Autophagy in the retinal neurovascular unit: New perspectives into diabetic retinopathy

Diabetic retinopathy (DR) is one of the most prevalent retinal disorders worldwide, and it is a major cause of vision impairment in individuals of productive age. Research has demonstrated the significance of autophagy in DR, which is a critical intracellular homeostasis mechanism required for the destruction and recovery of cytoplasmic components. Autophagy maintains the physiological function of senescent and impaired organelles under stress situations, thereby regulating cell fate via various signals. As the retina's functional and fundamental unit, the retinal neurovascular unit (NVU) is critical in keeping the retinal environment's stability and supporting the needs of retinal metabolism. However, autophagy is essential for the normal NVU structure and function. We discuss the strong association between DR and autophagy in this review, as well as the many kinds of autophagy and its crucial physiological activities in the retina. By evaluating the pathological changes of retinal NVU in DR and the latest advancements in the molecular mechanisms of autophagy that may be involved in the pathophysiology of DR in NVU, we seek to propose new ideas and methods for the prevention and treatment of DR.糖尿病视网膜病变(DR)是世界范围内最常见的视网膜疾病之一，是育龄人群视力损害的主要原因。研究表明，自噬是破坏和恢复胞质成分所需的一种重要的细胞内稳态机制，在DR中具有重要意义。自噬维持应激状态下衰老和受损细胞器的生理功能，从而通过多种信号调节细胞寿命。视网膜神经血管单元(NVU)作为视网膜的基本功能单位，在维持视网膜环境稳定和支持视网膜代谢需求方面起着至关重要的作用。然而，自噬对于NVU的正常结构和功能至关重要。本文就DR与自噬的密切关系、自噬的种类及其在视网膜中的重要生理活性进行综述。我们期望通过评估DR中视网膜NVU的病理变化以及自噬可能参与NVU中DR病理生理分子机制的最新进展，寻求防治DR的新思路和方法。.