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Current concepts in targeted therapies for the pathophysiology of diabetic microvascular complications

Authors Brian C Cumbie, Kathie L Hermayer

Published 15 January 2008 Volume 2007:3(6) Pages 823—832


Brian C Cumbie, Kathie L Hermayer

Division of Endocrinology, Diabetes and Medical Genetics, Medical University of South Carolina, Charleston, South Carolina, USA

Abstract: Microvascular complications characterized by retinopathy, nephropathy, and neuropathy are highly prevalent among diabetics. Glycemic control has long been the mainstay for preventing progression of these complications; however, such control is not easily achieved. Currently, alternative adjunctive approaches to treating and preventing microvascular damage are being undertaken by targeting the molecular pathogenesis of diabetic complications. This review summarizes the specific pathogenic mechanisms of microvascular complications for which clinical therapies have been developed, including the polyol pathway, advanced glycation end products, protein kinase c, vascular epithelium growth factor, and the superoxide pathway. The review further focuses on therapies for these targets that are currently available or are undergoing late-stage clinical trials.

Keywords: diabetes, aldose reductase inhibitor, advanced glycation end products, protein kinase C inhibitor, vascular epithelium growth factor inhibitor, antioxidants

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