外泌体是由各种细胞分泌产生,广泛存在于生物体液中的纳米级脂质双分子层结构小囊泡,其内容物复杂,具有多种生物学功能。外泌体在青光眼的发生和发展中扮演重要作用,眼内外泌体通过运输青光眼相关蛋白、调节Wnt信号通路、影响细胞外基质周转等参与小梁网细胞调节,从而影响房水循环;小胶质细胞外泌体介导视网膜神经炎症和相关的炎症信号通路。此外,眼内液中外泌体稳定存在,其中差异性表达的蛋白质、RNA等内容物使外泌体具有作为青光眼生物标志物的潜力。在青光眼治疗方面,干细胞源性外泌体抑制胶质细胞活化及神经炎症,减少视网膜神经节细胞的损失,起到神经保护作用。外泌体可通过血-视网膜屏障,输送神经营养因子、药物或其他治疗分子到靶细胞中,调节靶细胞的功能,为青光眼视神经退行性病变提供了新的治疗手段。本文总结国内外青光眼与外泌体领域的研究进展,并对外泌体在青光眼的发生和发展、诊断及治疗中的作用及机制进行综述,以期为早期诊断和治疗青光眼提供新思路。
Exosomes are small vesicles with nanoscale lipid bilayer structures, which are secreted by various cells and are widely present in biological fluids, with complex contents and multiple biological functions.Exosomes play an important role in the development of glaucoma.Exosomes in the eye are involved in trabecular meshwork cell regulation by transporting glaucoma-associated proteins, regulating the Wnt signaling pathway, and affecting extracellular matrix turnover, thereby affecting the atrial circulation.Microglial exosomes mediate retinal neuroinflammation and related inflammatory signaling pathways.In addition, the stable presence of exosomes in intraocular fluid, in which differentially expressed proteins, RNA and other contents give exosomes potential as glaucoma biomarkers.In the treatment of glaucoma, stem cell-derived exosomes inhibit glial cell activation and neuroinflammation, reduce the loss of retinal ganglion cells, and act as neuroprotective agents.Exosomes can cross the blood-retinal barrier, deliver neurotrophic factors, drugs or other therapeutic molecules to target cells, regulate the function of target cells, and provide a new therapeutic tool for glaucomatous optic nerve degeneration.This paper summarized the research progress in the field of glaucoma and exosomes at home and abroad, and reviewed the role of exosomes and related mechanisms in the development, diagnosis, and treatment of glaucoma, expecting to provide new ideas for the early diagnosis and treatment of glaucoma.
酆欣婷,张旭. 外泌体在青光眼诊疗中的作用研究进展[J]. 中华实验眼科杂志,2023,41(02):173-177.
DOI:10.3760/cma.j.cn115989-20220429-00186版权归中华医学会所有。
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