盐皮质激素受体(MR)属于核受体超家族,在视网膜和脉络膜中均有表达.MR拮抗剂(MRA)在非眼科临床上已有较长的应用史.多种细胞和动物模型显示,异常激活MR参与眼底病理性血管新生、氧化应激、炎症、水盐平衡紊乱、神经退行性改变等一系列病理生理过程,应用MRA可缓解或抑制这些病理过程.中心性浆液性脉络膜视网膜病变(CSC)患者使用MRA治疗后,患者视功能改善、视网膜下积液减少、中心凹下脉络膜厚度降低.慢性CSC患者MR的单核苷酸多态性和血浆中醛固酮水平与可自发缓解的CSC患者相比均有显著性差异.MRA眼部缓释剂型和炎症相关机制的研究可能成为眼底MR研究的新热点.了解MR和MRA在眼底疾病中的研究现状,以期为之后的基础研究和临床治疗提供参考.%The mineralocorticoid receptor (MR) belongs to the nuclear receptor superfamily and is expressed in the retina and choroid. MR antagonist (MRA) has a long history of application in non-ophthalmic clinical practice. Various cellular and animal models indicated that inappropriate activation of MR participated in pathological angiogenesis, oxidative stress, inflammation, disturbance of ion/water homeostasis and neurodegenerative changes, while the application of MRA can reduce or reverse these pathological processes. After using MRA in central serous chorioretinopathy (CSC) patients, improved visual function, less subretinal fluid and reduced sub-foveal choroidal thickness were observed. Single nucleotide polymorphisms in MR and plasma aldosterone levels were significantly different between chronic CSC patients and CSC patients with spontaneous remission. Novel formulation for sustained-release MRA and the mechanisms involving inflammation may become the new focus of MR study. This review summarizes the research status of MR and MRA in order to provide a reference for future basic research and clinical treatment.
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