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1.
Oxid Med Cell Longev ; 2019: 1479571, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31781321

RESUMO

Age-related macular degeneration (AMD) represents a major reason for blindness in the elderly population. Oxidative stress is a predominant factor in the pathology of AMD. We previously evaluated the effects of phospholipid complex of quercetin (Q-PC) on oxidative injury in ARPE-19 cells, but the underlying mechanisms are not fully understood. Herein, the solid dispersion of quercetin-PC (Q-SD) was prepared with solubility being 235.54 µg/mL in water and 2.3×104 µg/mL in chloroform, which were significantly higher than that of quercetin (QT) and Q-PC. Q-SD also exhibited a considerably higher dissolution rate than QT and Q-PC. Additionally, Q-SD had Cmax of 4.143 µg/mL and AUC of 12.015 µg·h/mL in rats, suggesting better bioavailability than QT and Q-PC. Then, a mouse model of dry AMD (Nrf2 wild-type (WT) and Nrf2 knockout (KO)) was established for evaluating the effects of Q-SD in vivo. Q-SD more potently reduced retinal pigment epithelium sediments and Bruch's membrane thickness than QT and Q-PC at 200 mg/kg in Nrf2 WT mice and did not work in Nrf2 KO mice at the same dosage. Additionally, Q-SD significantly decreased ROS and MDA contents and restored SOD, GSH-PX, and CAT activities of serum and retinal tissues in Nrf2 WT mice, but not in Nrf2 KO mice. Furthermore, Q-SD more potently increased Nrf2 mRNA expression and stimulated its nuclear translocation in retinal tissues of Nrf2 WT mice. Q-SD significantly increased the expression of Nrf2 target genes HO-1, HQO-1, and GCL of retinal tissues in Nrf2 WT mice, not in Nrf2 KO mice. Altogether, Q-SD had improved physicochemical and pharmacokinetic properties compared to QT and Q-PC and exhibited more potent protective effects on retina oxidative injury in vivo. These effects were associated with activation of Nrf2 signaling and upregulation of antioxidant enzymes.


Assuntos
Proteínas do Olho/metabolismo , Degeneração Macular/prevenção & controle , Fator 2 Relacionado a NF-E2/metabolismo , Quercetina/farmacologia , Animais , Proteínas do Olho/genética , Feminino , Regulação da Expressão Gênica/efeitos dos fármacos , Regulação Enzimológica da Expressão Gênica/efeitos dos fármacos , Degeneração Macular/genética , Degeneração Macular/metabolismo , Degeneração Macular/patologia , Camundongos , Camundongos Knockout , Fator 2 Relacionado a NF-E2/genética , Oxirredução/efeitos dos fármacos , Oxirredutases/biossíntese , Oxirredutases/genética , Ratos , Ratos Sprague-Dawley , Espécies Reativas de Oxigênio/metabolismo
2.
Expert Opin Ther Pat ; 29(10): 761-767, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31540558

RESUMO

Introduction: Macular degeneration (MD) and macular edema (ME) are ophthalmologic diseases affecting an increasing number of the aging population. Until recently, there were few therapeutic options for both conditions but the last two decades saw important advances. Areas covered: This review summarizes the agents used for the treatment of age-related MD (AMD), which include verteporfin, for photodynamic therapy, and anti-VEGF agents, the aptamer pegaptanib, the monoclonal antibodies (MAbs) ranibizumab (Lucentis®) and bevacizumab (Avastin®) and the fusion protein aflibercept (Eylea®). All these drugs are effective only for the wet form of AMD, whereas for the dry form there is no treatment available. ME is, on the other hand, treated with nonsteroidal anti-inflammatory drugs and carbonic anhydrase (CA) inhibitors. Recently, MAbs such as ranibizumab and bevacizumab were also shown to be effective for the management of the cystoid and diabetic ME. Expert opinion: There are important advances made in the field in the last years but longer-acting anti-VEGF agents or drugs with less ocular side effects are needed. Many such agents are in clinical development.


Assuntos
Desenvolvimento de Medicamentos , Degeneração Macular/tratamento farmacológico , Edema Macular/tratamento farmacológico , Idoso , Inibidores da Angiogênese/administração & dosagem , Inibidores da Angiogênese/farmacologia , Animais , Humanos , Degeneração Macular/fisiopatologia , Degeneração Macular/prevenção & controle , Edema Macular/fisiopatologia , Edema Macular/prevenção & controle , Patentes como Assunto , Fotoquimioterapia/métodos
3.
Nutrients ; 11(8)2019 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-31349710

RESUMO

The role of diet and circulatory carotenoids and docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) are implicated in age-related macular degeneration (AMD) but not well studied in Chinese. However, other fatty acids were not comprehensively evaluated if it had additional consequence on AMD. This study investigated the relationship among dietary habits, fatty acids levels, carotenoids and AMD in Hong Kong Chinese adults. In this cross-sectional case-controlled study, plasma fatty acids including, saturated fatty acids (SFA), monounsaturated fatty acids (MUFA) and polyunsaturated fatty acids (PUFA), and carotenoids levels were quantified between patients with neovascular AMD (n = 99) and age-gender-matched controls (n = 198). A food frequency questionnaire was also conducted. Low blood carotenoid levels and omega-3 PUFAs namely DHA, EPA and -linolenic acid increased the odds ratio of developing neovascular AMD. High blood omega-6 PUFAs specifically arachidonic acid and eicosadienoic acid, oleic acid (a MUFA) and SFA levels increased the odds ratio of having neovascular AMD. Neovascular AMD group had significantly less omega-3 PUFA rich food (vegetables, nuts, seafood) intake and higher SFA (meat) intake than controls. In short, neovascular AMD was associated with lower circulatory levels of carotenoids and omega-3 PUFAs, and higher level of omega-6 PUFAs, oleic acid and SFAs in the Hong Kong Chinese population. These findings enhance the understandings of dietary impacts on neovascular AMD and provide a context for future nutritional intervention studies.


Assuntos
Carotenoides/sangue , Dieta/efeitos adversos , Ácidos Graxos/sangue , Comportamento Alimentar , Degeneração Macular/epidemiologia , Neovascularização Patológica , Estado Nutricional , Valor Nutritivo , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Carotenoides/administração & dosagem , Estudos de Casos e Controles , Estudos Transversais , Ácidos Graxos/administração & dosagem , Feminino , Hong Kong/epidemiologia , Humanos , Degeneração Macular/diagnóstico , Degeneração Macular/patologia , Degeneração Macular/prevenção & controle , Masculino , Pessoa de Meia-Idade , Fatores de Proteção , Medição de Risco , Fatores de Risco
4.
Oxid Med Cell Longev ; 2019: 3632169, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31249643

RESUMO

Age-related macular degeneration (AMD) is a blinding disease caused by multiple factors and is the primary cause of vision loss in the elderly. The morbidity of AMD increases every year. Currently, there is no effective treatment option for AMD. Intravitreal injection of antivascular endothelial growth factor (anti-VEGF) is currently the most widely used therapy, but it only aims at neovascularization, which is an intermediate pathological phenomenon of wet AMD, not at the etiological treatment. Anti-VEGF therapy can only temporarily delay the degeneration process of wet AMD, and AMD is easy to relapse after drug withdrawal. Therefore, it is urgent to deepen our understanding of the pathophysiological processes underlying AMD and to identify integrated or new strategies for AMD prevention and treatment. Recent studies have found that autophagy dysfunction in retinal pigment epithelial (RPE) cells, cellular senescence, and abnormal immune-inflammatory responses play key roles in the pathogenesis of AMD. For many age-related diseases, the main focus is currently the clearing of senescent cells (SNCs) as an antiaging treatment, thereby delaying diseases. However, in AMD, there is no relevant antiaging application. This review will discuss the pathogenesis of AMD and how interactions among RPE autophagy dysfunction, cellular senescence, and abnormal immune-inflammatory responses are involved in AMD, and it will summarize the three antiaging strategies that have been developed, with the aim of providing important information for the integrated prevention and treatment of AMD and laying the ground work for the application of antiaging strategies in AMD treatment.


Assuntos
Anti-Inflamatórios/uso terapêutico , Autofagia , Senescência Celular , Inflamação/tratamento farmacológico , Degeneração Macular/patologia , Degeneração Macular/prevenção & controle , Fármacos Neuroprotetores/uso terapêutico , Humanos , Degeneração Macular/imunologia , Degeneração Macular/metabolismo , Prognóstico
5.
Discov Med ; 27(148): 153-160, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-31095924

RESUMO

Amyloid-ß (Aß) accumulation has been reported in patients with age-related macular degeneration (AMD), and it has been demonstrated to play an important role in the development of AMD. This study was performed to detect the activation of autophagy in retinal pigment epithelial (RPE) cells treated with Aß, aiming to investigate the potential protective mechanism of RPE cells against Aß stress. Human ARPE-19 cells were treated with soluble Aß1-42 oligomer. Transmission electron microscopy was used to assess the formation of autophagic compartments; immunofluorescence was used to detect the subcellular localization of LC3; and western blot was used to detect the conversion of LC3-I to LC3-II and the expression of p62. Activated autophagy in Aß-treated ARPE-19 cells was detected by three methodologies: 1) generation of autophagic compartments by transmission electron microscopy, 2) altered expression pattern of LC3 by immunofluorescence, and 3) elevated light-chain-3 II (LC3-II) and decreased p62 expression by western blot. These results suggest that Aß could induce autophagy in RPE cells, which provided a potential protective mechanism for the retina cells that encountered Aß deposition.


Assuntos
Peptídeos beta-Amiloides/metabolismo , Morte Celular Autofágica , Células Epiteliais/metabolismo , Degeneração Macular/metabolismo , Fragmentos de Peptídeos/metabolismo , Epitélio Pigmentado da Retina/metabolismo , Peptídeos beta-Amiloides/genética , Linhagem Celular , Células Epiteliais/ultraestrutura , Humanos , Degeneração Macular/genética , Degeneração Macular/patologia , Degeneração Macular/prevenção & controle , Proteínas Associadas aos Microtúbulos/genética , Proteínas Associadas aos Microtúbulos/metabolismo , Fragmentos de Peptídeos/genética , Proteínas de Ligação a RNA/genética , Proteínas de Ligação a RNA/metabolismo , Epitélio Pigmentado da Retina/ultraestrutura
6.
Nutrients ; 11(4)2019 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-30979051

RESUMO

: Eye care professionals should have access to high quality clinical practice guidelines that ideally are underpinned by evidence from robust systematic reviews of relevant research. The aim of this study was to identify clinical guidelines with recommendations pertaining to dietary modification and/or nutritional supplementation for age-related macular degeneration (AMD), and to evaluate the overall quality of the guidelines using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument. We also mapped recommendations to existing systematic review evidence. A comprehensive search was undertaken using bibliographic databases and other electronic resources for eligible guidelines. Quality appraisal was undertaken to generate scores for each of the six AGREE II domains, and mapping of extracted nutritional recommendations was performed for systematic reviews published up to March 2017. We identified 13 national and international guidelines, developed or updated between 2004 and 2019. These varied substantially in quality. The lowest scoring AGREE II domains were for 'Rigour of Development', 'Applicability' (which measures implementation strategies to improve uptake of recommendations), and 'Editorial Independence'. Only four guidelines used evidence from systematic reviews to support their nutritional recommendations. In conclusion, there is significant scope for improving current Clinical Practice Guidelines for AMD, and guideline developers should use evidence from existing high quality systematic reviews to inform clinical recommendations.


Assuntos
Medicina Baseada em Evidências , Degeneração Macular/terapia , Guias de Prática Clínica como Assunto , Suplementos Nutricionais , Humanos , Degeneração Macular/dietoterapia , Degeneração Macular/prevenção & controle , Política Nutricional , Terapia Nutricional
7.
Invest Ophthalmol Vis Sci ; 60(5): 1470-1477, 2019 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-30973575

RESUMO

Purpose: AMD is the leading cause of irreversible blindness in older individuals in the Western world, and there are currently no therapies to halt disease progression. Studies suggest that the commonly prescribed antidiabetic drug, metformin, is associated with decreased risk of several ocular diseases, but no work has investigated the effect of metformin use on development of AMD. Thus, we aim to investigate whether metformin use is associated with decreased risk of developing AMD. Methods: In this retrospective case-control study, we used medical records from patients older than 55 who have visited a University of Florida health clinic. Three controls were matched for every AMD case, defined by International Classification of Diseases, Ninth Revision code, based on the Charlson Comorbidity Index to ensure comparable baseline overall health status. Univariate and conditional multivariable logistic regressions were used to determine the association between a variety of covariates, including metformin use, and AMD diagnosis. Results: Metformin use was associated with decreased odds of developing AMD, independently of the other covariates investigated, with an odds ratio of 0.58 and a 95% confidence interval of 0.43 to 0.79. Other medications assessed were not associated with decreased odds of developing AMD. Conclusions: Patients who had taken metformin had decreased odds of developing AMD, suggesting that metformin may have a therapeutic role in AMD development or progression in those who are at risk. Further work should include clinical trials to investigate prospectively whether metformin has a protective effect in those at risk for developing AMD.


Assuntos
Diabetes Mellitus Tipo 2/tratamento farmacológico , Hipoglicemiantes/uso terapêutico , Degeneração Macular/prevenção & controle , Metformina/uso terapêutico , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Bases de Dados Factuais , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Estudos Retrospectivos , Fatores de Risco
8.
Am J Ophthalmol ; 198: 70-79, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30312575

RESUMO

PURPOSE: What patients should eat to reduce their risk of age-related macular degeneration (AMD) is still unclear. We investigated the effect of a diet recommended by Health Councils on AMD. DESIGN: Prospective population-based cohort study. METHODS: Four thousand two hundred and two participants from the Rotterdam Study ≥55 years of age who were free of AMD at baseline were included and followed up for 9.1 ± 5.8 years. Incident AMD was graded on fundus photographs. Dietary data were collected using a validated 170-item food frequency questionnaire, and food intakes were categorized into food patterns based on guidelines from Health Councils. Associations with incident AMD were analyzed using Cox proportional hazards models that were adjusted for age, sex, total energy intake, smoking, body mass index, hypertension, education, and income. RESULTS: Seven hundred fifty-four people developed incident AMD. Intake of the recommended amounts of vegetables (≥200 g/day), fruit (2×/day), and fish (2×/week) were 30.6%, 54.9%, and 12.5%, respectively. In particular, the intake of fish (2×/week) decreased the risk of incident AMD (hazard ratio 0.76 [95% confidence interval 0.60-0.97]). Intake of the recommended amounts of all 3 food groups was only 3.7%, but adherence to this pattern showed a further reduction of the risk of incident AMD (hazard ratio 0.58 [95% confidence interval 0.36-0.93]). Younger age, higher income, and not smoking were associated with this food pattern, but the risk-lowering effects remained significant after additional adjustment for these factors. CONCLUSION: A diet of 200 grams per day of vegetables, fruit two times per day, and fish two times per week is associated with a significantly reduced risk of AMD.


Assuntos
Dieta , Ingestão de Energia , Peixes , Frutas , Degeneração Macular/prevenção & controle , Verduras , Idoso , Idoso de 80 Anos ou mais , Animais , Estudos de Coortes , Estudos Transversais , Registros de Dieta , Comportamento Alimentar , Feminino , Humanos , Degeneração Macular/dietoterapia , Degeneração Macular/epidemiologia , Masculino , Pessoa de Meia-Idade , Países Baixos/epidemiologia , Estudos Prospectivos , Inquéritos e Questionários
9.
Exp Eye Res ; 178: 238-246, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-29908882

RESUMO

Macular xanthophylls (MXs) are distinguished from other dietary carotenoids by their high membrane solubility and preferential transmembrane orientation. Additionally, these properties enhance the chemical and physical stability of MXs in the eye retina, and maximize their protective activities. The effectiveness of MXs' protection is also enhanced by their selective accumulation in the most vulnerable domains of retinal membranes. The retina is protected by MXs mainly through blue-light filtration, quenching of the excited triplet states of potent photosensitizers, and physical quenching of singlet oxygen. To perform these physical, photo-related actions, the structure of MXs should remain intact. However, the conjugated double-bond structure of MXs makes them highly chemically reactive and susceptible to oxidation. Chemical quenching of singlet oxygen and scavenging of free radicals destroy their intact structure and consume MXs. Consequently, their physical actions, which are critical to the protection of retina, are diminished. Thus, it is timely and important to identify mechanisms whereby the chemical destruction (bleaching) of MXs in retinal membranes can be reduced. It was shown that nitroxide free radicals (spin labels) located in membranes protect MXs against destruction, and their effect is especially pronounced during the light-induced formation of singlet oxygen. That should extend and enhance their positive action in the retina through physical processes. In this review, we will discuss possible applications of this new strategy during ophthalmological procedures, which can cause acute bleaching of MXs and damage the retina through oxidative processes.


Assuntos
Proteínas do Olho/fisiologia , Macula Lutea/química , Degeneração Macular/prevenção & controle , Estresse Oxidativo , Retina/metabolismo , Xantofilas/fisiologia , Antioxidantes/fisiologia , Humanos , Peroxidação de Lipídeos
10.
Sao Paulo Med J ; 137(6): 530-542, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-32159640

RESUMO

BACKGROUND: Age-related macular degeneration (AMD) is the third largest cause of blindness worldwide, accounting for 8.7% of all cases. A considerable number of preventive or therapeutic interventions have been used for AMD. OBJECTIVE: This study presents a critical view of the interventions that have been assessed through Cochrane systematic reviews. DESIGN AND SETTING: Review of systematic reviews, conducted in the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP). METHODS: Review of Cochrane systematic reviews about interventions for AMD. RESULTS: The 18 systematic reviews included assessed the effects of surgical techniques, laser/photo/radiotherapy, intravitreal injections, systemic drugs and phytotherapy/vitamins/supplements. CONCLUSION: The Cochrane systematic reviews found evidence that use of bevacizumab, ranibizumab, pegaptanib, laser photocoagulation, photodynamic therapy and multivitamin compounds may present some benefits for treating AMD. There was insufficient evidence for supporting the use of macular translocation, submacular surgery, steroid implantation, radiotherapy, intravitreal aflibercept, interferon alfa, statins or omega-3 fatty acids for treating AMD; or the use of multivitamin antioxidant vitamins or mineral supplementation for preventing AMD. Future randomized controlled trials are imperative to reduce the uncertainty in several clinical questions regarding AMD.


Assuntos
Medicina Baseada em Evidências , Degeneração Macular/terapia , Humanos , Injeções Intravítreas/métodos , Fotocoagulação/métodos , Degeneração Macular/prevenção & controle , Degeneração Macular/cirurgia , Radioterapia/métodos , Literatura de Revisão como Assunto , Revisões Sistemáticas como Assunto
11.
Nutrients ; 10(12)2018 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-30558320

RESUMO

Age-related macular degeneration and retinitis pigmentosa are leading causes of blindness and share a pathological feature, which is photoreceptor degeneration. To date, the lack of a potential treatment to prevent such diseases has raised great concern. Photoreceptor degeneration can be accelerated by excessive light exposure via an inflammatory response; therefore, anti-inflammatory agents would be candidates to prevent the progress of photoreceptor degeneration. We previously reported that a lactic acid bacterium, Lactobacillus paracasei KW3110 (L. paracasei KW3110), activated macrophages suppressing inflammation in mice and humans. Recently, we also showed that intake of L. paracasei KW3110 could mitigate visual display terminal (VDT) load-induced ocular disorders in humans. However, the biological mechanism of L. paracasei KW3110 to retain visual function remains unclear. In this study, we found that L. paracasei KW3110 activated M2 macrophages inducing anti-inflammatory cytokine interleukin-10 (IL-10) production in vitro using bone marrow-derived M2 macrophages. We also show that IL-10 gene expression was significantly increased in the intestinal immune tissues 6 h after oral administration of L. paracasei KW3110 in vivo. Furthermore, we demonstrated that intake of L. paracasei KW3110 suppressed inflammation and photoreceptor degeneration in a murine model of light-induced retinopathy. These results suggest that L. paracasei KW3110 may have a preventive effect against degrative retinal diseases.


Assuntos
Inflamação/prevenção & controle , Lactobacillus paracasei , Luz/efeitos adversos , Células Fotorreceptoras de Vertebrados/patologia , Probióticos/uso terapêutico , Retina/patologia , Doenças Retinianas/prevenção & controle , Administração Oral , Animais , Terminais de Computador , Inflamação/metabolismo , Interleucina-10/metabolismo , Intestinos/patologia , Macrófagos/metabolismo , Degeneração Macular/patologia , Degeneração Macular/prevenção & controle , Masculino , Camundongos Endogâmicos BALB C , Doenças Retinianas/etiologia , Doenças Retinianas/metabolismo , Doenças Retinianas/patologia , Retinite Pigmentosa/patologia , Retinite Pigmentosa/prevenção & controle , Visão Ocular
12.
PLoS One ; 13(12): e0209328, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30571778

RESUMO

BACKGROUND: Age-related macular degeneration (AMD) is the leading cause of blindness in industrialized countries. It is a multifactorial disease of the retina modified by environmental/individual (e.g. smoking) and genetic factors. 34 independent genomic loci are associated with the risk to develop AMD; an interaction between smoking and genetics is currently investigated. It is unclear how the knowledge on the strong genetic component has entered the knowledge base of practicing ophthalmologists, and how they inform and counsel their (AMD) patients about it. In this study, we explore the ophthalmologists' view on AMD genetics, and their inclination towards communicating genetic risks to patients. METHODS: We recruited a purposive sample of thirty German ophthalmologists (office based: n = 15, hospital employees: n = 15, f:8/30), who took part in a recorded semi-standardized interview. Transcripts were analyzed using content analysis. RESULTS: The majority of office-based ophthalmologists claimed to be unfamiliar with genetics of AMD, in contrast to hospital-affiliated ophthalmologists. Both office and hospital ophthalmologists were convinced that genetics lacks practical relevance in everyday patient care. Many withhold information on heritability or genetic background of AMD from patients and their relatives, for fear of unsettling those individuals. The relevance of the genetic component of AMD or an individuals' high genetic risk for prevention, e.g. screening or lifestyle modifications in persons with adverse genetic profile, was rated low. CONCLUSION: Developing genetic educational programs tailored to the routine care of ophthalmologists may be indicated, as well as a better two-way communication between research and practice. Exploring patient views about their expectations to being informed about genetic disease etiology, or about their individual risk, would help inform communication strategies.


Assuntos
Degeneração Macular/genética , Oftalmologistas , Comunicação , Estudos Transversais , Aconselhamento Genético , Testes Genéticos , Alemanha , Humanos , Entrevistas como Assunto , Degeneração Macular/etiologia , Degeneração Macular/prevenção & controle , Herança Multifatorial , Oftalmologistas/educação , Educação de Pacientes como Assunto , Pesquisa Qualitativa , Fatores de Risco , Pesquisa Médica Translacional
13.
Nutrients ; 10(11)2018 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-30400586

RESUMO

Age-related macular degeneration (AMD) is a complex multifactorial disease and the primary cause of legal and irreversible blindness among individuals aged ≥65 years in developed countries. Globally, it affects 30⁻50 million individuals, with an estimated increase of approximately 200 million by 2020 and approximately 300 million by 2040. Currently, the neovascular form may be able to be treated with the use of anti-VEGF drugs, while no effective treatments are available for the dry form. Many studies, such as the randomized controlled trials (RCTs) Age-Related Eye Disease Study (AREDS) and AREDS 2, have shown a potential role of micronutrient supplementation in lowering the risk of progression of the early stages of AMD. Recently, low-grade inflammation, sustained by dysbiosis and a leaky gut, has been shown to contribute to the development of AMD. Given the ascertained influence of the gut microbiota in systemic low-grade inflammation and its potential modulation by macro- and micro-nutrients, a potential role of diet in AMD has been proposed. This review discusses the role of the gut microbiota in the development of AMD. Using PubMed, Web of Science and Scopus, we searched for recent scientific evidence discussing the impact of dietary habits (high-fat and high-glucose or -fructose diets), micronutrients (vitamins C, E, and D, zinc, beta-carotene, lutein and zeaxanthin) and omega-3 fatty acids on the modulation of the gut microbiota and their relationship with AMD risk and progression.


Assuntos
Dieta , Microbioma Gastrointestinal , Degeneração Macular/epidemiologia , Degeneração Macular/prevenção & controle , Micronutrientes , Idoso , Dieta Hiperlipídica/efeitos adversos , Frutose/efeitos adversos , Glucose/efeitos adversos , Humanos , Estilo de Vida , Estudos Observacionais como Assunto , Prevalência , Ensaios Clínicos Controlados Aleatórios como Assunto , Retina , Fatores de Risco
14.
Arch. Soc. Esp. Oftalmol ; 93(11): 530-541, nov. 2018. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-175137

RESUMO

La retina humana, como tejido transductor de la energía lumínica, está especialmente expuesta a la toxicidad inducida por la exposición a la luz. La maculopatía solar ha sido durante milenios la única forma de maculopatía fótica, muchas veces en relación con la observación de un eclipse. Durante el último siglo los avances tecnológicos han conducido a la aparición de nuevas formas de retinopatía fótica, en relación con la exposición a nuevas formas de luz artificial como los dispositivos de soldar o emisores de láser. En los últimos años la generalización del uso de punteros láser ha hecho que repunte el interés por esta patología. El objetivo de esta revisión es ofrecer una visión integrada de los diversos tipos de maculopatía fótica. La revisión se presenta dividida en dos partes, debido a la extensión del tema tratado. En esta primera parte se trata la maculopatía solar y la maculopatía producida por exposición a los dispositivos de soldar


The human retina, as transducer of light energy, is especially exposed to light toxicity. Solar maculopathy has been the only form of photic maculopathy for millennia, often secondary to the observation of an eclipse. During the last century, technological advances have led to the appearance of new forms of photic maculopathy, related to the exposure to new forms of artificial light, such as welding devices and lasers. In recent years, the general use of laser pointers has led to an upturn in interest in this pathology. The aim of this review is to offer an integrated view of the different types of photic maculopathy. Due to the extension of this topic, the review is presented divided into two parts. In this first part solar maculopathy and welding arc maculopathy are presented


Assuntos
Humanos , Estimulação Luminosa/métodos , Degeneração Macular/epidemiologia , Lasers/efeitos adversos , Traumatismos Oculares/epidemiologia , Retina/lesões , Prognóstico , Distrofias Musculares/complicações , Exposição Ocupacional , Radiação Solar/efeitos adversos , Degeneração Macular/prevenção & controle , Radiação Solar/prevenção & controle
15.
Arch. Soc. Esp. Oftalmol ; 93(11): 542-550, nov. 2018. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-175138

RESUMO

La retina humana, como tejido transductor de la energía lumínica, está especialmente expuesta a la toxicidad inducida por la exposición a la luz. La maculopatía solar ha sido durante milenios la única forma de maculopatía fótica, muchas veces en relación con la observación de un eclipse. Durante el último siglo los avances tecnológicos han conducido a la aparición de nuevas formas de retinopatía fótica, en relación con la exposición a nuevas formas de luz artificial como los dispositivos de soldar o emisores de láser. En los últimos años la generalización del uso de punteros láser ha hecho que repunte el interés por esta dolencia. El objetivo de esta revisión es ofrecer una visión integrada de los diversos tipos de maculopatía fótica. La revisión se presenta dividida en 2 partes, debido a la extensión del tema tratado. En esta segunda parte se presentan la maculopatía fótica secundaria a explosiones nucleares, a láser, las formas iatrogénicas de maculopatía fótica y la retinitis foveomacular


The human retina, as transducer of light energy, is especially exposed to light toxicity. Solar maculopathy has been the only form of photic maculopathy for millennia, often secondary to the observation of an eclipse. During the last century, technological advances have led to the appearance of new forms of photic maculopathy, related to the exposure to new forms of artificial light, such as welding devices and lasers. In recent years the general use of laser pointers has led to an upturn in interest in this pathology. The aim of this review is to offer an integrated view of the different types of photic maculopathy. Due to the extension of the topic, the review is presented divided into 2 parts. In this second part, atomic bomb maculopathy, laser maculopathy, iatrogenic forms of photic maculopathy, and foveomacular retinitis are presented


Assuntos
Humanos , Animais , Degeneração Macular/epidemiologia , Doenças Retinianas/epidemiologia , Lasers/efeitos adversos , Traumatismos Oculares/epidemiologia , Retina/lesões , Doenças Retinianas/veterinária , Luz/efeitos adversos , Luz Solar/efeitos adversos , Degeneração Macular/prevenção & controle , Catarata/epidemiologia , Retinite/epidemiologia , Traumatismos Oculares
16.
Biophys Chem ; 243: 17-23, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30352336

RESUMO

A dimer of quercetin prepared through a Mannich reaction protects pyridinium bisretinoid A2E from photooxidation at 430 nm in aqueous medium at pH 7.4. In the presence of light and O2, A2E is quickly attacked by 1O2 produced in situ (by excited A2E) to give nonaoxirane and other oxygenated compounds which can be involved in diseases of the macula. Peroxyl radicals might have only a marginal role on the photooxidation of A2E. The dimer is actually a potent quencher of 1O2 with a rate constant kQ of 8.5 × 108 M-1 s-1 in methanol at room temperature. On the other hand, its antioxidant abilities against ROO· radicals are quite limited since kROO·â€¯= 7.3 × 105 M-1 s-1 (in buffer solution at pH 7.4), the value being essentially identical to that of quercetin. The quenching of 1O2 by the dimer is therefore the main reason for the A2E protection and prevention of age-related macular degeneration.


Assuntos
Antioxidantes/química , Degeneração Macular/prevenção & controle , Quercetina/química , Oxigênio Singlete/química , Alcenos/química , Dimerização , Óxido de Etileno/análogos & derivados , Óxido de Etileno/química , Humanos , Degeneração Macular/patologia , Oxirredução , Compostos de Piridínio/química
17.
Am J Nephrol ; 48(4): 278-291, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30336463

RESUMO

BACKGROUND: Age-related macular degeneration (AMD) is an important cause of blindness in aged people. Chronic kidney disease (CKD) was reported to be associated with a higher risk of AMD. However, supporting evidence was inconsistent between studies. This work intends to examine whether a positive association exists between CKD and AMD by systematic review and meta-analysis. METHODS: A systematic search of electronic databases (Medline, PubMed, Cochrane and EMBASE) and reference lists on June 2017. The key inclusion criteria were controlled trials that investigated the relationship between AMD and CKD. The outcome measures included risk ratios and/or occurrence rates of AMD in CKD vs. non-CKD population. Data were pooled according to the type of AMD by random effect model. RESULTS: Twelve observational studies (3 cohorts, 2 case controls, and 7 cross-sectionals) with a total 335,601 participants were included. Eleven studies reported risk ratios and 9 reported occurrence rates. Pooled prevalence for early, advanced, and any AMD were all higher in the CKD population than in the non-CKD population. The pooled multivariate adjusted OR of CKD vs. non-CKD was 1.49 (95% CI 1.11-2.02) for early, 1.55 (95% CI 1.05-2.27) for exudative, 1.58 (95% CI 1.12-2.23) for advanced, and 1.35 (95% CI 1.05-1.73) for any AMD. However, high statistical heterogeneity and methodological diversity existed. Moreover, results were inconsistent between different study designs. CONCLUSIONS: The overall results support a positive association between CKD and AMD, although some limitations exist. Given the risk that AMD is increased in CKD, regular eye screenings for the CKD population is recommended for an early detection and intervention.


Assuntos
Degeneração Macular/epidemiologia , Insuficiência Renal Crônica/complicações , Humanos , Degeneração Macular/etiologia , Degeneração Macular/prevenção & controle , Estudos Observacionais como Assunto , Prevalência
18.
Am J Nurs ; 118(10): 21, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30260882

RESUMO

Editor's note: This is a summary of a nursing care-related systematic review from the Cochrane Library. For more information, see http://nursingcare.cochrane.org.


Assuntos
Antioxidantes/administração & dosagem , Ácido Ascórbico/administração & dosagem , Degeneração Macular/prevenção & controle , Vitamina E/administração & dosagem , beta Caroteno/administração & dosagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Suplementos Nutricionais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
19.
J Pharmacol Sci ; 137(4): 407-411, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30150144

RESUMO

Our previous studies found that an anti-placental growth factor (PlGF) antibody protected the retina in light-induced retinal damage model, a model of non-exudative age-related macular degeneration (AMD). Aflibercept is an inhibitor of vascular endothelial growth factor (VEGF) and PlGF. In present study, we revealed that the intravitreal injection of aflibercept lessens light-induced retinal damage, while anti-VEGF antibody has no effect on the light-exposed retina. Moreover, PlGF disrupted the tight junctions between the human retinal pigment epithelial cells in vitro, and aflibercept blocked the disruption. These data suggest that the aflibercept may be an effective treatment of non-exudative AMD.


Assuntos
Luz/efeitos adversos , Degeneração Macular/etiologia , Degeneração Macular/prevenção & controle , Células Fotorreceptoras de Vertebrados/efeitos da radiação , Receptores de Fatores de Crescimento do Endotélio Vascular/administração & dosagem , Proteínas Recombinantes de Fusão/administração & dosagem , Proteínas Recombinantes de Fusão/farmacologia , Animais , Células Cultivadas , Modelos Animais de Doenças , Humanos , Injeções Intravítreas , Masculino , Camundongos Endogâmicos , Células Fotorreceptoras de Vertebrados/patologia , Fator de Crescimento Placentário/efeitos adversos , Fator de Crescimento Placentário/antagonistas & inibidores , Epitélio Pigmentado da Retina/citologia , Junções Íntimas/efeitos dos fármacos , Junções Íntimas/patologia , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores
20.
Arch Soc Esp Oftalmol ; 93(12): 592-597, 2018 Dec.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30025989

RESUMO

OBJECTIVE: To analyse the morphometric characteristics and the concentration of (docosahexaenoic acid) DHA and eicosapentaenoic acid (EPA) of the different nutritional supplements with omega 3 available on the market for retinal disease. MATERIAL AND METHODS: A double-blind study was conducted with a single observer, of the different omega 3 supplementation tablets sample marketed in Spain. The length of the tablet, the concentration of omega 3 in total, as well as DHA and EPA were studied separately using the amount provided by the manufacturer and the volume of the capsule calculated from the development of a specific formula for it. RESULTS: A total of 10 different nutritional supplements were included. The mean of total omega 3, DHA and EPA was 383.10±160.90, 210.72±93.3, and 112.34±140.98mg, respectively. The mean size of the capsules was 14.77±0.19×8.13±0.09mm The smallest sized capsule was that of Oftan macula omega® (Esteve, Barcelona, Spain). Brudymacula® (Brudylab, Barcelona, Spain) and Brudyretina 1.5 g® (Brudylab, Barcelona, Spain) tablets contained more DHA, with Nutrof omega® (Thea Laboratories, Barcelona, Spain) having the lowest concentration of omega 3, DHA and EPA, per tablet. CONCLUSION: There are significant differences in size, volume, quantity, and concentration of omega 3 and its derivatives, between different commercial preparations. Only the knowledge of the characteristics of the nutritional supplements will enable us to provide a more personalised indication of their use for our patients.


Assuntos
Suplementos Nutricionais , Ácidos Docosa-Hexaenoicos/análise , Ácido Eicosapentaenoico/análise , Ácidos Graxos Ômega-3/uso terapêutico , Doenças Retinianas/tratamento farmacológico , Cápsulas , Formas de Dosagem , Método Duplo-Cego , Cálculos da Dosagem de Medicamento , Ácidos Graxos Ômega-3/administração & dosagem , Humanos , Degeneração Macular/tratamento farmacológico , Degeneração Macular/prevenção & controle , Medicamentos sem Prescrição/análise , Doenças Retinianas/prevenção & controle , Espanha
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