Ultrasmall copper nanodots eye drops for microenvironment regulation of diabetes retinopathy by relieving hypoxia and inhibiting HIF-1α/VEGF signaling pathway

Diabetic retinopathy (DR) is the main cause of visual loss among blinding diseases. The pathological microenvironment, characterized by hypoxia, reactive oxygen species (ROS) accumulation and oxidative stress, is critical to the onset and progression of DR. In this study, an ultrasmall (4–6 nm) copper nanodots was developed as nanozyme (Cu NZs) and dispersed in 2 % Methocel to formulate Cu NZs eye drops to relieve hypoxia and scavenge excrescent ROS for the effective treatment of DR. Due to its smaller size and higher specific surface area, Cu NZs exposes more active sites and can guarantee excellent antioxidant activity. The results of in vitro studies indicated that Cu NZs had biocompatible and protective effects on human retinal microvascular endothelial cells (HRMECs), alleviating hypoxia in HRMECs, reducing oxidative stress, and inhibiting hypoxia-inducing factor-1α (HIF-1α)/ vascular endotheliogenesis factor (VEGF) signaling pathway. In an animal model of streptozotocin (STZ)-induced DR, Cu NZs eye drops have been shown to greatly relieve the hypoxic microenvironment of DR and inhibit the expression of HIF-1α and VEGF. CuNZs eye drops reduced inflammatory factors in the DR microenvironment, significantly reducing the progression of neovascularization and vascular leakage. And the nano-enzyme eye drops have no toxic side effects on the eyes and important organs of the whole body. This treatment mode based on the nano enzyme cascade reaction from comprehensive microenvironment regulation (hypoxia relief, free radical scavenging, anti-inflammatory), has excellent ability to treat DR. Although the nanoparticle is effective against DR in the short term at the cellular and animal levels, the long-term efficacy and safety remains to be evaluated.