Serum Concentrations of Bevacizumab (Avastin) and Vascular Endothelial Growth Factor in Infants With Retinopathy of Prematurity
Serum Concentrations of Bevacizumab (Avastin) and Vascular Endothelial Growth Factor in Infants With Retinopathy of Prematurity
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DOI：
10.1016/j.ajo.2011.07.005
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发表时间：
2012-02-01
影响因子：
4.2
通讯作者：
Kusaka, Shunji
中科院分区：
文献类型：
--
作者：
Sato, Tatsuhiko;Wada, Kazuko;Kusaka, Shunji
目的：检测应用贝伐单抗治疗的早产儿视网膜病变(ROP)患者的血清贝伐单抗和血管内皮生长因子(VEGF)浓度，并探讨其变化与贝伐单抗治疗后血清VEGF浓度的相关性。对于血管活动性ROP的1只眼(单眼)或双眼(双眼)，他们接受0.25 mg或0.5 mg的贝伐单抗玻璃体内注射。分别在玻璃体腔内注射贝伐单抗前、后1天、1周和2周采集血清样本。结果：玻璃体腔内注射贝伐单抗0.5 mg前、1d、1周、2周的血药浓度分别为0 ng/m L、195+/-324 ng/m l、946+/-680 ng/m l、1214+/-351 ng/m L。玻璃体腔内注射1 mg贝伐单抗前、后1天和1周的血清贝伐单抗浓度分别为0 ng/m L、248+/-174 ng/m L和548+/-89 ng/m L。玻璃体腔内注射贝伐单抗0.5 mg前、1d、1周、2周的血清VEGF浓度分别为1628+/-929pg/mL、427+/-140pg/mL、246+/-110pg/mL、269+/-157pg/mL。贝伐单抗浓度与血管内皮细胞生长因子呈显著负相关(r=-0.575.2 5，P=0.0 12 5)。结论：贝伐单抗可使ROP患儿血清血管内皮细胞生长因子水平降低，从眼内逃逸至体循环。对于ROP患者玻璃体内注射贝伐单抗后可能产生的影响，需要继续对婴儿进行广泛的评估。《眼科杂志》2012；153：327-333。(C)2012年由Elsevier Inc.保留所有权利。)
PURPOSE: To determine the serum concentrations of bevacizumab and vascular endothelial growth factor (VEGF) in infants with retinopathy of prematurity (ROP) who received intravitreal bevacizumab; and to determine whether the changes in the serum concentration of bevacizumab were significantly correlated with the serum concentration of VEGF after intravitreal bevacizumab.DESIGN: Case series.METHODS: Eleven infants (4 girls and 7 boys) with ROP were studied. They received 0.25 mg or 0.5 mg of intravitreal bevacizumab to either 1 eye (unilateral cases) or both eyes (bilateral cases) with vascularly active ROP. Serum samples were collected before and 1 day, 1 week, and 2 weeks after the intravitreal bevacizumab. The serum concentrations of bevacizumab and VEGF were measured by enzyme-linked immunosorbent assay, and the correlation in the serum levels between the 2 was determined.RESULTS: The serum concentration of bevacizumab before and 1 day, 1week, and 2 weeks after a total of 0.5 mg of intravitreal bevacizumab was 0 ng/mL, 195 +/- 324 ng/mL, 946 +/- 680 ng/mL, and 1214 +/- 351 ng/mL, respectively. The serum bevacizumab level before and 1 day and 1 week after a total 1.0 mg of intravitreal bevacizumab was 0 ng/mL, 248 +/- 174 ng/mL, and 548 +/- 89 ng/mL, respectively. The serum concentration of VEGF before and 1 day, 1 week, and 2 weeks after a total of 0.5 mg intravitreal bevacizumab was 1628 +/- 929 pg/mL, 427 +/- 140 pg/mL, 246 +/- 110 pg/mL, and 269 +/- 157 pg/mL, respectively. There was a significant negative correlation (r = -0.575, P = .0125) between the serum concentration of bevacizumab and VEGF when a total of 0.25 mg or 0.5 mg of bevacizumab was injected.CONCLUSIONS: These results indicate that bevacizumab can escape from the eye into the systemic circulation and reduce the serum level of VEGF in infants with ROP. Continued extensive evaluations of infants are warranted for possible effects after intravitreal bevacizumab in ROP patients. (Am J Ophthalmol 2012;153:327-333. (C) 2012 by Elsevier Inc. All rights reserved.)