The Center for Nanomedicine, The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Graybug Vision, Inc., Redwood City, CA, USA.
Nat Commun. 2020 Feb 4;11(1):694. doi: 10.1038/s41467-020-14340-x.
Neovascular age-related macular degeneration and diabetic retinopathy are prevalent causes of vision loss requiring frequent intravitreous injections of VEGF-neutralizing proteins, and under-treatment is common and problematic. Here we report incorporation of sunitinib, a tyrosine kinase inhibitor that blocks VEGF receptors, into a non-inflammatory biodegradable polymer to generate sunitinib microparticles specially formulated to self-aggregate into a depot. A single intravitreous injection of sunitinib microparticles potently suppresses choroidal neovascularization in mice for six months and in another model, blocks VEGF-induced leukostasis and retinal nonperfusion, which are associated with diabetic retinopathy progression. After intravitreous injection in rabbits, sunitinib microparticles self-aggregate into a depot that remains localized and maintains therapeutic levels of sunitinib in retinal pigmented epithelium/choroid and retina for more than six months. There is no intraocular inflammation or retinal toxicity. Intravitreous injection of sunitinib microparticles provides a promising approach to achieve sustained suppression of VEGF signaling and improve outcomes in patients with retinal vascular diseases.
新生血管性年龄相关性黄斑变性和糖尿病性视网膜病变是导致视力丧失的常见原因,需要频繁进行玻璃体内注射 VEGF 中和蛋白,但治疗不足的情况很常见,且存在问题。在此,我们报告将舒尼替尼(一种可阻断 VEGF 受体的酪氨酸激酶抑制剂)掺入非炎症性可生物降解聚合物中,生成舒尼替尼微粒,专门设计用于自聚集形成储库。单次玻璃体内注射舒尼替尼微粒可在六个月内有效抑制小鼠脉络膜新生血管生成,并在另一种模型中阻断 VEGF 诱导的白细胞淤滞和视网膜无灌注,这与糖尿病性视网膜病变的进展有关。在兔子中玻璃体内注射后,舒尼替尼微粒自聚集形成储库,该储库保持局部定位,并在超过六个月的时间内维持视网膜色素上皮/脉络膜和视网膜中舒尼替尼的治疗水平。没有眼内炎症或视网膜毒性。玻璃体内注射舒尼替尼微粒为实现持续抑制 VEGF 信号传导和改善视网膜血管疾病患者的预后提供了一种很有前途的方法。
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