Abstract:

Diabetic retinopathy (DR) is one of the most common microvascular complications of diabetes mellitus.The incidence of DR （1980-2018: 2.2%-12.7%） increases year by year. The incidence of DR in China is 18.45%, and global prevalence is 22.27%. DR becomes the leading cause of blindness in adults around the world. DR seriously affects the quality of life of diabetic patients. The retinal pigment epithelium (RPE) is the outermost layer of the retina and is essential for maintaining visual function. RPE cells secrete pigment epithelium-derived factor (PEDF), a natural glycoprotein with a molecular weight of 50 000. PEDF is a member of the serine protease superfamily. Existing studies have demonstrated that PEDF has a wide variety of biological activities, including angiogenesis inhibition, antioxidant, anti-inflammatory, and neurotrophic activities, which have significant effects on a variety of diseases, including DR. The pathogenesis of DR is complex and is related to oxidative stress, inflammatory response, mitochondrial dysfunction, vascular endothelial growth factor (VEGF), abnormal activation of microglia, and accumulation of advanced glycosylation end-products (AGEs), which involves the Wnt/β-cantenin signaling pathway, mitochondrial uncoupling proteins (UCPs), nuclear factor-κB (NF-κB) pathway, peroxisome proliferator-activated receptor γ (PPARγ), AGEs, etc. PEDF may work through these targets and pathways to prevent the occurrence and development of DR. This paper mainly focus on the function of PEDF, including inhibition of neovascularization, anti-oxidative stress and anti-inflammation, and elaborate on the mechanism of PEDF on inhibiting the occurrence and development of DR through different targets and pathways, providing a theoretical basis for the development of new DR therapeutic drugs.

Key words: Pigment epithelium-derived factor, Diabetic retinopathy, Inhibit neovascularization, Antioxidative stress, Anti-inflammation