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A proposed mechanistic model for the protective effects of metformin in the injured retina. In NMDA-induced neuronal cell death, an increase in the intracellular Ca2+ concentration is the key initial step; however, inflammatory responses are also involved. Metformin suppresses the inflammatory responses associated with neuronal cell damage. In addition, metformin may strengthen the endogenous neuroprotective system involving the MEK/ERK signaling pathway.
