昼夜节律和生物钟基因与糖尿病视网膜病变发病的相关性研究进展

Research progress on the correlation between circadian rhythm and clock genes and the pathogenesis of diabetic retinopathy

摘要:

糖尿病视网膜病变(diabetic retinopathy， DR)是糖尿病患者最常见的微血管并发症，已成为全球工作年龄人群视力障碍的主要原因之一。DR的发生是多种机制共同作用的结果，越来越多的研究表明昼夜节律及生物钟基因与DR的发病密切相关。昼夜节律是受生物钟基因调控，以24h为周期，与外界明暗变化相一致的生理过程，生物钟调控机体的各种生理活动。昼夜节律紊乱通过影响糖尿病患者的血糖水平和眼部的生理稳态等诱导DR的发生，生物钟基因可能通过调控DR的氧化应激反应、炎症反应、视网膜自噬节律、线粒体功能障碍以及内皮祖细胞功能等各方面参与DR的发病。本文介绍了昼夜节律的产生及调控机制，以及视网膜内在昼夜节律生物钟，深入探讨了昼夜节律系统以及生物钟基因在DR发生发展过程中的影响，旨在为DR的预防及治疗提供参考。

Abstract:

Diabetic retinopathy(DR)is the most common microvascular complication of patients with diabetes mellitus, and it has become one of the leading causes of visual impairment among working-age people worldwide. The pathogenesis of DR is complicated with multiple mechanisms. Plenty of studies have indicated that circadian rhythm and clock genes are closely related to the pathogenesis of DR. Circadian rhythm is a physiological process regulated by clock genes, which takes 24h as a cycle and is consistent with the changes of light and dark outside. Circadian rhythm regulates various physiological activities of the body. The disturbance of circadian rhythm induces DR by affecting the blood glucose level and the physiological homeostasis of the eye in patients with diabetes mellitus, and clock genes may be involved in the pathogenesis of DR by regulating oxidative stress response, inflammatory response, retinal autophagy rhythm, mitochondrial dysfunction and endothelial progenitor cell function. This paper will introduce the generation and regulation mechanism of circadian rhythm, as well as the internal circadian rhythm of retina, and further discuss the influence of circadian rhythm and clock genes on the occurrence and development of DR, aiming to provide a reference for the prevention and treatment of DR.