Do nutritional supplements have a role in age macular degeneration prevention? - PubMed (original) (raw)

Review

doi: 10.1155/2014/901686. Epub 2014 Jan 23.

Francisco Gómez-Ulla 2, Luis Arias 3, Javier Araiz 4, Ricardo Casaroli-Marano 5, Roberto Gallego-Pinazo 6, Jose J García-Medina [ 7](#full-view-affiliation-7 "University of Murcia, General University Hospital Reina Sofia, Murcia, Spain ; Ophthalmic Reseach Unit "Santiago Grisolia", Valencia, Spain."), Maria Isabel López-Gálvez 8, Lucía Manzanas 9, Anna Salas 10, Miguel Zapata 11, Manuel Diaz-Llopis 12, Alfredo García-Layana 13

Affiliations

Review

Do nutritional supplements have a role in age macular degeneration prevention?

Maria D Pinazo-Durán et al. J Ophthalmol. 2014.

Abstract

Purpose. To review the proposed pathogenic mechanisms of age macular degeneration (AMD), as well as the role of antioxidants (AOX) and omega-3 fatty acids ( ω -3) supplements in AMD prevention. Materials and Methods. Current knowledge on the cellular/molecular mechanisms of AMD and the epidemiologic/experimental studies on the effects of AOX and ω -3 were addressed all together with the scientific evidence and the personal opinion of professionals involved in the Retina Group of the OFTARED (Spain). Results. High dietary intakes of ω -3 and macular pigments lutein/zeaxanthin are associated with lower risk of prevalence and incidence in AMD. The Age-Related Eye Disease study (AREDS) showed a beneficial effect of high doses of vitamins C, E, beta-carotene, and zinc/copper in reducing the rate of progression to advanced AMD in patients with intermediate AMD or with one-sided late AMD. The AREDS-2 study has shown that lutein and zeaxanthin may substitute beta-carotene because of its potential relationship with increased lung cancer incidence. Conclusion. Research has proved that elder people with poor diets, especially with low AOX and ω -3 micronutrients intake and subsequently having low plasmatic levels, are more prone to developing AMD. Micronutrient supplementation enhances antioxidant defense and healthy eyes and might prevent/retard/modify AMD.

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Figures

Figure 1

Figure 1

Oxidative stress (OS) is widely accepted as a key player in the initiation and progression of ocular diseases, including AMD. The chain reactions of reactive oxygen species (ROS) include the anion superoxide (O2 •−), hydrogen peroxide (H2O2), and hydroxyl radical (•OH), all of them being able to importantly damage the cells through oxidation of lipids, proteins, and nucleic acids. These alterations lead to changes in protein function. Abbreviations: e: electron, SOD: superoxide dysmutase, and Fe: iron.

Figure 2

Figure 2

Molecules involved in angiogenesis. There are many molecules that mediate-regulate angiogenesis. The seven classes enclosed in the figure are (1) growth factors and its receptors, (2) transcription factors, (3) cell adhesion molecules, (4) signalling molecules, (5) extracellular matrix proteins, (6) proteinases, and (7) molecules involved in development and maturation. Several of these molecules have been considered for potential diagnosis or therapeutic approaches to control pathological angiogenesis.

Figure 3

Figure 3

ROS-mediated apoptosis. In order to transmit physiological ROS-mediated signals and to accommodate to the OS, the cells have a wide spectrum of intracellular signal transduction systems, including protein kinase cascades. Much of these pathways are engaged in the route to apoptosis, including MAP kinases/ASK1 upstream regulator, PKB/Akt-ERK. MKP/1 and glutamate-induced cell death. Abbreviations: Akt protein kinase B (PKB), a serine/threonine-specific protein kinase; ASK1 apoptosis signal-regulating kinase 1, ERK extracellular signal-regulated kinase, Glu glutamate, JNK c-Jun NH2-terminal kinase, MAPK mitogen-activated protein kinase, MKP-1 MAPK phosphatase-1, PI3-K phosphatidylinositol 3-kinase, PKA protein kinase A, PKB protein kinase B, PKC protein kinase C, PKD protein kinase D, ROK Rho kinase, and ROS reactive oxygen species.

Figure 4

Figure 4

Inflammation and immune response (IIR). The primary defense mechanism of the immune system needs the activation of different cell phenotypes and intercellular signals to orchestrate all actions. Among the cytokines, the interleukines (IL) IL-1 and IL-6 and the TNFa are inducers of the IIR through the regulation of the monocytes. Immunocompetent cells are essential for an adequate immune system function, such as the macrophages, neutrophils, fibroblasts, and endothelial cells.

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