The retinal pigment epithelium (RPE) is a highly specialized, unique epithelial cell that interacts with photoreceptors on its apical side and with Bruch's membrane and the choriocapillaris on its basal side. Due to vital functions that keep photoreceptors healthy, the RPE is essential for maintaining vision. With aging and the accumulated effects of environmental stresses, the RPE can become dysfunctional and die. This degeneration plays a central role in age-related macular degeneration (AMD) pathobiology, the leading cause of blindness among the elderly in western societies. Oxidative stress and inflammation have both physiological and potentially pathological roles in RPE degeneration. Given the central role of the RPE, this review will focus on the impact of oxidative stress and inflammation on the RPE with AMD pathobiology. Physiological sources of oxidative stress as well as unique sources from photo-oxidative stress, the phagocytosis of photoreceptor outer segments, and modifiable factors such as cigarette smoking and high fat diet ingestion that can convert oxidative stress into a pathological role, and the negative impact of impairing the cytoprotective roles of mitochondrial dynamics and the Nrf2 signaling system on RPE health in AMD will be discussed. Likewise, the response by the innate immune system to an inciting trigger, and the potential role of local RPE production of inflammation, as well as a potential role for damage by inflammation with chronicity if the inciting trigger is not neutralized, will be debated.

视网膜色素上皮（RPE）是高度专业化的独特上皮细胞，在其顶侧与感光器相互作用，在其基底侧与Bruch膜和脉络膜毛细血管相互作用。由于维持感光细胞健康的重要功能，RPE对于维持视力至关重要。随着老化和环境压力的累积影响，RPE可能会失灵并死亡。这种变性在与年龄有关的黄斑变性（AMD）病理生物学中起着核心作用，而黄斑变性是西方社会老年人失明的主要原因。氧化应激和炎症在RPE变性中具有生理和潜在的病理作用。考虑到RPE的核心作用，本文将重点探讨氧化应激和炎症对AMD病理生物学对RPE的影响。氧化应激的生理来源，以及来自光氧化应激的独特来源，光感受器外段的吞噬作用，以及可改变因素，例如吸烟和高脂饮食摄入，可将氧化应激转化为病理作用，以及将讨论损害线粒体动力学的细胞保护作用以及Nrf2信号系统对AMD中RPE健康的影响。同样，将讨论先天免疫系统对诱因的反应，以及局部RPE产生炎症的潜在作用，以及如果诱因没有被中和则对慢性炎症引起的损害的潜在作用。讨论了吸烟和高脂饮食摄入等可将氧化应激转化为病理作用的可调节因素，以及线粒体动力学和Nrf2信号传导系统损害细胞保护作用对AMD中RPE健康的负面影响。同样，将讨论先天免疫系统对诱因的反应，以及局部RPE产生炎症的潜在作用，以及如果诱因没有被中和则对慢性炎症引起的损害的潜在作用。讨论了吸烟和高脂饮食摄入等可将氧化应激转化为病理作用的可调节因素，以及线粒体动力学和Nrf2信号传导系统损害细胞保护作用对AMD中RPE健康的负面影响。同样，将讨论先天免疫系统对诱因的反应，以及局部RPE产生炎症的潜在作用，以及如果诱因没有被中和则对慢性炎症引起的损害的潜在作用。