Michels Stephan, Schmidt-Erfurth Ursula, Rosenfeld Philip J
Klinik für Augenheilkunde und Optometrie, Medizinische Universität Wien, Währinger Gürtel 18-20, Allgemeines Krankenhaus 8i, 1090 Wien/Vienna, Austria.
Expert Opin Investig Drugs. 2006 Jul;15(7):779-93. doi: 10.1517/13543784.15.7.779.
Angiogenesis, the growth of new blood vessels from existing blood vessels, is responsible for vision loss in a variety of ophthalmic diseases. In neovascular age-related macular degeneration (AMD), the leading cause for legal blindness in many industrialised countries, abnormal blood vessels grow in the macula and cause blindness. There are a number of factors important in the angiogenic cascade but VEGF-A has been implicated in recent years as the major factor responsible for neovascular and exudative diseases of the eye. Numerous antiangiogenic drugs are in development but anti-VEGF drugs have shown great promise in treating neovascular AMD and other ocular diseases, and many of these drugs have been adopted from oncology where antiangiogenic therapy is gaining wide acceptance. For the first time in neovascular AMD, anti-VEGF drugs have brought the hope of vision improvement to a significant proportion of patients. This review provides an overview on angiogenic mechanisms, potential antiangiogenic treatment strategies and different antiangiogenic drugs with special focus on neovascular AMD.
血管生成,即从现有血管生长出新的血管,是多种眼科疾病导致视力丧失的原因。在新生血管性年龄相关性黄斑变性(AMD)中,这是许多工业化国家法定失明的主要原因,黄斑区会生长出异常血管并导致失明。血管生成级联反应中有许多重要因素,但近年来,血管内皮生长因子A(VEGF-A)被认为是导致眼部新生血管和渗出性疾病的主要因素。众多抗血管生成药物正在研发中,但抗VEGF药物在治疗新生血管性AMD和其他眼部疾病方面显示出巨大潜力,其中许多药物是从肿瘤学领域借鉴而来的,抗血管生成疗法在肿瘤学领域正获得广泛认可。在新生血管性AMD中,抗VEGF药物首次给相当一部分患者带来了视力改善的希望。本综述概述了血管生成机制、潜在的抗血管生成治疗策略以及不同的抗血管生成药物,特别关注新生血管性AMD。