Journal
BRITISH JOURNAL OF PHARMACOLOGY
Volume 179, Issue 13, Pages 3190-3204Publisher
WILEY
DOI: 10.1111/bph.15770
Keywords
age-related macular degeneration; corticosteroids; diabetic retinopathy; glaucoma; mineralocorticoid; pachychoroid; retina
Categories
Funding
- Agence Nationale de la Recherche [ANR-15-CE18-0032-03, PCRE-2020-20-CE17-0034]
- Abraham J. and Phyllis Katz Foundation
- Union Nationale des Aveugles et Deficients Visuels
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The mineralocorticoid receptor is expressed in various cells in the retina and has shown potential in the treatment of retinal diseases. However, specific formulations and molecular biomarkers are still needed.
In the retina, the mineralocorticoid receptor is expressed in retinal and choroidal vessels and in cells from neural and glial origins. Like in the brain, the major ligand of the mineralocorticoid receptor is cortisol, and the mineralocorticoid/glucocorticoid receptor balance regulates the activation of the MR pathway. Experimental mineralocorticoid receptor pathway activation using either pharmacological agents or transgenic manipulation favours retinal and choroidal pathology. In various models of retinal diseases, such as glaucomatous neuropathy, retinopathy of prematurity, ischaemic retinopathies, diabetic retinopathy and choroidal neovascularization, mineralocorticoid receptor antagonism exerts beneficial effects, demonstrating its potential in the treatment of major blinding retinal diseases. But specific formulations are required to optimize the bioavailability of mineralocorticoid receptor antagonists in various compartments of the eye, and molecular biomarkers of mineralocorticoid receptor pathway activation remain to be identified in humans to select patients amenable to clinical trials.
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