Основы диабетического катарактогенеза и перспективные пути его фармакологической коррекции

Среди поздних осложнений сахарного диабета отдельно выделяется катаракта, приводящая к снижению зрительных функций и в дальнейшем – к слепоте. Несмотря на превалирование в настоящее время хирургии катаракты, которая при сахарном диабете сопровождается рядом ограничений и осложнений, продолжаются поиски эффективных средств консервативной терапии. В настоящем обзоре, выполненном на основе анализа данных научных источников преимущественно за 2015–2020 гг. c использованием Интернет-ресурсов (PubMed, Web of Science, Medline, eLibrary.ru, Cyberleninka), диабетический катарактогенез представлен как совокупность параллельных, но связанных и взаимовлияющих патобиохимических процессов, основными из которых являются избыточно интенсифицированные при сахарном диабете полиоловый путь превращения глюкозы, неферментативное гликирование и окислительная модификация хрусталиковых белков. Учитывая тот факт, что в хрусталике имеется высокое содержание белка, особое значение в появлении зон светорассеяния и снижения прозрачности хрусталика имеет формирование белковых агрегатов с высокой молекулярной массой. В обзоре подробно изложены данные о наиболее перспективных в эксперименте антикатарактальных соединениях, влияющих на посттрансляционную модификацию кристаллинов, препятствующих осмотическому и оксидативному стрессу в хрусталике и проявляющих антигликирующие свойства в отношении хрусталиковых белков. Эти данные наглядно подтверждают точку зрения о том, что поиск средств фармакологической коррекции катарактогенеза должен проводится, в первую очередь, среди соединений, обладающих антиоксидантной и антигликирующей активностью. 

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