Sun WJ, An XD, Zhang YH, Tang SS, Sun YT, Kang XM, Jiang LL, Zhao XF, Gao Q, Ji HY, Lian FM. Autophagy-dependent ferroptosis may play a critical role in early stages of diabetic retinopathy. World J Diabetes 2024; 15(11): 2189-2202 [PMID: 39582563 DOI: 10.4239/wjd.v15.i11.2189]
Corresponding Author of This Article
Feng-Mei Lian, PhD, Professor, Department of Endocrinology, Guang’anmen Hospital, No. 5 Beixiange, Xicheng District, Beijing 100053, China. lfm565@sohu.com
Research Domain of This Article
Endocrinology & Metabolism
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Diabetes. Nov 15, 2024; 15(11): 2189-2202 Published online Nov 15, 2024. doi: 10.4239/wjd.v15.i11.2189
Autophagy-dependent ferroptosis may play a critical role in early stages of diabetic retinopathy
Wen-Jie Sun, Xue-Dong An, Yue-Hong Zhang, Shan-Shan Tang, Yu-Ting Sun, Xiao-Min Kang, Lin-Lin Jiang, Xue-Fei Zhao, Qing Gao, Hang-Yu Ji, Feng-Mei Lian
Wen-Jie Sun, Xue-Dong An, Yu-Ting Sun, Xiao-Min Kang, Lin-Lin Jiang, Xue-Fei Zhao, Qing Gao, Hang-Yu Ji, Feng-Mei Lian, Department of Endocrinology, Guang’anmen Hospital, Beijing 100053, China
Yue-Hong Zhang, Department of Endocrinology, Fangshan Hospital of Beijing University of Chinese Medicine, Beijing 102400, China
Shan-Shan Tang, Department of Endocrinology, Changchun University of Chinese Medicine, Changchun 130117, Jilin Province, China
Co-first authors: Wen-Jie Sun, Xue-Dong An, and Yue-Hong Zhang.
Co-corresponding authors: Hang-Yu Ji and Feng-Mei Lian.
Author contributions: Sun WJ, An XD, and Zhang YH contributed equally to this work; Ji HY and Lian FM supervised and directed the focus of this review; Sun WJ, An XD, and Zhang YH performed the literature review and wrote the review; Tang SS designed the graphical figures; Sun YT, Kang XM, Jiang LL, Zhao XF, and Gao Q refined the format of the review; Ji HY and Lian FM performed the major work in structuring and harmonizing the overall review content; all authors have read and approved the final version of the manuscript. Sun WJ and An XD respectively reviewed and summarized the literature, and wrote the first draft of the paper. Zhang YH was responsible for literature integration and review. All three authors have made crucial and indispensable contributions towards the completion of the project and thus qualified as the co-first authors of the paper. As co-corresponding authors, Ji HY and Lian FM played an important and indispensable role in the conception, design and supervision of the entire project process.
Supported bythe National Natural Science Foundation of China, No. 82305205; the Clinical Research Business Fund of the Central High-level Traditional Chinese Medicine Hospital, No. HLCMHPP2023084; and Chinese Association of Traditional Chinese Medicine (2023-2025) Youth Talent Support Project, No. CACM-2023-QNRC2-A05.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Feng-Mei Lian, PhD, Professor, Department of Endocrinology, Guang’anmen Hospital, No. 5 Beixiange, Xicheng District, Beijing 100053, China. lfm565@sohu.com
Received: December 26, 2023 Revised: June 10, 2024 Accepted: September 10, 2024 Published online: November 15, 2024 Processing time: 294 Days and 21.1 Hours
Abstract
Diabetic retinopathy (DR), as one of the most common and significant microvascular complications of diabetes mellitus (DM), continues to elude effective targeted treatment for vision loss despite ongoing enrichment of the understanding of its pathogenic mechanisms from perspectives such as inflammation and oxidative stress. Recent studies have indicated that characteristic neuroglial degeneration induced by DM occurs before the onset of apparent microvascular lesions. In order to comprehensively grasp the early-stage pathological changes of DR, the retinal neurovascular unit (NVU) will become a crucial focal point for future research into the occurrence and progression of DR. Based on existing evidence, ferroptosis, a form of cell death regulated by processes like ferritinophagy and chaperone-mediated autophagy, mediates apoptosis in retinal NVU components, including pericytes and ganglion cells. Autophagy-dependent ferroptosis-related factors, including BECN1 and FABP4, may serve as both biomarkers for DR occurrence and development and potentially crucial targets for future effective DR treatments. The aforementioned findings present novel perspectives for comprehending the mechanisms underlying the early-stage pathological alterations in DR and open up innovative avenues for investigating supplementary therapeutic strategies.
Core Tip: This article initially investigates the early pathological alterations of diabetic retinopathy (DR), with a particular emphasis on the retinal neurovascular unit (NVU) as a pivotal focal point in the initial stage of DR. Recent studies have revealed that ferroptosis may exert a significant role in the early phase of DR. Autophagy-dependent ferroptosis-related factors, including BECN1 and FABP4, could potentially serve as biomarkers for the onset and progression of DR, thereby representing promising targets for effective treatment strategies in the future. These findings provide novel insights into understanding the mechanisms underlying early pathological changes in DR and offer supplementary avenues for innovative research on treatment approaches.
