SEARCHNARRATIVE_REVIEWglaucoma, ophthalmology

narrative_review·glaucoma, ophthalmology, epidemiology, public health, preclinical research·PMC10855412

Stress, Allostatic Load, and Neuroinflammation: Implications for Racial and Socioeconomic Health Disparities in Glaucoma

International Journal of Molecular Sciences · 4 authors, 2 centres

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TL;DR

It discusses mechanisms linking stress-associated mediators to retinal neurodegeneration, particularly in normal-tension glaucoma.

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304 CHARS

It discusses mechanisms linking stress-associated mediators to retinal neurodegeneration, particularly in normal-tension glaucoma. Its primary contribution is a hypothesis-generation synthesis; thus, implications are speculative and require further research to establish causality and test interventions.

STUDY TYPE

narrative_review

SPECIALTY

glaucoma

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AI pipeline

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100% · A

ORIGINAL PAPER

PMC10855412

Stress, Allostatic Load, and Neuroinflammation: Implications for Racial and Socioeconomic Health Disparities in Glaucoma

International Journal of Molecular Sciences

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ABSTRACT

Abstract Glaucoma is the leading cause of irreversible blindness, and its pathophysiology includes neuroinflammatory changes. The present therapies for glaucoma target pressure-lowering mechanisms with limited success, making neuroinflammation a target for future interventions. This review summarizes the neuroinflammatory pathways seen in glaucoma and their interplay with stress. Glucocorticoids have been shown to activate proinflammatory glial cells, contributing to the neuroinflammation in glaucoma. Glucocorticoids have also been shown to increase the IOP directly. Stress-associated autonomic dysfunction can affect the vascular homeostasis in the retina and create oxidative stress. Diabetes, hyperglycemic-mediated endothelial damage, and vascular inflammation also play important roles in the neuroinflammation in glaucoma and diabetic retinopathy. Psychosocial stress has been implicated in an increased IOP and glaucoma outcomes. People who experience maladaptive chronic stress suffer from a condition known as allostatic load, which describes pathologic neuroendocrine dysregulation. The effects of allostatic load and chronic stress have been studied in patients affected by a lower socioeconomic status (SES) and marginalized racial identities. A lower SES is associated with higher rates of glaucoma and also affects the access to care and screening. Additionally, people of African ancestry are disproportionately affected by glaucoma for reasons that are multifactorial. In conclusion, this review explores neuroinflammation in glaucoma, highlighting opportunities for future investigation. Keywords: glaucoma, neuroinflammation, vascular homeostasis, HPA axis, neuroendocrine signaling, allostatic load, chronic stress, socioeconomic disparities, racial disparities

CITATION EXPORT

Colleen E McDermott, Rebecca J Salowe, Isabel Di Rosa et al.. Stress, Allostatic Load, and Neuroinflammation: Implications for Racial and Socioeconomic Health Disparities in Glaucoma. International Journal of Molecular Sciences. (2024). https://doi.org/10.3390/ijms25031653

AUTHORS

4 · 2 CENTRES

Colleen E McDermott, Rebecca J Salowe, Isabel Di Rosa, Joan M O’Brien

1Department of Surgery, University of Utah, Salt Lake City, UT 84101, USA
2Scheie Eye Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; [email protected] (R.J.S.); [email protected] (I.D.R.);