Aldose Reductase as a Key Target in the Prevention and Treatment of Diabetic Retinopathy: A Comprehensive Review

Abstract

The escalating global prevalence of diabetes mellitus (DM) over the past two decades has led to a persistent high incidence of diabetic retinopathy (DR), necessitating screening for early symptoms and proper treatment. Effective management of DR aims to decrease vision impairment by controlling modifiable risk factors including hypertension, obesity, and dyslipidemia. Moreover, systemic medications and plant-based therapy show promise in advancing DR treatment. One of the key mechanisms related to DR pathogenesis is the polyol pathway, through which aldose reductase (AR) catalyzes the conversion of glucose to sorbitol within various tissues, including the retina, lens, ciliary body and iris. Elevated glucose levels activate AR, leading to osmotic stress, advanced glycation end-product formation, and oxidative damage. This further implies chronic inflammation, vascular permeability, and angiogenesis. Our comprehensive narrative review describes the therapeutic potential of aldose reductase inhibitors in treating DR, where both synthetic and natural inhibitors have been studied in recent decades. Our synthesis aims to guide future research and clinical interventions in DR management.

Mucin-Producing Lobular Breast Carcinoma Metastasis to an Ovarian Fibroma: Histopathological and Immunohistochemical Analysis of a Rare Case and Literature Review

“…During immunohistochemistry, a diagnostic technique that may use several specific antibodies to detect proteins [46], the fibroma exhibited positive staining for inhibin and calretinin. Recent investigations have proposed the utility of inhibin and calretinin in diagnosing ovarian sex-cord stromal tumors, with fibromas demonstrating positivity for these markers in approximately 25-30% of cases studied [37,47,48].…”

Immune-Mediated Ocular Surface Disease in Diabetes Mellitus—Clinical Perspectives and Treatment: A Narrative Review

“…Vascular and metabolic mechanisms interact throughout the entire course of the disease to cause synergistic effects. The polyol pathway, increased production of AGEs, oxidative stress, and protein kinase C (PKC) activation are among the processes and mechanisms that lead to DM consequences shown in Figure 2 [ 63 ]. With worsening diabetic neuropathy, a decrease in corneal nerve fiber length, nerve fiber density, and nerve fiber branch density has been observed [ 64 , 65 ].…”