MPH Department, Shiraz University of Medical Sciences, Shiraz, Iran.
Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
Ophthalmic Res. 2024;67(1):358-386. doi: 10.1159/000539377. Epub 2024 May 21.
Anti-vascular endothelial growth factor (anti-VEGF) agents have a variable effect on patients with age-related macular degeneration (AMD) that has been attributed to several causes, including genetic factors. We evaluated the effects of Complement Factor H (CFH) rs1061170/Y402H polymorphism on the response to anti-VEGF therapy among AMD patients.
PubMed, Scopus, EMBASE, Web of Science, and Google Scholar were used for a literature search. Pooled odds ratios (ORs) and their 95% confidence intervals (CIs) were estimated to assess the effects of CFH Y402H polymorphism on the response to anti-VEGF therapy in AMD. I2 was used to present the amount of heterogeneity. We used STATA version 14.0 software.
Twenty-five papers reporting data for 4,681 patients were included in this study. Better response to anti-VEGF therapy was seen in T over C (OR = 1.25, 95% CI = 1.04-1.50), TT over CC (OR = 1.60, 95% CI = 1.06-2.4), and TT + TC over CC (OR = 1.68, 95% CI = 1.23-2.28) genotypes. There was no significant difference in the three other genetic models (TT vs. TC, TT vs. TC + CC, TC vs. TT + CC). In Asians, no significant difference was observed in all six genetic models. Ranibizumab and bevacizumab had similar efficacy; however, conbercept was more effective in homozygous genotypes. The literature indicated that TT and TC genotypes and T allele were associated with a better functional response, while the CC genotype and C alleles had a better anatomical response. The combination of risk alleles in ARMS2 A69S (rs10490924), VEGF-A (rs699947), and VEGF-A (rs833069) with Y420H is a predictor of non-respondents.
In patients with AMD, the CFH Y402H is a predictor of the response to anti-VEGF agents and should be considered in the treatment plan.
抗血管内皮生长因子（anti-VEGF）药物对年龄相关性黄斑变性（AMD）患者的疗效存在差异，这归因于多种原因，包括遗传因素。我们评估了补体因子 H（CFH）rs1061170/Y402H 多态性对 AMD 患者抗 VEGF 治疗反应的影响。
使用 PubMed、Scopus、EMBASE、Web of Science 和 Google Scholar 进行文献检索。采用合并优势比（OR）及其 95%置信区间（CI）评估 CFH Y402H 多态性对 AMD 患者抗 VEGF 治疗反应的影响。采用 I2 表示异质性程度。使用 STATA 版本 14.0 软件。
本研究纳入了 25 篇报告了 4681 例患者数据的文献。与 C 相比，T 等位基因（OR=1.25，95%CI=1.04-1.50）、TT 基因型比 CC 基因型（OR=1.60，95%CI=1.06-2.4）、TT+TC 基因型比 CC 基因型（OR=1.68，95%CI=1.23-2.28）对治疗反应更好。在其他三种遗传模型中（TT 与 TC、TT 与 TT+CC、TC 与 TT+CC），未观察到显著差异。在亚洲人群中，在所有 6 种遗传模型中均未观察到显著差异。雷珠单抗和贝伐珠单抗疗效相似，但康柏西普在纯合子基因型中更有效。文献表明 TT 和 TC 基因型和 T 等位基因与更好的功能反应相关，而 CC 基因型和 C 等位基因与更好的解剖学反应相关。ARMS2 A69S（rs10490924）、VEGF-A（rs699947）和 VEGF-A（rs833069）与 Y420H 的风险等位基因组合是无应答者的预测因子。
在 AMD 患者中，CFH Y402H 是抗 VEGF 药物反应的预测因子，应在治疗计划中考虑。
