Abstrakt

Zwyrodnienie plamki związane z wiekiem (AMD – age-related macular degeneration) to obecnie istotny problem zdrowotny, bowiem w krajach rozwiniętych jest jedną z najczęstszych przyczyn utraty widzenia centralnego u osób powyżej 50. roku życia. Patogeneza AMD jest wieloczynnikowa i niedokładnie poznana. Wśród czynników odpowiedzialnych za rozwój choroby wymienia się, poza naturalnym procesem starzenia się siatkówki, nasilony stres oksydacyjny, nadmierną aktywację dopełniacza, tlące się przewlekłe zapalenie w przestrzeni podsiatkówkowej, uwarunkowania genetyczne i środowiskowe. W ostatnim czasie zwrócono uwagę na zaburzenia procesów autofagii jako wiodącej przyczyny rozwoju AMD. Autofagia jest mechanizmem komórkowym, polegającym na eliminowaniu zużytych lub uszkodzonych fragmentów i składników komórki, pozwalającym osiągnąć komórce dynamiczną równowagę między syntezą a rozkładem jej komponentów, umożliwia zatem przeżycie komórki w warunkach stresowych. Zaburzenia tych mechanizmów w postaci ich nadmiernej aktywacji lub inhibicji prowadzą do rozwoju wielu patologii. Autofagia pełni zatem podwójną rolę, jest odpowiedzialna zarówno za ochronę, jak i za śmierć komórki. W pracy przybliżono mechanizmy autofagii oraz jej znaczenie w fizjologicznym procesie starzenia się komórek siatkówki oraz omówiono istotny wpływ jej zaburzeń na rozwój zmian zwyrodnieniowych w plamce jakim jest AMD. Przedstawiono także potencjalny wpływ leczenia doszklistkowymi iniekcjami czynników anty-VEGF na zjawiska autofagii w siatkówce oraz możliwe nowe terapie AMD oparte na modulowaniu zjawiska autofagii.

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