Rutland Catrin S, Jiang Keyi, Soff Gerald A, Mitchell Christopher A
Academic Division of Obstetrics and Gynaecology, Nottingham City Hospital, University of Nottingham, Nottingham, UK.
Mol Vis. 2009 Jun 26;15:1260-9.
Agents specifically targeting the vasculature as a mode of therapy are finding increasing use in the clinic, primarily in the treatment of colon cancer (Avastin) and age-related macular degeneration (Lucentis). We have previously shown that maternal administration of angiogenic inhibitors (TNP-470 [O-[chloroacetyl-carbamoyl]fumagillol, initially called AGM-1470], the first angiogenic inhibitor to undergo clinical trials, and Angiostatin(4.5), currently in phase I-III clinical trials) cause fetal growth restriction and/or placental abnormalities. During a rapid growth phase of ocular development in the mouse (embryonic days 12 to 19 [E12-E19]), the placenta mediates the metabolic requirements of the fetus and consequently may impact upon the growth of the highly oxygen sensitive fetal eye.
We injected pregnant dams (between E10.5 - E18.5) with anti-angiogenic agents, which caused either a placental insufficiency type of IUGR (intrauterine growth restriction; i.e., TNP-470) or frank placental pathology (Angiostatin(4.5) [AS(4.5)]), and assessed changes in absolute ocular dimensions, tissue types, and vascular profiles using stereological techniques.
The experiments showed that ocular volumes were significantly reduced in fetal mice where dams were treated with either TNP-470 or AS(4.5). Furthermore, TNP-470 specifically caused a reduction in hyaloid blood vessel length and volume, the only intraocular vascular circulation in fetal mice.
These experiments support the hypothesis that the angiogenic inhibitors (specifically TNP-470 and AS(4.5)) induce microphthalmia either indirectly by their known effects on placental morphology (and/or function) or directly via altering microvascular growth in the fetus. These results also warrant further investigation of a new experimental paradigm linking placental pathology-related fetal growth restriction and microphthalmia.
作为一种治疗方式,专门靶向脉管系统的药物在临床上的应用越来越广泛,主要用于治疗结肠癌(阿瓦斯汀)和年龄相关性黄斑变性(雷珠单抗)。我们之前已经表明,母体给予血管生成抑制剂(TNP - 470 [O - [氯乙酰 - 氨基甲酰]烟曲霉素,最初称为AGM - 1470,首个进入临床试验的血管生成抑制剂,以及血管抑素(4.5),目前处于I - III期临床试验阶段])会导致胎儿生长受限和/或胎盘异常。在小鼠眼部发育的快速生长阶段(胚胎第12至19天[E12 - E19]),胎盘介导胎儿的代谢需求,因此可能会影响对氧气高度敏感的胎儿眼睛的生长。
我们在怀孕母鼠(E10.5 - E18.5之间)注射抗血管生成药物,这些药物会导致胎盘功能不全型宫内生长受限(IUGR;即TNP - 470)或明显的胎盘病理改变(血管抑素(4.5) [AS(4.5)]),并使用体视学技术评估绝对眼尺寸、组织类型和血管分布的变化。
实验表明,用TNP - 470或AS(4.5)处理母鼠后,胎鼠的眼体积显著减小。此外,TNP - 470特别导致玻璃样血管长度和体积减少,玻璃样血管是胎鼠唯一的眼内血管循环。
这些实验支持以下假设:血管生成抑制剂(特别是TNP - 470和AS(4.5))通过其对胎盘形态(和/或功能)的已知影响间接诱导小眼畸形,或直接通过改变胎儿的微血管生长来诱导小眼畸形。这些结果也值得进一步研究将胎盘病理相关的胎儿生长受限与小眼畸形联系起来的新实验范式。