Is PPARG the key gene in diabetic retinopathy?

Diabetic retinopathy, a microvascular complication of diabetes mellitus, is major cause of non-inherited blindness among adults. Although diabetic retinopathy is a common complication of diabetes, we still know little about the underlying molecular mechanisms. In recent years, complex connections between important molecules and pathways in the onset and progression of diabetic retinopathy, such as advanced glycation end products, oxidative stress and inflammation, have been elucidated. Biochemical, genetic and functional studies strongly indicate peroxisome proliferator-activated receptor-g (PPARg), a pleiotropic transcription factor, as a primary target in the treatment of diabetic retinopathy. In this issue, Song et al. detail the role of PPARg in diabetic retinopathy-related disorders, illustrating PPARg-mediated inhibition of diabetes-induced leukostasis and leakage, and its beneficial role in modulating inflammation, angiogenesis and apoptosis in retinal and endothelial cells. Moreover, they describe alternative treatments for diabetic retinopathy, such as plant-derived PPARg ligands, proposing their use - in combination with standard therapies - for modulation of diabetic retinopathy.