Tolentino Michael J, Brucker Alexander J, Fosnot Joshua, Ying Gui-Shuang, Wu I-Hui, Malik Gulraiz, Wan Shanhong, Reich Samuel J
Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania, 51 North 39th Street, Philadelphia, PA 19104, USA.
Retina. 2004 Feb;24(1):132-8. doi: 10.1097/00006982-200402000-00018.
To determine the safety and efficacy of small interfering RNA (siRNA) directed against vascular endothelial growth factor (VEGF) in a nonhuman primate model of laser-induced choroidal neovascularization (CNV).
Each animal received laser rupture of Bruch's membrane to induce CNV in both eyes. Each animal was then randomized to receive 0.05 mL of either vehicle alone or VEGF siRNA at 70 microg, 150 microg, or 350 microg in both eyes by intravitreal injection. Eyes were monitored weekly by ophthalmic examination, color photography, and fluorescein angiography for 36 days after laser injury. Electroretinograms were measured at baseline and at 5 weeks after laser. CNV on fluorescein angiograms were measured for area and graded for clinically significant leakage in a standardized, randomized, and double-masked fashion on days 15, 22, 29, and 36 after laser.
VEGF siRNA did not cause any change in electroretinographic, hemorrhage, inflammation, or clinical signs of toxicity. A single administration of VEGF siRNA significantly inhibited growth of CNV and attenuated angiographic leakage in a dose-dependent manner.
Intravitreal injection of VEGF siRNA is capable of inhibiting the growth and vascular permeability of laser-induced CNV in a nonhuman primate in a dose-dependent manner. This study demonstrates preclinical proof of a principle that supports proceeding to clinical studies of VEGF siRNA in patients with exudative age-related macular degeneration.
在激光诱导脉络膜新生血管(CNV)的非人灵长类动物模型中,确定针对血管内皮生长因子(VEGF)的小干扰RNA(siRNA)的安全性和有效性。
每只动物均接受 Bruch 膜激光破裂以诱导双眼 CNV。然后将每只动物随机分为两组,通过玻璃体腔注射,一组双眼接受 0.05 mL 单独的赋形剂,另一组双眼接受 70 μg、150 μg 或 350 μg 的 VEGF siRNA。激光损伤后 36 天,每周通过眼科检查、彩色照相和荧光素血管造影对眼睛进行监测。在基线和激光后 5 周测量视网膜电图。在激光后第 15、22、29 和 36 天,以标准化、随机化和双盲方式测量荧光素血管造影上的 CNV 面积,并对临床上显著的渗漏进行分级。
VEGF siRNA 未引起视网膜电图、出血、炎症或毒性临床体征的任何变化。单次给予 VEGF siRNA 可显著抑制 CNV 的生长,并以剂量依赖方式减轻血管造影渗漏。
玻璃体腔注射 VEGF siRNA 能够以剂量依赖方式抑制非人灵长类动物激光诱导的 CNV 的生长和血管通透性。本研究证明了一项临床前原理证据,支持对渗出性年龄相关性黄斑变性患者进行 VEGF siRNA 的临床研究。