Higher plasma levels of complement C3a, C4a and C5a increase the risk of subretinal fibrosis in neovascular age-related macular degeneration: Complement activation in AMD.
Higher plasma levels of complement C3a, C4a and C5a increase the risk of subretinal fibrosis in neovascular age-related macular degeneration: Complement activation in AMD.
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DOI：
10.1186/s12979-016-0060-5
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发表时间：
2016
期刊：
影响因子：
--
通讯作者：
Xu H
中科院分区：
文献类型：
--
作者：
Lechner J;Chen M;Hogg RE;Toth L;Silvestri G;Chakravarthy U;Xu H
本研究旨在探讨不同类型新生血管性年龄相关性黄斑变性（nAMD）患者血浆补体C3a、C4a和C5a水平及其与患者抗VEGF治疗反应性的关系。96名nAMD患者（包括61名脉络膜新生血管（CNV）、17名视网膜血管瘤增生（RAP）、14名息肉状脉络膜血管病变（PCV）和4名未分类患者）和43名对照被招募到该病例对照研究中。在45例nAMD患者中观察到视网膜下纤维化，在51例nAMD患者中不存在。此外，还在nAMD患者中评价了对抗VEGF（Lucentis）治疗的反应性。44例患者为完全应答者，48例为部分应答者，仅4例患者对治疗无应答。与对照组相比，nAMD患者中C3a、C4a和C5a的血浆水平显著较高。nAMD亚组的进一步分析显示，CNV患者的C3a、C4a和C5a水平显著升高，而RAP和PCV患者的C3a、C4a和C5a水平无显著升高。在伴有视网膜下纤维化的nAMD患者中也观察到C3a、C4a和C5a水平显著升高，但在没有视网膜下纤维化的患者中未观察到。在对抗VEGF治疗有部分反应的nAMD患者中观察到更高水平的C3a。我们的研究结果表明，增加系统性补体激活nAMD患者CNV，但不是RAP和PCV。我们的研究结果还表明，较高水平的全身补体激活可能会增加nAMD患者视网膜下纤维化的风险。本文的在线版本（doi：10.1186/s12979 - 016 - 0060 - 5）包含补充材料，可供授权用户使用。
The aim of this study was to investigate the plasma levels of complement C3a, C4a, and C5a in different types of neovascular age-related macular degeneration (nAMD) and whether the levels were related to patients’ responsiveness to anti-VEGF therapy. Ninety-six nAMD patients (including 61 with choroidal neovascularisation (CNV), 17 with retinal angiomatous proliferation (RAP), 14 with polypoidal choroidal vasculopathy (PCV) and 4 unclassified patients) and 43 controls were recruited to this case–control study. Subretinal fibrosis was observed in 45 nAMD patients and was absent in 51 nAMD patients. In addition, the responsiveness to anti-VEGF (Lucentis) therapy was also evaluated in nAMD patients. Forty-four patients were complete responders, 48 were partially responders, and only 4 patients did not respond to the therapy. The plasma levels of C3a, C4a and C5a were significantly higher in nAMD patients compared to controls. Further analysis of nAMD subgroups showed that the levels of C3a, C4a and C5a were significantly increased in patients with CNV but not RAP and PCV. Significantly increased levels of C3a, C4a and C5a were also observed in nAMD patients with subretinal fibrosis but not in those without subretinal fibrosis. Higher levels of C3a were observed in nAMD patients who responded partially to anti-VEGF therapy. Our results suggest increased systemic complement activation in nAMD patients with CNV but not RAP and PCV. Our results also suggest that higher levels of systemic complement activation may increase the risk of subretinal fibrosis in nAMD patients. The online version of this article (doi:10.1186/s12979-016-0060-5) contains supplementary material, which is available to authorized users.