The Role of AREDS2 Supplementation in Reducing the Progression of Age-Related Macular Degeneration
Literature Review
DOI:
https://doi.org/10.55175/cdk.v53i03.2135Keywords:
Age-related macular degeneration, antioxidant, AREDS2, supplementationAbstract
Age-related macular degeneration (AMD) is a degenerative macular disease that is the leading cause of irreversible vision loss in the elderly in developed countries. The prevalence of AMD in Asian populations is 6.8% for early-stage AMD and 0.56% for late-stage AMD. Increased production of reactive oxygen species (ROS) that cannot be balanced by the retinal antioxidant system causes structural damage to the retinal pigment epithelium (RPE) layer. This damage results in RPE cell dysfunction, drusen accumulation, and disease progression to advanced stages. Antioxidant supplementation such as the AREDS2 formulation is a therapeutic option that can reduce AMD progression from intermediate to late stages. The AREDS2 formulation consists of lutein, zeaxanthin, vitamin C, vitamin E, zinc, and copper, which work through various mechanisms to protect the retina from oxidative stress, inhibit inflammation, and restore cellular function. This literature review discusses the role of AREDS2 supplementation in AMD along with the mechanism of action of each component in reducing disease progression and maintaining visual function in elderly patients.
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References
Riordan-Eva P, Augsburger J. Vaughan & Asbury’s general ophthalmology. 19th ed. United States: McGraw-Hill; 2018.
Deng Y, Qiao L, Du M, Qu C, Wan L, Li J, et al. Age-related macular degeneration: Epidemiology, genetics, pathophysiology, diagnosis, and targeted therapy. Genes Dis. 2021;9(1):62–79. doi: 10.1016/j.gendis.2021.02.009.
Cheung CMG, Tai ES, Kawasaki R, Tay WT, Lee JL, Hamzah H, et al. Prevalence of and risk factors for age-related macular degeneration in a multiethnic Asian cohort. Arch Ophthalmol. 2012;130;(4):480−6. doi: 10.1001/archophthalmol.2011.376.
Supanji, Perdamaian ABI, Aulia R, Adelia RK, Prayogo ME, Widayanti TW, et al. Smoking as a risk factor for rs10490924 variant age-related macular degeneration in Yogyakarta, Indonesia. Mal J Med Health Sci. 2020;16(SUPP15):1–5.
Salmon JF. Kanski’s clinical ophthalmology: a systematic approach. 9th ed. China: Elsevier; 2020.
Ferris FL, Wilkinson CP, Bird A, Chakravarthy U, Chew E, Csaky K, et al. Clinical classification of age-related macular degeneration. Ophthalmology 2013;120(4):844–51. doi: 10.1016/j.ophtha.2012.10.036.
Hunt MS, Chee YE, Saraf SS, Chew EY, Lee CS, Lee AY, et al. Association of environmental factors with age-related macular degeneration using the Intelligent Research in Sight Registry. Ophthalmol Sci. 2022;2(4):100195. doi: 10.1016/j.xops.2022.100195.
Ruan Y, Jiang S, Gericke A. Age-related macular degeneration: role of oxidative stress and blood vessels. Int J Mol Sci. 2021;22(3):1296. doi:10.3390/ijms22031296.
Blasiak J, Pawlowska E, Chojnacki J, Szczepanska J, Chojnacki C, Kaarniranta K. Zinc and autophagy in age-related macular degeneration.IJMS. 2020;21(14):4994. doi: 10.3390/ijms21144994.
Arslan S, Kadayifcilar S, Samur G. The potential role of dietary antioxidant capacity in preventing age-related macular degeneration. J Am Coll Nutr. 2019;38(5):424–32. doi: 10.1080/07315724.2018.1538830.
Harju N. Regulation of oxidative stress and inflammatory responses in human retinal pigment epithelial cells. Acta Ophthalmologica 2022;100(S273):3–59. doi: 10.1111/aos.15275.
Chew EY, Clemons TE, SanGiovanni JP, Danis RP, Ferris FL, Elman MJ, et al. Secondary analyses of the effects of lutein/zeaxanthin
on age-related macular degeneration progression: AREDS2 report no. 3. JAMA Ophthalmol. 2014;132(2):142–9. doi: 10.1001/jamaophthalmol.2013.7376.
Age-Related Eye Disease Study Research Group. A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, beta carotene, and zinc for age-related macular degeneration and vision loss: AREDS report no. 8. Arch Ophthalmol. 2001;119(10):1417–36. doi: 10.1001/archopht.119.10.1417.
Chew EY, Clemons TE, Agron E, Domalpally A, Keenan TDL, Vitale S, et al. Long-term outcomes of adding lutein/zeaxanthin and ω-3 fatty acids to the AREDS supplements on age-related macular degeneration progression: AREDS2 report 28. JAMA Ophthalmology. 2022;140(7):692–8. doi: 10.1001/jamaophthalmol.2022.1640.
Parodi MB, Mollo MR, Brunoro A, Arrigo A, Romano F. Micronutrients and benefits of supplementation for reducing the risk of progression of age-related macular degeneration – an update. Eur Ophthalmic Rev. 2018;12(1):39. doi: https://doi.org/10.17925/EOR.2018.12.1.39.
Mrowicka M, Mrowicki J, Kucharska E, Majsterek I. Lutein and zeaxanthin and their roles in age-related macular degeneration neurodegenerative disease. Nutrients 2022;14(4):827. doi: 10.3390/nu14040827.
Shen H, Ding C, Yuan S, Pan T, Li D, Li H, et al. Vitamin C- and valproic acid-induced fetal RPE stem-like cells recover retinal degeneration via regulating SOX2. Molecular Ther. 2020;28(7):1645–57. doi: 10.1016/j.ymthe.2020.04.008.
Edwards G, Olson CG, Euritt CP, Koulen P. Molecular mechanisms underlying the therapeutic role of vitamin E in age-related macular degeneration. Front Neurosci. 2022:16:890021. doi: 10.3389/fnins.2022.890021.
Emri E, Cappa O, Kelly C, Kortvely E, SanGiovanni JP, McKay BS, et al. Zinc supplementation induced transcriptional changes in primary human retinal pigment epithelium: a single-cell RNA sequencing study to understand age-related macular degeneration. Cells. 2023;12(5):773. doi:10.3390/cells12050773.
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