The therapeutic potential of sodium-glucose 2 transporter inhibitors in diabetic retinopathy: integrative review

Authors

  • Éliton Aparecido Ferreira Centro Universitário Redentor/Afya
  • Emerson Fábio De Carvalho Campos Centro Universitário UNINOVAFAPI (Teresina/PI)
  • Ytallo Rangell Dias Centro Universitário UNINOVAFAPI (Teresina/PI)
  • Ronald Mateus Santos De Oliveira Centro Universitário UNINOVAFAPI (Teresina/PI)
  • Renata de Alencar Nogueira Centro Universitário UNINOVAFAPI (Teresina/PI)

DOI:

https://doi.org/10.29327/2393773.17.1-11

Abstract

Objective: To summarize the main results of studies that evaluated the use of iSGLT2 in patients with diabetic retinopathy. Methods: An integrative literature review was carried out in April 2024. Using the terms “Diabetic Retinopathy”, “Sodium-Glucose Transporter 2 Inhibitors” and related terms. The search was carried out in PubMed, Elsevier Science Direct Journals and Web of Science, regardless of the year of publication. Includes research with patients or animal models of diabetic retinopathy. Works in languages ​​other than English and full text not available are excluded. 12 studies were selected for the scope of this review. Results and discussion: Studies highlight iSGLT2 as inhibitors of inflammatory cytokines and retinal protectors in diabetic retinopathy. They regulate inflammatory factors, preserve vascular integrity and reduce apoptosis, suggesting significant therapeutic potential and beneficial effects in retinal degeneration and diabetic macular edema. Conclusion: iSGLT2 can improve markers in diabetic retinopathy, but randomized clinical studies are limited.

References

BOLAC, R.; BAS, S.; OZKAN, E. M. A. et al. Evaluation of the effect of sodium-glucose cotransporter-2 inhibitor treatment on choroidal vascular parameters in patients with type 2 diabetes mellitus. Photodiagnosis Photodyn Ther. 2023 Dec;44:103804. doi: 10.1016/j.pdpdt.2023.103804. Epub 2023 Sep 14. PMID: 37714281.

BRASIL. Vigitel: vigilância de fatores de risco e proteção para doenças crônicas por inquérito telefônico [recurso eletrônico] / Ministério da Saúde, Secretaria de Vigilância em Saúde e Ambiente, Departamento de Análise Epidemiológica e Vigilância de Doenças Não Transmissíveis, 2023.

CHO, E. H.; PARK, S. J.; HAN, S.; et al. Potent Oral Hypoglycemic Agents for Microvascular Complication: Sodium-Glucose Cotransporter 2 Inhibitors for Diabetic Retinopathy. Journal of diabetes research, 2018. https://doi.org/10.1155/2018/6807219

CHUNG, Y.R.; HA, K. H.; LEE, K. et al. Effects of sodium-glucose cotransporter-2 inhibitors and dipeptidyl peptidase-4 inhibitors on diabetic retinopathy and its progression: A real-world Korean study. PLoS One. v. 14, n. 10, oct, 2019. doi: 10.1371/journal.pone.0224549. PMID: 31658289; PMCID: PMC6816558.

FERNANDES, V. H. R.; CHAVES, F. R. P.; SOARES A. A. S. et al. Dapagliflozin increases retinal thickness in type 2 diabetic patients as compared with glibenclamide: A randomized controlled trial. Diabetes Metab. v. 47, n; 6, nov, 2021. doi: 10.1016/j.diabet.2021.101280. Epub 2021 Sep 16. PMID: 34537385.

GONG, Q.; ZHANG, R.; WEI, F. et al. SGLT2 inhibitor-empagliflozin treatment ameliorates diabetic retinopathy manifestations and exerts protective effects associated with augmenting branched chain amino acids catabolism and transportation in db/db mice. Biomed Pharmacother. v. 152, aug, 2022. doi: 10.1016/j.biopha.2022.113222. Epub 2022 Jun 4. PMID: 35671581.

GULLAKSEN, S.; VERNSTRØM, L.; SØRENSEN, S. S. et al. “Effects of Semaglutide and Empagliflozin on Oxygenation, Vascular Autoregulation, and Central Thickness of the Retina in People with Type 2 Diabetes: A Prespecified Secondary Analysis of a Randomised Clinical Trial.” Journal of diabetes and its complications, v. 37, n. 5, 2023.

HANAGURI, J.; YOKOTA, H.; KUSHIYAMA, A.; et al. The Effect of Sodium-Dependent Glucose Cotransporter 2 Inhibitor Tofogliflozin on Neurovascular Coupling in the Retina in Type 2 Diabetic Mice. Int. J. Mol. Sci. 2022, 23, 1362. https://doi.org/10.3390/ijms23031362

HERAT, L.Y.; MATTHEWS, V. B.; RAKOCZY, P. E.; et al. “Focusing on Sodium Glucose Cotransporter-2 and the Sympathetic Nervous System: Potential Impact in Diabetic Retinopathy.” International journal of endocrinology, 2018. 9254126–8. Print.

HU, Y.; XU, Q.; LI, H.; et al. Dapagliflozin Reduces Apoptosis of Diabetic Retina and Human Retinal Microvascular Endothelial Cells Through ERK1/2/cPLA2/AA/ROS Pathway Independent of Hypoglycemic. Front Pharmacol. v. 24, fev, 2022. doi: 10.3389/fphar.2022.827896. PMID: 35281932; PMCID: PMC8908030.

ISHIBASHI, R.; INABA, Y.; KOSHIZAKA, M.; et al. Sodium-glucose co-transporter 2 inhibitor therapy reduces the administration frequency of anti-vascular endothelial growth factor agents in patients with diabetic macular oedema with a history of anti-vascular endothelial growth factor agent use: A cohort study using the Japanese health insurance claims database. Diabetes Obes Metab. v. 26, n. 4, p. 1510-1518, apr, 2024. doi: 10.1111/dom.15454. Epub 2024 Jan 19. PMID: 38240052.

LAKSHINI, Y.; HERAT, J. R.; MATTHEWS, E. P. et al. Comparando e contrastando os efeitos dos inibidores de SGLT Canagliflozina e Empagliflozina na progressão da retinopatia. Frente. Biosci. (Landmark Ed), v. 28, n. 4, 2023. https://doi.org/10.31083/j.fbl2804083

LUO, Q.; LELEY, S. P.; BELLO, E.; et al. Dapagliflozin protects neural and vascular dysfunction of the retina in diabetes. BMJ open diabetes research & care, v. 10, n. 3, 2022. https://doi.org/10.1136/bmjdrc-2022-002801

TAKAKURA, S.; TOYOSHI, T.; HAYASHIZAKI, Y.; et al. Effect of ipragliflozin, an SGLT2 inhibitor, on progression of diabetic microvascular complications in spontaneously diabetic Torii fatty rats. Life Sci. v. 147, p. 125-31, feb, 2016. doi: 10.1016/j.lfs.2016.01.042. Epub 2016 Jan 29. PMID: 26829386.

TAKATSUNA, Y.; ISHIBASHI, R.; TATSUMI, T.; et al. Sodium-Glucose Cotransporter 2 Inhibitors Improve Chronic Diabetic Macular Edema. Case reports in ophthalmological medicine, 2020, 8867079. https://doi.org/10.1155/2020/8867079

XU, C.; LI, H.; XU, Q.; et al. Dapagliflozin ameliorated retinal vascular permeability in diabetic retinopathy rats by suppressing inflammatory factors. J Diabetes Complications. v. 38, n. 3, mar, 2024. doi: 10.1016/j.jdiacomp.2023.108631. Epub 2023 Oct 17. PMID: 38340519.

Downloads

Published

2024-10-02

Issue

Vol. 17 No. 1 (2024)

Section

Revisão

License

Transferência de Direitos Autorais

Declaro que em caso de aceitação do artigo, concordo que os direitos autorais a ele referentes se tornarão propriedade exclusiva da Revista Interdisciplinar.

Assinatura do(s) autor(es)

 

 Data: _____________________________________________________________________

Envio de manuscritos

Os manuscritos devem ser enviados pelo sistema eletrônico para a Revista Interdisciplinar.