视网膜脱离后光感受器细胞死亡机制及潜在治疗策略

摘要

Retinal detachment (RD) is one of the most common sight-threatening retinal diseases.Visual acuity is not always restored after successful reattachment of the retina.Photoreceptor cell death has been thought to be the major cause of vision loss after RD through various pathways and their interactions,including caspase-dependent apoptosis,endoplasmic reticulum stress-induced apoptosis and non-apoptotic death forms,such as necroptosis,autophagy,and so on.Based on the understanding of the mechanism of photoreceptor cell death after RD,current efforts on combinatorial inhibition of multiple death pathways,targeting upstream molecules and enhancement of intrinsic neuroprotection would help us to protect photoreceptors effectively and improve visual acuity of RD patients.This review summarized current opinions on mechanisms of photoreceptor cell death and the potential treatment strategies.%视网膜脱离(RD)是临床上常见的致盲眼病之一,患者术后视功能恢复不理想.近年来研究表明,光感受器细胞死亡是导致RD后视功能损伤的主要原因,其发生机制复杂,涉及半胱氨酸蛋白酶依赖性的经典凋亡途径、内质网应激等非半胱氨酸蛋白酶依赖性凋亡途径以及坏死性凋亡、自噬等多种信号通路及其相互作用.阐明RD光感受器细胞的死亡机制,并在此基础上采取联合抑制多条死亡通路、干预上游靶点和加强内源性保护等策略有助于保护光感受器细胞,最终改善RD患者的视功能.本文综述了近年来RD光感受器细胞死亡机制的研究进展,探讨了可能存在的干预靶点以及未来潜在的治疗策略.