Abstract
Impairment of neuroprotection and vasculopathy are the main reasons for the progression of diabetic retinopathy. In this review, we decided to illustrate the molecular and clinical aspects of diabetic retinal neuro-vasculopathy. We searched the Web of Science, PubMed, and Scopus databases with these keywords: “brain-derived neurotrophic factor” and “vascular endothelial growth factor” and/or “diabetic retinopathy.” The most relevant in vitro and clinical trial studies were then extracted for final interpretation. Brain-derived neurotrophic factor and the vascular endothelial growth factor have pivotal roles in the pathogenesis of diabetic retinopathy. They have neuroprotective effects on the retina. However, there are controversial results on the relation between these two factors. Reviewing available articles, we have concluded that various concentrations of these molecules at different stages of retinopathy may exert different effects. Optimal doses of the brain-derived neurotrophic factor at the early stages of retinopathy may have a neuroprotective effect. In contrast, higher concentrations of brain-derived neurotrophic factor might induce inflammatory responses. Damage to the retinal cells due to metabolic alterations associated with diabetes and its consequence vasculopathy may also lead to changes in the ocular microenvironment and cytokines. Changes in cytokines result in the modification of neural cell receptors and the overproduction of vascular endothelial growth factor. It seems that controlling the optimal levels of neuroprotective molecules in the retinal tissue is the main step to halter diabetic retinopathy.
Highlights
Brain-derived neurotrophic factor (BDNF) is a neuroprotective factor that may have various effects on the pathogenesis of some neurologic disorders [1]. e effect of BDNF has been studied in some retinal diseases
Retinal ganglion cells and amacrine cells are the first target cells affected by diabetic retinopathy (DR)-induced apoptosis. e clinical sign of this apoptosis is the structural changes of the inner retinal layer and nerve fiber layer such as a reduced thickness of this layer diagnosed by optical coherence tomography (OCT) [30]
BDNF and Vascular endothelial growth factor (VEGF) are two important factors that should be under consideration for DR treatment. ey have neuroprotective effects in the retina, can prevent apoptosis, and establish regeneration of RGCs in the retina
Summary
Brain-derived neurotrophic factor (BDNF) is a neuroprotective factor that may have various effects on the pathogenesis of some neurologic disorders [1]. e effect of BDNF has been studied in some retinal diseases. According to the known physiologic mechanisms of BDNF, the impact of this protein has been studied in age-related macular degeneration (AMD) [2, 3]. Age-related macular degeneration is one of the main causes of blindness in the elderly population in the world [4]. E focus of this study is to review documents related to DR. Today there is a great interest to discover the pathogenesis and molecular mechanism of diabetic retinopathy and AMD. It seems that vasculopathy and impairment of neuroprotection underlie the progression of DR. E aim of this study is to review the documented reports on the role of BDNF and VEGF in pathogenesis and control of diabetic retinopathy and suggesting a relationship between these two factors The relationship between BDNF and VEGF and their regulatory effect on each other is needed to be investigated. e aim of this study is to review the documented reports on the role of BDNF and VEGF in pathogenesis and control of diabetic retinopathy and suggesting a relationship between these two factors
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