Research and prospects on the protective effect of ursodeoxycholic acid on retina under high glucose

Diabetic retinopathy (DR) is one of the severe microvascular complications of diabetes, which can lead to irreversible retinal damage and significant visual impairment.Ursodeoxycholic acid (UDCA) and its derivative tauroursodeoxycholic acid (TUDCA), as hydrophilic bile acids, exhibit multiple cytoprotective effects including anti-apoptotic, anti-inflammatory, and antioxidant properties and show promising potential in the prevention and treatment of DR.This article reviews the protective effects and molecular mechanisms of UDCA/TUDCA on the retinal neurovascular unit under high glucose conditions.Studies have demonstrated that UDCA/TUDCA protects retinal neurons from high glucose-induced damage by inhibiting mitochondrial-dependent apoptotic pathways and the JNK/AP-1 signaling pathway, maintains the integrity of retinal vascular endothelial cells and pericytes by suppressing endoplasmic reticulum stress and reducing vascular leakage, and alleviates retinal inflammation by downregulating the expression of inflammatory factors and inhibiting microglial activation.Moreover, UDCA/TUDCA exerts its protective effects by binding to bile acid receptors, such as TGR5, on retinal cells and activating related signaling pathways.UDCA/TUDCA holds great potential in the treatment of DR, and future research should focus on optimizing delivery methods and dosages to provide new strategies for the early prevention and treatment of DR.

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