Gut Microbiota Dysbiosis in Diabetic Retinopathy—Current Knowledge and Future Therapeutic Targets

Author:

Serban Dragos12ORCID,Dascalu Ana13ORCID,Arsene Andreea4ORCID,Tribus Laura56,Vancea Geta17ORCID,Pantea Stoian Anca1ORCID,Costea Daniel89,Tudosie Mihail1,Stana Daniela3,Cristea Bogdan1,Nicolae Vanessa13,Tudor Corneliu12,Costea Andreea10,Comandasu Meda2,Faur Mihai1112,Tanasescu Ciprian1112

Affiliation:

1. Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania

2. Fourth Surgery Department, Emergency University Hospital Bucharest, 050098 Bucharest, Romania

3. Ophthalmology Department, Emergency University Hospital Bucharest, 050098 Bucharest, Romania

4. Faculty of Pharmacy, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania

5. Faculty of Dental Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania

6. Department of Internal Medicine, Ilfov Emergency Clinic Hospital, 022113 Bucharest, Romania

7. “Victor Babes” Infectious and Tropical Disease Hospital, 030303 Bucharest, Romania

8. Faculty of Medicine, Ovidius University Constanta, 900470 Constanta, Romania

9. General Surgery Department, Emergency County Hospital Constanta, 900591 Constanta, Romania

10. Department of Nephrology, Diaverum Clinic Constanta, 900612 Constanta, Romania

11. Faculty of Medicine, University “Lucian Blaga”, 550169 Sibiu, Romania

12. Department of Surgery, Emergency County Hospital Sibiu, 550245 Sibiu, Romania

Abstract

Diabetic retinopathy is one of the major causes of blindness today, despite important achievements in diagnosis and therapy. The involvement of a gut–retina axis is thought to be a possible risk factor for several chronic eye disease, such as glaucoma, age-related macular degeneration, uveitis, and, recently, diabetic retinopathy. Dysbiosis may cause endothelial disfunction and alter retinal metabolism. This review analyzes the evidence regarding changes in gut microbiota in patients with DR compared with diabetics and healthy controls (HCs). A systematic review was performed on PubMed, Web of Science, and Google Scholar for the following terms: “gut microbiota” OR “gut microbiome” AND “diabetic retinopathy”. Ultimately, 9 articles published between 2020 and 2022 presenting comparative data on a total of 228 T2DM patients with DR, 220 patients with T2DM, and 118 HCs were analyzed. All of the studies found a distinctive microbial beta diversity in DR vs. T2DM and HC, characterized by an altered Firmicutes/Bacteroidetes ratio, a decrease in butyrate producers, and an increase in LPS-expressing and pro-inflammatory species in the Bacteroidetes and Proteobacteria phyla. The probiotic species Bifidobacterium and Lactobacillus were decreased when compared with T2DM. Gut microbiota influence retinal health in multiple ways and may represent a future therapeutic target in DR.

Publisher

MDPI AG

Subject

Paleontology,Space and Planetary Science,General Biochemistry, Genetics and Molecular Biology,Ecology, Evolution, Behavior and Systematics

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