and Diabetology, Russian Medical Academy of Postgraduate Education, Moscow
- In vivo effect of lipoic acid on lipid peroxidation in patients with diabetic neuropathy, Androne L, Gavan NA, Veresiu IA, Orasan R, Diabetes Center & Clinic, Cluj Napoca
- Alpha-lipoic acid in the treatment of diabetic polyneuropathy in Germany: current evidence from clinical trials, Ziegler D, Reljanovic M, Mehnert H, Gries FA, Diabetes-Forschungsinstitut an der Heinrich-Heine-Universitat, Dusseldorf, Germany. dan.ziegler@dfi.uni-duesseldorf.de
- Effect of alpha-lipoic acid on the peripheral conversion of thyroxine to triiodothyronine and on serum lipid-, protein- and glucose levels, Segermann J, Hotze A, Ulrich H, Rao GS, Institute of Clinical Biochemistry, University of Bonn, Fed. Rep. of Germany.
SITE MAP
Maagdarmstoornissen: Candida infectie - Prikkelbaredarmsyndroom - Crohn - Colitus Ulcerosa - CVS/ME: Chronische vermoeidheid Syndroom - Diabetische complicaties: Bloeduiker stabilisatie - Neuropathie - Retinopathie - Nefropathie - Hart- en vaatziekten: Cardiomyopathie en Hartfalen - Hoge bloeddruk - Cholesterol verlaging - Aderverkalking (atherosclerose) - Spataderen - Levensverlenging: 100 jaren jong - DHEA - Melatonine - 65+ - Kanker: - Ondersteuningstherapie bij kanker - Bot en gewrichtsaandoeningen: - Artrose - Artritis - Osteoporose - Fibromyalgie: - Fibromyalgie - Urinewegaandoeningen: - Prostaatklachten - Blaasontsteking - Vrouwenklachten: Menopauze - Premenstrueelsyndroom - Overgewicht: - Overgewicht - SLIM - Oogaandoeningen: Staar - Slecht zien Andere artikelen: - HPU - Astma - Multiple Sclerose - Psoriasis - Depressie
Maagdarmstoornissen: Candida infectie - Prikkelbaredarmsyndroom - Crohn - Colitus Ulcerosa - CVS/ME: Chronische vermoeidheid Syndroom - Diabetische complicaties: Bloeduiker stabilisatie - Neuropathie - Retinopathie - Nefropathie - Hart- en vaatziekten: Cardiomyopathie en Hartfalen - Hoge bloeddruk - Cholesterol verlaging - Aderverkalking (atherosclerose) - Spataderen - Levensverlenging: 100 jaren jong - DHEA - Melatonine - 65+ - Kanker: - Ondersteuningstherapie bij kanker - Bot en gewrichtsaandoeningen: - Artrose - Artritis - Osteoporose - Fibromyalgie: - Fibromyalgie - Urinewegaandoeningen: - Prostaatklachten - Blaasontsteking - Vrouwenklachten: Menopauze - Premenstrueelsyndroom - Overgewicht: - Overgewicht - SLIM - Oogaandoeningen: Staar - Slecht zien Andere artikelen: - HPU - Astma - Multiple Sclerose - Psoriasis - Depressie
