维替泊芬光动力疗法后脉络膜新生血管膜中VEGF和PEDF的表达

Expression of VEGF and PEDF in choroidal neovascular membranes following verteporfin photodynamic therapy.

作者信息

Tatar Olcay, Adam Annemarie, Shinoda Kei, Stalmans Peter, Eckardt Claus, Lüke Matthias, Bartz-Schmidt Karl Ulrich, Grisanti Salvatore

机构信息

University Eye Clinic, Centre for Ophthalmology, Eberhard-Karls University, Tuebingen, Germany.

出版信息

Am J Ophthalmol. 2006 Jul;142(1):95-104. doi: 10.1016/j.ajo.2006.01.085.

DOI:10.1016/j.ajo.2006.01.085

PMID:16815256

Abstract

PURPOSE

To examine the impact of photodynamic therapy (PDT) on pigment epithelium derived factor (PEDF) expression in human choroidal neovascularization (CNV) membranes with regard to vascular endothelial growth factor (VEGF) expression.

DESIGN

Interventional case series.

METHODS

Retrospective review of interventional case series of 42 patients (42 eyes) who underwent removal of CNV. CNV was secondary to age-related macular degeneration (AMD) in all cases. Fifteen patients were treated with PDT, 3 to 246 days before surgery. CNV were stained for CD34, CD105, cytokeratin 18, VEGF, and PEDF. Twenty-seven CNV without previous treatment were used as control.

RESULTS

Specimens without pretreatment disclosed varying degrees of vascularization, VEGF, and PEDF expression by different cells. Specimens treated by PDT, three days previously showed mostly occluded vessels lined with damaged endothelial cells (EC). In contrast, specimens excised at later time points after PDT were highly vascularized with healthy EC. This chronology was associated with an impressive VEGF immunoreactivity increased considerably in retinal pigment epithelial cells as well as significantly reduced PEDF expression in EC and stroma.

CONCLUSIONS

PDT induces a selective vascular damage in CNV. The effectiveness of PDT, however, seems to be jeopardized by a rebound effect initiated by an enhanced VEGF and reduced PEDF expression in CNV.

摘要

目的

探讨光动力疗法（PDT）对人脉络膜新生血管（CNV）膜中色素上皮衍生因子（PEDF）表达的影响，并研究其与血管内皮生长因子（VEGF）表达的关系。

设计

干预性病例系列研究。

方法

回顾性分析42例（42只眼）接受CNV切除手术患者的干预性病例系列。所有病例的CNV均继发于年龄相关性黄斑变性（AMD）。15例患者在手术前3至246天接受了PDT治疗。对CNV进行CD34、CD105、细胞角蛋白18、VEGF和PEDF染色。将27例未经治疗的CNV作为对照。

结果

未经预处理的标本显示不同细胞具有不同程度的血管化、VEGF和PEDF表达。术前三天接受PDT治疗的标本大多显示血管闭塞，内皮细胞（EC）受损。相比之下，PDT治疗后较晚时间点切除的标本血管高度化，EC健康。这种时间顺序与视网膜色素上皮细胞中VEGF免疫反应性显著增加以及EC和基质中PEDF表达显著降低有关。