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Diabetic retinopathy (DR) is an ocular complication of diabetes mellitus (DM), a metabolic disorder characterized by elevation in blood glucose level. The pathogenesis of DR includes vascular, neuronal, and inflammatory components leading to activation of complex cellular molecular signaling. If untreated, the disease can culminate in vision loss that eventually leads to blindness. Animal models mimicking different aspects of DM complications have been developed to study the development and progression of DR. Despite the significant contribution of the developed DR models to discovering the mechanisms of DR and the recent achievements in the research field, the sequence of cellular events in diabetic retinas is still under investigation. Partially, this is due to the complexity of molecular mechanisms, although the lack of availability of models that adequately mimic all the neurovascular pathobiological features observed in patients has also contributed to the delay in determining a precise molecular trigger.
Molecular Signaling | ||||
---|---|---|---|---|
Model | Changes | Duration of Hyperglycemia | References | |
1. | STZ Rat | Elevated CHOP, Caspase 12, MAPK retinal cytokines | 8 weeks | [57][80][87][97] |
Reduced IR kinase activity | 8 weeks | |||
Elevated retinal cytokines | 3 months | |||
Reduced IR kinase activity and autophosphorylation and downregulation of IRS-2 & PI3K | 3 months | |||
Upregulation of HIF-A, ATF-6, XBP1 | 4 months | |||
2. | ZFD Rat | Elevated Bax, TNF-α and NF-kappaB | 6 weeks | [89] |
3. | OIR Rat | Elevated VEGF, PDEG and TNF-α | P16 | [36][37] |
4. | STZ Mouse | Upregulation of GRP78, pPERK, CHOP, VEGF, pEIF2α, retinal cytokine and TNF-α | 4 weeks | [59][81][82][90][91][92][93] |
Elevated IR expression and tyrosine phosphorylation; upregulated IRS-2 and reduced PDK1/ AKT protein levels and phosphorylation | 1 week | |||
Reduced IR phosphorylation | 1 week | |||
Upregulation of TRIB3 and inflammatory cytokines (Icam1, Nf-kb1, Rc3h1, Zc3h12a, VEGF, COX2, and AIF1) | 4 weeks | |||
5. | Ins2Akita Mouse |
VEGF and TNF-α elevation, increased mRNA expression; protein expression of GRP78 and elevated peIF2α and ATF4 and reduced IR kinase activity | 12 weeks | [26][92][93] |
6. | Leprdb (db/db) Mouse |
Increased IRS-2 expression and reduced PDK1/ AKT protein levels and phosphorylation | 10 weeks | [92][95] |
GFAP activation, increased expression of HIF-A, VEGF, GRP78, p-IRE-1, CHOP, Casapase-3 and ATF4 | 15 months | |||
Microangiopathy | ||||
Model | Changes | Duration of Hyperglycemia |
References | |
1. | STZ Rat | Blood retinal barrier disruption | 2 weeks | [8][46][48] |
Adherent leukocytes | 8 weeks | |||
Thickened Basement Membrane (BM) | 12 weeks | |||
Neovascularization | 3–4 months | |||
2. | Alloxan Rat | Leukocytosis | 2 months | [49][50] |
Neovascularization | 9 months | |||
Pericyte loss, acellular capillaries, and BM thickening | 12 months | |||
3. | BB Rat | Basement membrane thickening | 4 months | [18][19][51] |
Blood retinal barrier breakdown | 6 months | |||
Pericyte loss | 8 months | |||
4. | ZDF Rat | BM thickening, pericyte loss and acellular capillaries | 6 months | [21][22] |
5. | OLETF Rat | BM thickening, pericyte loss and acellular capillaries | 9 months | [23][52] |
6. | OIR SD Rat | Increased extra retinal neovascularization and impaired pericyte distribution | P18 | [40] |
7. | STZ Mouse | Increased vascular permeability | 8 days | [44][43][45][59] |
Decreased arteriolar diameter and velocity | 8 weeks | |||
BM thickening | 4–15 months | |||
Pericyte loss, acellular capillaries and pericyte ghost | 6–9 months | |||
8. | Ins2Akita Mouse |
Leukocytosis | 8 weeks | [26][42] |
Increased vascular permeability | 12 weeks | |||
Blood vessels in the outer plexiform layer (OPL) and microaneurysms | 6 months | |||
Acellular capillaries, BM thickening and neovascularization. | 9 months | |||
9. | Kimba Mouse | Abnormal blood vessel development around photoreceptor | P28 | [29][41] |
Increased vascular permeability and adherent leukocytes | 6 weeks | |||
Loss of retinal capillaries, neovascularization, increased avascular area and alteration in the vessel length | 9 weeks | |||
Pericyte loss | 24 weeks | |||
10. | Akimba Mouse | Microaneurysms, neovascularization, blood vessel constriction, beading, vessel edema, capillary dropout, and new vessel formation it the ONL | 8 weeks | [30] |
11. | OIR Mouse | Irregular blood vessel development and reduced inner retinal plexus and deep plexus | P18 | [39] |
12. | Db/db Mouse | Increased vascular permeability and BM thickening | 13–14 weeks | [53][54] |
Pericyte loss | 18 weeks | |||
Acellular capillaries | 26 weeks | |||
13. | High-fat diet Mouse |
Pericyte loss, blood retinal barrier disruption and vascular leakage | 12 months | [55] |
Retinal Integrity | ||||
Model | Changes | Duration of Hyperglycemia | References | |
1. | STZ Rat | Decreased pre- and post-synaptic photoreceptor ribbon synapses | 4 weeks | [56][57][58] |
Increased GFAP reactivity | 6–7 weeks | |||
Loss of ONL, INL, GCL | 12–16 weeks | |||
Severe photoreceptor cell loss | 24 weeks | |||
2. | WBN/Kob Rat | Photoreceptor degeneration | 4 weeks | [20] |
Severe OS and ONL degeneration | 5–14 months | |||
3. | BB Rat | RPE degeneration | 4 months | [61] |
4. | ZDF Rat | Decreased OS, damage to amacrine cells and RPE with gliosis | 32 weeks | [62] |
5. | OLETF Rat | Decreased INL and photoreceptor cells | 9 months | [23] |
6. | OIR Rat | Reduction in OS, INL, IPL, total retinal thickness, astrocytes and increased muller activity | P18 | [40][63] |
7. | High galactose Rat |
Increased gliosis and reduced INL and OPL |
28 months | [61] |
8. | STZ Mouse | GFAP hyperactivity | 5 weeks | [45][59][65][67][70] |
Reduced ONL, INL thickness | 6–14 weeks | |||
Total retinal thickness reduced | 20 weeks | |||
No retinal cell loss and gliosis | 8–12 months | |||
Reduced RGCs | 8 months | |||
9. | Ins2Akita Mouse |
GFAP hyperactivity | 8 weeks | [26][68] |
Reduced IPL, INL and cone photoreceptors | 3 months | |||
Reduced RGCs | 22 weeks | |||
Decreased presynaptic and post-synaptic photoreceptor ribbons | 36 weeks | |||
10. | db/db Mouse | Reduced NFL and RGCs | 16-28 weeks | [67][69] |
Reduced total retinal thickness | 28 weeks | |||
11. | Akimba Mouse | Photoreceptor cell death | 28 weeks | [30] |
12. | OIR Mouse | Total retinal thickness reduction, distorted photoreceptor OS, neuronal loss, hyperactivity of Müller cells, microglial activation and disrupted INL and IPL | P17-188 | [39][59] |
Retinal Electrophysiology | ||||
Model | Changes | Duration of Hyperglycemia |
References | |
1. | STZ Rat | Decrease in OP amplitude | 2–7 weeks | [56][74][75] |
Decrease in OP implicit time | 7 weeks | |||
Decreased a- and b-wave amplitude | 10–12 weeks and at 44 weeks | |||
2. | OIR Rat | Decreased a- and b-wave amplitude | P18 | [40][63][64] |
3. | STZ Mouse | Reduced OP amplitude and implicit time | 4–6 weeks | [59][76][77][78] |
Reduced a- and b-wave amplitude | 6 months | |||
Reduced PhNR amplitude | 8 months | |||
4. | Ins2Akita Mouse |
Decreased OP amplitude, delay in the OP and decreased b-wave | 9 months | [26][68] |
5. | Db/db Mouse | Delay in the b-wave, delay in the OP implicit time and decreased amplitude of both photopic and scotopic b-wave | 16–24 weeks | [69][79] |
6. | OIR Mouse | Significant decrease in the amplitude of a- and b-wave | P18 | [39] |
7. | High-fat diet Mouse |
Decreased OP amplitude | 12 months | [55] |