Kai Jin
Honghua Yu
Wenbin Wei
Andrzej Grzybowski
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- 1Zhejiang University, Eye Center of Second Affiliated Hospital, School of Medicine, Hangzhou, China
- 2Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang University, Hangzhou, China
- 3Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang University, Hangzhou, China
- 4Zhejiang Provincial Engineering Institute on Eye Diseases, Zhejiang University, Hangzhou, China
- 5Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Southern Medical University, Guangzhou, China
- 6Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- 7Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, Poznan, Poland
- 8Department of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland
Editorial on the Research Topic
Personalized medicine of diabetes retinopathy: from bench to bedside
Introduction
Diabetic retinopathy (DR) stands as a prevalent complication of diabetes mellitus, imposing a substantial burden on individuals worldwide and serving as a leading cause of vision impairment among the middle-aged and elderly populations (1). The progression of DR encompasses various stages, ranging from the initial microvascular alterations to advanced manifestations such as proliferative DR and diabetic macular edema, which significantly compromise visual function (2). Traditionally conceived as primarily a microvascular disorder, emerging evidence underscores the intricate involvement of retinal neurodegeneration in the pathogenesis of DR.
Pathophysiological insights: beyond microvasculature
DR is a multifaceted disease driven by a persistent hyperglycemic environment characteristic of diabetes. Beyond microvascular alterations, the pathophysiological mechanisms orchestrating DR onset and progression are diverse and interconnected (3). Genetic predisposition, epigenetic modifications, oxidative stress-induced free radical generation, accumulation of advanced glycosylation end products, inflammatory mediators, and dysregulated vascular endothelial growth factor (VEGF) signaling collectively contribute to the intricate landscape of DR pathogenesis (4). This intricate interplay of molecular pathways underscores the heterogeneous nature of DR, posing a significant challenge in devising tailored therapeutic strategies for individual patients.
Advancements in personalized medicine
The identification of distinct phenotypes of DR, characterized by unique molecular signatures and varying risks for vision-threatening complications, represents a significant breakthrough in patient stratification (5). Molecular profiling techniques, including genomics, proteomics, and metabolomics, have provided valuable insights into the underlying pathophysiological mechanisms of DR (6). By tailoring treatment strategies to match individual patient profiles, personalized medicine holds promise for optimizing therapeutic outcomes and minimizing treatment-related adverse effects.
Optimization of current treatment strategies
While anti-VEGF therapy and laser photocoagulation remain the mainstays of treatment for diabetic macular edema and proliferative DR, respectively, personalized medicine offers the opportunity to refine and optimize these approaches. Targeted therapies, guided by the specific molecular characteristics of each patient’s disease, have the potential to enhance treatment efficacy and improve long-term visual outcomes (7, 8). By minimizing treatment burden and maximizing therapeutic benefit, personalized approaches aim to improve patient adherence and quality of life.
Challenges and opportunities
Despite the significant progress made in personalized medicine for DR, several challenges remain. Integration of omics technologies into clinical practice presents logistical and technical hurdles, including standardization of methodologies and interpretation of complex data sets (9). Additionally, the cost-effectiveness and accessibility of personalized approaches must be carefully considered to ensure equitable access to care for all patients (10). However, with continued advancements in technology and collaboration between researchers, clinicians, and industry partners, personalized medicine holds the promise of revolutionizing the management of DR and improving outcomes for patients worldwide.
Conclusions
In conclusion, the journey towards personalized medicine in DR represents a transformative paradigm shift, poised to revolutionize our approach to patient care and therapeutic decision-making. By embracing the principles of precision medicine and harnessing the power of molecular profiling and biomarker-driven strategies, we can strive towards optimizing visual outcomes and enhancing the quality of life for individuals afflicted with this sight-threatening complication of diabetes.
Author contributions
KJ: Writing – review & editing, Writing – original draft. HY: Writing – review & editing. WW: Writing – review & editing. AG: Writing – review & editing.
Conflict of interest
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Generative AI statement
The author(s) declare that no Generative AI was used in the creation of this manuscript.
Publisher’s note
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References
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2. Sabanayagam C, Banu R, Chee ML, Lee R, Wang YX, Tan G, et al. Incidence and progression of diabetic retinopathy: a systematic review. Lancet Diabetes Endocrinol. (2019) 7:140–9. doi: 10.1016/S2213-8587(18)30128-1
3. Yue T, Shi Y, Luo S, Weng J, Wu Y, Zheng X. The role of inflammation in immune system of diabetic retinopathy: Molecular mechanisms, pathogenetic role and therapeutic implications. Front Immunol. (2022) 13:1055087. doi: 10.3389/fimmu.2022.1055087
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5. Li L, Cheng WY, Glicksberg BS, Gottesman O, Tamler R, Chen R, et al. Identification of type 2 diabetes subgroups through topological analysis of patient similarity. Sci Trans Med. (2015) 7:311ra174. doi: 10.1126/scitranslmed.aaa9364
6. Wang N, Ding L, Liu D, Zhang Q, Zheng G, Xia X, et al. Molecular investigation of candidate genes for pyroptosis-induced inflammation in diabetic retinopathy. Front Endocrinol. (2022) 13:918605. doi: 10.3389/fendo.2022.918605
7. Van Hove I, Hu TT, Beets K, Van Bergen T, Etienne I, Stitt AW, et al. Targeting RGD-binding integrins as an integrative therapy for diabetic retinopathy and neovascular age-related macular degeneration. Prog retinal eye Res. (2021) 85:100966. doi: 10.1016/j.preteyeres.2021.100966
8. Silva M, Peng T, Zhao X, Li S, Farhan M, Zheng W. Recent trends in drug-delivery systems for the treatment of diabetic retinopathy and associated fibrosis. Advanced Drug delivery Rev. (2021) 173:439–60. doi: 10.1016/j.addr.2021.04.007
9. Du X, Yang L, Kong L, Sun Y, Shen K, Cai Y, et al. Metabolomics of various samples advancing biomarker discovery and pathogenesis elucidation for diabetic retinopathy. Front Endocrinol. (2022) 13:1037164. doi: 10.3389/fendo.2022.1037164
Keywords: diabetes retinopathy, etiology, biomarker, diagnosis, treatment
Citation: Jin K, Yu H, Wei W and Grzybowski A (2025) Editorial: Personalized medicine of diabetes retinopathy: from bench to bedside. Front. Endocrinol. 16:1597332. doi: 10.3389/fendo.2025.1597332
Received: 21 March 2025; Accepted: 21 March 2025;
Published: 01 April 2025.
Edited and Reviewed by:
Åke Sjöholm, Gävle Hospital, SwedenCopyright © 2025 Jin, Yu, Wei and Grzybowski. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Kai Jin, amlua2FpQHpqdS5lZHUuY24=