Pathogenesis and treatment of glaucoma based on mitophagy from"stagnation of deficient qi"theory
Retinal ganglion cells(RGCs)apoptosis is a direct cause of blindness in glaucoma.Mitophagy is a self-protective mechanism of RGCs to maintain mitochondrial quality,and is closely related to optic nerve damage in glaucoma.Since mitophagy has a double-sided effect on glaucoma,regulating mitophagy levels is of great significance in the field of glaucoma."Stagnation of deficient qi"refers to the process in which prolonged illness depletes the body's vital energy,leading to deficiency of qi,blood,yin,and yang in the zang and fu organs.This weakness results in an inability to promote the circulation of qi,blood,and body fluids,giving rise to pathological products such as phlegm retention and blood stasis.The essential pathogenesis of optic nerve damage in glaucoma is the deficiency of the liver,spleen,and kidney due to"deficient qi",while the manifestation is blood stasis and phlegm retention caused by"stagnation".There is a direct connection between"stagnation of deficient qi"and mitophagy.Deficiency of the three zang organs of liver,spleen,and kidney can increase mitophagy in RGCs,and the increase of incomplete mitophagy is the key factor promoting the apoptosis of RGCs.The direct cause of incomplete mitophagy is the evil of phlegm and blood stasis.Based on the theory of"stagnation of deficient qi",Chinese medicine treats the condition by reinforcing the healthy qi to eliminate pathogenic factors.The treatment principles involve supplementing qi,activating blood circulation,and promoting diuresis.By focusing on supplementing qi to reinforce healthy qi as the root treatment,and activating blood circulation and promoting diuresis as the manifestation treatment,mitochondrial autophagy in RGCs can be adjusted to an appropriate state.The combination of mitophagy and the theory of"stagnation of deficient qi"provides a new perspective and fresh viewpoints for TCM to understand glaucoma.
glaucomastagnation of deficient qimitophagyretinal ganglion cellsoptic nervepathogenesis
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