Abstract
Glaucoma is a progressive neurodegenerative disease that represents the major cause of irreversible blindness. Recent findings have shown which oxidative stress, inflammation, and glutamatergic pathway have main roles in the causes of glaucoma. Lithium is the major commonly used drug for the therapy of chronic mental illness. Lithium therapeutic mechanisms remain complex, including several pathways and gene expression, such as neurotransmitter and receptors, circadian modulation, ion transport, and signal transduction processes. Recent studies have shown that the benefits of lithium extend beyond just the therapy of mood. Neuroprotection against excitotoxicity or brain damages are other actions of lithium. Moreover, recent findings have investigated the role of lithium in glaucoma. The combination of lithium and atypical antipsychotics (AAPs) has been the main common choice for the treatment of bipolar disorder. Due to the possible side effects gradually introduced in therapy. Currently, no studies have focused on the possible actions of AAPs in glaucoma. Recent studies have shown a down regulation of the WNT/β-catenin pathway in glaucoma, associated with the overactivation of the GSK-3β signaling. The WNT/β-catenin pathway is mainly associated with oxidative stress, inflammation and glutamatergic pathway. Lithium is correlated with upregulation the WNT/β-catenin pathway and downregulation of the GSK-3β activity. Thus, this review focuses on the possible actions of lithium and AAPs, as possible therapeutic strategies, on glaucoma and some of the presumed mechanisms by which these drugs provide their possible benefit properties through the WNT/β-catenin pathway.
Highlights
Glaucoma is a progressive neurodegenerative disease and one of the major cause of irreversible blindness
The PI3K/Akt pathway, which is activated by β-catenin [112,210], interacts by phosphorylating GSK-3β to negatively control the expression of PPARγ [211]
By the negative crosstalk between WNT and PPARγ, Lithium administration by inhibiting the GSK-3β could act as a PPARγ antagonist and leads to increase the WNT pathway resulting in the diminution of oxidative stress
Summary
Glaucoma is a progressive neurodegenerative disease and one of the major cause of irreversible blindness. The mechanical process implicates compression of the axons due to increased IOP, while the vascular mechanism shows events in which blood flow and ocular perfusion pressure are decreased to the posterior pole leading to damage [5,6]. Lithium remains a first-line treatment for bipolar disorder, manic-depressive illness, [9], traumatic brain injury [10], and numerous neurodegenerative diseases, such as Alzheimer’s, Huntington’s, and Parkinson’s diseases [11]. Recent studies have highlight possible mechanisms of lithium action through the WNT/beta-catenin pathway in glaucoma [19,20]. This review focuses on the possible actions of lithium and AAPs as possible therapeutic strategies for glaucoma and some of the presumed mechanisms by which these drugs provide their possible benefit properties through the WNT/β-catenin pathway
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