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      Phytochemicals: Target-Based Therapeutic Strategies for Diabetic Retinopathy

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          Abstract

          Background: A variety of causative factors are involved in the initiation of diabetic retinopathy (DR). Current antidiabetic therapies are expensive and not easily accessible by the public. Furthermore, the use of multiple synthetic drugs leads to severe side effects, which worsen the diabetic patient’s condition. Medicinal plants and their derived phytochemicals are considered safe and effective treatment and their consumption can reduce the DR risk. In this article, we discuss a variety of medicinal plants, and their noteworthy bio-active constituents, that will be utilized as target based therapeutic strategies for DR. Methods: A broad-spectrum study was conducted using published English works in various electronic databases including Science Direct, PubMed, Scopus, and Google Scholar. Results: Targeting the multiple pathological factors including ROS, AGEs formation, hexosamine flux, PARP, PKC, and MAPK activation through variety of bioactive constituents in medicinal plants, diabetes progression can be delayed with improved loss of vision. Conclusions: Data reveals that traditional herbs and their prominent bioactive components control and normalize pathological cellular factors involved in DR progression. Therefore, studies should be carried out to explore the protective retinopathy effects of medicinal plants using experimental animal and humans models.

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          WHO Global report on diabetes: A summary

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            A review of anti-VEGF agents for proliferative diabetic retinopathy.

            Previous research has implicated vascular endothelial growth factor (VEGF) in the pathogenesis of diabetic retinopathy (DR). Although many studies reviewed the use of anti-VEGF for diabetic macular oedema, little has been written about the use of anti-VEGF for proliferative diabetic retinopathy (PDR). This study is a review of relevant publications dealing with the use of anti-VEGF for the treatment of PDR. The articles were identified through systematic searches of PUBMED and the Cochrane Central Register of Controlled Trials. At the end of each section, we summarized the level of evidence of the scientific literature. Off-label use of anti-VEGF agents was found to be beneficial in PDR, especially in cases with neovascular glaucoma, persistent vitreous haemorrhage, and before vitrectomy. The disadvantages of the use of anti-VEGF are its short-effect duration, causing tractional retinal detachment in cases with pre-existing pre-retinal fibrosis and endophthalmitis in rare cases. There is no conclusive evidence from large randomized trials regarding the efficacy of anti-VEGF treatment in PDR. However, numerous case series, sound biochemical mechanism of action, and increasing experience with using anti-VEGF drugs can be used to support the ongoing use of this treatment modality in selected patients.
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              Oxidative stress and diabetic retinopathy: development and treatment

              Oxidative stress and diabetic retinopathy: development and treatment
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                Author and article information

                Journal
                Molecules
                Molecules
                molecules
                Molecules : A Journal of Synthetic Chemistry and Natural Product Chemistry
                MDPI
                1420-3049
                23 June 2018
                July 2018
                : 23
                : 7
                : 1519
                Affiliations
                [1 ]Department of Pharmacognosy, College of Pharmacy, Government College University Faisalabad, Faisalabad 3800, Pakistan; amnaparvin@ 123456gmail.com
                [2 ]College of Pharmacy, Gachon University, Hambakmoero, Yeonsu-gu, Incheon 406-799, Korea; nirvana995@ 123456naver.com (J.H.K.); saxa12@ 123456naver.com (B.G.O.); subedilali@ 123456gmail.com (L.S.); Zahra.khan37@ 123456gmail.com (Z.H.)
                [3 ]Gachon Institute of Pharmaceutical Science, Gachon University, Hambakmoe-ro, Yeonsu-gu, Incheon 406-799, Korea
                Author notes
                [* ]Correspondence: sunnykim@ 123456gachon.ac.kr ; Tel.: +82-32-820-4931; Fax: +82-32-899-8962
                Author information
                https://orcid.org/0000-0001-8044-5613
                Article
                molecules-23-01519
                10.3390/molecules23071519
                6100391
                29937497
                37deb516-7379-444f-a2bf-80c5333fa0df
                © 2018 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 07 June 2018
                : 19 June 2018
                Categories
                Review

                diabetic retinopathy,protein kinase c,advanced glycation end-products,phytochemicals,oxidative stress,mitogen-activated protein kinases,vascular endothelial growth factor,poly (adp-ribose) polymerase,metalloproteinase-9,reactive oxygen species,aldose reductase

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