Kubicka-Trząska Agnieszka, Wilańska Joanna, Romanowska-Dixon Bożena, Sanak Marek
Department of Ophthalmology and Ocular Oncology, Jagiellonian University Medical College, Krakow, Malopolska, Poland.
Division of Molecular Biology and Clinical Genetics, Jagiellonian University Medical College, Krakow, Malopolska, Poland.
Acta Ophthalmol. 2016 Nov;94(7):e617-e623. doi: 10.1111/aos.13033. Epub 2016 Jun 22.
To analyse the prevalence and changes in circulating anti-endothelial cell antibodies (AECA) during anti-vascular endothelial growth factor (anti-VEGF) therapy.
Ninety-eight patients with exudative age-related macular degeneration (AMD) were treated with intravitreal bevacizumab. Fifty sex- and age-matched healthy subjects were used as controls. Serum AECA were detected using indirect immunofluorescence on primate skeletal muscle and cultivated human umbilical vein endothelial cells (HUVEC). These investigations were repeated at 4-week intervals within 8 months of follow-up.
At baseline examination, 30 of the 98 patients (30.6%) were positive for AECA. The titres of AECA ranged from 1:10 to 1:320. In the control group, AECA were present in only nine sera (18%) with titres ranging between 1:20 and 1:80 (p = 0.0000). The greatest rates of reduction of AECA titres were observed during the 'loading' phase of therapy. During the 'maintenance' phase, the rates of changes in serum AECA levels were less significant and remained constant. In follow-up period in 13 patients (13.3%), serum AECA were detected de novo in titres of 1:10 to 1:80. Statistical analysis did not show any significant correlation between the presence of AECA and activity of the disease.
There is growing evidence that AMD is an immune-mediated disease, and thus it cannot be excluded that AECA may be involved in its pathogenesis and progression. We also speculate that AECA develop in response to retinal damage and anti-VEGF therapy.
分析抗血管内皮生长因子（抗VEGF）治疗期间循环抗内皮细胞抗体（AECA）的患病率及变化情况。
98例渗出性年龄相关性黄斑变性（AMD）患者接受玻璃体内注射贝伐单抗治疗。选取50名年龄和性别匹配的健康受试者作为对照。采用间接免疫荧光法在灵长类动物骨骼肌和培养的人脐静脉内皮细胞（HUVEC）上检测血清AECA。在随访的8个月内，每隔4周重复进行这些检测。
在基线检查时，98例患者中有30例（30.6%）AECA呈阳性。AECA滴度范围为1:10至1:320。在对照组中，仅9份血清（18%）中存在AECA，滴度在1:20至1:80之间（p = 0.0000）。在治疗的“负荷”阶段观察到AECA滴度下降幅度最大。在“维持”阶段，血清AECA水平的变化率不太显著且保持稳定。在随访期间，13例患者（13.3%）血清中首次检测到AECA，滴度为1:10至1:80。统计学分析未显示AECA的存在与疾病活动之间有任何显著相关性。
越来越多的证据表明AMD是一种免疫介导的疾病，因此不能排除AECA可能参与其发病机制和进展。我们还推测AECA是对视网膜损伤和抗VEGF治疗的反应而产生的。
