Abstract:

Diabetic retinopathy (DR) is the main complication of type 2 diabetes mellitus (T2DM), and is the main cause of visual impairment and preventable blindness. It is well known that inflammation plays an important role in the pathogenesis of T2DM and DR. Retinol binding protein 4 (RBP4) is a novel adipocyte factor, which can induce the insulin resistance and retinal degeneration indirectly through proinflammatory mechanisms, such as Toll like receptor 4 (TLR4), c-Jun amino terminal kinase (JNK), extracellular signal regulated kinase (ERK), p38 signaling pathway, and nuclear factor kappa B (NF-κB), etc. Also the rise of RBP4 can induce insulin resistance and retinal degeneration directly through inflammatory mechanism. In addition, the serum transthyretin (TTR) might inhibit the inflammation of retinal endothelial cells induced by RBP4.