Neurovascular Unit: A New Target for Treating Early Stages of Diabetic Retinopathy

Abstract

Retinopatía diabética; Neurodegeneración; Unidad neurovascular

Retinopatia diabètica; Neurodegeneració; Unitat neurovascular

Diabetic retinopathy; Neurodegeneration; Neurovascular unit

The concept of diabetic retinopathy as a microvascular disease has evolved and is now considered a more complex diabetic complication in which neurovascular unit impairment plays an essential role and, therefore, can be considered as a main therapeutic target in the early stages of the disease. However, neurodegeneration is not always the apparent primary event in the natural story of diabetic retinopathy, and a phenotyping characterization is recommendable to identify those patients in whom neuroprotective treatment might be of benefit. In recent years, a myriad of treatments based on neuroprotection have been tested in experimental models, but more interestingly, there are drugs with a dual activity (neuroprotective and vasculotropic). In this review, the recent evidence concerning the therapeutic approaches targeting neurovascular unit impairment will be presented, along with a critical review of the scientific gaps and problems which remain to be overcome before our knowledge can be transferred to clinical practice.

This research was funded by grants from the Instituto de Salud Carlos III (DTS18/0163, PI19/01215, and ICI20/00129). The funders had no role in the design of the study; in the collection, analyses, or the interpretation of the data; in the writing of the manuscript, or in the decision to publish the results.