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Thromb Haemost
DOI: 10.1055/s-0044-1791232
Review Article

Potential of Sulodexide in the Treatment of Diabetic Retinopathy and Retinal Vein Occlusion

Elsa Wilma Böhm
1   Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
,
Francesco Buonfiglio
1   Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
,
Christina A. Korb
1   Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
,
Alice Dauth
2   Department of Neurosurgery, University Medical Center Mainz, Johannes Gutenberg University of Mainz, Mainz, Germany
,
Norbert Pfeiffer
1   Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
,
Andrzej Bręborowicz
3   Department of Pathophysiology, Poznan University of Medical Sciences, Poznan, Poland
4   Collegium Medicum, Zielona Góra University, Zielona Góra, Poland
,
Adrian Gericke
1   Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
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Abstract

Retinal vascular diseases, such as diabetic retinopathy or retinal vein occlusion, are common causes of severe vision loss. Central to the pathophysiology of these conditions are endothelial dysfunction, inflammation, capillary leakage, ischemia, and pathological neoangiogenesis. Capillary damage leads to leakage and the development of macular edema, which is associated with vision loss and requires complex treatment. Sulodexide, a glycosaminoglycan composed of heparan sulfate and dermatan sulfate with high oral bioavailability, exhibits several favorable pharmacologic properties, including antithrombotic, anti-inflammatory, and endothelium-protective effects. Additionally, treatment with sulodexide has been associated with the reduction of oxidative stress and decreased expression of angiogenic growth factors, such as vascular endothelial growth factor. This review aims to provide an overview of the pharmacological properties, mechanisms of action, and therapeutic effects of sulodexide. Furthermore, its potential for clinical application in venous and diabetic diseases, such as venous thromboembolism, chronic venous insufficiency, peripheral artery disease, or diabetic nephropathy, is summarized. We also present experimental and clinical studies evaluating the potential of sulodexide in ocular conditions and discuss its therapeutic implications for the treatment of retinal vascular diseases.

Keywords

sulodexide - retinal vein occlusion - diabetic retinopathy - vascular endothelial growth factor - oxidative stress

Authors' Contribution

E.W.B. and A.G. wrote the manuscript. F.B., C.A.K., A.D., A.B., and N.P. made critical revisions. F.B. was responsible for figure editing. All authors reviewed the manuscript.




Publication History

Received: 29 May 2024

Accepted: 27 August 2024

Article published online:
18 September 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Stuttgart · New York

 

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