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糖尿病视网膜病变和年龄相关性黄斑变性中的血管内皮生长因子

VEGF in Diabetic Retinopathy and Age-Related Macular Degeneration.

作者信息

Callan Andrew, Heckman Justin, Tah Giani, Lopez Samantha, Valdez Laura, Tsin Andrew

机构信息

School of Medicine, The University of Texas Rio Grande Valley, Edinburg, TX 78539, USA.

出版信息

Int J Mol Sci. 2025 May 22;26(11):4992. doi: 10.3390/ijms26114992.

Abstract

Vascular endothelial growth factor (VEGF) plays a key role in angiogenesis throughout the human body, influencing countless physiological and pathological processes, including tumor growth, preeclampsia, and retinal diseases such as diabetic retinopathy (DR) and age-related macular degeneration (AMD). In DR, VEGF promotes retinal neovascularization and intraretinal fluid accumulation, leading to complications like diabetic macular edema (DME) and proliferative diabetic retinopathy (PDR). Regular intravitreal anti-VEGF injections are commonly used to manage PDR and DME, though repeated treatments are often required, and efficacy can be limited. AMD, a major cause of vision loss in older adults, is characterized by either dry or wet forms. While the dry form has not been shown to be influenced by VEGF, the choroidal neovascularization of wet AMD has strong associations with VEGF. Current treatment for wet AMD consists primarily of anti-VEGF injections, the gold standard of care, but is limited by varying patient responses, as treatments are often repeated every 4-8 weeks indefinitely. This review explores the pathogenic role of VEGF in both DR and AMD, discussing the molecular mechanisms underlying these diseases and the therapeutic approaches targeting VEGF. Despite advancements, the variability in treatment responses highlights the need for continued research to develop more effective therapies to prevent vision loss and blindness associated with these retinal diseases.

摘要

血管内皮生长因子(VEGF)在人体全身血管生成过程中发挥关键作用,影响着无数的生理和病理过程,包括肿瘤生长、先兆子痫以及视网膜疾病,如糖尿病性视网膜病变(DR)和年龄相关性黄斑变性(AMD)。在糖尿病性视网膜病变中,VEGF促进视网膜新生血管形成和视网膜内液体积聚,导致诸如糖尿病性黄斑水肿(DME)和增殖性糖尿病性视网膜病变(PDR)等并发症。玻璃体内定期注射抗VEGF药物常用于治疗PDR和DME,尽管通常需要重复治疗,且疗效可能有限。AMD是老年人视力丧失的主要原因,有干性或湿性两种形式。虽然干性AMD尚未显示受VEGF影响,但湿性AMD的脉络膜新生血管形成与VEGF密切相关。目前湿性AMD的治疗主要包括抗VEGF注射,这是护理的金标准,但由于治疗通常每4 - 8周无限期重复进行,患者反应各不相同,治疗受到限制。本综述探讨了VEGF在DR和AMD中的致病作用,讨论了这些疾病的分子机制以及针对VEGF的治疗方法。尽管取得了进展,但治疗反应的变异性凸显了继续开展研究以开发更有效疗法来预防与这些视网膜疾病相关的视力丧失和失明的必要性。

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