Neurodegeneration is a crucial aspect in the pathogenesis of diabetic retinopathy, hence the clinical importance of research aimed at discovering and identifying new therapeutic strategies based on neuroprotection. The name of Rafael Simó Canonge is immediately associated with this line of work, with significant and numerous contributions from the research group he leads. This expert, who is head of the Endocrinology and Nutrition Service at Vall d'Hebron University Hospital (Barcelona) and head of the Diabetes and Metabolism research group at Vall d'Hebron Research Institute (VHIR), has received today the Alberto Sols award from the SED Foundation, which recognizes the scientific trajectory in senior basic research in diabetes.

At the award conference, this expert has assured that "the evaluation and management of diabetic retinopathy will change radically in the next 5 years", being particularly proud to have been able to contribute, together with his team, to this change.

Important contributions

Among other contributions, the research group led by Dr. Simó has demonstrated that in the incipient stages of diabetic retinopathy there is a decrease in the production of locally synthesized neuroprotective substances in the retina, both in experimental diabetes and in people with diabetes. This decrease favors retinal neurodegeneration and early vascular alterations. In addition, treatment with neuroprotective agents, such as GLP-1 receptor agonists or DPP-IV inhibitors, has been confirmed to be effective in the prevention and even regression of incipient diabetic retinopathy in various experimental models.

In these very early stages of diabetic retinopathy, the administration of intravitreal injections (normally used for the treatment of advanced stages of the disease) is considered too aggressive an approach. As Dr. Simó points out, "our group has been a pioneer in demonstrating that topical ocular administration (eye drops) of many of these neuroprotective agents is effective in preventing retinal neurodegeneration"; therefore, he adds, "we have opened up a new therapeutic strategy based not only on the concept but also on the route of administration".

Now, the great challenge is to demonstrate its safety and effectiveness in humans. For this, as Dr. Simó explains, "we have recently created D-Sight, a spin-off of VHIR, whose main objective is to commercialize sitagliptin eye drops (a DPP-IV inhibitor), in order to respond to an unmet need such as the treatment of the incipient stages of diabetic retinopathy".

In addition to this project, Dr. Rafael Simó's research group is immersed in the exploration and evaluation of other therapeutic targets, both for the incipient stages and for more advanced phases of this disease, obtaining very promising results for the moment, which even extend to another very prevalent disease: glaucoma.

Likewise, as the winner of the current edition of the Alberto Sols Award of the SED Foundation points out, "we are very interested in using retinal images and recordings as predictors of cardiovascular risk and cognitive deterioration". Thus, they are coordinating a European project (RECOGNISED), in order to assess the risk of cognitive impairment and dementia in patients with type 2 diabetes mellitus over 65 years of age; the first results are expected to be available by the end of 2024.

A special award...and with a message

All these merits accumulated over the past decades by this researcher have been taken into account in the awarding of the SED Foundation prize, a recognition by the SED and, in other words, by colleagues in the profession for the research career in diabetes and, in particular, in the field of diabetic retinopathy. "I am very proud of the award, which is a milestone in my research career and which should be enjoyed by all the members of the group I lead", says Dr. Simó, who also assures that "without a well-organized team it is impossible to be competitive in today's world".

As a general message, the expert from the Vall d'Hebron University Hospital tells the younger researchers that "research requires study, patience, and a lot of perseverance". As Dr. Rafael Simó affirms, "there is a lot of talent in our country, which we must know how to manage, motivate and reward fairly, as this is the way to guarantee generational succession in research groups; otherwise, all the efforts made will have no continuity and will fade away in the course of history".