Clay F. Semenkovich, MD and Rithwick Rajagopal, MD, PhD recently published an article in Lipid Maps titled, “’Fatty retina’ – A root cause of vision loss in diabetes?”
“Diabetes is a disease of broadly disordered metabolism that affects how cells handle lipids, amino acids and signaling networks that regulate growth and proliferation, in addition to glucose.” One of its major complications is vision loss, which is a result of diabetic retinopathy (DR) — a progessive pathogenic process. The predominant risk factor for DR is elevated blood glucose.
As abnormalities of lipid metabolism are common in diabetes, Semenkovich and Rajagopal suggest that “the retina might switch its lipid metabolic programming in response to abundance of fuel in diabetes.” To test this theory, they studied retinal lipid biogenesis pathways in mice, which is where synthesizing fatty acids from small precursors takes place. By observing “a 70% increase over controls in the synthesis of retinal palmitate,” they determined that this lipid production shift was specifically caused by elevated glucose. “Isolated retinal tissue exposed to high glucose showed the same increase in palmitate production.”
These results indicated that increased retinal FAS activity and elevated palmitate are significant causes of vision loss in diabetes.
“Though glucose is the major risk factor for vision loss in diabetes, it only explains a fraction of the variability in disease progression. Differences among individuals in terms of their retinal lipid biosynthetic flux could account for some of the variance in glucose response.
Future pharmacotherapy to finely tune retinal lipid biogenesis in DR could offer a novel approach to the treatment of an increasingly common cause of visual disability.”