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Wu D, Chan KE, Lim BXH, Lim DKA, Wong WM, Chai C, Manotosh R, Lim CHL. Management of corneal neovascularization: Current and emerging therapeutic approaches. Indian J Ophthalmol 2024; 72:S354-S371. [PMID: 38648452 DOI: 10.4103/ijo.ijo_3043_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 12/25/2023] [Indexed: 04/25/2024] Open
Abstract
Corneal neovascularization (CoNV) is a sight-threatening condition affecting an estimated 1.4 million people per year, and the incidence is expected to rise. It is a complication of corneal pathological diseases such as infective keratitis, chemical burn, corneal limbal stem cell deficiency, mechanical trauma, and immunological rejection after keratoplasties. CoNV occurs due to a disequilibrium in proangiogenic and antiangiogenic mediators, involving a complex system of molecular interactions. Treatment of CoNV is challenging, and no therapy thus far has been curative. Anti-inflammatory agents such as corticosteroids are the mainstay of treatment due to their accessibility and well-studied safety profile. However, they have limited effectiveness and are unable to regress more mature neovascularization. With the advent of advanced imaging modalities and an expanding understanding of its pathogenesis, contemporary treatments targeting a wide array of molecular mechanisms and surgical options are gaining traction. This review aims to summarize evidence regarding conventional and emerging therapeutic options for CoNV.
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Affiliation(s)
- Duoduo Wu
- Department of Ophthalmology, National University Hospital, Singapore
| | - Kai En Chan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Blanche Xiao Hong Lim
- Department of Ophthalmology, National University Hospital, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Dawn Ka-Ann Lim
- Department of Ophthalmology, National University Hospital, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Wendy Meihua Wong
- Department of Ophthalmology, National University Hospital, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Charmaine Chai
- Department of Ophthalmology, National University Hospital, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ray Manotosh
- Department of Ophthalmology, National University Hospital, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Chris Hong Long Lim
- Department of Ophthalmology, National University Hospital, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
- Singapore Eye Research Institute, Singapore
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Eski MT, Teberik K, Oltulu P, Ankaralı H, Kaya M, Alpay M. The effects of subconjunctival bevacizumab, ranibizumab, and aflibercept on corneal neovascularization. Hum Exp Toxicol 2022; 41:9603271221084674. [PMID: 35465742 DOI: 10.1177/09603271221084674] [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: 11/15/2022]
Abstract
PURPOSE To investigate the effects of subconjunctival bevacizumab, ranibizumab, and aflibercept in an experimental corneal neovascularization model. MATERIALS AND METHODS The eyes of 24 rats were chemically cauterized and randomly divided into four groups: bevacizumab group (0.05 mL/1.25 mg bevacizumab), ranibizumab group (0.05 mL/0.5 mg ranibizumab), aflibercept group (0.05 mL/1.25 mg aflibercept), and control group (0.05 mL saline solution). Plasma vascular endothelial growth factor (VEGF) levels were among the major measurement outcomes to assess corneal neovascularization. The collected plasmas were analyzed using the SIGMA RAB0511 Rat VEGF Elisa kit. The PCR technique and VEGF amplification procedures were used for molecular analysis. Each cornea was removed and histologically examined on day 21. Corneal images were evaluated by image analyzer software. RESULTS In the post-injection period, the number of major corneal arteries decreased significantly in the injection groups when compared to the control group (p = 0.037), but no statistically significant differences were noted among the injection groups (p > 0.05). The aflibercept group had the lowest area of neovascularization. Immunohistochemical staining revealed substantially lower VEGF percentages in neovascularized arteries of the injection groups than the control group (p = 0.015). In TUNEL staining, the mean TUNEL value (number/1hpf) was substantially greater in the control group than in the injection groups, but the mean TUNEL values were similar between the injection groups (p = 0.019, p > 0.05, respectively). No statistically significant differences were observed between the groups in terms of corneal surface area with increased cellularity, edema, and inflammation (p = 0.263). The mean plasma VEGF concentration in the control group was statistically greater than those in the injection groups (p = 0.001). CONCLUSION Subconjunctival bevacizumab, ranibizumab, and aflibercept crossed the blood and seemed to be effective in inhibiting corneal neovascularization without causing epitheliopathy in an experimental rat model compared to the controls. However, no significant results were noted between these three anti-VEGF molecules.
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Affiliation(s)
- M T Eski
- 498080Private Neon Hospital, Erzincan, Turkey
| | - Kuddusi Teberik
- Department of Ophthalmology, Medical School, 121595Duzce University, Duzce, Turkey
| | - Pembe Oltulu
- Department of Pathology, Faculty of Medicine, 226846Necmettin Erbakan University, Konya, Turkey
| | - Handan Ankaralı
- Department of Biostatistics and Medical Informatics, Medical School, 226842İstanbul Medeniyet University, Istanbul, Turkey
| | - Murat Kaya
- Department of Ophthalmology, Medical School, 121595Duzce University, Duzce, Turkey
| | - Merve Alpay
- Department of Medical Biochemistry, Faculty of Medicine, 121595Duzce University, Duzce, Turkey
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Therapeutic Efficacy of a Novel Acetylated Tetrapeptide in Animal Models of Age-Related Macular Degeneration. Int J Mol Sci 2021; 22:ijms22083893. [PMID: 33918777 PMCID: PMC8070582 DOI: 10.3390/ijms22083893] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/05/2021] [Accepted: 04/07/2021] [Indexed: 12/12/2022] Open
Abstract
It has been shown previously that a novel tetrapeptide, Arg-Leu-Tyr-Glu (RLYE), derived from human plasminogen inhibits vascular endothelial growth factor (VEGF)-induced angiogenesis, suppresses choroidal neovascularization in mice by an inhibition of VEGF receptor-2 (VEGFR-2) specific signaling pathway. In this study, we report that a modified tetrapeptide (Ac-RLYE) showed improved anti-choroidal neovascularization (CNV) efficacy in a number of animal models of neovascular age-related macular degeneration (AMD) which include rat, rabbit, and minipig. The preventive and therapeutic in vivo efficacy of Ac-RLYE via following intravitreal administration was determined to be either similar or superior to that of ranibizumab and aflibercept. Assessment of the intraocular pharmacokinetic and toxicokinetic properties of Ac-RLYE in rabbits demonstrated that it rapidly reached the retina with minimal systemic exposure after a single intravitreal dose, and it did not accumulate in plasma during repetitive dosing (bi-weekly for 14 weeks). Our results suggested that Ac-RLYE has a great potential for an alternative therapeutics for neovascular (wet) AMD. Since the amino acids in human VEGFR-2 targeted by Ac-RLYE are conserved among the animals employed in this study, the therapeutic efficacies of Ac-RLYE evaluated in those animals are predicted to be observed in human patients suffering from retinal degenerative diseases.
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Intrastromal versus subconjunctival anti-VEGF agents for treatment of corneal neovascularization: a rabbit study. Eye (Lond) 2021; 35:3123-3130. [PMID: 33469129 DOI: 10.1038/s41433-020-01347-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 11/14/2020] [Accepted: 11/26/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE To determine whether subconjunctival or intrastromal administration of anti-VEGF agents is more effective on suture-induced corneal neovascularization (CoNV) in rabbits. METHODS CoNV was induced in 48 eyes of 24 New Zealand white rabbits by using an 8/0 silk suture. On the 7th day after suturing, the rabbits were divided into four treatment groups as follows: six rabbits received subconjunctival bevacizumab (group 1), six rabbits received subconjunctival aflibercept (group 2), six rabbits received intrastromal bevacizumab (group 3) and six rabbits received intrastromal aflibercept (group 4). On the 7th and 14th days after suturing, the CoNV area was calculated by standardised analysis of photographs using the Image-J program. On the 14th day after suturing, all rabbits were sacrificed and then corneal tissue was harvested for the analysis of vascular endothelial growth factor (VEGF)-A, VEGF-B and placental growth factor (PIGF) levels. RESULTS On the 7th day after suturing, CoNV areas were 17.10 ± 2.98, 18.88 ± 3.78, 17.36 ± 4.52, 18.57 ± 4.16 and 17.31 ± 2.81 mm2 in the groups 1-4 and control group, respectively. On the 7th day after intervention and removal of suture, CoNV areas were 4.85 ± 1.99, 6.66 ± 1.73, 2.83 ± 1.08, 2.63 ± 1.16 and 11.93 ± 2.64 mm2 in the group 1-4 and control group, respectively. CoNV area was reduced by 88.1% and 82.5% in eyes receiving intrastromal aflibercept and bevacizumab, respectively (both p < 0.001), and by 64.5% and 69.9% in eyes receiving subconjunctival aflibercept and bevacizumab, respectively (both p = 0.001). CONCLUSION Intrastromal anti-VEGF therapy regressed CoNV more effectively than subconjunctival therapy regardless of the type of anti-VEGF agent.
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Prevention of corneal neovascularization by subconjunctival injection of avastin® loaded thermosensitive hydrogels in rabbit model. Int J Pharm 2018; 552:164-170. [PMID: 30217769 DOI: 10.1016/j.ijpharm.2018.09.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 09/06/2018] [Accepted: 09/10/2018] [Indexed: 12/22/2022]
Abstract
The antibody avastin® (Ava) has been clinically to treat various intraocular neovascular diseases, but suffering from the rapid clearance and short shelf-life of Ava in the requirement of frequent administration. In the present study, we reports the sustained release of Ava from a thermosensitive hydrogel based on poly(ethylene glycol)-poly(ɛ-caprolactone)-poly(ethylene glycol) (PECE) copolymer for the control of corneal neovascularization in rabbit model. Ava were physically mixed with PECE aqueous solution at 4 °C, and resulting Ava-PECE solution showed a sol-gel transition at physiological temperature (37 °C). In vitro release study indicated that Ava-PECE hydrogel provided a sustained release of Ava up to 28 days and the drug release behavior could be finely modulated by the change of PECE concentration. A single subconjunctival injection of PECE hydrogel hardly caused the change of intraocular pressure and corneal endothelial morphology during the entire study period. Intraocular pharmacokinetic analysis suggested that the Ava-PECE hydrogel provided a relatively higher Ava concentration in cornea over Ava solution up to 14 days. In addition, anti-angiogenic effects of the Ava-PECE hydrogel in a suture-induced corneal neovascularization rabbit model indicated that the Ava-PECE hydrogel treatment exhibited superior anti-angiogenic efficacy over Ava solution treatment by decreasing the area ratio of neovascularization on 17 days. Overall, the proposed Ava-PECE hydrogel acting a sustained drug delivery system might be a promising vehicle for the treatment of corneal neovascularization.
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Menguy T, Briaux A, Jeunesse E, Giustiniani J, Calcei A, Guyon T, Mizrahi J, Haegel H, Duong V, Soler V, Brousset P, Bensussan A, Raymond Letron I, Le Bouteiller P. Anti-CD160, Alone or in Combination With Bevacizumab, Is a Potent Inhibitor of Ocular Neovascularization in Rabbit and Monkey Models. ACTA ACUST UNITED AC 2018; 59:2687-2698. [DOI: 10.1167/iovs.18-24024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
| | - Anne Briaux
- Centre de Physiopathologie de Toulouse Purpan, INSERM UMR 1043, CNRS UMR 5282, Université Toulouse III, Toulouse, France
| | - Elisabeth Jeunesse
- STROMALab, Université de Toulouse, EFS, ENVT, INSERM U1031, Toulouse, France et LabHPEC, Ecole Nationale Vétérinaire, Toulouse, France
| | - Jérôme Giustiniani
- INSERM UMR 976, Hôpital Saint-Louis, Paris, France
- Université Paris Diderot-Paris 7, Paris, France
- Institut Jean Godinot, Unicancer, F-51726 Reims, France
- Université Reims-Champagne-Ardenne, DERM-I-C, EA7319, Reims, France
| | | | | | | | | | | | - Vincent Soler
- Unité de Rétine, Ophthalmology Department, Hôpital Pierre-Paul Riquet, Toulouse University Hospital, Place Baylac, Toulouse, France
- Unité Différenciation Epithéliale et Autoimmunité Rhumatoïde UMR 1056 Inserm - Université Toulouse III, Toulouse, France
- Université Toulouse III, Toulouse, France
| | - Pierre Brousset
- Centre de Recherche en Cancérologie de Toulouse, INSERM UMR1037, Toulouse, France
| | | | - Isabelle Raymond Letron
- STROMALab, Université de Toulouse, EFS, ENVT, INSERM U1031, Toulouse, France et LabHPEC, Ecole Nationale Vétérinaire, Toulouse, France
| | - Philippe Le Bouteiller
- Centre de Physiopathologie de Toulouse Purpan, INSERM UMR 1043, CNRS UMR 5282, Université Toulouse III, Toulouse, France
- INSERM UMR 976, Hôpital Saint-Louis, Paris, France
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Feizi S, Azari AA, Safapour S. Therapeutic approaches for corneal neovascularization. EYE AND VISION 2017; 4:28. [PMID: 29234686 PMCID: PMC5723406 DOI: 10.1186/s40662-017-0094-6] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 11/26/2017] [Indexed: 02/07/2023]
Abstract
Angiogenesis refers to new blood vessels that originate from pre-existing vascular structures. Corneal neovascularization which can lead to compromised visual acuity occurs in a wide variety of corneal pathologies. A large subset of measures has been advocated to prevent and/or treat corneal neovascularization with varying degrees of success. These approaches include topical corticosteroid administration, laser treatment, cautery, and fine needle diathermy. Since the imbalance between proangiogenic agents and antiangiogenic agents primarily mediate the process of corneal neovascularization, recent therapies are intended to disrupt the different steps in the synthesis and actions of proangiogenic factors. These approaches, however, are only partially effective and may lead to several side effects. The aim of this article is to review the most relevant treatments for corneal neovascularization available so far.
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Affiliation(s)
- Sepehr Feizi
- Ophthalmic Research Center, Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, 16666 Iran
| | - Amir A Azari
- Ophthalmic Research Center, Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, 16666 Iran
| | - Sharareh Safapour
- Ophthalmic Research Center, Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, 16666 Iran
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Effects of Combined Photodynamic Therapy and Topical Bevacizumab Treatment on Corneal Neovascularization in Rabbits. Cornea 2017; 35:1615-1620. [PMID: 27684458 DOI: 10.1097/ico.0000000000001016] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate the effects of combined photodynamic therapy (PDT) and topical bevacizumab treatment on corneal neovascularization in rabbits. METHODS Corneal neovascularization was induced by placing a suture for 7 days in both eyes of 15 rabbits. After suture removal, the right eyes of the rabbits were divided into 3 treatment groups (n = 5 each): group 1, 5 mg/mL bevacizumab eye drops; group 2, PDT at 150 J/cm; and group 3, combined PDT and topical bevacizumab treatment. All 15 left eyes formed a control group. After 2 weeks of treatment, digital photographs were obtained and analyzed to determine the area of corneal neovascularization. The rabbits were then killed to measure vascular endothelial growth factor (VEGF) levels in corneal tissues. RESULTS The corneal neovascularization area after treatment was significantly smaller in the 3 treatment groups compared with that in the control group. A significant difference was observed between groups 1 and 2 and group 3, but not between groups 1 and 2. VEGF levels were significantly lower in groups 1 and 3 than in the control group. Although group 2 exhibited relatively higher VEGF levels compared with the control group, the difference was not significant. CONCLUSIONS Our results suggest that combined PDT and topical bevacizumab treatment is significantly more effective than monotherapy for the treatment of corneal neovascularization in rabbits. Such quantitative comparison in the laboratory is believed to provide the theoretical basis for clinical application of combined PDT and topical bevacizumab treatment.
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Cakmak H, Gokmen E, Bozkurt G, Kocaturk T, Ergin K. Effects of sunitinib and bevacizumab on VEGF and miRNA levels on corneal neovascularization. Cutan Ocul Toxicol 2017; 37:191-195. [DOI: 10.1080/15569527.2017.1375943] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Harun Cakmak
- Department of Ophthalmology, Adnan Menderes University Medical Faculty, Aydin, Turkey
| | - Esra Gokmen
- Department of Histology and Embryology, Adnan Menderes University Medical Faculty, Aydin, Turkey
| | - Gokay Bozkurt
- Department of Medical Genetics, Adnan Menderes University Medical Faculty, Aydin, Turkey
| | - Tolga Kocaturk
- Department of Ophthalmology, Adnan Menderes University Medical Faculty, Aydin, Turkey
| | - Kemal Ergin
- Department of Histology and Embryology, Adnan Menderes University Medical Faculty, Aydin, Turkey
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Liu X, Wang S, Wang X, Liang J, Zhang Y. Recent drug therapies for corneal neovascularization. Chem Biol Drug Des 2017; 90:653-664. [PMID: 28489275 DOI: 10.1111/cbdd.13018] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 04/17/2017] [Accepted: 04/25/2017] [Indexed: 12/18/2022]
Affiliation(s)
- Xinyao Liu
- Department of Ophthalmology; The 2nd Teaching Hospital of Jilin University; Changchun Jilin China
| | - Shurong Wang
- Department of Ophthalmology; The 2nd Teaching Hospital of Jilin University; Changchun Jilin China
| | - Xuanzhong Wang
- Department of Ophthalmology; The 2nd Teaching Hospital of Jilin University; Changchun Jilin China
| | - Jiaming Liang
- Department of Ophthalmology; The 2nd Teaching Hospital of Jilin University; Changchun Jilin China
| | - Yan Zhang
- Department of Ophthalmology; The 2nd Teaching Hospital of Jilin University; Changchun Jilin China
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Comparison of Topical Low-Molecular-Weight Heparin-Taurocholate and Bevacizumab for Treatment and Prevention of Corneal Neovascularization. Cornea 2016; 36:497-501. [PMID: 27941385 DOI: 10.1097/ico.0000000000001105] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
PURPOSE To compare the therapeutic and preventive effects of topically administered 7-taurocholic acid-conjugated low-molecular-weight heparin (LHT7) and bevacizumab in experimentally induced corneal neovascularization (CoNV). METHODS CoNV was induced using sutures in the right eyes of 24 mice. To investigate the therapeutic effects, CoNV was allowed to develop for 1 week before treatment. To ascertain the preventive effects, the treatments were applied immediately after the suture. In each experiment, 12 eyes were divided into 3 groups and treated topically using bevacizumab (bevacizumab group), LHT7 (LHT7 group), and normal saline (control group). The treatments were instilled 3 times daily for 2 weeks. The CoNV area was measured before instillation and after 1 and 2 weeks after instillation. RESULTS In the investigation of therapeutic effects, the CoNV area had decreased significantly 1 week after treatment in the bevacizumab group (1.58-0.75 mm; P = 0.036) and LHT7 group (1.38-0.74 mm; P = 0.018). Two weeks after treatment, the CoNV area was significantly smaller in the bevacizumab groups (0.60 mm; P = 0.005) and LHT7 group (0.64 mm; P = 0.015) than in the control group (1.68 mm), but the bevacizumab group did not differ significantly from the LHT7 group. In the experiment addressing the preventive effects, CoNV was less developed in the bevacizumab group (0.70 mm; P = 0.003) and LHT7 group (0.54 mm; P = 0.003) than in the control group (1.75 mm), and the CoNV area was smaller in the LHT7 group than in the bevacizumab group (P = 0.021). CONCLUSIONS The effects of LHT7 on CoNV regression are comparable to those of bevacizumab. Topical administration of LHT7 prevents CoNV more effectively than bevacizumab.
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Subhani S, Vavilala DT, Mukherji M. HIF inhibitors for ischemic retinopathies and cancers: options beyond anti-VEGF therapies. Angiogenesis 2016; 19:257-73. [DOI: 10.1007/s10456-016-9510-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 04/16/2016] [Indexed: 12/15/2022]
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Abstract
PURPOSE To examine the inhibitory effect of topical aflibercept [vascular endothelial growth factor (VEGF) trapR1R2] on corneal neovascularization (NV) in rabbits. METHODS Corneal NV was induced in 24 eyes of 12 rabbits. Seven days after a silk suture in the corneal stroma, the rabbits were divided into 4 groups of 6 eyes each. Two groups were treated with topical aflibercept at 2 different concentrations: 2 mg/0.5 mL (0.1%, group 1) and 2 mg/5 mL (0.01%, group 2). The other 2 groups were treated with topical bevacizumab 2.5 mg/1 mL (0.1%, group 3) and topical balanced salt solution (group 4, control). The concentration of VEGF and placental growth factor (PIGF) messenger RNA (mRNA) was measured by reverse transcriptase-polymerase chain reaction. RESULTS The surface area of NV was significantly smaller in the treatment groups compared with that of the control group. The expression of VEGF mRNA was 0.227 in 0.1% aflibercept (group 1), 0.811 in 0.01% aflibercept (group 2), and 0.495 in 0.1% bevacizumab (group 3). There was a significant decrease in the VEGF concentration in all 3 treatment groups compared with the control group, 1.491 (P = 0.031, <0.05). In the 0.01% aflibercept group, the difference was less than that of the 0.1% aflibercept and 0.1% bevacizumab groups. There was no significant difference in the 0.1% aflibercept and 0.1% bevacizumab groups. The expression of PIGF mRNA was 0.791 in 0.1% aflibercept (group 1), 0.743 in 0.01% aflibercept (group 2), 1.194 in 0.1% bevacizumab (group 3), and 1.458 in the control group. The expression of PIGF mRNA was significantly decreased in the 0.1% aflibercept and 0.01% aflibercept groups. CONCLUSIONS Topical aflibercept may have an inhibitory effect on corneal NV in rabbits.
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Abstract
PURPOSE To compare the antiangiogenic effects of tacrolimus and bevacizumab on corneal neovascularization (CNV) in rabbits. METHODS Neovascularization was induced in 32 eyes of 16 rabbits by placing a suture in the corneal stroma. Seven days after suture placement, all rabbits were divided into 4 groups and were treated subconjunctivally with bevacizumab (AVA_sub) 0.05 mL (5 mg/0.05 mL), tacrolimus (TAC_sub) 0.05 mL (0.25 mg/0.05 mL), balanced salt solution (0.05 mL was subconjunctivally injected in 1 eye of each rabbit and applied by eye drops in the other eyes, control group), and tacrolimus eye drops (TAC_drop) (5 mg/5 mL applied 4 times daily). Digital photographs were obtained and surface area of CNV was measured 7 days after subconjunctival injections. Corneal specimens were analyzed histopathologically and were used to measure the concentration of vascular endothelial growth factor (VEGF), tumor necrosis factor alpha (TNF-α), interferon gamma (IFN-γ), interleukin-1 beta (IL-1β), and monocyte chemoattractant protein 1 mRNA by reverse transcription polymerase chain reaction. RESULTS In digital photographs, the neovascularized area was decreased in all treatment groups (AVA_sub, 0.58; TAC_sub, 0.60; TAC_drop, 0.68) compared with the control group (balanced salt solution, 0.81). Histological examination showed markedly regressed new vessels in treatment groups, and immunohistochemical staining revealed weakly stained anti-VEGF and anti-F4/80 antibodies in treatment groups. In semiquantitative reverse transcription polymerase chain reaction, concentration of VEGF (AVA_sub, 0.24; TAC_drop, 0.18), TNF-α (AVA_sub, 0.19; TAC_sub, 0.24; TAC_drop 0.15), and IL-1β (AVA_sub, 0.19; TAC_sub, 0.33; TAC_drop, 0.18) mRNA were significantly lower in treatment groups than in the control group (VEGF, 0.47; TNF-α, 0.44; IL-1β, 0.87) (P < 0.05). CONCLUSIONS Topical and subconjunctival tacrolimus application may be useful in reducing CNV and have comparable effects to subconjunctival bevacizumab injection.
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Çakmak H, Ergin K, Bozkurt G, Kocatürk T, Evliçoğlu GE. The effects of topical everolimus and sunitinib on corneal neovascularization. Cutan Ocul Toxicol 2015; 35:97-103. [PMID: 25864572 DOI: 10.3109/15569527.2015.1034360] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
PURPOSE To evaluate the effects of topical everolimus and sunitinib on corneal neovascularization (CNV). METHODS CNV was induced by application of silver nitrate to the cornea for all groups. Rats were divided into four groups of 10 rats each, and two corneas were obtained from each rat. Group I received 1 mg/ml everolimus, Group II received 0.5 mg/ml sunitinib, Group IV received no treatment (control group) and Group IV received 1% Dimethylsulfoxide (DMSO). All treatments were administrated twice daily for 2 weeks. The right corneas were used for extracellular signal-regulated kinase 1/2 (ERK 1/2) protein analysis by western blot analysis and the left corneas were used for ERK 1/2 and vascular endothelial growth factor-receptor (VEGFR-2) gene expression analysis by quantitative real-time PCR. RESULTS VEGFR-2 mRNA expression levels (ΔCt, median, min-max) were reduced in the everolimus 1.0 (0.25-1.81) and sunitinib 1.06 (0.24-2.68) treated groups compared with the control 4.74 (1.02-14.74) and DMSO groups 7.41 (0.72-13.10). The expression of ERK 1/2 protein and mRNA levels were reduced in everolimus group compared with the control group (p < 0.05). These differences were not seen between the sunitinib and control groups. CONCLUSION Topical administration of both everolimus and sunitinib reduced VEGFR-2 levels and inhibited CNV. In additon, everolimus reduced ERK 1/2 levels and seems to be more effective than sunitinib on CNV.
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Affiliation(s)
| | - Kemal Ergin
- b Department of Histology and Embryology , and
| | - Gökay Bozkurt
- c Department of Genetics, Adnan Menderes University Medical Faculty , Aytepe , Aydin , Turkey
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Choi BH, Choi KH, Lee HS, Song BR, Park SR, Yang JW, Min BH. Inhibition of blood vessel formation by a chondrocyte-derived extracellular matrix. Biomaterials 2014; 35:5711-20. [PMID: 24768193 DOI: 10.1016/j.biomaterials.2014.03.083] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Accepted: 03/28/2014] [Indexed: 12/20/2022]
Abstract
In this study, the chondrocyte-derived extracellular matrix (CECM) was evaluated for its activity to inhibit vessel invasion in vitro and in vivo. Human umbilical vein endothelial cells (HUVECs) and rabbit chondrocytes were plated on a bio-membrane made of CECM or human amniotic membrane (HAM). The adhesion, proliferation, and tube formation activity of HUVECs and chondrocytes were examined. The CECM and HAM powders were then mixed individually in Matrigel and injected subcutaneously into nude mice to examine vessel invasion in vivo after 1 week. Finally, a rabbit model of corneal neovascularization (NV) was induced by 3-point sutures in the upper cornea, and CECM and HAM membranes were implanted onto the corneal surface at day 5 after suture injury. The rabbits were sacrificed at 7 days after transplantation and the histopathological analysis was performed. The adhesion and proliferation of HUVECs were more efficient on the HAM than on the CECM membrane. However, chondrocytes on each membrane showed an opposite result being more efficient on the CECM membrane. The vessel invasion in vivo also occurred more deeply and intensively in Matrigel containing HAM than in the one containing CECM. In the rabbit NV model, CECM efficiently inhibited the neovessels formation and histological remodeling in the injured cornea. In summary, our findings suggest that CECM, an integral cartilage ECM composite, shows an inhibitory effect on vessel invasion both in vitro and in vivo, and could be a useful tool in a variety of biological and therapeutic applications including the prevention of neovascularization after cornea injury.
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Affiliation(s)
- Byung Hyune Choi
- Department of Advanced Biomedical Sciences, College of Medicine, Inha University, Incheon, Republic of Korea
| | - Kyoung-Hwan Choi
- Department of Molecular Science and Technology, Ajou University, Suwon, Republic of Korea; Cell Therapy Center, Ajou Medical Center, Suwon, Republic of Korea
| | - Hye Sook Lee
- Ocular Neovascular Disease Research Center, Inje University Busan Paik Hospital, Busan, Republic of Korea
| | - Bo Ram Song
- Department of Molecular Science and Technology, Ajou University, Suwon, Republic of Korea; Cell Therapy Center, Ajou Medical Center, Suwon, Republic of Korea
| | - So Ra Park
- Department of Physiology, College of Medicine, Inha University, Incheon, Republic of Korea
| | - Jae Wook Yang
- Ocular Neovascular Disease Research Center, Inje University Busan Paik Hospital, Busan, Republic of Korea; Department of Ophthalmology, Inje University College of Medicine, Busan Paik Hospital, Busan, Republic of Korea.
| | - Byoung-Hyun Min
- Department of Molecular Science and Technology, Ajou University, Suwon, Republic of Korea; Cell Therapy Center, Ajou Medical Center, Suwon, Republic of Korea; Department of Orthopedic Surgery, School of Medicine, Ajou University, Suwon, Republic of Korea.
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