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Quist SW, Nab H, Postma M, Amarakoon S, van Asten F, Freriks R. A cost-minimization analysis of anti-VEGFs for the treatment of neovascular age-related macular degeneration in the Netherlands. Graefes Arch Clin Exp Ophthalmol 2024:10.1007/s00417-024-06588-6. [PMID: 39322853 DOI: 10.1007/s00417-024-06588-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 07/04/2024] [Accepted: 07/16/2024] [Indexed: 09/27/2024] Open
Abstract
OBJECTIVE Age-related macular degeneration (AMD) is the main cause of severe vision loss globally. Neovascular AMD (nAMD) is an advanced stage of AMD treated with anti-vascular endothelial growth factors (anti-VEGFs). Although anti-VEGF treatment is effective, the frequent intravitreal injections place a burden on patients, (in)formal caregivers, and clinics. This study assesses the health-economic impact of anti-VEGF agents with lower injection frequency that have the potential to reduce treatment burden and compares it to the standard of care. METHODS We developed a cost-minimization model to evaluate the direct medical costs associated with first-line unilateral anti-VEGF treatment across a 3-year time horizon in the Netherlands. The analysis compared aflibercept 8 mg, aflibercept 2 mg, bevacizumab, faricimab, and ranibizumab. Our model adopted a treat-and-extend (T&E) regimen for aflibercept 2 mg, bevacizumab, and ranibizumab. For aflibercept 8 mg, a flexible regimen that was extendable up to 24 weeks was applied, while faricimab followed a flexible regimen that was extendable up to 16 weeks. Additionally, since list prices may vary from net prices, we calculated the break-even price for each anti-VEGF in comparison to bevacizumab, which is the recommended first-line treatment due to its low medication price. RESULTS Based on list prices, aflibercept 8 mg led to the lowest treatment costs (€16,251 per patient over a 3-year time horizon), closely followed by bevacizumab (€17,616 per patient over a 3-year time horizon). Ranibizumab led to the highest per-patient costs (€31,746 over a 3-year time horizon). For bevacizumab, most costs were attributable to administration, while for the other anti-VEGFs, most were attributable to medication. Aflibercept 8 mg is cost-saving compared to bevacizumab at their medication prices at the time of writing. Aflibercept 2 mg, faricimab, and ranibizumab should be priced below €488, €591, and €75, respectively. To be cost-equal to bevacizumab with current list prices, anti-VEGFs should be administered with a maximum of 12.7 to 13.8 injections over a 3-year time horizon. CONCLUSION According to the injection frequency observed in clinical trials, aflibercept 8 mg would be the anti-VEGF that generates the lowest per-patient healthcare costs for the treatment of nAMD in the Netherlands after a treatment period of three years. Our study indicates that anti-VEGF drugs with a lower injection frequency might provide a cost-saving solution to the increasing burden of anti-VEGF treatment on the healthcare system.
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Affiliation(s)
- Sara W Quist
- Department of Health Sciences, University Medical Center Groningen, Groningen, The Netherlands.
- Asc Academics, Groningen, The Netherlands.
| | - Hidde Nab
- Asc Academics, Groningen, The Netherlands
| | - Maarten Postma
- Department of Health Sciences, University Medical Center Groningen, Groningen, The Netherlands
- Department of Economics, Econometrics and Finance, University of Groningen, Groningen, The Netherlands
| | - Sankha Amarakoon
- University Eye Clinic Maastricht, MUMC+, Maastricht, The Netherlands
| | - Freekje van Asten
- University Eye Clinic Maastricht, MUMC+, Maastricht, The Netherlands
| | - Roel Freriks
- Asc Academics, Groningen, The Netherlands
- Department of Health Technology and Services Research, TechMed Centre, University of Twente, Enschede, Netherlands
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Quist SW, Dorsthorst ST, Freriks RD, Postma MJ, Hoyng CB, van Asten F. Cost-effectiveness of hydroxychloroquine retinopathy screening: the current guideline versus no screening and reduced regimens. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2024:10.1007/s10198-024-01715-w. [PMID: 39162892 DOI: 10.1007/s10198-024-01715-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 07/24/2024] [Indexed: 08/21/2024]
Abstract
OBJECTIVE Hydroxychloroquine (HCQ) effectively treats autoimmune diseases but prolonged use may lead to retinopathy and subsequent vision loss. Guidelines suggest annual follow-up after 5 years for low-risk and 1 year for high-risk patients. This study evaluates the cost-effectiveness of current screening guidelines and a reduced regimen in the Netherlands from a societal perspective. METHODS A Markov model assessed costs and quality-adjusted life-years (QALYs) for current and reduced screening regimens. The model included 359 HCQ-treated patients from Radboud University Medical Center. Cost-effectiveness was examined in the general population and patients using < 5.0 mg/kg, 5.0-6.0 mg/kg, or > 6.0 mg/kg HCQ per day for several reduced regimens. RESULTS Compared to no screening, the current screening guideline saves costs (i.e., €210 per patient), while gaining QALYs (i.e., 0.79 QALY per patient) over a lifetime in the Netherlands. However, in patients receiving < 5.0 mg/kg HCQ per day, a biennial screening regimen after 10 years using SD-OCT was more cost-effective. For those with 5.0-6.0 mg/kg and > 6.0 mg/kg per day, initiating annual screening with an SD-OCT after 5 years was more cost-effective than the current guideline. CONCLUSIONS Screening for HCQ retinopathy is cost-effective, but delayed initiation and a reduced frequency, using solely an SD-OCT, are more cost-effective. We recommend screening with an SD-OCT and a biennial regimen after 10 years for low-risk patients, an annual regimen after 5 years for intermediate- and high-risk patients.
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Affiliation(s)
- Sara W Quist
- Department of Health Sciences, University of Groningen, University Medical Center, Groningen, The Netherlands.
- Asc Academics B.V., Groningen, The Netherlands.
| | - Sophie Te Dorsthorst
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Roel D Freriks
- Asc Academics B.V., Groningen, The Netherlands
- Department of Health Technology and Services Research, TechMed Centre, University of Twente, Enschede, The Netherlands
| | - Maarten J Postma
- Department of Health Sciences, University of Groningen, University Medical Center, Groningen, The Netherlands
- Department of Economics, Econometrics & Finance, Faculty of Economics & Business, University of Groningen, Groningen, The Netherlands
| | - Carel B Hoyng
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Freekje van Asten
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, The Netherlands
- University Eye Clinic, Maastricht University Medical Center+, Maastricht, The Netherlands
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3
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Kaufmann M, Han Z. RPE melanin and its influence on the progression of AMD. Ageing Res Rev 2024; 99:102358. [PMID: 38830546 PMCID: PMC11260545 DOI: 10.1016/j.arr.2024.102358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 05/27/2024] [Indexed: 06/05/2024]
Abstract
OBJECTIVE The aim of this review article is to summarize the latest findings and current understanding of the origin of melanin in the retinal pigment epithelium (RPE), its function within the RPE, its role in the pathogenesis of age-related macular degeneration (AMD), its effect on retinal development, and its potential therapeutic benefit in the treatment of AMD. METHODS A comprehensive search of peer-reviewed journals was conducted using various combinations of key terms such as "melanin," "retinal pigment epithelium" or "RPE," "age-related macular degeneration" or AMD," "lipofuscin," "oxidative stress," and "albinism." Databases searched include PubMed, Scopus, Science Direct, and Google Scholar. 147 papers published between the years of 1957 and 2023 were considered with an emphasis on recent findings. SUMMARY OF FINDINGS AMD is thought to result from chronic oxidative stress within the RPE that results in cellular dysfunction, metabolic dysregulation, inflammation, and lipofuscin accumulation. Melanin functions as a photoscreener, free radical scavenger, and metal cation binding reservoir within the RPE. RPE melanin does not regenerate, and it undergoes degradation over time in response to chronic light exposure and oxidative stress. RPE melanin is important for retinal development and RPE function, and in the aging eye, melanin loss is associated with increased lipid peroxidation, inflammation, and the accumulation of toxic oxidized cellular products. Therefore, melanin-based treatments may serve to preserve RPE and retinal function in AMD. CONCLUSIONS The pathogenesis of AMD is not fully understood, but RPE dysfunction and melanin loss in response to chronic oxidative stress and inflammation are thought to be primary drivers of the disease. Due to melanin's antioxidative effects, melanin-based nanotechnology represents a promising avenue for the treatment of AMD.
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Affiliation(s)
- Mary Kaufmann
- University of North Carolina School of Medicine, Chapel Hill, NC 27599, USA
| | - Zongchao Han
- Department of Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; Division of Pharmacoengineering & Molecular Pharmaceutics, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
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4
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Cheng MJ, Rohan EMF, Rai BB, Sabeti F, Maddess T, Lane J. The experience of visual art for people living with mild-to-moderate vision loss. Arts Health 2024; 16:147-166. [PMID: 37012640 DOI: 10.1080/17533015.2023.2192741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 03/04/2023] [Indexed: 04/05/2023]
Abstract
BACKGROUND Visual art can enhance wellbeing and quality-of-life; however, the experience of visual art for people with mild-to-moderate vision loss has not been examined. METHODS Eight participants (6 females, 2 males; Mean age = 81 years, SD = 7.9, range 70-91 years; 4 with mild vision loss and 4 with moderate vision loss based on binocular visual acuity) completed a mixed-methods study comprising: a semi-structured interview on visual art experience; an eye examination; and questionnaires about visual functioning and quality-of-life. RESULTS Various themes were identified: visual perception of art (e.g. altered colours, visual distortions, etc.), viewing conditions, elements of art, personal preference, deriving meaning, appreciation of art, impact of impaired visual perception, and social aspects of art. CONCLUSIONS The overall experience of art is influenced by how an individual sees, perceives, and makes meaning from art. Even mild vision loss can impair this experience and impact emotional and social wellbeing.
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Affiliation(s)
- Meredith J Cheng
- Australian National University Medical School, College of Health and Medicine, Canberra, ACT, Australia
| | - Emilie M F Rohan
- Eccles Institute for Neuroscience, The John Curtin School of Medical Research, The Australian National University, Canberra, ACT, Australia
| | - Bhim B Rai
- Eccles Institute for Neuroscience, The John Curtin School of Medical Research, The Australian National University, Canberra, ACT, Australia
| | - Faran Sabeti
- Eccles Institute for Neuroscience, The John Curtin School of Medical Research, The Australian National University, Canberra, ACT, Australia
- Discipline of Optometry, Faculty of Health, University of Canberra, ACT, Australia
| | - Ted Maddess
- Eccles Institute for Neuroscience, The John Curtin School of Medical Research, The Australian National University, Canberra, ACT, Australia
| | - Jo Lane
- National Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, Canberra, ACT, Australia
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Lin HY, Chou W, Chien TW, Yeh YT, Kuo SC, Hsu SY. Analyzing shifts in age-related macular degeneration research trends since 2014: A bibliometric study with triple-map Sankey diagrams (TMSD). Medicine (Baltimore) 2024; 103:e36547. [PMID: 38241545 PMCID: PMC10798733 DOI: 10.1097/md.0000000000036547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 11/17/2023] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND Age-related macular degeneration (AMD) is the primary cause of vision impairment in older adults, especially in developed countries. While many articles on AMD exist in the literature, none specifically delve into the trends based on document categories. While bibliometric studies typically use dual-map overlays to highlight new trends, these can become congested and unclear with standard formats (e.g., in CiteSpace software). In this study, we introduce a unique triple-map Sankey diagram (TMSD) to assess the evolution of AMD research. Our objective is to understand the nuances of AMD articles and show the effectiveness of TMSD in determining whether AMD research trends have shifted over the past decade. METHODS We collected 7465 articles and review pieces related to AMD written by ophthalmologists from the Web of Science core collection, accumulating article metadata from 2014 onward. To delve into the characteristics of these AMD articles, we employed various visualization methods, with a special focus on TMSD to track research evolution. We adopted the descriptive, diagnostic, predictive, and prescriptive analytics (DDPP) model, complemented by the follower-leading clustering algorithm (FLCA) for clustering analysis. This synergistic approach proved efficient in identifying and showcasing research focal points and budding trends using network charts within the DDPP framework. RESULTS Our findings indicate that: in countries, institutes, years, authors, and journals, the dominant entities were the United States, the University of Bonn in Germany, the year 2021, Dr Jae Hui Kim from South Korea, and the journal "Retina"; in accordance with the TMSD, AMD research trends have not changed significantly since 2014, as the top 4 categories for 3 citing, active, and cited articles have not changed, in sequence (Ophthalmology, Science & Technology - Other Topics, General & Internal Medicine, Pharmacology & Pharmacy). CONCLUSION The introduced TMSD, which incorporates the FLCA algorithm and features in 3 columns-cited, active, and citing research categories-offers readers clearer insights into research developments compared to the traditional dual-map overlays from CiteSpace software. Such tools are especially valuable for streamlining the visualization of the intricate data often seen in bibliometric studies.
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Affiliation(s)
- Hsin-Ying Lin
- Department of Ophthalmology, Chi-Mei Medical Center, Yong Kang, Tainan City, Taiwan
| | - Willy Chou
- Department of Physical Medicine and Rehabilitation, Chiali Chi-Mei Hospital, Tainan, Taiwan
- Department of Physical Medicine and Rehabilitation, Chung San Medical University Hospital, Taichung, Taiwan
| | - Tsair-Wei Chien
- Department of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan
| | - Yu-Tsen Yeh
- Medical School, St. George’s, University of London, United Kingdom
| | - Shu-Chun Kuo
- Department of Optometry, Chung Hwa University of Medical Technology, Tainan, Taiwan
- Department of Ophthalmology, Chi-Mei Medical Center, Yong Kang, Tainan City, Taiwan
| | - Sheng-Yao Hsu
- Department of Optometry, Chung Hwa University of Medical Technology, Tainan, Taiwan
- Department of Ophthalmology, An Nan Hospital, China Medical University, Tainan, Taiwan
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Jun JH, Kim JS, Palomera LF, Jo DG. Dysregulation of histone deacetylases in ocular diseases. Arch Pharm Res 2024; 47:20-39. [PMID: 38151648 DOI: 10.1007/s12272-023-01482-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 12/20/2023] [Indexed: 12/29/2023]
Abstract
Ocular diseases are a growing global concern and have a significant impact on the quality of life. Cataracts, glaucoma, age-related macular degeneration, and diabetic retinopathy are the most prevalent ocular diseases. Their prevalence and the global market size are also increasing. However, the available pharmacotherapy is currently limited. These diseases share common pathophysiological features, including neovascularization, inflammation, and/or neurodegeneration. Histone deacetylases (HDACs) are a class of enzymes that catalyze the removal of acetyl groups from lysine residues of histone and nonhistone proteins. HDACs are crucial for regulating various cellular processes, such as gene expression, protein stability, localization, and function. They have also been studied in various research fields, including cancer, inflammatory diseases, neurological disorders, and vascular diseases. Our study aimed to investigate the relationship between HDACs and ocular diseases, to identify a new strategy for pharmacotherapy. This review article explores the role of HDACs in ocular diseases, specifically focusing on diabetic retinopathy, age-related macular degeneration, and retinopathy of prematurity, as well as optic nerve disorders, such as glaucoma and optic neuropathy. Additionally, we explore the interplay between HDACs and key regulators of fibrosis and angiogenesis, such as TGF-β and VEGF, highlighting the potential of targeting HDAC as novel therapeutic strategies for ocular diseases.
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Affiliation(s)
- Jae Hyun Jun
- School of Pharmacy, Sungkyunkwan University, Suwon, 16419, Korea
- Department of Pharmacology, CKD Research Institute, Chong Kun Dang Pharmaceutical Co., Yongin, 16995, Korea
| | - Jun-Sik Kim
- School of Pharmacy, Sungkyunkwan University, Suwon, 16419, Korea
| | - Leon F Palomera
- School of Pharmacy, Sungkyunkwan University, Suwon, 16419, Korea
| | - Dong-Gyu Jo
- School of Pharmacy, Sungkyunkwan University, Suwon, 16419, Korea.
- Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, 06351, Korea.
- Biomedical Institute for Convergence, Sungkyunkwan University, Suwon, 16419, Korea.
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Chang YH, Hsing CH, Chiu CJ, Wu YR, Hsu SM, Hsu YH. Protective role of IL-17-producing γδ T cells in a laser-induced choroidal neovascularization mouse model. J Neuroinflammation 2023; 20:279. [PMID: 38007487 PMCID: PMC10676594 DOI: 10.1186/s12974-023-02952-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 11/07/2023] [Indexed: 11/27/2023] Open
Abstract
BACKGROUND Vision loss in patients with wet/exudative age-related macular degeneration (AMD) is associated with choroidal neovascularization (CNV), and AMD is the leading cause of irreversible vision impairment in older adults. Interleukin-17A (IL-17A) is a component of the microenvironment associated with some autoimmune diseases. Previous studies have indicated that wet AMD patients have elevated serum IL-17A levels. However, the effect of IL-17A on AMD progression needs to be better understood. We aimed to investigate the role of IL-17A in a laser-induced CNV mouse model. METHODS We established a laser-induced CNV mouse model in wild-type (WT) and IL-17A-deficient mice and then evaluated the disease severity of these mice by using fluorescence angiography. We performed enzyme-linked immunosorbent assay (ELISA) and fluorescence-activated cell sorting (FACS) to analyze the levels of IL-17A and to investigate the immune cell populations in the eyes of WT and IL-17A-deficient mice. We used ARPE-19 cells to clarify the effect of IL-17A under oxidative stress. RESULTS In the laser-induced CNV model, the CNV lesions were larger in IL-17A-deficient mice than in WT mice. The numbers of γδ T cells, CD3+CD4+RORγt+ T cells, Treg cells, and neutrophils were decreased and the number of macrophages was increased in the eyes of IL-17A-deficient mice compared with WT mice. In WT mice, IL-17A-producing γδ T-cell numbers increased in a time-dependent manner from day 7 to 28 after laser injury. IL-6 levels increased and IL-10, IL-24, IL-17F, and GM-CSF levels decreased in the eyes of IL-17A-deficient mice after laser injury. In vitro, IL-17A inhibited apoptosis and induced the expression of the antioxidant protein HO-1 in ARPE-19 cells under oxidative stress conditions. IL-17A facilitated the repair of oxidative stress-induced barrier dysfunction in ARPE-19 cells. CONCLUSIONS Our findings provide new insight into the protective effect of IL-17A in a laser-induced CNV model and reveal a novel regulatory role of IL-17A-producing γδ T cells in the ocular microenvironment in wet AMD.
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Affiliation(s)
- Yu-Hsien Chang
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chung-Hsi Hsing
- Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan
- Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan
| | - Chiao-Juno Chiu
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yi-Rou Wu
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Sheng-Min Hsu
- Department of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Hsiang Hsu
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
- Research Center of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
- Antibody New Drug Research Center, National Cheng Kung University, Tainan, Taiwan.
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Zhu S, Fan S, Tang T, Huang J, Zhou H, Huang C, Chen Y, Qian F. Polymorphic nanobody crystals as long-acting intravitreal therapy for wet age-related macular degeneration. Bioeng Transl Med 2023; 8:e10523. [PMID: 38023710 PMCID: PMC10658565 DOI: 10.1002/btm2.10523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 03/23/2023] [Accepted: 03/29/2023] [Indexed: 12/01/2023] Open
Abstract
Wet age-related macular degeneration (wet AMD) is the most common cause of blindness, and chronic intravitreal injection of anti-vascular endothelial growth factor (VEGF) proteins has been the dominant therapeutic approach. Less intravitreal injection and a prolonged inter-injection interval are the main drivers behind new wet AMD drug innovations. By rationally engineering the surface residues of a model anti-VEGF nanobody, we obtained a series of anti-VEGF nanobodies with identical protein structures and VEGF binding affinities, while drastically different crystallization propensities and crystal lattice structures. Among these nanobody crystals, the P212121 lattice appeared to be denser and released protein slower than the P1 lattice, while nanobody crystals embedding zinc coordination further slowed the protein release rate. The polymorphic protein crystals could be a potentially breakthrough strategy for chronic intravitreal administration of anti-VEGF proteins.
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Affiliation(s)
- Shuqian Zhu
- School of Pharmaceutical Sciences, Beijing Advanced Innovation Center for Structural Biology, and Key Laboratory of Bioorganic Phosphorus Chemistry and Chemical Biology (Ministry of Education)Tsinghua UniversityBeijingPeople's Republic of China
| | - Shilong Fan
- Beijing Frontier Research Center for Biological StructureTsinghua UniversityBeijingPeople's Republic of China
| | - Tianxin Tang
- School of Pharmaceutical Sciences, Beijing Advanced Innovation Center for Structural Biology, and Key Laboratory of Bioorganic Phosphorus Chemistry and Chemical Biology (Ministry of Education)Tsinghua UniversityBeijingPeople's Republic of China
| | - Jinliang Huang
- Quaerite Biopharm ResearchBeijingPeople's Republic of China
| | - Heng Zhou
- Shuimu BioSciences Co. Ltd.BeijingPeople's Republic of China
| | - Chengnan Huang
- School of Pharmaceutical Sciences, Beijing Advanced Innovation Center for Structural Biology, and Key Laboratory of Bioorganic Phosphorus Chemistry and Chemical Biology (Ministry of Education)Tsinghua UniversityBeijingPeople's Republic of China
| | - Youxin Chen
- Peking Union Medical College HospitalBeijingPeople's Republic of China
| | - Feng Qian
- School of Pharmaceutical Sciences, Beijing Advanced Innovation Center for Structural Biology, and Key Laboratory of Bioorganic Phosphorus Chemistry and Chemical Biology (Ministry of Education)Tsinghua UniversityBeijingPeople's Republic of China
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Ibragimova RR, Gilmanov II, Lopukhova EA, Lakman IA, Bilyalov AR, Mukhamadeev TR, Kutluyarov RV, Idrisova GM. Algorithm of segmentation of OCT macular images to analyze the results in patients with age-related macular degeneration. BULLETIN OF RUSSIAN STATE MEDICAL UNIVERSITY 2022. [DOI: 10.24075/brsmu.2022.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Age-related macular degeneration (AMD) is one of the main causes of loss of sight and hypovision in people over working age. Results of optical coherence tomography (OCT) are essential for diagnostics of the disease. Developing the recommendation system to analyze OCT images will reduce the time to process visual data and decrease the probability of errors while working as a doctor. The purpose of the study was to develop an algorithm of segmentation to analyze the results of macular OCT in patients with AMD. It allows to provide a correct prediction of an AMD stage based on the form of discovered pathologies. A program has been developed in the Python programming language using the Pytorch and TensorFlow libraries. Its quality was estimated using OCT macular images of 51 patients with early, intermediate, late AMD. A segmentation algorithm of OCT images was developed based on convolutional neural network. UNet network was selected as architecture of high-accuracy neural net. The neural net is trained on macular OCT images of 125 patients (197 eyes). The author algorithm displayed 98.1% of properly segmented areas on OCT images, which are the most essential for diagnostics and determination of an AMD stage. Weighted sensitivity and specificity of AMD stage classifier amounted to 83.8% and 84.9% respectively. The developed algorithm is promising as a recommendation system that implements the AMD classification based on data that promote taking decisions regarding the treatment strategy.
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Affiliation(s)
| | - II Gilmanov
- Ufa State Aviation Technical University, Ufa, Russia
| | - EA Lopukhova
- Ufa State Aviation Technical University, Ufa, Russia
| | - IA Lakman
- Bashkir State Medical University, Ufa, Russia
| | - AR Bilyalov
- Bashkir State Medical University, Ufa, Russia
| | | | - RV Kutluyarov
- Ufa State Aviation Technical University, Ufa, Russia
| | - GM Idrisova
- Bashkir State Medical University, Ufa, Russia
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10
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Veldhuis N, Nuijts MA, Isphording L, Lee-Kong FVYL, Imhof SM, Stegeman I. Linguistic spin in randomized controlled trials about age-related macular degeneration. FRONTIERS IN EPIDEMIOLOGY 2022; 2:961996. [PMID: 38455287 PMCID: PMC10910936 DOI: 10.3389/fepid.2022.961996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 10/13/2022] [Indexed: 03/09/2024]
Abstract
Objective To evaluate the prevalence, type and extent of linguistic spin in randomized controlled trials (RCTs) exploring interventions in patients with age-related macular degeneration (AMD), as well as to investigate whether study variables were correlated with linguistic spin. Study design and setting PubMed was searched from 2011 to 2020 to identify RCTs including patients with AMD. Two authors independently assessed a total of 96 RCTs. Linear regression analyses were performed to investigate whether linguistic spin was correlated with predefined study variables. Results Linguistic spin was found in 61 of 96 abstracts (63.5%) and in 90 of 96 main texts (93.8%). Use of words pointing out the beneficial effect of a treatment and the use of '(statistically) significant/significance' without reporting a P-value or a 95% confidence interval (CI) were the most frequently identified categories of linguistic spin. Sample size was significantly correlated with the total linguistic spin score (95% CI 0.38-5.23, P = 0.02). Conclusion A high prevalence and extent of linguistic spin in RCTs about AMD was found. We highlighted the importance of objective reporting and awareness of linguistic spin among ophthalmologists and other readers.
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Affiliation(s)
- Nienke Veldhuis
- Faculty of Medicine, Utrecht University, Utrecht, Netherlands
| | - Myrthe A. Nuijts
- Department of Ophthalmology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Luka Isphording
- Faculty of Medicine, Utrecht University, Utrecht, Netherlands
| | | | - Saskia M. Imhof
- Department of Ophthalmology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Inge Stegeman
- Department of Ophthalmology, University Medical Center Utrecht, Utrecht, Netherlands
- Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Center Utrecht, Utrecht, Netherlands
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands
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Zhan P, Cui Y, Cao Y, Bao X, Wu M, Yang Q, Yang J, Zheng H, Zou J, Xie T, Cai J, Yao Y, Wang X. PGE 2 promotes macrophage recruitment and neovascularization in murine wet-type AMD models. Cell Commun Signal 2022; 20:155. [PMID: 36229856 PMCID: PMC9558420 DOI: 10.1186/s12964-022-00973-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 09/18/2022] [Indexed: 11/24/2022] Open
Abstract
Age-related macular degeneration (AMD), a progressive chronic disease of the central retina, is a leading cause of blindness worldwide. Activated macrophages recruited to the injured eyes greatly contribute to the pathogenesis of choroidal neovascularization (CNV) in exudative AMD (wet AMD). This study describes the effects of cyclooxygenase-2 (COX2)/prostaglandin E2 (PGE2) signalling on the macrophage activation and CNV formation of wet AMD. In a mouse model of laser-induced wet AMD, the mice received an intravitreal injection of celecoxib (a selective COX2 inhibitor). Optical coherence tomography (OCT), fundus fluorescein angiography (FFA), choroidal histology of the CNV lesions, and biochemical markers were assessed. The level of PGE2 expression was high in the laser-induced CNV lesions. Macrophage recruitment and CNV development were significantly less after celecoxib treatment. E-prostanoid1 receptor (EP1R)/protein kinase C (PKC) signalling was involved in M2 macrophage activation and interleukin-10 (IL-10) production of bone marrow-derived macrophages (BMDMs) in vitro. In addition, IL-10 was found to induce the proliferation and migration of human choroidal microvascular endothelial cells (HCECs). Thus, the PGE2/EP1R signalling network serves as a potential therapeutic target for CNV of the wet-type AMD.
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Affiliation(s)
- Pengfei Zhan
- Department of Ophthalmology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, 299 Qingyang Road, Wuxi, 214023, Jiangsu, People's Republic of China
| | - Yuqing Cui
- Department of Ophthalmology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, 299 Qingyang Road, Wuxi, 214023, Jiangsu, People's Republic of China
| | - Yujuan Cao
- Department of Ophthalmology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, 299 Qingyang Road, Wuxi, 214023, Jiangsu, People's Republic of China.,Center of Clinical Research, The Affiliated Wuxi People's Hospital of Nanjing Medical University, 299 Qingyang Road, Wuxi, 214023, Jiangsu, People's Republic of China.,Department of Ophthalmology, The Affiliated Wuxi No.2 People's Hospital of Nanjing Medical University, Wuxi, 214023, Jiangsu, People's Republic of China
| | - Xun Bao
- Department of Ophthalmology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, 299 Qingyang Road, Wuxi, 214023, Jiangsu, People's Republic of China
| | - Meili Wu
- Center of Clinical Research, The Affiliated Wuxi People's Hospital of Nanjing Medical University, 299 Qingyang Road, Wuxi, 214023, Jiangsu, People's Republic of China
| | - Qian Yang
- Department of Ophthalmology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, 299 Qingyang Road, Wuxi, 214023, Jiangsu, People's Republic of China
| | - Jiahui Yang
- Department of Ophthalmology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, 299 Qingyang Road, Wuxi, 214023, Jiangsu, People's Republic of China
| | - Haohan Zheng
- Department of Ophthalmology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, 299 Qingyang Road, Wuxi, 214023, Jiangsu, People's Republic of China
| | - Jian Zou
- Center of Clinical Research, The Affiliated Wuxi People's Hospital of Nanjing Medical University, 299 Qingyang Road, Wuxi, 214023, Jiangsu, People's Republic of China
| | - Tianhua Xie
- Department of Ophthalmology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, 299 Qingyang Road, Wuxi, 214023, Jiangsu, People's Republic of China
| | - Jiping Cai
- Department of Ophthalmology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, 299 Qingyang Road, Wuxi, 214023, Jiangsu, People's Republic of China
| | - Yong Yao
- Department of Ophthalmology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, 299 Qingyang Road, Wuxi, 214023, Jiangsu, People's Republic of China. .,Department of Ophthalmology, The Affiliated Wuxi No.2 People's Hospital of Nanjing Medical University, Wuxi, 214023, Jiangsu, People's Republic of China.
| | - Xiaolu Wang
- Center of Clinical Research, The Affiliated Wuxi People's Hospital of Nanjing Medical University, 299 Qingyang Road, Wuxi, 214023, Jiangsu, People's Republic of China.
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12
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Ocular Drug Delivery: Advancements and Innovations. Pharmaceutics 2022; 14:pharmaceutics14091931. [PMID: 36145679 PMCID: PMC9506479 DOI: 10.3390/pharmaceutics14091931] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/24/2022] [Accepted: 09/06/2022] [Indexed: 11/16/2022] Open
Abstract
Ocular drug delivery has been significantly advanced for not only pharmaceutical compounds, such as steroids, nonsteroidal anti-inflammatory drugs, immune modulators, antibiotics, and so forth, but also for the rapidly progressed gene therapy products. For conventional non-gene therapy drugs, appropriate surgical approaches and releasing systems are the main deliberation to achieve adequate treatment outcomes, whereas the scope of “drug delivery” for gene therapy drugs further expands to transgene construct optimization, vector selection, and vector engineering. The eye is the particularly well-suited organ as the gene therapy target, owing to multiple advantages. In this review, we will delve into three main aspects of ocular drug delivery for both conventional drugs and adeno-associated virus (AAV)-based gene therapy products: (1) the development of AAV vector systems for ocular gene therapy, (2) the innovative carriers of medication, and (3) administration routes progression.
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13
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Ayón C, Castán D, Mora A, Naranjo D, Obando F, Mora JJ. Monoclonal Antibodies: A Therapeutic Option for the Treatment of Ophthalmic Diseases of the Eye Posterior Segment. BORNEO JOURNAL OF PHARMACY 2022. [DOI: 10.33084/bjop.v5i3.2095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The eye is an organ that allows us to observe the outside world. Pathologies of the eye's posterior segment, such as glaucoma, macular degeneration, diabetic retinopathy, uveitis, and retinoblastoma, cause vision loss. Traditional treatments consist of applying topical medications that do not penetrate properly or using high doses that generate adverse effects. Different laser surgeries stop the pathology's progression but do not allow visual improvement. So, an alternative is to use monoclonal antibodies, proteins produced by different processes that selectively bind to metabolites associated with diseases, reducing the adverse effects of traditional treatments and improving the application of the drug in the area. The two main molecular targets are TNF (adalimumab, infliximab, and certolizumab pegol) and VEGF (bevacizumab and ranibizumab); other possibilities are under investigation.
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14
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Fabre M, Mateo L, Lamaa D, Baillif S, Pagès G, Demange L, Ronco C, Benhida R. Recent Advances in Age-Related Macular Degeneration Therapies. Molecules 2022; 27:molecules27165089. [PMID: 36014339 PMCID: PMC9414333 DOI: 10.3390/molecules27165089] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/03/2022] [Accepted: 08/04/2022] [Indexed: 11/16/2022] Open
Abstract
Age-related macular degeneration (AMD) was described for the first time in the 1840s and is currently the leading cause of blindness for patients over 65 years in Western Countries. This disease impacts the eye’s posterior segment and damages the macula, a retina section with high levels of photoreceptor cells and responsible for the central vision. Advanced AMD stages are divided into the atrophic (dry) form and the exudative (wet) form. Atrophic AMD consists in the progressive atrophy of the retinal pigment epithelium (RPE) and the outer retinal layers, while the exudative form results in the anarchic invasion by choroidal neo-vessels of RPE and the retina. This invasion is responsible for fluid accumulation in the intra/sub-retinal spaces and for a progressive dysfunction of the photoreceptor cells. To date, the few existing anti-AMD therapies may only delay or suspend its progression, without providing cure to patients. However, in the last decade, an outstanding number of research programs targeting its different aspects have been initiated by academics and industrials. This review aims to bring together the most recent advances and insights into the mechanisms underlying AMD pathogenicity and disease evolution, and to highlight the current hypotheses towards the development of new treatments, i.e., symptomatic vs. curative. The therapeutic options and drugs proposed to tackle these mechanisms are analyzed and critically compared. A particular emphasis has been given to the therapeutic agents currently tested in clinical trials, whose results have been carefully collected and discussed whenever possible.
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Affiliation(s)
- Marie Fabre
- Institut de Chimie de Nice UMR 7272, Université Côte d’Azur, CNRS, 06108 Nice, France
| | - Lou Mateo
- Institut de Chimie de Nice UMR 7272, Université Côte d’Azur, CNRS, 06108 Nice, France
| | - Diana Lamaa
- CiTCoM, UMR 8038 CNRS, Faculté de Pharmacie, Université de Paris Cité, 4, Avenue de l’Observatoire, 75006 Paris, France
| | - Stéphanie Baillif
- Ophthalmology Department, University Hospital of Nice, 30 Avenue De La Voie Romaine, 06000 Nice, France
| | - Gilles Pagès
- Institute for Research on Cancer and Aging (IRCAN), UMR 7284 and INSERM U 1081, Université Côte d’Azur, CNRS 28 Avenue de Valombrose, 06107 Nice, France
| | - Luc Demange
- Institut de Chimie de Nice UMR 7272, Université Côte d’Azur, CNRS, 06108 Nice, France
- CiTCoM, UMR 8038 CNRS, Faculté de Pharmacie, Université de Paris Cité, 4, Avenue de l’Observatoire, 75006 Paris, France
- Correspondence: (L.D.); (C.R.); (R.B.)
| | - Cyril Ronco
- Institut de Chimie de Nice UMR 7272, Université Côte d’Azur, CNRS, 06108 Nice, France
- Correspondence: (L.D.); (C.R.); (R.B.)
| | - Rachid Benhida
- Institut de Chimie de Nice UMR 7272, Université Côte d’Azur, CNRS, 06108 Nice, France
- Department of Chemical and Biochemical Sciences-Green Process Engineering (CBS-GPE), Mohamed VI Polytechnic University (UM6P), Benguerir 43150, Morocco
- Correspondence: (L.D.); (C.R.); (R.B.)
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Zhao S, Huang Z, Jiang H, Xiu J, Zhang L, Long Q, Yang Y, Yu L, Lu L, Gu H. Sirtuin 1 Induces Choroidal Neovascularization and Triggers Age-Related Macular Degeneration by Promoting LCN2 through SOX9 Deacetylation. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:1671438. [PMID: 35720180 PMCID: PMC9203240 DOI: 10.1155/2022/1671438] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 05/07/2022] [Accepted: 05/13/2022] [Indexed: 12/03/2022]
Abstract
Increasing studies have identified the function of sirtuin-1 (SIRT1) in ocular diseases. Hence, this study is aimed at exploring the potential role of SIRT1 in choroidal neovascularization- (CNV-) induced age-related macular degeneration (AMD) development and the associated mechanism. Expression of SIRT1/SOX9/LCN2 in the hypoxic cells was determined, and their interactions were predicted by bioinformatics websites and followed by the verification by luciferase assay and chromatin immunoprecipitation (ChIP). Their in vitro effects on hypoxic cells concerning cell viability, apoptosis, migration, and angiogenesis were detected through gain- and loss-of-function assays. Besides, their in vivo effect was explored using the established CNV mouse models. Highly expressed LCN2, SOX9, and SIRT1 were observed in hypoxic cells. LCN2 was increased by SOX9 and SIRT1 deacetylated SOX9 to promote its nuclear translocation, which further inhibited the viability of human retinal pigment epithelial cells and promoted cell apoptosis and angiogenesis as well as CNV-induced AMD formation. The relieving role of LCN2 inhibition on CNV-induced AMD without toxicity for mice was also demonstrated by in vivo experiments. Overall, SIRT1 promoted the formation of CNV-induced AMD through SOX9 deacetylation-caused LCN2 upregulation, representing a promising target for CNV-induced AMD management.
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Affiliation(s)
- Su Zhao
- Department of Ophthalmology, The Affiliated Hospital of Guizhou Medical University, Guiyang 550002, China
- School of Clinical Medicine, Guizhou Medical University, Guiyang 550002, China
| | - Zhi Huang
- School of Basic Medical Science, Guizhou Medical University, Guiyang 550002, China
| | - Hao Jiang
- Department of Ophthalmology, The Affiliated Hospital of Guizhou Medical University, Guiyang 550002, China
| | - Jiangfan Xiu
- School of Basic Medical Science, Guizhou Medical University, Guiyang 550002, China
| | - Liying Zhang
- Department of Ophthalmology, The Affiliated Hospital of Guizhou Medical University, Guiyang 550002, China
| | - Qiurong Long
- Department of Ophthalmology, The Affiliated Hospital of Guizhou Medical University, Guiyang 550002, China
| | - Yuhan Yang
- Department of Ophthalmology, The Affiliated Hospital of Guizhou Medical University, Guiyang 550002, China
| | - Lu Yu
- Department of Ophthalmology, The Affiliated Hospital of Guizhou Medical University, Guiyang 550002, China
| | - Lu Lu
- Shenzhen Key Laboratory of Ophthalmology, Shenzhen Eye Hospital, Shenzhen 5180403, China
| | - Hao Gu
- Department of Ophthalmology, The Affiliated Hospital of Guizhou Medical University, Guiyang 550002, China
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16
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Estarreja J, Valente C, Silva C, Camacho P, Mateus V. Efficacy, safety, and efficiency on the off-label use of bevacizumab in patients diagnosed with age-related macular degeneration: protocol for a systematic review and meta-analysis (Preprint). JMIR Res Protoc 2022. [DOI: 10.2196/38658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023] Open
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17
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Chen YM, Huang WT, Ho WH, Tsai JT. Classification of age-related macular degeneration using convolutional-neural-network-based transfer learning. BMC Bioinformatics 2021; 22:99. [PMID: 34749641 PMCID: PMC8576967 DOI: 10.1186/s12859-021-04001-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 02/05/2021] [Indexed: 01/21/2023] Open
Abstract
Background To diagnose key pathologies of age-related macular degeneration (AMD) and diabetic macular edema (DME) quickly and accurately, researchers attempted to develop effective artificial intelligence methods by using medical images. Results A convolutional neural network (CNN) with transfer learning capability is proposed and appropriate hyperparameters are selected for classifying optical coherence tomography (OCT) images of AMD and DME. To perform transfer learning, a pre-trained CNN model is used as the starting point for a new CNN model for solving related problems. The hyperparameters (parameters that have set values before the learning process begins) in this study were algorithm hyperparameters that affect learning speed and quality. During training, different CNN-based models require different algorithm hyperparameters (e.g., optimizer, learning rate, and mini-batch size). Experiments showed that, after transfer learning, the CNN models (8-layer Alexnet, 22-layer Googlenet, 16-layer VGG, 19-layer VGG, 18-layer Resnet, 50-layer Resnet, and a 101-layer Resnet) successfully classified OCT images of AMD and DME. Conclusions The experimental results further showed that, after transfer learning, the VGG19, Resnet101, and Resnet50 models with appropriate algorithm hyperparameters had excellent capability and performance in classifying OCT images of AMD and DME.
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Affiliation(s)
- Yao-Mei Chen
- School of Nursing, Kaohsiung Medical University, Kaohsiung, 807, Taiwan.,Superintendent Office, Kaohsiung Medical University Hospital, Kaohsiung, 807, Taiwan
| | - Wei-Tai Huang
- Department of Mechanical Engineering, National Pingtung University of Science and Technology, Pingtung, 912, Taiwan
| | - Wen-Hsien Ho
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, 807, Taiwan. .,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, 807, Taiwan.
| | - Jinn-Tsong Tsai
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, 807, Taiwan. .,Department of Computer Science, National Pingtung University, Pingtung, 900, Taiwan.
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18
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Kim JM, Lee M, Lim HB, Won YK, Shin Y, Lee W, Kim J. Longitudinal changes in the ganglion cell-inner plexiform layer thickness of age-related macular degeneration. Acta Ophthalmol 2021; 99:e1056-e1062. [PMID: 33555661 DOI: 10.1111/aos.14784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 11/22/2020] [Accepted: 01/12/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE To determine longitudinal changes of the ganglion cell-inner plexiform layer (GC-IPL) thickness in patients with non-exudative age-related macular degeneration (AMD) without other ophthalmic disease. METHODS Thirty-three eyes of 33 patients with early and intermediate non-exudative AMD (non-exudative AMD group) and 33 normal control eyes were followed for 2 years, and GC-IPL thickness was measured by spectral domain optical coherence tomography at 1-year intervals. The mean rate of GC-IPL reduction was estimated using a linear mixed model and compared between two groups. RESULTS The mean age of patients in the non-exudative AMD group and control groups were 68.82 ± 6.81 years and 67.73 ± 5.87 years, respectively (p = 0.488). The mean GC-IPL thickness at the first visit was 76.61 ± 16.33 μm in the non-exudative AMD and 81.76 ± 3.69 μm in control group (p = 0.387), and these values significantly decreased over time, with an average reduction rate of average GC-IPL -0.86 μm/year in the non-exudative AMD group and -0.32 μm/year in the control group. The difference between two groups was statistically significant (p < 0.001), and there was also a significant interaction between group and duration in linear mixed models in mean GC-IPL thickness (p = 0.001). CONCLUSIONS The reduction rate of the GC-IPL thickness was greater in non-exudative AMD eyes, even at relatively early stages of the disease. Physicians should maintain awareness of the presence of non-exudative AMD in various cases of ophthalmic diseases where GC-IPL thickness evaluation is necessary.
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Affiliation(s)
- Ju Mi Kim
- Department of Ophthalmology Chungnam National University College of Medicine Daejeon Korea
| | - Min‐Woo Lee
- Department of Ophthalmology Konyang University college of medicine Daejeon Korea
| | - Hyung Bin Lim
- Department of Ophthalmology Chungnam National University College of Medicine Daejeon Korea
| | - Yeo Kyoung Won
- Department of Ophthalmology Chungnam National University College of Medicine Daejeon Korea
| | - Yong‐il Shin
- Department of Ophthalmology Chungnam National University College of Medicine Daejeon Korea
| | - Woo‐Hyuck Lee
- Department of Ophthalmology Chungnam National University College of Medicine Daejeon Korea
| | - Jung‐Yeul Kim
- Department of Ophthalmology Chungnam National University College of Medicine Daejeon Korea
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19
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Quist SW, de Jong LA, van Asten F, Knoester P, Postma MJ, Freriks RD. Cost-minimisation analysis of a treat-and-extend regimen with anti-VEGFs in patients with neovascular age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol 2021; 260:1083-1095. [PMID: 34643793 PMCID: PMC8511619 DOI: 10.1007/s00417-021-05359-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 07/16/2021] [Accepted: 07/27/2021] [Indexed: 12/02/2022] Open
Abstract
Purpose Although intraocular anti-vascular endothelial growth factors (anti-VEGFs) are effective as treatment of neovascular age-related macular degeneration (nAMD), the (economic) burden on the healthcare system is considerable. A treat-and-extend (T&E) regimen is associated with a lower number of injections without compromising the effectiveness and can therefore help optimise nAMD treatment. This study investigates the per-patient costs associated with nAMD treatment, when using aflibercept, bevacizumab, or ranibizumab with a T&E regimen. Methods In this cost-minimisation model, the per-patient costs in the Netherlands were modelled using a healthcare payers’ perspective over a 3-year time horizon with the assumption that efficacy of treatments is similar. Additionally, the break-even price of the different anti-VEGFs was calculated relative to the cheapest option and injection frequency. Results The injection frequency varied from 14.2 for aflibercept to 27.4 for bevacizumab in 3 years. Nonetheless, bevacizumab remains the cheapest treatment option (€14,215), followed by aflibercept (€18,202) and ranibizumab (€31,048). The medication covers the majority of the per-patient costs for aflibercept and ranibizumab, while administration covers the majority of the per-patient costs for bevacizumab. The break-even prices of aflibercept and ranibizumab are respectively €507 and €60.58 per injection. Brolucizumab was included in the scenario analysis and was more expensive than aflibercept (€20,446). Brolucizumab should reduce to 13.8 injections over 3 years to be as costly as aflibercept. Conclusion Bevacizumab is the cheapest anti-VEGF treatment. The list prices of all anti-VEGFs should reduce to be as costly as bevacizumab. Aflibercept is the second-choice treatment and so far brolucizumab is not.
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Affiliation(s)
- S W Quist
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Hanzeplein 1, Groningen, The Netherlands. .,Asc Academics, Professor Enno Dirk Wiersmastraat 5, Groningen, The Netherlands.
| | - L A de Jong
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Hanzeplein 1, Groningen, The Netherlands.,Asc Academics, Professor Enno Dirk Wiersmastraat 5, Groningen, The Netherlands
| | - F van Asten
- Department of Ophthalmology, Radboud University Medical Center, Philips Van Leydenlaan 15, Nijmegen, The Netherlands
| | - P Knoester
- Department of Pharmacy, Alrijne Hospital, Simon Smitweg 1, Leiderdorp, The Netherlands
| | - M J Postma
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Hanzeplein 1, Groningen, The Netherlands.,Department of Economics, Econometrics & Finance, University of Groningen, Faculty of Economics & Business, Nettelbosje 2, Groningen, The Netherlands
| | - R D Freriks
- Asc Academics, Professor Enno Dirk Wiersmastraat 5, Groningen, The Netherlands.,Department of Economics, Econometrics & Finance, University of Groningen, Faculty of Economics & Business, Nettelbosje 2, Groningen, The Netherlands
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20
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Feng R, Patil S, Zhao X, Miao Z, Qian A. RNA Therapeutics - Research and Clinical Advancements. Front Mol Biosci 2021; 8:710738. [PMID: 34631795 PMCID: PMC8492966 DOI: 10.3389/fmolb.2021.710738] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 09/07/2021] [Indexed: 12/16/2022] Open
Abstract
RNA therapeutics involve the use of coding RNA such as mRNA as well as non-coding RNAs such as small interfering RNAs (siRNA), antisense oligonucleotides (ASO) to target mRNA, aptamers, ribozymes, and clustered regularly interspaced short palindromic repeats-CRISPR-associated (CRISPR/Cas) endonuclease to target proteins and DNA. Due to their diverse targeting ability and research in RNA modification and delivery systems, RNA-based formulations have emerged as suitable treatment options for many diseases. Therefore, in this article, we have summarized different RNA therapeutics, their targeting strategies, and clinical progress for various diseases as well as limitations; so that it might help researchers formulate new and advanced RNA therapeutics for various diseases. Additionally, U.S. Food and Drug Administration (USFDA)-approved RNA-based therapeutics have also been discussed.
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Affiliation(s)
- Rundong Feng
- Shaanxi Institute for Food and Drug Control, Xi'an, China
| | - Suryaji Patil
- Lab for Bone Metabolism, Xi'an Key Laboratory of Special Medicine and Health Engineering, Key Lab for Space Biosciences and Biotechnology, Research Center for Special Medicine and Health Systems Engineering, NPU-UAB Joint Laboratory for Bone Metabolism, School of Life Sciences, Northwestern Polytechnical University, Xi'an, China
| | - Xin Zhao
- School of Pharmacy, Shaanxi Institute of International Trade & Commerce, Xi'an, China
| | - Zhiping Miao
- Lab for Bone Metabolism, Xi'an Key Laboratory of Special Medicine and Health Engineering, Key Lab for Space Biosciences and Biotechnology, Research Center for Special Medicine and Health Systems Engineering, NPU-UAB Joint Laboratory for Bone Metabolism, School of Life Sciences, Northwestern Polytechnical University, Xi'an, China
| | - Airong Qian
- Lab for Bone Metabolism, Xi'an Key Laboratory of Special Medicine and Health Engineering, Key Lab for Space Biosciences and Biotechnology, Research Center for Special Medicine and Health Systems Engineering, NPU-UAB Joint Laboratory for Bone Metabolism, School of Life Sciences, Northwestern Polytechnical University, Xi'an, China
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21
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Chae SY, Shin MC, Jeon S, Kang MS, Han DW, Hong SW. A Simple Route to the Complexation of Lutein with Reduced Graphene Oxide Nanocarriers and Antioxidant Protection Against Blue Light. Int J Nanomedicine 2021; 16:6843-6860. [PMID: 34675511 PMCID: PMC8505195 DOI: 10.2147/ijn.s320790] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 09/11/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The excellent physicochemical properties of graphene-based materials, including graphene oxide (GO) and reduced GO (rGO), offer significant technological potential as multifunctional nanomaterials in biomedical fields. Lutein is a type of carotenoid that forms human macular pigments in the retina, where it inhibits harmful blue light and contributes to the strengthening of the antioxidant defense of retinal pigment epithelium cells. METHODS Synthesis of the Lutein-rGO (Lu-rGO) complex was carried out for the optimized concentration. Then characterization of material was analyzed through ultraviolet-visible spectrophotometer (UV-Vis spectra), Fourier-transform infrared spectroscopy (FT-IR), Raman spectroscopy, x-ray photoelectron spectroscopy (XPS), transmission electron microscopy (TEM). Antioxidant activity of Lu-rGO complex was measured by 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS), 2.2-diphenyl-1-picrylhydrazyl (DPPH), glutathione (GSH) oxidation assay. Then, oxidative stress induction by blue light and analyzed intracellular reactive oxygen species (ROS). RESULTS AND CONCLUSION Based on the FT-IR measurement, the reduction efficiency defined by area was found to be 87.3%, the ID/IG ratio of 0.98 demonstrated by the Lu-rGO complex in the Raman spectrum was slightly higher than that of the original GO. The exhibited significant decrease in the peak intensities of the oxygen functional groups of the XPS spectra of the Lu-rGO complex was observed compared with the GO. In the TEM image for the Lu-rGO complex, folded and wrinkled nanostructures over the lutein-covered rGO surface were evidenced by tight molecular binding. The Lu-rGO complex provided superior DPPH and ABTS radical scavenging activity than GO and lutein alone, and the oxidation of GSH was suppressed. It was confirmed that the content of intracellular ROS and lysosomes, increased by blue light, was reduced after treatment with the Lu-rGO complex on ARPE-19 cells. In summary, graphene-based nanocarriers could function as preventative antioxidants during photochemical ROS generation based on the mechanism of antioxidant action.
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Affiliation(s)
- Seon Yeong Chae
- Research Center for Dielectric and Advanced Matter Physics, Pusan National University, Busan, 46241, Republic of Korea
| | - Min Chan Shin
- Department of Cogno-Mechatronics Engineering, Department of Optics and Mechatronics Engineering, College of Nanoscience and Nanotechnology, Pusan National University, Busan, 46241, Republic of Korea
| | - Sangheon Jeon
- Department of Cogno-Mechatronics Engineering, Department of Optics and Mechatronics Engineering, College of Nanoscience and Nanotechnology, Pusan National University, Busan, 46241, Republic of Korea
| | - Moon Sung Kang
- Department of Cogno-Mechatronics Engineering, Department of Optics and Mechatronics Engineering, College of Nanoscience and Nanotechnology, Pusan National University, Busan, 46241, Republic of Korea
| | - Dong-Wook Han
- Department of Cogno-Mechatronics Engineering, Department of Optics and Mechatronics Engineering, College of Nanoscience and Nanotechnology, Pusan National University, Busan, 46241, Republic of Korea
| | - Suck Won Hong
- Department of Cogno-Mechatronics Engineering, Department of Optics and Mechatronics Engineering, College of Nanoscience and Nanotechnology, Pusan National University, Busan, 46241, Republic of Korea
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Kloosterboer A, Yannuzzi NA, Topilow NJ, Patel NA, Kuriyan AE, Sridhar J. Assessing the Quality, Content, and Readability of Freely Available Online Information for Patients Regarding Age-Related Macular Degeneration. Semin Ophthalmol 2021; 36:400-405. [PMID: 33646928 PMCID: PMC8328874 DOI: 10.1080/08820538.2021.1893761] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 12/28/2020] [Accepted: 02/04/2021] [Indexed: 10/22/2022]
Abstract
IMPORTANCE One of the top ten causes of disability in the United States is vision loss, primarily due to age-related eye diseases such as age-related macular degeneration. With an aging population, the number of people affected by this condition is expected to rise. Patients increasingly turn to the internet for health-related information, but no standard exists across published websites. OBJECTIVE To assess the quality, content, accountability and readability of information found online for age-related macular degeneration. DESIGN This cross-sectional study analyzed 12 freely available medical sites with information on age-related macular degeneration and used PubMed as a gold standard for comparison. Thirty-four questions were composed to include information most relevant to patients and each website was independently evaluated by one vitreoretinal surgeon, two vitreoretinal fellows and one ophthalmology resident. Readability was analyzed using an online readability tool. The JAMA benchmarks were used to evaluate the accountability of each site. SETTING Freely available online information was used in this study. RESULTS The average questionnaire score for all websites was 90.23 (SD 17.56, CI 95% ±9.55) out of 136 possible points. There was a significant difference between the content quality of the websites (P = .01). The mean reading grade for all websites was 11.44 (SD 1.75, CI 95% ±0.99). No significant correlation was found between content accuracy and the mean reading grade or Google rank (r = 0.392, P = .207 and r = 0.133, P = .732, respectively). Without including PubMed, only one website achieved the full 4 JAMA benchmarks. There was no correlation between the accuracy of the content of the website and JAMA benchmarks (r = 0.344, P = .273). The interobserver reproducibility was similar among 3 out of 4 observers (r = 0.747 between JS and NT, r = 0.643 between JS and NP, r = 0.686 between NP and NT, r = 0.581 between JS and NY; P ≤ 0.05). CONCLUSION AND RELEVANCE The freely available information online on age-related macular degeneration varies by source but is generally of low quality. The material presented is difficult to interpret and exceeds the recommended reading level for health information. Most websites reviewed did not provide sufficient information using the grading scheme we used to support the patient in making medical decisions.
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Affiliation(s)
- Amy Kloosterboer
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17th Street, Miami, Florida 33136
| | - Nicolas A. Yannuzzi
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17th Street, Miami, Florida 33136
| | - Nicole J. Topilow
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17th Street, Miami, Florida 33136
| | - Nimesh A. Patel
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17th Street, Miami, Florida 33136
| | - Ajay E. Kuriyan
- Mid Atlantic Retina, Wills Eye Hospital, Thomas Jefferson University, 840 Walnut Street Suite 1020, Philadelphia, PA 19107
| | - Jayanth Sridhar
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17th Street, Miami, Florida 33136
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Melatonin level as a risk factor for age-related macular degeneration. ACTA BIOMEDICA SCIENTIFICA 2021. [DOI: 10.29413/abs.2021-6.3.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background. The current trend towards an increase in age-related macular degeneration (AMD) incidence rate in the population, including the working-age population, with a possible loss of professional activity, indicates the need for early preclinical identification of risk groups, timely prevention and treatment. In the prevention and treatment of AMD, the prospect of using melatonin is being actively discussed.Aim: to analyze serum and tear fluid levels of melatonin in patients with AMD and study their correlation with risk factors.Materials and methods. In the course of the study, two groups were formed: the main group - patients with non-exudative AMD and senile cataract (n = 40) and the reference group - conditionally healthy patients without AMD and cataract (n = 20). Patients of both groups were surveyed to identify risk factors for AMD. The content of melatonin in blood serum and lacrimal fluid was determined by enzyme-linked immunosorbent assay using the Melatonin ELISA Kit (USA).Results. In the course of the study, it was found that the concentration of melatonin in blood serum and tear fluid in patients with AMD was significantly lower than in patients of the reference group (p <0.05). Serum and tear fluid melatonin levels depend on the following factors: age, body mass index (BMI), arterial hypertension, eye color, insomnia, and night work. It is possible that the local determination of melatonin in the lacrimal fluid can be a biomarker in the determination of ophthalmic pathological conditions.Conclusion. The obtained results can be used as recommendations for clarifying individual regimens for the use of melatonin, especially in the treatment of patients with AMD.
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Comparison of subretinal versus intravitreal injection of recombinant tissue plasminogen activator with gas for submacular hemorrhage secondary to wet age-related macular degeneration: treatment outcomes and brief literature review. Int Ophthalmol 2021; 41:4037-4046. [PMID: 34331185 DOI: 10.1007/s10792-021-01976-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 07/16/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Contradictory evidence exists over the best approach for the management of submacular hemorrhage (SMH). In this study, we compared the outcomes of subretinal versus intravitreal injection of recombinant tissue plasminogen activator (r-tPA) and gas in cases of SMH secondary to age-related macular degeneration (AMD). METHODS Twenty five eyes with SMH were retrospectively divided in 2 groups. Group A underwent vitrectomy, subretinal r-tPA and gas (Vitrectomy group, n = 14), and group B received intravitreal r-tPA and gas (Pneumatic group, n = 11). SMH displacement and change in subfoveal hemorrhage thickness (SFHT) at 1 month post-op were assessed. Additionally, best corrected visual acuity (BCVA) and central retinal thickness (CRT) at the end of the 12 month follow-up (FU) were analyzed. Clinical and epidemiological prognostic factors were tested. RESULTS Mean duration of SMH prior intervention was 8.2(± 7.3) days. Baseline BCVA was 1.53 ± 0.73 LogMAR, mean extension of SMH was 4.604 ± 2079 μm and mean CRT pre-treatment was 795 ± 365 μm. SMH displacement at 1 month post-treatment was total in 9/14 versus 6/11 and partial in 4/14 versus 2/11 in Group A and Group B, respectively (Fisher's exact test p = 0.38). SFHT reduced by 404 ± 312 μm in Group A versus 376 ± 405 μm in group B (p = 0.86). BCVA improvement and reduction of CRT were highly significant at the end of FU (p = 0.002 and p < 0.001 respectively) but did not differ between the 2 groups. Only baseline BCVA and preoperative CRT proved to be significant prognostic factors for the final functional outcome (p = 0.013 and p = 0.047 respectively). CONCLUSION Both treatment options proved equal efficacy in displacing SMH in AMD. A multicenter trial may delineate a desirable algorithm of treatment.
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Kodjikian L, Mehanna CJ, Cohen SY, Devin F, Razavi S, Querques G, Massin P, Coscas F, Souied E. The role of future treatments in the management of neovascular age-related macular degeneration in Europe. Eur J Ophthalmol 2021; 31:2179-2188. [PMID: 34053331 DOI: 10.1177/11206721211018348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Anti-vascular endothelial growth factor (VEGF) agents have transformed the management of patients with neovascular age-related macular degeneration (nAMD) over the past two decades. However, as more long-term real-world data become available, it is clear that treatment outcomes are inferior to those reported in large, controlled clinical trials. This is largely driven by undertreatment, that is, not maintaining a consistent injection frequency to achieve sustained VEGF suppression, whether due to patient non-compliance, an important injection burden, or non/incomplete anatomical response. Newer therapeutic advances under evaluation hold promise in achieving more, for less. We review the latest drugs currently in or having successfully finished phase III clinical trials, and determine their potential place in the management of patients with nAMD in Europe.
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Affiliation(s)
- Laurent Kodjikian
- Department of Ophthalmology, Croix-Rousse University Hospital, Claude Bernard University Lyon 1, Lyon, Rhône-Alpes, France.,UMR-CNRS 5510 Mateis Laboratory, University Lyon 1, Villeurbanne, France
| | - Carl Joe Mehanna
- Intercommunal Hospital of Créteil, Paris-Est University, Créteil, France
| | | | - François Devin
- Center Monticelli-Paradis, Juge Clinic, Marseille, France
| | - Sam Razavi
- St. Exupery Ophthalmic Center, Saint Cyr sur Loire, France
| | - Giuseppe Querques
- Department of Ophthalmology, IRCCS Ospedale San Raffaele, Vita-Salute University, Milan, Lombardy, Italy
| | - Pascale Massin
- Ophthalmic Center of Breteuil, Paris, Île-de-France, France
| | | | - Eric Souied
- Intercommunal Hospital of Créteil, Paris-Est University, Créteil, France
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Formica ML, Awde Alfonso HG, Palma SD. Biological drug therapy for ocular angiogenesis: Anti-VEGF agents and novel strategies based on nanotechnology. Pharmacol Res Perspect 2021; 9:e00723. [PMID: 33694304 PMCID: PMC7947217 DOI: 10.1002/prp2.723] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 01/08/2021] [Indexed: 12/13/2022] Open
Abstract
Currently, biological drug therapy for ocular angiogenesis treatment is based on the administration of anti‐VEGF agents via intravitreal route. The molecules approved with this purpose for ocular use include pegaptanib, ranibizumab, and aflibercept, whereas bevacizumab is commonly off‐label used in the clinical practice. The schedule dosage involves repeated intravitreal injections of anti‐VEGF agents to achieve and maintain effective concentrations in retina and choroids, which are administrated as solutions form. In this review article, we describe the features of different anti‐VEGF agents, major challenges for their ocular delivery and the nanoparticles in development as delivery system of them. In this way, several polymeric and lipid nanoparticles are explored to load anti‐VEGF agents with the aim of achieving sustained drug release and thus, minimize the number of intravitreal injections required. The main challenges were focused in the loading the molecules that maintain their bioactivity after their release from nanoparticulate system, followed the evaluation of them through studies of formulation stability, pharmacokinetic, and efficacy in in vitro and in vivo models. The analysis was based on the information published in peer‐reviewed published papers relevant to anti‐VEGF treatments and nanoparticles developed as ocular anti‐VEGF delivery system.
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Affiliation(s)
- María L Formica
- Unidad de Investigación y Desarrollo en Tecnología Farmacéutica (UNITEFA), CONICET and Departamento de Farmacia, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Ciudad Universitaria, Córdoba, 5000, Argentina
| | - Hamoudi G Awde Alfonso
- Unidad de Investigación y Desarrollo en Tecnología Farmacéutica (UNITEFA), CONICET and Departamento de Farmacia, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Ciudad Universitaria, Córdoba, 5000, Argentina
| | - Santiago D Palma
- Unidad de Investigación y Desarrollo en Tecnología Farmacéutica (UNITEFA), CONICET and Departamento de Farmacia, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Ciudad Universitaria, Córdoba, 5000, Argentina
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Nesper PL, Ong JX, Fawzi AA. Exploring the Relationship Between Multilayered Choroidal Neovascularization and Choriocapillaris Flow Deficits in AMD. Invest Ophthalmol Vis Sci 2021; 62:12. [PMID: 33687474 PMCID: PMC7960838 DOI: 10.1167/iovs.62.3.12] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Purpose We used optical coherence tomography angiography to test the hypothesis that more complex, multilayered choroidal neovascular (CNV) membranes in AMD are associated with worse flow deficits (FD) in the choriocapillaris. Methods Retrospective, cross-sectional study including 29 eyes of 29 subjects with neovascular AMD. En face choriocapillaris images were compensated for signal attenuation using the structural OCT slab and signal normalization based on a cohort of healthy subjects. We binarized the choriocapillaris using both local Phansalkar and global MinError(I) methods and quantified FD count, FD density, and mean FD size in the entire area outside the CNV, in the 200-µm annulus surrounding the CNV, and in the area outside the annulus. We used projection-resolved optical coherence tomography angiography to quantify CNV complexity, including highest CNV flow height, number of flow layers, and flow layer thickness. We explored the relationship between CNV complexity and choriocapillaris FD using Spearman correlations. Results The highest CNV flow signal significantly correlated with lower FD count (P < 0.01), higher FD density (P < 0.05), and higher mean FD size (P < 0.05) in the area outside the annulus and the entire area outside the CNV using both Phansalkar and MinError(I). Within the annulus, CNV complexity was not consistently correlated with choriocapillaris defects. Conclusions CNV vascular complexity is correlated with choriocapillaris FD outside the CNV area, providing evidence for the importance of choriocapillaris dysfunction in neovascular AMD, as well as the potential role of choroidal ischemia in the pathogenesis of complex CNV membranes.
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Affiliation(s)
- Peter L Nesper
- Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States
| | - Janice X Ong
- Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States
| | - Amani A Fawzi
- Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States
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28
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Zhou Y. Two Co(II)-coordination polymers: reducing the inflammasome activation and exerting treatment activity on age-related macular degeneration. INORG NANO-MET CHEM 2021. [DOI: 10.1080/24701556.2020.1862230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Ying Zhou
- College of Industry and Commerce, Shandong Management University, Jinan, Shandong, China
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29
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Ho J, Jang KH, Koo TS, Park C, Kim YH, Lee J, Kim E. Protective effects of PARP1-inhibitory compound in dry age-related macular degeneration. Biomed Pharmacother 2021; 133:111041. [PMID: 33378949 DOI: 10.1016/j.biopha.2020.111041] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 11/16/2020] [Accepted: 11/18/2020] [Indexed: 11/23/2022] Open
Abstract
Poly (ADP-ribose) polymerase 1 (PARP1)-dependent cell death in the retinal pigment epithelium (RPE) is implicated in dry age-related macular degeneration (AMD). Although PARP1 inhibitors are available for treating dry AMD, their delivery route is not ideal for patients. The aim of this study was to test the efficacy of a novel PARP1-inhibitory compound (PIC) in vitro and in vivo. This study presents PIC, a novel small molecule, with superior efficacy to PARP1 inhibitors in the market. PIC demonstrated a distinctive inhibitory profile against PARP isotypes than the FDA-approved PARP1 inhibitors. PIC inhibited PARP1 activation at an IC50 of 0.41 ± 0.15 nM in an enzyme-based assay in vitro and at IC50 and EC50 in ARPE-19 cells of 0.11 ± 0.02 nM and 0.22 ± 0.02 nM, respectively, upon H2O2 insult. PIC also moderated mitochondrial fission and depolarization and maintained cellular energy levels under oxidative stress in ARPE-19 cells. Furthermore, PIC demonstrated good corneal penetration in a rat model, presenting PIC as a promising candidate for eye drop therapeutics for dry AMD. When PIC was administered as an eye drop formulation, RPE morphology was preserved, maintaining the thickness of the outer nuclear layers under sodium iodate (SI) treatment in rats. In SI-treated rabbits, eye drop administration of PIC also retained the structural and functional integrity when analyzed using funduscopy and electroretinogram. Collectively, our data portray PIC as an attractive treatment measure for dry AMD.
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Affiliation(s)
- Jeongmin Ho
- Department of Biological Sciences, Chungnam National University, Daejeon, South Korea
| | - Ki-Hong Jang
- Department of Biological Sciences, Chungnam National University, Daejeon, South Korea
| | - Tae-Sung Koo
- Graduate School of New Drug Discovery and Development, Chungnam National University, Daejeon, South Korea
| | - Changmin Park
- Kukjepharma R&D Center, Sanseong-ro 47, Ansan, Gyeonggi-do, South Korea
| | - Young-Hoon Kim
- Kukjepharma R&D Center, Sanseong-ro 47, Ansan, Gyeonggi-do, South Korea
| | - Juhee Lee
- Kukjepharma R&D Center, Sanseong-ro 47, Ansan, Gyeonggi-do, South Korea
| | - Eunhee Kim
- Department of Biological Sciences, Chungnam National University, Daejeon, South Korea.
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30
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Toffoletto N, Saramago B, Serro AP. Therapeutic Ophthalmic Lenses: A Review. Pharmaceutics 2020; 13:36. [PMID: 33379411 PMCID: PMC7824655 DOI: 10.3390/pharmaceutics13010036] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 12/09/2020] [Accepted: 12/17/2020] [Indexed: 12/17/2022] Open
Abstract
An increasing incidence of eye diseases has been registered in the last decades in developed countries due to the ageing of population, changes in lifestyle, environmental factors, and the presence of concomitant medical conditions. The increase of public awareness on ocular conditions leads to an early diagnosis and treatment, as well as an increased demand for more effective and minimally invasive solutions for the treatment of both the anterior and posterior segments of the eye. Despite being the most common route of ophthalmic drug administration, eye drops are associated with compliance issues, drug wastage by lacrimation, and low bioavailability due to the ocular barriers. In order to overcome these problems, the design of drug-eluting ophthalmic lenses constitutes a non-invasive and patient-friendly approach for the sustained drug delivery to the eye. Several examples of therapeutic contact lenses and intraocular lenses have been developed, by means of different strategies of drug loading, leading to promising results. This review aims to report the recent advances in the development of therapeutic ophthalmic lenses for the treatment and/or prophylaxis of eye pathologies (i.e., glaucoma, cataract, corneal diseases, or posterior segment diseases) and it gives an overview of the future perspectives and challenges in the field.
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Affiliation(s)
- Nadia Toffoletto
- Centro de Química Estrutural, Instituto Superior Técnico, University of Lisbon, Av. Rovisco Pais, 1049-001 Lisbon, Portugal; (B.S.); (A.P.S.)
| | - Benilde Saramago
- Centro de Química Estrutural, Instituto Superior Técnico, University of Lisbon, Av. Rovisco Pais, 1049-001 Lisbon, Portugal; (B.S.); (A.P.S.)
| | - Ana Paula Serro
- Centro de Química Estrutural, Instituto Superior Técnico, University of Lisbon, Av. Rovisco Pais, 1049-001 Lisbon, Portugal; (B.S.); (A.P.S.)
- Centro de Investigação Interdisciplinar Egas Moniz, Instituto Universitário Egas Moniz, Quinta da Granja, Monte de Caparica, 2829-511 Caparica, Portugal
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Lemoine D, Simon E, Buc G, Deterre M. In vitro reliability testing and in vivo lifespan estimation of wireless Pixium Vision PRIMA photovoltaic subretinal prostheses suggest prolonged durability and functionality in clinical practice. J Neural Eng 2020; 17:035005. [PMID: 32357356 DOI: 10.1088/1741-2552/ab8f70] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Retinal implants have the potential to restore some sight in patients with retinal degeneration. The PRIMA implant's novel design features simpler insertion and no transscleral cabling or extraocular components. This in vitro study investigated PRIMA's durability under real time and accelerated conditions and estimated the device's lifespan in vivo. APPROACH Two potential failure modes were examined: corrosion and overstimulation. Real-time aging was tested using implants immersed in balanced saline solution (BSS) at 37 °C, mimicking the intraocular environment. Accelerated aging was examined at 77 °C (Arrhenius theory). Confirmatory testing of acceleration factor was performed using different temperatures (37 °C-87 °C) and weakened implant coatings. The effect of repeated maximum stimulation was tested using a pulsed infrared laser (6x acceleration factor). Data were used to estimate device lifespan. MAIN RESULTS 175 implants were tested for up to 33 months. No corrosion or water ingress was observed after approximately 20 accelerated years. A pixel failure rate of 0.15% was recorded after 10 accelerated years' stimulation. The derived lifespan estimation for the PRIMA implant was 27.0 years with a reliability of 90% (95% confidence interval). SIGNIFICANCE The PRIMA implant was found to be robust, with in vitro reliability of at least 10 years. The PRIMA implant shows durability and functionality for clinically relevant timespans under similar environmental conditions to the human eye. These results require in vivo confirmation.
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Chen L, Wang B, Cui W, Fang S. Efficacy of ranibizumab combined with photodynamic therapy on wet age-related macular degeneration. Exp Ther Med 2020; 19:3691-3697. [PMID: 32346433 PMCID: PMC7185075 DOI: 10.3892/etm.2020.8641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 12/19/2019] [Indexed: 01/14/2023] Open
Abstract
Efficacy and safety of intravitreal ranibizumab (IVR) combined with photodynamic therapy (PDT) in treating wet age-related macular degeneration (wAMD) were studied. A total of 130 eyes were collected from 130 wAMD patients treated in Affiliated to Qingdao University Yuhuangding Hospital of Yantai, of which 65 were given IVR combined with PDT (combination therapy group) and the remaining 65 were treated with simple IVR (ranibizumab group). The differences in best corrected visual acuity (BCVA), central macular thickness (CMT), intraocular pressure, choroidal neovascularization (CNV) leakage, levels of serum vascular endothelial growth factor (VEGF) and transforming growth factor-β1 (TGF-β1) as well as complication rate were compared before and after treatment between the two groups. At 1, 3, 6 and 12 months after treatment, combination therapy group had remarkably better BCVA and notably smaller CMT than ranibizumab group. Fundus fluorescein angiography (FFA) showed that the area of macular degeneration was reduced markedly after treatment in both groups, and the area in combination therapy group was evidently smaller than that in ranibizumab group at 1, 3 and 6 months after treatment. At 3 months after treatment, the levels of serum VEGF and TGF-β1 declined obviously in the two groups compared with those before treatment. The IVR combined with PDT can effectively improve the visual acuity, decrease CMT and prominently reduce the area of macular degeneration of wAMD patients, and its therapeutic effects are long-standing and tolerable for the patients, so it is worthy of clinical popularization.
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Affiliation(s)
- Ling Chen
- Department of Ophthalmology, Affiliated to Qingdao University Yuhuangding Hospital of Yantai, Yantai, Shandong 264000, P.R. China
| | - Bing Wang
- Department of Ophthalmology, Yantaishan Hospital, Yantai, Shandong 264000, P.R. China
| | - Wei Cui
- Department of Ophthalmology and Otolaryngology, Qingdao Fuwai Cardiovascular Disease Hospital, Qingdao, Shandong 266034, P.R. China
| | - Shufen Fang
- Department of Ophthalmology, Laizhou People's Hospital of Yantai, Yantai, Shandong 261400, P.R. China
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Chavkin NW, Hirschi KK. Single Cell Analysis in Vascular Biology. Front Cardiovasc Med 2020; 7:42. [PMID: 32296715 PMCID: PMC7137757 DOI: 10.3389/fcvm.2020.00042] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 03/05/2020] [Indexed: 12/12/2022] Open
Abstract
The ability to quantify DNA, RNA, and protein variations at the single cell level has revolutionized our understanding of cellular heterogeneity within tissues. Via such analyses, individual cells within populations previously thought to be homogeneous can now be delineated into specific subpopulations expressing unique sets of genes, enabling specialized functions. In vascular biology, studies using single cell RNA sequencing have revealed extensive heterogeneity among endothelial and mural cells even within the same vessel, key intermediate cell types that arise during blood and lymphatic vessel development, and cell-type specific responses to disease. Thus, emerging new single cell analysis techniques are enabling vascular biologists to elucidate mechanisms of vascular development, homeostasis, and disease that were previously not possible. In this review, we will provide an overview of single cell analysis methods and highlight recent advances in vascular biology made possible through single cell RNA sequencing.
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Affiliation(s)
- Nicholas W Chavkin
- Department of Cell Biology, Developmental Genomics Center, School of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Karen K Hirschi
- Department of Cell Biology, Developmental Genomics Center, School of Medicine, University of Virginia, Charlottesville, VA, United States.,Departments of Medicine and Genetics, Cardiovascular Research Center, School of Medicine, Yale University, New Haven, CT, United States
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Affiliation(s)
- Claudiu T Supuran
- NEUROFARBA Department, Sezione di Scienze Farmaceutiche e Nutraceutiche, Università degli Studi di Firenze , Firenze , Italy
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Starr MR, Dalvin LA, AbouChehade JE, Damento GM, Garcia MD, Shah SM, Hodge DO, Meissner I, Iezzi R, Bakri SJ. Classification of Strokes in Patients Receiving Intravitreal Anti-Vascular Endothelial Growth Factor. Ophthalmic Surg Lasers Imaging Retina 2019; 50:e140-e157. [PMID: 31100168 DOI: 10.3928/23258160-20190503-14] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 06/04/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND OBJECTIVE The purpose of this study was to identify the differences in the types of strokes seen in patients receiving intravitreal anti-vascular endothelial growth factor (VEGF) compared with normal control populations. PATIENTS AND METHODS We performed a retrospective consecutive review of all patients receiving intravitreal anti-VEGF injections in Olmsted County, Minnesota, from January 1, 2004, to December 31, 2013, for exudative age-related macular degeneration (AMD), diabetic macular edema (DME), proliferative diabetic retinopathy (PDR), or retinal vein occlusion (RVO). A 2-year follow-up period was required for study inclusion. Three age- and sex-matched cohorts were identified. RESULTS A total of 2,541 patients were examined. There were 690 patients identified during the study period as receiving an intravitreal injection for AMD, DME, PDR, or RVO. Of these patients, 38 (5.8%) suffered a stroke after starting intravitreal injection therapy. Of these strokes, 27 (71.1%) were ischemic, six (15.8%) were embolic, and five (13.2%) were hemorrhagic. There were no differences in the types of strokes identified among the patients receiving intravitreal injections between the case cohort and the control cohorts (P > .05 for all). CONCLUSION The authors' data suggest there is no predilection to the development of ischemic infarcts or hemorrhagic strokes in those patients receiving intravitreal anti-VEGF compared with control populations. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:e140-e157.].
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Hernandez M, Recalde S, Garcia-Garcia L, Bezunartea J, Miskey C, Johnen S, Diarra S, Sebe A, Rodriguez-Madoz JR, Pouillot S, Marie C, Izsvák Z, Scherman D, Kropp M, Prosper F, Thumann G, Ivics Z, Garcia-Layana A, Fernandez-Robredo P. Preclinical Evaluation of a Cell-Based Gene Therapy Using the Sleeping Beauty Transposon System in Choroidal Neovascularization. Mol Ther Methods Clin Dev 2019; 15:403-417. [PMID: 31890733 PMCID: PMC6909167 DOI: 10.1016/j.omtm.2019.10.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 10/30/2019] [Indexed: 01/05/2023]
Abstract
Age-related macular degeneration (AMD) is a progressive retinal disorder characterized by imbalanced pro- and antiangiogenic signals. The aim of this study was to evaluate the effect of ex vivo cell-based gene therapy with stable expression of human pigment epithelium-derived factor (PEDF) release using the non-viral Sleeping Beauty (SB100X) transposon system delivered by miniplasmids free of antibiotic resistance markers (pFAR4). Retinal pigment epithelial (RPE) cells and iris pigment epithelial (IPE) cells were co-transfected with pFAR4-inverted terminal repeats (ITRs) CMV-PEDF-BGH and pFAR4-CMV-SB100X-SV40 plasmids. Laser-induced choroidal neovascularization (CNV) was performed in rats, and transfected primary cells (transfected RPE [tRPE] and transfected IPE [tIPE] cells) were injected into the subretinal space. The leakage and CNV areas, vascular endothelial growth factor (VEGF), PEDF protein expression, metalloproteinases 2 and 9 (MMP-2/9), and microglial/macrophage markers were measured. Injection with tRPE/IPE cells significantly reduced the leakage area at 7 and 14 days and the CNV area at 7 days. There was a significant increase in PEDF and the PEDF/VEGF ratio with tRPE cells and a reduction in the MMP-2 activity. Our data demonstrated that ex vivo non-viral gene therapy reduces CNV and could be an effective and safe therapeutic option for angiogenic retinal diseases.
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Affiliation(s)
- Maria Hernandez
- Experimental Ophthalmology Laboratory, Ophthalmology, Clínica Universidad de Navarra, IdiSNA, Pamplona, Spain
- Red Temática de Investigación Cooperativa Sanitaria en Enfermedades Oculares, Oftared, ISCIII, Madrid, Spain
| | - Sergio Recalde
- Experimental Ophthalmology Laboratory, Ophthalmology, Clínica Universidad de Navarra, IdiSNA, Pamplona, Spain
- Red Temática de Investigación Cooperativa Sanitaria en Enfermedades Oculares, Oftared, ISCIII, Madrid, Spain
| | - Laura Garcia-Garcia
- Experimental Ophthalmology Laboratory, Ophthalmology, Clínica Universidad de Navarra, IdiSNA, Pamplona, Spain
- Red Temática de Investigación Cooperativa Sanitaria en Enfermedades Oculares, Oftared, ISCIII, Madrid, Spain
| | - Jaione Bezunartea
- Experimental Ophthalmology Laboratory, Ophthalmology, Clínica Universidad de Navarra, IdiSNA, Pamplona, Spain
| | - Csaba Miskey
- Division of Medical Biotechnology, Paul Ehrlich-Institut, 63225 Langen, Germany
| | - Sandra Johnen
- Department of Ophthalmology, University Hospital RWTH Aachen, 52074 Aachen, Germany
| | - Sabine Diarra
- Department of Ophthalmology, University Hospital RWTH Aachen, 52074 Aachen, Germany
| | - Attila Sebe
- Division of Medical Biotechnology, Paul Ehrlich-Institut, 63225 Langen, Germany
| | - Juan Roberto Rodriguez-Madoz
- Regenerative Medicine Program, Center for Applied Medical Research (CIMA), University of Navarra, IdiSNA, Pamplona 31008, Spain
| | | | - Corinne Marie
- Université de Paris, UTCBS, CNRS, INSERM, F-75006 Paris, France
- Chimie ParisTech, PSL Research University, F-75005 Paris, France
| | - Zsuzsanna Izsvák
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
- Berlin Institute of Health, Berlin, Germany
| | - Daniel Scherman
- Université de Paris, UTCBS, CNRS, INSERM, F-75006 Paris, France
| | - Martina Kropp
- Experimental Ophthalmology, University of Geneva, 1205 Geneva, Switzerland
- Department of Ophthalmology, University Hospitals of Geneva, 1205 Geneva, Switzerland
| | - Felipe Prosper
- Regenerative Medicine Program, Center for Applied Medical Research (CIMA), University of Navarra, IdiSNA, Pamplona 31008, Spain
- Area of Cell Therapy, Clínica Universidad de Navarra, University of Navarra, IdiSNA, Pamplona 31008, Spain
| | - Gabriele Thumann
- Experimental Ophthalmology, University of Geneva, 1205 Geneva, Switzerland
- Department of Ophthalmology, University Hospitals of Geneva, 1205 Geneva, Switzerland
| | - Zoltán Ivics
- Division of Medical Biotechnology, Paul Ehrlich-Institut, 63225 Langen, Germany
| | - Alfredo Garcia-Layana
- Experimental Ophthalmology Laboratory, Ophthalmology, Clínica Universidad de Navarra, IdiSNA, Pamplona, Spain
- Red Temática de Investigación Cooperativa Sanitaria en Enfermedades Oculares, Oftared, ISCIII, Madrid, Spain
| | - Patricia Fernandez-Robredo
- Experimental Ophthalmology Laboratory, Ophthalmology, Clínica Universidad de Navarra, IdiSNA, Pamplona, Spain
- Red Temática de Investigación Cooperativa Sanitaria en Enfermedades Oculares, Oftared, ISCIII, Madrid, Spain
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Supuran CT. Agents for the prevention and treatment of age-related macular degeneration and macular edema: a literature and patent review. Expert Opin Ther Pat 2019; 29:761-767. [PMID: 31540558 DOI: 10.1080/13543776.2019.1671353] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Introduction: Macular degeneration (MD) and macular edema (ME) are ophthalmologic diseases affecting an increasing number of the aging population. Until recently, there were few therapeutic options for both conditions but the last two decades saw important advances. Areas covered: This review summarizes the agents used for the treatment of age-related MD (AMD), which include verteporfin, for photodynamic therapy, and anti-VEGF agents, the aptamer pegaptanib, the monoclonal antibodies (MAbs) ranibizumab (Lucentis®) and bevacizumab (Avastin®) and the fusion protein aflibercept (Eylea®). All these drugs are effective only for the wet form of AMD, whereas for the dry form there is no treatment available. ME is, on the other hand, treated with nonsteroidal anti-inflammatory drugs and carbonic anhydrase (CA) inhibitors. Recently, MAbs such as ranibizumab and bevacizumab were also shown to be effective for the management of the cystoid and diabetic ME. Expert opinion: There are important advances made in the field in the last years but longer-acting anti-VEGF agents or drugs with less ocular side effects are needed. Many such agents are in clinical development.
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Affiliation(s)
- Claudiu T Supuran
- NEUROFARBA Department, Sezione di Scienze Farmaceutiche e Nutraceutiche, Università degli Studi di Firenze , Firenze , Italy
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Ferro Desideri L, Barra F, Ferrero S, Traverso CE, Nicolò M. Clinical efficacy and safety of ranibizumab in the treatment of wet age-related macular degeneration. Expert Opin Biol Ther 2019; 19:735-751. [DOI: 10.1080/14712598.2019.1627322] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Lorenzo Ferro Desideri
- University Eye Clinic of Genoa, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy
| | - Fabio Barra
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy
- Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Simone Ferrero
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy
- Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Carlo Enrico Traverso
- University Eye Clinic of Genoa, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy
| | - Massimo Nicolò
- University Eye Clinic of Genoa, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy
- Macula Onlus Foundation, Genoa, Italy
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Test performance of optical coherence tomography angiography in detecting retinal diseases: a systematic review and meta-analysis. Eye (Lond) 2019; 33:1327-1338. [PMID: 30971815 DOI: 10.1038/s41433-019-0421-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 12/22/2018] [Accepted: 02/07/2019] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE To investigate the diagnostic accuracy of optical coherence tomography angiography (OCTA) in detecting vascular characteristics of chorio-retinal disease. METHODS Evidence acquisition: We searched Web of Science, Scopus, and Medline by the citation of references and complemented these electronic searches by checking the list of references of included and review articles. Screening, selection, assessment, and extraction was performed in parallel by two authors. RESULTS Evidence synthesis: Systematic review and exploratory meta-analysis. The ten studies that contributed to the meta-analysis enrolled 440 eyes and allowed constructing ten two-by-two tables. The tables reported on detection of choroidal neovascularization (CNV) in eyes suffering from either age-related macular degeneration (4), central serous chorioretinopathy (2), myopia (2), foveomacular vitelliform dystrophy (1), or a mixed cohort suffering from multiple retinal diseases (1). Of the ten studies, six used a cohort and four a case-control design. We found a pooled sensitivity of 0.90 (95% confidence intervals (CIs): 0.82-0.95) and a pooled specificity of 0.97 (95% CI: 0.89-0.99). Corresponding positive and negative likelihood ratios were 32.3 (95% CI: 7.4-141.6) and 0.10 (95% CI: 0.06-0.20), respectively. No pooling was possible for retinal vascular parameters of diabetic retinopathy, polypoidal choroidal vasculopathy, or detection of CNV activity. CONCLUSIONS The results of highly biased and heterogeneous studies assessing the diagnostic performance of OCTA highlight the need for further analyses of methodologically sound and sufficiently sized clinical evaluations.
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Harris A, Siesky B, Huang A, Do T, Mathew S, Frantz R, Gross J, Januleviciene I, Verticchio Vercellin AC. Lutein Complex Supplementation Increases Ocular Blood Flow Biomarkers in Healthy Subjects. INT J VITAM NUTR RES 2019; 89:5-12. [PMID: 30932775 DOI: 10.1024/0300-9831/a000576] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Introduction: To investigate the effects of a lutein complex supplementation on ocular blood flow in healthy subjects. Materials and Methods: Sixteen healthy female patients (mean age 36.8 ± 12.1 years) were enrolled in this randomized, placebo-controlled, double-blinded, two-period crossover study. Subjects received daily an oral dose of the lutein with synergistic phytochemicals complex (lutein (10 mg), ascorbic acid (500 mg), tocopherols (364 mg), carnosic acid (2.5 mg), zeaxanthin (2 mg), copper (2 mg), with synergistic effects in reducing pro-inflammatory mediators and cytokines when administered together in combination) and placebo during administration periods. Measurements were taken before and after three-week supplementation periods, with crossover visits separated by a three-week washout period. Data analysis included blood pressure, heart rate, intraocular pressure, visual acuity, contrast sensitivity detection, ocular perfusion pressure, confocal scanning laser Doppler imaging of retinal capillary blood flow, and Doppler imaging of the retrobulbar blood vessels. Results: Lutein complex supplementation produced a statistically significant increase in mean superior retinal capillary blood flow, measured in arbitrary units (60, p = 0.0466) and a decrease in the percentage of avascular area in the superior (-0.029, p = 0.0491) and inferior (-0.023, p = 0.0477) retina, as well as reduced systolic (-4.06, p = 0.0295) and diastolic (-3.69, p = 0.0441) blood pressure measured in mmHg from baseline. Data comparison between the two supplement groups revealed a significant decrease in systemic diastolic blood pressure (change from pre- to post-treatment with lutein supplement (mean (SE)): -3.69 (1.68); change from pre- to post-treatment with placebo: 0.31 (2.57); p = 0.0357) and a significant increase in the peak systolic velocity (measured in cm/sec) in the central retinal artery (change from pre- to post-treatment with lutein supplement: 0.36 (0.19); change from pre- to post-treatment with placebo: -0.33 (0.21); p = 0.0384) with lutein complex supplement; data analyses from the placebo group were all non-significant. Discussion: In healthy participants, oral administration of a lutein phytochemicals complex for three weeks produced increased ocular blood flow biomarkers within retinal vascular beds and reduced diastolic blood pressure compared to placebo.
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Affiliation(s)
- Alon Harris
- 1Glick Eye Institute, Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Brent Siesky
- 1Glick Eye Institute, Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Amelia Huang
- 1Glick Eye Institute, Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Thai Do
- 1Glick Eye Institute, Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Sunu Mathew
- 1Glick Eye Institute, Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Rachel Frantz
- 1Glick Eye Institute, Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Josh Gross
- 1Glick Eye Institute, Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Ingrida Januleviciene
- 2Eye Clinic of Medical Academy of Lithuanian University of Health Sciences, Kaunas, Lithuania
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Ramlogan-Steel CA, Murali A, Andrzejewski S, Dhungel B, Steel JC, Layton CJ. Gene therapy and the adeno-associated virus in the treatment of genetic and acquired ophthalmic diseases in humans: Trials, future directions and safety considerations. Clin Exp Ophthalmol 2019; 47:521-536. [PMID: 30345694 DOI: 10.1111/ceo.13416] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Revised: 10/04/2018] [Accepted: 10/15/2018] [Indexed: 12/27/2022]
Abstract
Voretigene neparvovec-rzyl was recently approved for the treatment of Leber congenital amaurosis, and the use of gene therapy for eye disease is attracting even greater interest. The eye has immune privileged status, is easily accessible, requires a reduced dosage of therapy due to its size and is highly compartmentalized, significantly reducing systemic spread. Adeno-associated virus (AAV), with its low pathogenicity, prolonged expression profile and ability to transduce multiple cell types, has become the leading gene therapy vector. Target diseases have moved beyond currently untreatable inherited dystrophies to common, partially treatable acquired conditions such as exudative age-related macular degeneration and glaucoma, but use of the technology in these conditions imposes added obligations for caution in vector design. This review discusses the current status of AAV gene therapy trials in genetic and acquired ocular diseases, and explores new scientific developments, which could help ensure effective and safe use of the therapy in the future.
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Affiliation(s)
- Charmaine A Ramlogan-Steel
- LVF Ophthalmology Research Centre, Translational Research Institute, Brisbane, Australia.,Greenslopes Clinical School, Faculty of Medicine, University of Queensland, Greenslopes Hospital, Brisbane, Australia.,Medical and Applied Science, Central Queensland University, School of Health, Rockhampton, Australia
| | - Aparna Murali
- LVF Ophthalmology Research Centre, Translational Research Institute, Brisbane, Australia.,Greenslopes Clinical School, Faculty of Medicine, University of Queensland, Greenslopes Hospital, Brisbane, Australia
| | - Slawomir Andrzejewski
- LVF Ophthalmology Research Centre, Translational Research Institute, Brisbane, Australia.,Greenslopes Clinical School, Faculty of Medicine, University of Queensland, Greenslopes Hospital, Brisbane, Australia
| | - Bijay Dhungel
- Greenslopes Clinical School, Faculty of Medicine, University of Queensland, Greenslopes Hospital, Brisbane, Australia
| | - Jason C Steel
- Medical and Applied Science, Central Queensland University, School of Health, Rockhampton, Australia
| | - Christopher J Layton
- LVF Ophthalmology Research Centre, Translational Research Institute, Brisbane, Australia.,Greenslopes Clinical School, Faculty of Medicine, University of Queensland, Greenslopes Hospital, Brisbane, Australia
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Hanif AM, Yan J, Jain N. Pattern Dystrophy: An Imprecise Diagnosis in the Age of Precision Medicine. Int Ophthalmol Clin 2019; 59:173-194. [PMID: 30585925 DOI: 10.1097/iio.0000000000000262] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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The Different Facades of Retinal and Choroidal Endothelial Cells in Response to Hypoxia. Int J Mol Sci 2018; 19:ijms19123846. [PMID: 30513885 PMCID: PMC6321100 DOI: 10.3390/ijms19123846] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 11/28/2018] [Accepted: 11/29/2018] [Indexed: 02/06/2023] Open
Abstract
Ocular angiogenic diseases, such as proliferative diabetic retinopathy and neovascular age-related macular degeneration, are associated with severe loss of vision. These pathologies originate from different vascular beds, retinal and choroidal microvasculatures, respectively. The activation of endothelial cells (EC) plays pivotal roles in angiogenesis, often triggered by oxygen deficiency. Hypoxia-inducible factors in ECs mediate the transcription of multiple angiogenic genes, including the canonical vascular endothelial growth factors. ECs show notable heterogeneity in function, structure, and disease, therefore the understanding of retinal/choroidal ECs (REC; CEC) biochemical and molecular responses to hypoxia may offer key insights into tissue-specific vascular targeting treatments. The aim of this review is to discuss the differences spanning between REC and CEC, with focus on their response to hypoxia, which could provide innovative and sustainable strategies for site specific targeting of ocular neovascularization.
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Swendeman SL, Hla T. Lipid Mediators, M2 Macrophages, and Pathological Neovascularization. Trends Mol Med 2018; 24:977-978. [PMID: 30448396 DOI: 10.1016/j.molmed.2018.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 10/11/2018] [Indexed: 12/17/2022]
Abstract
Sasaki and colleagues [1] (JCI Insight 2018;3,e96902) identified the leukocyte inflammatory lipid mediator leukotriene B4 (LTB4)/LTB4 receptor 1 receptor-signaling axis in M2 macrophages as a causal pathway for the vascular endothelial growth factor-dependent pathological neovascularization in a mouse model that mimics wet age-related macular degeneration. This observation provides a novel mechanism by which an eicosanoid lipid mediator drives retinal vascular pathology and suggests a novel therapeutic target for proliferative retinal vascular diseases.
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Affiliation(s)
- Steven L Swendeman
- Vascular Biology Program, Boston Children's Hospital and Department of Surgery, Harvard Medical School, Boston, MA 02115, USA
| | - Timothy Hla
- Vascular Biology Program, Boston Children's Hospital and Department of Surgery, Harvard Medical School, Boston, MA 02115, USA.
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Hu X, Liang Y, Zhao B, Wang Y. Thymoquinone protects human retinal pigment epithelial cells against hydrogen peroxide induced oxidative stress and apoptosis. J Cell Biochem 2018; 120:4514-4522. [PMID: 30269355 DOI: 10.1002/jcb.27739] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 09/30/2018] [Indexed: 01/22/2023]
Abstract
Oxidative stress in retinal pigment epithelium (RPE) cells may contribute to the progression of age-related macular degeneration. Thymoquinone (TQ), an active component derived from Nigella sativa, possesses antioxidative effect. However, the role of TQ in RPE cells under oxidative stress condition remains unclear. The present study aimed to examine the protective effect of TQ against hydrogen peroxide (H2 O2 )-induced oxidative stress in human RPE cells. Our results showed that TQ improved the cell viability and apoptosis in H2 O2 -induced ARPE cells. We also found that the levels of reactive oxygen species and malondialdehyde induced by H2 O2 were reduced after the pretreatment of TQ. In addition, the inhibitory effect of H2 O2 on the glutathione (GSH) level and superoxide dismutase activity was markedly attenuated by TQ pretreatment. Moreover, TQ enhanced the activation of Nrf2/heme oxygenase 1 (HO-1) signaling pathway in H2 O2 -induced ARPE cells. Knockdown of Nrf2 abolished the protective effect of TQ on H2 O2 -induced oxidative damage. These results suggested that TQ protected ARPE cells from H2 O2 -induced oxidative stress and apoptosis via the Nrf2/HO-1 signaling pathway.
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Affiliation(s)
- Xin Hu
- Department of Ophthalmology, Huaihe Hospital, Henan University, Kaifeng, China
| | - Yuanyuan Liang
- Department of Ophthalmology, Huaihe Hospital, Henan University, Kaifeng, China
| | - Bo Zhao
- Department of Ophthalmology, Huaihe Hospital, Henan University, Kaifeng, China
| | - Yongyi Wang
- Department of Ophthalmology, Huaihe Hospital, Henan University, Kaifeng, China
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Soto-Breceda A, Kameneva T, Meffin H, Maturana M, Ibbotson MR. Irregularly timed electrical pulses reduce adaptation of retinal ganglion cells. J Neural Eng 2018; 15:056017. [PMID: 30021932 DOI: 10.1088/1741-2552/aad46e] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Retinal prostheses aim to provide visual percepts to blind people affected by diseases caused by photoreceptor degeneration. One of the main challenges presented by current devices is neural adaptation in the retina, which is believed to be the cause of fading-an effect where artificially produced percepts disappear over a short period of time, despite continuous stimulation of the retina. We aim to understand the neural adaptation generated in retinal ganglion cells (RGCs) during electrical stimulation. APPROACH Current visual prostheses use electrical pulses with fixed frequencies and amplitudes modulated over hundreds of milliseconds to stimulate the retina. However, in nature, neuronal spiking occurs with stochastic timing, hence the information received naturally from other neurons by RGCs is irregularly timed. We used a single epiretinal electrode to stimulate and compare rat RGC responses to stimulus trains of biphasic pulses delivered at regular and random inter-pulse intervals (IPI), the latter taken from an exponential distribution. MAIN RESULTS Our observations suggest that stimulation with random IPIs result in lower adaptation rates than stimulation with constant IPIs at frequencies of 50 Hz and 200 Hz. We also found a high proportion of lower amplitude action potentials, or spikelets. The spikelets were more prominent at high stimulation frequencies (50 Hz and 200 Hz) and were less susceptible to adaptation, but it was not clear if they propagated along the axon. SIGNIFICANCE Using random IPI stimulation in retinal prostheses reduces the decay of RGCs and this could potentially reduce fading of electrically induced visual perception.
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Affiliation(s)
- A Soto-Breceda
- National Vision Research Institute, Australian College of Optometry, Melbourne, Australia. Department of Biomedical Engineering, The University of Melbourne, Melbourne, Australia. CSIRO, Data 61, Melbourne, Australia
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Ye Z, He SZ, Li ZH. Effect of Aβ protein on inhibiting proliferation and promoting apoptosis of retinal pigment epithelial cells. Int J Ophthalmol 2018; 11:929-934. [PMID: 29977803 DOI: 10.18240/ijo.2018.06.06] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 09/15/2017] [Indexed: 01/06/2023] Open
Abstract
AIM To identify the effect and regulatory mechanism of amyloid β (Aβ) protein on retinal pigment epithelial (RPE) cells in cell proliferation and apoptosis, and clarify Aβ role in the pathogenesis of age-related macular degeneration (AMD). METHODS The model of Aβ25-35 protein cytotoxicity in RPE cell was successfully established to investigate the effect of Aβ protein on RPE cells in vitro. Based on Aβ protein, the specific inhibitors (HY-50682 or BAY11-7082) or activating agent (lipopolysaccharide) was used to analyze the regulatory mechanism of Aβ protein to RPE cells on cell proliferation and apoptosis by flow cytometry, real-time polymerase chain reaction, Western blotting, enzyme-linked immunosorbent assay and dual-luciferase reporter gene assay. RESULTS The number of RPE cells, treated with Aβ25-35 from 0.3 to 60 µmol/L, significantly reduce (P<0.01), and had the dose-dependent effect. Aβ protein 60 µmol/L inhibits the G1/S phase transition (P<0.01) and down-regulated cyclin E mRNA level (P<0.01). Similarly, Aβ25-35 induced a significant increase of cell apoptosis, accompanied by the significantly higher level of activated caspase 3 protein. Furthermore, nuclear factor-kappaB (NF-κB) activity and phosphorylated Iκ-Ba level would significantly lower in treated RPE cells. Using specific inhibitors or activating agent based on the Aβ, the cell numbers, NF-κB activity, phosphorylated Iκ-Ba level, receptor for advanced glycation endproducts (RAGE) gene expression levels, cyclin E mRNA level and activated caspase 3 level had accordingly changed by different methods, confirming that RAGE/NF-κB signaling pathway involved in the regulation of Aβ protein on RPE cell apoptosis and proliferation. CONCLUSION Aβ protein inhibits cell proliferation and activates apoptosis via inactivation of the RAGE/NF-κB signaling pathway in RPE cell.
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Affiliation(s)
- Zi Ye
- Department of Ophthalmology, the Chinese PLA General Hospital, Beijing 100853, China
| | - Shou-Zhi He
- Department of Ophthalmology, the Chinese PLA General Hospital, Beijing 100853, China
| | - Zhao-Hui Li
- Department of Ophthalmology, the Chinese PLA General Hospital, Beijing 100853, China
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Rasti R, Rabbani H, Mehridehnavi A, Hajizadeh F. Macular OCT Classification Using a Multi-Scale Convolutional Neural Network Ensemble. IEEE TRANSACTIONS ON MEDICAL IMAGING 2018; 37:1024-1034. [PMID: 29610079 DOI: 10.1109/tmi.2017.2780115] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Computer-aided diagnosis (CAD) of retinal pathologies is a current active area in medical image analysis. Due to the increasing use of retinal optical coherence tomography (OCT) imaging technique, a CAD system in retinal OCT is essential to assist ophthalmologist in the early detection of ocular diseases and treatment monitoring. This paper presents a novel CAD system based on a multi-scale convolutional mixture of expert (MCME) ensemble model to identify normal retina, and two common types of macular pathologies, namely, dry age-related macular degeneration, and diabetic macular edema. The proposed MCME modular model is a data-driven neural structure, which employs a new cost function for discriminative and fast learning of image features by applying convolutional neural networks on multiple-scale sub-images. MCME maximizes the likelihood function of the training data set and ground truth by considering a mixture model, which tries also to model the joint interaction between individual experts by using a correlated multivariate component for each expert module instead of only modeling the marginal distributions by independent Gaussian components. Two different macular OCT data sets from Heidelberg devices were considered for the evaluation of the method, i.e., a local data set of OCT images of 148 subjects and a public data set of 45 OCT acquisitions. For comparison purpose, we performed a wide range of classification measures to compare the results with the best configurations of the MCME method. With the MCME model of four scale-dependent experts, the precision rate of 98.86%, and the area under the receiver operating characteristic curve (AUC) of 0.9985 were obtained on average.
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Wei X, Zhang T, Yao Y, Zeng S, Li M, Xiang H, Zhao C, Cao G, Li M, Wan R, Yang P, Yang J. Efficacy of Lenvatinib, a multitargeted tyrosine kinase inhibitor, on laser-induced CNV mouse model of neovascular AMD. Exp Eye Res 2018; 168:2-11. [DOI: 10.1016/j.exer.2017.12.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 12/22/2017] [Accepted: 12/22/2017] [Indexed: 02/06/2023]
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Chen L, Liu GQ, Wu HY, Jin J, Yin X, Li D, Lu PR. Monocyte chemoattractant protein 1 and fractalkine play opposite roles in angiogenesis via recruitment of different macrophage subtypes. Int J Ophthalmol 2018; 11:216-222. [PMID: 29487809 DOI: 10.18240/ijo.2018.02.06] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 12/08/2017] [Indexed: 12/13/2022] Open
Abstract
AIM To explore the interaction between macrophages and chemokines [monocyte chemoattractant protein 1 (MCP-1/CCL2) and fractalkine/CX3CL1] and the effects of their interaction on neovascularization. METHODS Human peripheral blood mononuclear cells, donated by healthy volunteers, were separated and cultured in RPMI-1640 medium containing 10% fetal bovine serum, then induced into macrophages by stimulation with 30 µg/L granulocyte macrophage-colony stimulating factor (GM-CSF). The expression of CCR2 and/or CX3CR1 in the macrophages was examined using flow cytometry. Macrophages were then stimulated with recombinant human CCL2 (rh-CCL2) or recombinant human CX3CL1 (rh-CX3CL1). The expression of angiogenesis-related genes, including VEGF-A, THBS-1 and ADAMTS-1 were examined using real-time quantitative polymerase chain reaction (PCR). Supernatants from stimulated macrophages were used in an assay of human retinal endothelial cell (HREC) proliferation. Finally, stimulated macrophages were co-cultured with HREC in a migration assay. RESULTS The expression rate of CCR2 in macrophages stimulated by GM-CSF was 42%±1.9%. The expression rate of CX3CR1 was 71%±3.3%. Compared with vehicle-treated groups, gene expression of VEGF-A in the macrophages was greater in 150 mg/L CCL2-treated groups (P<0.05), while expression of THBS-1 and ADAMTS-1 was significantly lower (P<0.05). By contrast, compared with vehicle-treated groups, expression of VEGF-A in 150 mg/L CX3CL1-treated groups was significantly lower (P<0.05), while expression of THBS-1 and ADAMTS-1 was greater (P<0.05). Supernatants from CCL2 treated macrophages promoted proliferation of HREC (P<0.05), while supernatants from CX3CL1-treated macrophages inhibited the proliferation of HREC (P<0.05). HREC migration increased when co-cultured with CCL2-treated macrophages, but decreased with CX3CL1-treated macrophages (P<0.05). CONCLUSION CCL2 and CX3CL1 exert different effects in regulation of macrophage in expression of angiogenesis-related factors, including VEGF-A, THBS-1 and ADAMTS-1. Our findings suggest that CCL2 and CX3CL1 may be candidate proteins for further exploration of novel targets for treatment of ocular neovascularization.
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Affiliation(s)
- Lei Chen
- Department of Ophthalmology, the First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu Province, China
| | - Gao-Qin Liu
- Department of Ophthalmology, the First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu Province, China.,Jiangsu Key Laboratory of Clinical Immunology, Soochow University, Suzhou 215006, Jiangsu Province, China
| | - Hong-Ya Wu
- Jiangsu Key Laboratory of Clinical Immunology, Soochow University, Suzhou 215006, Jiangsu Province, China
| | - Ji Jin
- Department of Ophthalmology, the First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu Province, China
| | - Xue Yin
- Department of Ophthalmology, the First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu Province, China
| | - Dan Li
- Department of Ophthalmology, the First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu Province, China
| | - Pei-Rong Lu
- Department of Ophthalmology, the First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu Province, China.,Jiangsu Key Laboratory of Clinical Immunology, Soochow University, Suzhou 215006, Jiangsu Province, China
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