The session declared that high glucose is responsible for diabetic retinopathy - but how they exactly cause it is not known, according to Prof renu, Univ Kresge, and said that high glucose can cause epigenetic modifications that change the way genes act and the proteins they code for. If we can stop or reverse these epigenetic changes, ehen we can prevent or retard diabetic retinopathy in a new better way and the other comolications of diabetes. Diabetes may noy change the basic genetic structures responsible for creating and maintaining the microvasculature in the eyes. The high glucose enviroment could turn genes on or off by adding or removing compounds on top of DNA.
Genes that should be active are silenced while genes that are normally silent are switched on. As retinal blood vessels detoriate , portions of the retina become ischemic and hypoxic. The physiological responses is to grow new vessels to replace dysfunctional blood supply. The new vessels are twisted and snaky, hampering blood flow, and they also leak blood cells and serum, obscure vision and contribute to even more ischemia, said prof Kowluru.
Laser treatment is photocoagulation, but improvements are temporary. Laser removes unwanted vessels but it can also kill retinal cells. And the epigenetic changes triggered by high glucose ensure the regrowth of more dysfunctional vessels. What we need to do is to block those epigenetic changes, There are already in use for cancer agents to block epiogenetic changes. These drugs are not specific for diabetes or retinopathy, but they may be a start to blocking at least some epigenetic changes that affect the eyes.
The good news is that the diabetic nowadays with better treatment progress more slowly over decades.
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