早产儿视网膜病变患儿血清bevacizumab（阿瓦斯汀）和血管内皮生长因子浓度。
Serum concentrations of bevacizumab (avastin) and vascular endothelial growth factor in infants with retinopathy of prematurity.
机构信息
Department of Applied Visual Science, Osaka University Graduate School of Medicine, Suita, Japan.
出版信息
Am J Ophthalmol. 2012 Feb;153(2):327-333.e1. doi: 10.1016/j.ajo.2011.07.005. Epub 2011 Sep 17.
PURPOSE
To determine the serum concentrations of bevacizumab and vascular endothelial growth factor (VEGF) in infants with retinopathy of prematurity (ROP) who received intravitreal bevacizumab; and to determine whether the changes in the serum concentration of bevacizumab were significantly correlated with the serum concentration of VEGF after intravitreal bevacizumab.
DESIGN
Case series.
METHODS
Eleven infants (4 girls and 7 boys) with ROP were studied. They received 0.25 mg or 0.5 mg of intravitreal bevacizumab to either 1 eye (unilateral cases) or both eyes (bilateral cases) with vascularly active ROP. Serum samples were collected before and 1 day, 1 week, and 2 weeks after the intravitreal bevacizumab. The serum concentrations of bevacizumab and VEGF were measured by enzyme-linked immunosorbent assay, and the correlation in the serum levels between the 2 was determined.
RESULTS
The serum concentration of bevacizumab before and 1 day, 1week, and 2 weeks after a total of 0.5 mg of intravitreal bevacizumab was 0 ng/mL, 195 ± 324 ng/mL, 946 ± 680 ng/mL, and 1214 ± 351 ng/mL, respectively. The serum bevacizumab level before and 1 day and 1 week after a total 1.0 mg of intravitreal bevacizumab was 0 ng/mL, 248 ± 174 ng/mL, and 548 ± 89 ng/mL, respectively. The serum concentration of VEGF before and 1 day, 1 week, and 2 weeks after a total of 0.5 mg intravitreal bevacizumab was 1628 ± 929 pg/mL, 427 ± 140 pg/mL, 246 ± 110 pg/mL, and 269 ± 157 pg/mL, respectively. There was a significant negative correlation (r = -0.575, P = .0125) between the serum concentration of bevacizumab and VEGF when a total of 0.25 mg or 0.5 mg of bevacizumab was injected.
CONCLUSIONS
These results indicate that bevacizumab can escape from the eye into the systemic circulation and reduce the serum level of VEGF in infants with ROP. Continued extensive evaluations of infants are warranted for possible effects after intravitreal bevacizumab in ROP patients.
目的
检测接受玻璃体内注射贝伐单抗的早产儿视网膜病变（ROP）患儿的血清贝伐单抗和血管内皮生长因子（VEGF）浓度，确定玻璃体内注射贝伐单抗后血清贝伐单抗浓度的变化与 VEGF 浓度的变化是否存在显著相关性。
设计
病例系列。
方法
本研究纳入 11 名 ROP 患儿（女 4 名，男 7 名），单侧病变患儿（4 名）或双眼病变患儿（7 名）分别玻璃体内注射 0.25 mg 或 0.5 mg 贝伐单抗。在玻璃体内注射贝伐单抗前及注射后 1 天、1 周和 2 周采集血清样本，采用酶联免疫吸附试验检测血清中贝伐单抗和 VEGF 的浓度，并分析两者之间的相关性。
结果
玻璃体内注射 0.5 mg 贝伐单抗总量后，患儿血清贝伐单抗浓度分别为 0 ng/mL、195 ± 324 ng/mL、946 ± 680 ng/mL 和 1214 ± 351 ng/mL；玻璃体内注射 1.0 mg 贝伐单抗总量后，患儿血清贝伐单抗浓度分别为 0 ng/mL、248 ± 174 ng/mL 和 548 ± 89 ng/mL。玻璃体内注射 0.5 mg 贝伐单抗总量后，患儿血清 VEGF 浓度分别为 1628 ± 929 pg/mL、427 ± 140 pg/mL、246 ± 110 pg/mL 和 269 ± 157 pg/mL；玻璃体内注射 0.25 mg 或 0.5 mg 贝伐单抗总量后，血清贝伐单抗浓度与 VEGF 浓度呈显著负相关（r = -0.575，P =.0125）。
结论
这些结果表明，贝伐单抗可从眼部进入全身循环，并降低 ROP 患儿的血清 VEGF 水平。玻璃体内注射贝伐单抗治疗 ROP 患者后，应继续对婴儿进行广泛评估，以确定可能的影响。
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