Research progress on mechanisms of glucagon-like peptide-1 receptor agonists in diabetic retinopathy

doi:10.16150/j.1671-2870.2025.01.012

Abstract

Abstract:

The prevalence of diabetes mellitus (DM) and its complication, diabetic retinopathy (DR), continues to rise year by year in China and globally. The global prevalence of DM is approximately 34.6%, with around 30% of patients progressing to DR, which is a major cause of adult blindness. In China, the DR prevalence among DM patients is 16.3%, with no significant urban-rural disparity. Notably, patients with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) show substantially higher DR prevalence rates of 40.6% and 37.3%, respectively. The pathogenesis of DR involves complex interplay among multiple mechanisms, including inflammatory responses, microglial activation, oxidative stress, accumulation of advanced glycation end-products (AGEs), vascular endothelial growth factor (VEGF) upregulation, retinal neurodegeneration, and blood-retinal barrier (BRB) disruption. However, the precise mechanisms remain incompletely understood, and current clinical interventions cannot fully halt DR progression or prevent irreversible vision loss. Recent studies on glucagon-like peptide-1 receptor agonists (GLP-1RAs) demonstrate their protective effects against DR through multifaceted molecular mechanisms and cellular pathways. These include suppressing glial cell activation, inhibi-ting the release of inflammatory factors, blocking the nuclear factor κB (NF-κB) signaling pathway, and reducing reactive oxygen species (ROS) generation, along with AGE deposition, mitochondrial protection, vascular endothelial cell protection, neuroprotection, and metabolic regulation. Consequently, GLP-1RAs can mitigate or control the onset and progression of DR. This review summarizes the mechanisms by which GLP-1RAs alleviate or control the onset and progression of DR through anti-inflammatory, antioxidative stress, and anti-angiogenic effects, providing a theoretical reference for future DR treatment strategies.

Key words: Diabetic retinopathy, Glucagon-like peptide-1 receptor agonists, Anti-inflammation, Antioxidative stress, Inhibit neovascularization

CLC Number:

R587.2

HE Cuihuan, SHI Derong, SUN Dandan, LI Yurui, XIA Guanghao. Research progress on mechanisms of glucagon-like peptide-1 receptor agonists in diabetic retinopathy[J]. Journal of Diagnostics Concepts & Practice, 2025, 24(01): 80-88.

Figures/Tables 3

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