Zusammenfassung
Oxidativer Stress im chemischen Sinne beschreibt den Zustand der oxidativen Überflutung.
Heute wird häufig als oxidativer Stress auch jeder Zustand bezeichnet, der mit einer
Erhöhung an Oxidantien oder auch einem Mangel an Antioxidantien sowohl im Gesamtorganismus
als auch in einem Organkompartiment einhergeht. Vom molekularen Sauerstoff ausgehend
werden in entsprechender Umgebung hochreaktive Metabolite generiert, die entweder
direkt schädigend wirken oder die Bildung von Sekundärreaktionen ermöglichen, die
schließlich zu oxidativen Prozessen führen. Die Zelle hat zahlreiche Mechanismen und
Strategien entwickelt, die potenziell toxische Sauerstoffspezies auf verschiedenen
Stufen ihrer Entstehung oder ihrer Reaktion mit Biomolekülen hemmen oder blockieren
sollen. Zahlreiche Krankheitsbilder werden mit oxidativem Stress in Verbindung gebracht.
Das Auge ist im Vergleich zu anderen Organen insofern vermehrt gefährdet, oxidative
Schäden zu erleiden, da es permanent mit oxidativen Stimuli umgehen muss. Die biochemische
Zusammensetzung der okulären Strukturen ist ein weiterer Faktor, der diese im Vergleich
zu anderen Organen vermehrte oxidative Gefährdung ausmacht. Insbesondere die okuläre
bzw. die Netzhautischämie, die diabetische Retinopathie sowie die altersbedingte Makuladegeneration
und auch das Glaukom werden mit oxidativen Prozessen in Verbindung gebracht. Während
bei der Netzhautischämie die klassischen Generierungsmechanismen von Oxidantien von
Relevanz sind, gelten diese bei der diabetischen Retinopathie im Hinblick auf die
Generierung oxidativer Metabolite mittlerweile eher als Sekundärreaktionen. Hier stehen
heute Glykosylierungsprodukte (AGE’s) und die auch oxidativ induzierbare Expression
von Wachstumsfaktoren im Mittelpunkt. Bei der altersbedingten Makuladegeneration scheinen
photodynamische Prozesse (v. a. Typ-2-Reaktion), die von Kindheit an ablaufen und
auch durch sichtbares, v. a. blaues Licht unterhalten werden, mitverantwortlich für
die Entstehung des Krankheitsbilds zu sein. Zusätzlich kann die Induktion des Gefäßwachstums
bzw. die Expression von Wachstumsfaktoren über Entzündungsreaktionen aber auch oxidativ
erfolgen.
Abstract
Oxidative stress is defined as an overflow of oxidative metabolites either in the
human body or in a compartment of the body. Today this chemical definition has been
slightly modified and encompasses an elevation of oxidative metabolites or a relative
deficiency of anti-oxidants. Molecular oxygen is the basis of many highly reactive
oxidative species which are able to directly damage or lead to the generation of secondary
reactions which then initiate oxidative processes. The cell has established numerous
mechanisms and strategies to antagonise those oxidative processes at different steps.
Many diseases have been shown to be either related to or even be initiated by oxidative
processes. The eye is at high risk to be damaged by oxidative mechanisms. One major
reason is its permanent exposition to oxidative stimuli. The biochemical composition
of ocular structures, especially that of the retina (unsaturated fatty acids), is
an important factor making the eye more susceptible as compared to other organs. Ocular
ischaemia, ischaemia or hypoxia of the retina, diabetic retinopathy and glaucoma are
important disease entities that are initiated or propagated by oxidative processes.
Ischaemic processes lead to classical reactions of the oxidative pathway. This is
no longer believed to be the case in diabetic retinopathy. Here, advanced glycation
end products (AGE’s) and related species are able to induce oxidative reactions and
the expression of growth factors. In age-related macular degeneration, photodynamic
processes that already occur in childhood are believed to be a major factor contributing
to the pathogenesis of the disease process. In addition, the expression of growth
factors and new vessel growth can be initiated via inflammatory reactions or oxidative
metabolites.
Schlüsselwörter
oxidativer Gewebeschaden - Sauerstoff - Antioxidantien - Diabetes mellitus - altersbedingte
Makuladegeneration
Key words
oxidative tissue damage - oxygen - anti-oxidants - diabetes - age-related macular
degeneration
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