血管内皮生长因子受体的持续阻断不会损害视网膜光感受器或节细胞。
Prolonged blockade of VEGF receptors does not damage retinal photoreceptors or ganglion cells.
机构信息
Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287-9277, USA.
出版信息
J Cell Physiol. 2010 Jul;224(1):262-72. doi: 10.1002/jcp.22129.
It has recently been reported that relatively short-term inhibition of vascular endothelial growth factor (VEGF) signaling can cause photoreceptor cell death, a potentially clinically important finding since VEGF blockade has become an important modality of treatment of ocular neovascularization and macular edema. However, in a set of studies in which we achieved extended and complete blockage of VEGF-induced vascular leakage through retinal expression of a VEGF binding protein, we did not observe any toxicity to retinal neurons. To follow-up on these apparently discrepant findings, we designed a set of experiments with the kinase inhibitor SU4312, which blocks phosphorylation of VEGF receptors, to look directly for evidence of VEGF inhibition-related retinal toxicity. Using transgenic mice with sustained expression of VEGF in photoreceptors, we determined that periocular injection of 3 microg of SU4312 every 5 days markedly suppressed subretinal neovascularization, indicating effective blockade of VEGF signaling. Wild-type mice given periocular injections of 5 microg of SU4312 every 5 days for up to 12 weeks showed normal scotopic and photopic electroretinograms (ERGs), no TUNEL stained cells in the retina, and no reduction in outer nuclear layer thickness. Incubation of cultured ganglion cells or retinal cultures containing photoreceptors with high doses of SU4312 did not reduce cell viability. These data suggest that blocking VEGF signaling in the retina for up to 12 weeks does not damage photoreceptors nor alter ERG function and should reassure patients who are receiving frequent injections of VEGF antagonists for choroidal and retinal vascular diseases.
最近有报道称,血管内皮生长因子(VEGF)信号的短期抑制可能导致光感受器细胞死亡,这是一个具有潜在临床重要性的发现,因为 VEGF 阻断已成为治疗眼新生血管和黄斑水肿的重要手段。然而,在一系列研究中,我们通过视网膜表达 VEGF 结合蛋白实现了对 VEGF 诱导的血管渗漏的延长和完全阻断,但我们没有观察到对视网膜神经元的任何毒性。为了跟进这些明显不一致的发现,我们设计了一组使用激酶抑制剂 SU4312 的实验,该抑制剂可阻断 VEGF 受体的磷酸化,以直接寻找与 VEGF 抑制相关的视网膜毒性的证据。使用在光感受器中持续表达 VEGF 的转基因小鼠,我们确定,在眼周注射 3 微克的 SU4312 每 5 天,明显抑制了脉络膜新生血管,表明 VEGF 信号的有效阻断。在眼周注射 5 微克的 SU4312 每 5 天,持续 12 周的野生型小鼠显示正常的暗适应和明适应视网膜电图(ERG),视网膜中没有 TUNEL 染色的细胞,外核层厚度没有减少。用高剂量的 SU4312 孵育培养的神经节细胞或含有光感受器的视网膜培养物不会降低细胞活力。这些数据表明,在视网膜中阻断 VEGF 信号长达 12 周不会损害光感受器,也不会改变 ERG 功能,这应该使正在接受频繁 VEGF 拮抗剂注射治疗脉络膜和视网膜血管疾病的患者感到放心。