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用于新生血管性年龄相关性黄斑变性的白细胞介素-18免疫疗法:非人灵长类动物的耐受性和疗效

IL-18 Immunotherapy for Neovascular AMD: Tolerability and Efficacy in Nonhuman Primates.

作者信息

Doyle Sarah L, López Francisco J, Celkova Lucia, Brennan Kiva, Mulfaul Kelly, Ozaki Ema, Kenna Paul F, Kurali Edit, Hudson Natalie, Doggett Teresa, Ferguson Thomas A, Humphries Peter, Adamson Peter, Campbell Matthew

机构信息

Department of Clinical Medicine School of Medicine, Trinity College Dublin, Dublin, Ireland.

Ophthalmology Discovery Performance Unit, GlaxoSmithKline, King of Prussia, Pennsylvania, United States.

出版信息

Invest Ophthalmol Vis Sci. 2015 Aug;56(9):5424-30. doi: 10.1167/iovs.15-17264.

Abstract

PURPOSE

Age-related macular degeneration is the most common form of central retinal blindness in the elderly. Of the two end stages of disease, neovascular AMD-although the minority form-is the most severe. Current therapies are highly successful at controlling progression of neovascular lesions; however, a significant number of patients remain refractory to treatment and the development of alternative and additive therapies to anti-VEGFs is essential.

METHODS

In order to address the translational potential of interleukin (IL)-18 for use in neovascular AMD, we initiated a nonhuman primate tolerability and efficacy study for the use of intravitreally (IVT) administered clinical grade human IL-18 (SB-485232). Cynomolgus monkeys were injected IVT with increasing doses of human IL-18 (two each at 1000, 3000, and 10,000 ng per eye). In tandem, 21 monkeys were administered nine laser burns in each eye prior to receiving IL-18 as an IVT injection at a range of doses. Fundus fluorescein angiography (FFA) was performed on days 8, 15, and 22 post injection and the development of neovascular lesions was assessed.

RESULTS

We show intravitreal, mature, recombinant human IL-18 is safe and can reduce choroidal neovascular lesion development in cynomolgus monkeys.

CONCLUSIONS

Based on our data comparing human IL-18 to current anti-VEGF-based therapy, clinical deployment of IL-18 for neovascular AMD has the potential to lead to a new adjuvant immunotherapy-based treatment for this severe form of central blindness.

摘要

目的

年龄相关性黄斑变性是老年人中心性视网膜失明最常见的形式。在该疾病的两个终末期阶段中,新生血管性年龄相关性黄斑变性(neovascular AMD,nAMD)虽然是少数形式,但却是最严重的。目前的治疗方法在控制新生血管病变进展方面非常成功;然而,相当数量的患者对治疗仍然无效,因此开发抗血管内皮生长因子(anti-VEGFs)的替代疗法和辅助疗法至关重要。

方法

为了探讨白细胞介素(IL)-18用于治疗nAMD的转化潜力,我们启动了一项非人类灵长类动物耐受性和疗效研究,以评估玻璃体内(IVT)注射临床级人IL-18(SB-485232)的效果。食蟹猴接受不同剂量递增的人IL-18玻璃体内注射(每只眼睛分别注射1000、3000和10000 ng,各两只)。同时,21只猴子在接受不同剂量的IL-18玻璃体内注射前,每只眼睛接受9次激光烧灼。在注射后第8、15和22天进行眼底荧光血管造影(FFA),并评估新生血管病变的发展情况。

结果

我们发现玻璃体内注射成熟的重组人IL-18是安全的,并且可以减少食蟹猴脉络膜新生血管病变的发展。

结论

基于我们将人IL-18与目前基于抗VEGF的治疗方法进行比较的数据,IL-18用于治疗nAMD的临床应用有可能为这种严重的中心性失明形式带来一种新的基于辅助免疫疗法的治疗方法。

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