Chronic elevation of blood glucose at first causes relatively minor changes to the neural and vascular components of the retina. As the duration of hyperglycemia persists, the nature and extent of damage increases and becomes readily detectable. While this second, overt manifestation of diabetic retinopathy (DR) has been studied extensively, what prevents maximal damage from the very start of hyperglycemia remains largely unexplored. Recent studies indicate that diabetes (DM) engages mitochondria-based defense during the retinopathy-resistant phase, and thereby enables the retina to remain healthy in the face of hyperglycemia. Such resilience is transient, and its deterioration results in progressive accumulation of retinal damage. The concepts that co-emerge with these discoveries set the stage for novel intellectual and therapeutic opportunities within the DR field. Identification of biomarkers and mediators of protection from DM-mediated damage will enable development of resilience-based therapies that will indefinitely delay the onset of DR.

中文翻译：

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对糖尿病视网膜病变的抵抗力


血糖的慢性升高首先会导致视网膜的神经和血管成分发生相对较小的变化。随着高血糖持续时间的延长，损害的性质和程度会增加并变得容易检测到。虽然糖尿病视网膜病变 (DR) 的第二种明显表现已得到广泛研究，但从高血糖一开始就防止最大损害的因素仍然很大程度上尚未探索。最近的研究表明，糖尿病（DM）在视网膜病变抵抗阶段参与基于线粒体的防御，从而使视网膜在面对高血糖时保持健康。这种恢复力是短暂的，其恶化会导致视网膜损伤逐渐累积。与这些发现一起出现的概念为 DR 领域的新知识和治疗机会奠定了基础。鉴定出可预防 DM 介导的损伤的生物标志物和介质，将有助于开发基于恢复力的疗法，从而无限期地延迟 DR 的发生。