Fenofibrate， which is a peroxisome proliferator-activated receptor α （PPARα） agonist， has beneficial effects on lipid profiles that include lowering triglycerides and increasing high-density lipoprotein cholesterol， and reducing coronary vascular events in large clinical trials. Results from recent clinical trials suggest a role for fenofibrate in reducing the progression and/or inducing regression in mild-to-moderate nonproliferative diabetic retinopathy （DR）. The role of fenofibrate in the pathogenesis of diabetic retinopathy is associated with its anti-inflammatory properties. The effect and mechanisms of fenofibrate in the pathogenesis of diabetic retinopathy are reviewed in this article.
王娜 赵姝芝 郑志. 非诺贝特治疗糖尿病视网膜病变的临床研究进展[J]. 中华眼视光学与视觉科学杂志, 2013, 15(8): 510-512.
WANG Na， ZHAO Shu-zhi， ZHENG Zhi. Progress in clinical research on the beneficial effects of fenofibrate in diabetic retinopathy. Chinese Journal of Optometry Ophthalmology and Visual Science, 2013, 15(8): 510-512. DOI: 10.3760/cma.j.issn.1674-845X.2013.08.016
Treacy MP， Hurst TP. The case for intraocular delivery of PPAR agonists in thetreatment of diabetic retinopathy. BMC Ophthalmol，2012，12：46.
[2]
Wong TY， Simó R， Mitchell P. Fenofibrate-a potential systemic treatment for diabetic retinopathy? Am J Ophthalmol，2012， 154：6-12.
[3]
Forcheron F， Cachefo A， Thevenon S， et al. Mechanisms of the triglyceride- and cholesterol-lowering effect of fenofibrate in hyperlipidemic type 2 diabetic patients. Diabetes，2002，12：3486-3491.
[4]
Schoonjans K， Staels B， Auwerx J. The peroxisome proliferator activated receptors （PPARS） and their effects on lipid metabolism and adipocyte differentiation. Biochim Biophys Acta，1996，2：93-109.
[5]
Schoonjans K， Staels B， Auwerx J. Role of the peroxisome proliferator-activated receptor （PPAR） in mediating the effects of fibrates and fatty acids on gene expression. J Lipid Res，1996，5：907-925.
[6]
Fruchart JC. Peroxisome proliferator-activated receptoralpha（PPARa）： at the crossroads of obesity， diabetes and cardiovascular disease. Atherosclerosis，2009，1：1-8.
[7]
Zambon A， Gervois P， Pauletto P， et al. Modulation of hepatic inflammation risk markers of cardiovascular diseases by PPAR-a activators： clinical and experimental evidence. Arterioscler Throm Vasc Biol，2006，5：977-986.
[8]
Saougos VG， Tambaki AP， Kalogirou M， et al. Differential effect of hypolipidemic drugs on lipoprotein-associated phospholipase A2. Arterioscler Thromb Vasc Biol，2007，10： 2236-2243.
[9]
Rosenson RS. Fenofibrate reduces lipoprotein associated phospholipase A2 mass and oxidative lipids in hypertriglyceridemic subjects with the metabolic syndrome. Am Heart J，2008，3：499.e9-499.e16.
[10]
Koh KK， Quon MJ， Han SH， et al. Additive beneficial effects of fenofibrate combined with atorvastatin in the treatment of combined hyperlipidemia. J Am Coll Cardiol，2005，10：1649-1653.
[11]
Wright AD， Dodson PM. Medical management of diabetic retinopathy： fenofibrate and ACCORD Eye studies. Eye，2011， 25：843-849.
[12]
Keech A， Simes RJ， Barter P， et al. Effects of long-term fenofibrate therapy on cardiovascular events in 9795 people with type 2 diabetes mellitus （the FIELD study）： randomised controlled trial. Lancet，2005，9500：1849-1861.
[13]
Ansquer JC， Foucher C， Aubonnet P， et al. Fibrates and microvascular complications in diabetes-insight from the FIELD Study. Cur Pharm Des，2009，15：537-552
[14]
McKeage K， Keating GM. Fenofibrate： a review of its use in dyslipidaemia. Drugs，2011，14：1917-1946.
[15]
Simó R， Hernández C. Prevention and treatment of diabetic retinopathy： evidence from large， randomized trials. The emerging role of fenofibrate. Rev Recent Clin Trials，2012，7：71-80.
[16]
Keech AC， Mitchell P， Summanen PA， et al. Effect of fenofibrate on the need for laser treatment for diabetic retinopathy（FIELD study）： a randomised controlled trial. Lancet，2007，9600：1687-1697.
[17]
Miranda S， González-Rodríguez A， García-Ramírez M， et al.Beneficial effects of fenofibrate in retinal pigment epithelium by the modulation of stress and survival signaling under diabetic conditions. J Cell Physiol，2012，6：2352-2362.
[18]
Ruderman N， Prentki M. AMP kinase and malonyl-CoA： targets for therapy of the metabolic syndrome. Nat Rev Drug Discov，2004，3：340-351.
[19]
Ruderman NB， Xu XJ， Nelson L， et al. AMPK and SIRT1： a longstanding partnership? Am J Physiol Endocrinol Metab，2010，298：E751-E760.
[20]
Joussen AM， Poulaki V， Le ML， et al. A central role for inflammation in the pathogenesis of diabetic retinopathy. FASEB J，2004，18：1450-1452.
[21]
Chibber R， Ben-Mahmud BM， Chibber S， et al. Leukocytes in diabetic retinopathy. Curr Diabetes Rev，2007，3：3-14.
[22]
Kern TS. Contributions of inflammatory processes to the development of the early stages of diabetic retinopathy. Exp Diabetes Res，2007，95：103.
[23]
Murakami H， Murakami R， Kambe F， et al. Fenofibrate activates AMPK and increases eNOS phosphorylation in HUVEC. Biochem Biophys Res Commun，2006，4：973-978.
[24]
Okayasu T， Tomizawa A， Suzuki K， et al. PPARalpha activators upregulate eNOS activity and inhibit cytokine- induced NF-?资B activation through AMP-activated protein kinase activation. Life Sci，2008，82：884-891.
浙公网安备 33030202001892号