Review

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

  • HE Cuihuan ,
  • SHI Derong ,
  • SUN Dandan ,
  • LI Yurui ,
  • XIA Guanghao
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  • 1. First Clinical Medical Department, Gansu University of Chinese Medicine, Lanzhou 730000, Gansu Province, China
    2. Department of Endocrinology, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China

Received date: 2025-01-24

  Accepted date: 2025-02-08

  Online published: 2025-02-25

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.

Cite this article

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 . DOI: 10.16150/j.1671-2870.2025.01.012

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