Xuyang Liu  Xiaoming Chen

Department of Ophthalmology & Ophthalmic labs, West China Hospital, Sichuan University, Chengdu, China

Glaucoma is an IOP sensitive optic neuropathy, and therefore, lowering IOP is currently the only therapeutic approach for this disease. It is generally accepted that the main resistance to outflow resides in the juxtacanalicular region of the trabecular meshwork and inner wall cells of Schlemm's canal and that changes in the actin cytoskeleton and associated cell-cell junctions and cell-extracellular matrix interactions in these areas will alter outflow facility.  There are currently a number of therapies designed to lower IOP for glaucoma treatment, but most of them do not target the place where the main resistance to outflow resides. The actin cytoskeleton and associated cellular adhesion proteins are attractive targets for novel therapeutic approaches for glaucoma. Compounds and proteins, or  transferred genes that express such proteins,  capable of disrupting actin and associated cellular adhesions were able to lower IOP and increase outflow facility in organ cultured anterior segments in vitro and in rats, rabbits and primates in vivo.  Certain inhibitors of Rho and ROCK seem to be in this new category of IOP lowering agents.

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