Zhang Yin, Yang Yunlong, Hosaka Kayoko, Huang Guichun, Zang Jingwu, Chen Fang, Zhang Yun, Samani Nilesh J, Cao Yihai
Department of Microbiology, Tumor and Cell Biology, Karolinska Institute, 171 77 Stockholm, Sweden;
BioSciKin Biopharma, Nanjing, Jiangsu 210042, People's Republic of China;
Proc Natl Acad Sci U S A. 2016 Apr 12;113(15):4158-63. doi: 10.1073/pnas.1601649113. Epub 2016 Mar 28.
Anti-VEGF-based antiangiogenic drugs are designed to block tumor angiogenesis for treatment of cancer patients. However, anti-VEGF drugs produce off-tumor target effects on multiple tissues and organs and cause broad adverse effects. Here, we show that vasculatures in endocrine organs were more sensitive to anti-VEGF treatment than tumor vasculatures. In thyroid, adrenal glands, and pancreatic islets, systemic treatment with low doses of an anti-VEGF neutralizing antibody caused marked vascular regression, whereas tumor vessels remained unaffected. Additionally, a low dose of VEGF blockade significantly inhibited the formation of thyroid vascular fenestrae, leaving tumor vascular structures unchanged. Along with vascular structural changes, the low dose of VEGF blockade inhibited vascular perfusion and permeability in thyroid, but not in tumors. Prolonged treatment with the low-dose VEGF blockade caused hypertension and significantly decreased circulating levels of thyroid hormone free-T3 and -T4, leading to functional impairment of thyroid. These findings show that the fenestrated microvasculatures in endocrine organs are more sensitive than tumor vasculatures in response to systemic anti-VEGF drugs. Thus, our data support the notion that clinically nonbeneficial treatments with anti-VEGF drugs could potentially cause adverse effects.
基于抗血管内皮生长因子(VEGF)的抗血管生成药物旨在通过阻断肿瘤血管生成来治疗癌症患者。然而,抗VEGF药物会对多种组织和器官产生肿瘤外靶点效应,并引发广泛的不良反应。在此,我们表明内分泌器官中的血管系统对抗VEGF治疗比肿瘤血管系统更敏感。在甲状腺、肾上腺和胰岛中,低剂量抗VEGF中和抗体的全身治疗导致明显的血管消退,而肿瘤血管则不受影响。此外,低剂量的VEGF阻断显著抑制了甲状腺血管窗孔的形成,而肿瘤血管结构未发生变化。伴随血管结构变化,低剂量的VEGF阻断抑制了甲状腺的血管灌注和通透性,但对肿瘤无此作用。低剂量VEGF阻断的长期治疗导致高血压,并显著降低循环中甲状腺激素游离T3和T4的水平,从而导致甲状腺功能受损。这些发现表明,内分泌器官中的有窗孔微血管系统在对全身抗VEGF药物的反应中比肿瘤血管系统更敏感。因此,我们的数据支持这样一种观点,即抗VEGF药物在临床上无益处的治疗可能会潜在地导致不良反应。