摘要
随着人们对青光眼治疗机制研究的深入,涌现了不少新的抗青光眼药物。最经典的治疗方法仍然是降低眼压。新的降眼压药物可能通过以下途径发挥作用:①诱导金属蛋白酶的产生;②使小梁网细胞收缩;③抑制房水的生成;④激活CB-1受体等。另一类重点研究的药物,可增加眼部血流,尤其是视网膜和视神经的血流。对于正常眼压或低眼压性青光眼患者,不依赖于眼压改变而增加血流的药物有非常重要的临床意义。神经保护药物,是近年来才出现的新的青光眼治疗方法。虽然其研究历史很短,但包含了多种类型的药物。其中包括NMDA受体阻断剂,神经营养因子,可诱导的一氧化氮合成酶抑制剂,能抑制细胞调亡的药物,保护性自身免疫治疗,干细胞治疗等等。所有的抗青光眼药物都只能稳定病情,而不能治愈疾病,因此理想的药物应该具有较高的性价比。
New drugs are developed rapidly with novel ideas of action mechanisms for treatment of glaucoma. The most classic drugs under development are to lower the intraocular pressure (IOP). New agents were invented to lower the IOP through a) induction of metalloproteinases (MMPs), b) contraction of trabecular meshwork cells, c) inhibition of aqueous humor secretion, and d) activation of CB-1 receptor, etc. The second class of drugs under development is intended to improve the ocular blood flow, particularly in retina and optic nerve head. Drugs that improve the ocular blood flow irrespective of the IOP changes could be quite useful for the treatment of normal tension or low-tension glaucoma. Neuroprotection is the latest developed mechanisms of glaucoma treatment. Although the history of neuroprotection research is very short, there are a lot of agents under investigation in this class. They include a) blockade of N-methyl-D-aspartate receptor, b) neurotrophic agents, c) inhibition of inducible nitric oxide synthases (iNOS), d) inhibition of apoptosis, e) protective autoimmunity, f) stem cell therapy, and so on. Since all drugs for glaucoma treatment are used to stabilize the disease rather than to cure it, it is critical that an ideal drug with high therapeutic index and low cost price should be invented. ·
出处
《国际眼科杂志》
CAS
2005年第3期411-422,共12页
International Eye Science
关键词
青光眼
药物疗法
降眼压药物
神经保护
眼血流
glaucoma
treatment
intraocular pressure
ocular blood flow
neuroprotection
