The role of aldose reductase inhibitors in diabetic complications: recent trends

Pharmacological intervention of hyperglycemia-induced diabetic complications would be of great clinical significance since it is very difficult to maintain normoglycemia by any means in patients with diabetes mellitus. Several factors and pathways are involved in diabetic complications. One of the major contributory factors is aldose reductase. The beneficial effects of aldose reductase inhibitors in animal models have been reported. The clinical efficacy of these agents, however, is far from satisfactory and the reasons for this may vary. Recent advances in understanding the structure-based functioning, physiological and pathophysiological role of aldose reductase, the use of transgenic animal models and the abundant availability of human aldose reductase have greatly influenced the design and development of its inhibitors, which are highly selective, specific, potent and less toxic. Concurrently, other mechanisms involved in diabetic complications are being explored as targets for better therapeutic agents.