PPARα agonist oral therapy in diabetic retinopathy

Yohei Tomita, Deokho Lee, Kazuo Tsubota, Toshihide Kurihara

Research output: Contribution to journalReview articlepeer-review

26 Citations (Scopus)


Diabetic retinopathy (DR) is an eye condition that develops after chronically poorly-managed diabetes, and is presently the main cause for blindness on a global scale. Current treatments for DR such as laser photocoagulation, topical injection of corticosteroids, intravitreal injection of anti-vascular endothelial growth factor (VEGF) agents and vitreoretinal surgery are only applicable at the late stages of DR and there are possibilities of significant adverse effects. Moreover, the forms of treatment available for DR are highly invasive to the eyes. Safer and more effective pharmacological treatments are required for DR treatment, in particular at an early stage. In this review, we cover recently investigated promising oral pharmacotherapies, the methods of which are safer, easier to use, patient-friendly and pain-free, in clinical studies. We especially focus on peroxisome proliferator-activator receptor alpha (PPARα) agonists in which experimental evidence suggests PPARα activation may be closely related to the attenuation of vascular damages, including lipid-induced toxicity, inflammation, an excess of free radical generation, endothelial dysfunction and angiogenesis. Furthermore, oral administration of selective peroxisome proliferator-activated receptor alpha modulator (SPPARMα) agonists may induce hepatic fibroblast growth factor 21 expression, indirectly resulting in retinal protection in animal studies. Our review will enable more comprehensive approaches for understanding protective roles of PPARα for the prevention of DR development.

Original languageEnglish
Article number433
Pages (from-to)1-18
Number of pages18
Issue number10
Publication statusPublished - 2020 Oct


  • Advanced glycation end products (AGEs)
  • Antioxidants
  • Diabetes retinopathy (DR)
  • Fenofibrate
  • Fibroblast growth factor 21 (FGF21)
  • Microglial activation inhibitor
  • Pemafibrate
  • Selective peroxisome proliferator-activated receptor alpha modulator (SPPARMα)
  • Vascular adhesion protein-1 (VAP-1)

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • General Biochemistry,Genetics and Molecular Biology


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