Aqueous cytokine and growth factor levels indicate response to ranibizumab for diabetic macular oedema
Aqueous cytokine and growth factor levels indicate response to ranibizumab for diabetic macular oedema
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DOI：
10.1136/bjophthalmol-2016-309953
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发表时间：
2017-11-01
影响因子：
4.1
通讯作者：
Noma, Hidetaka
中科院分区：
文献类型：
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作者：
Shimura, Masahiko;Yasuda, Kanako;Noma, Hidetaka
目的：探讨玻璃体内注射雷珠单抗（IVR）治疗糖尿病性黄斑水肿（DME）的疗效与房水中细胞因子/生长因子水平的关系。方法：收集68例（68只眼）未接受过治疗的中心受累DME患者，中心黄斑厚度（CMT）大于400 μ m，视力（VA）低于logMAR 0.3。每例患者每月接受IVR注射（0.5 mg/0.05 mL），直至CMT降至300 μ m以下。在6个月的临床过程中给予额外的IVR以维持CMT低于300 μ m，每月随访。使用第一次IVR注射前获得的样品测量细胞因子/趋化因子和生长因子的水溶液浓度。每月监测CMT和VA，持续6个月。结果24只眼在第一次IVR注射后不久显示CMT < 300 μ m（良好反应者），而12只眼在连续6次注射后未达到目标（不良反应者）。两组间基线CMT和VA无显著差异。然而，良好反应者显示血管内皮生长因子（VEGF）、胎盘生长因子、可溶性VEGF受体-1（sVEGFR 1）、单核细胞趋化蛋白-1、细胞间粘附分子-1、白细胞介素6和诱导蛋白-10的基线水溶液浓度显著增加，但sVEGFR 2的基线水溶液浓度未增加。结论雷珠单抗治疗DME的反应似乎与VEGFR 1家族和某些炎性细胞因子的水溶液浓度相关，但与临床参数无关。
Background/Aims To investigate the relations between aqueous humour levels of cytokines/growth factors and treatment response to intravitreal ranibizumab (IVR) for diabetic macular oedema (DME)Methods Sixty-eight eyes of 68 patients with treatment-naive centre-involved DME, central macular thickness (CMT) greater than 400 mu m and visual acuity (VA) worse than logMAR 0.3 were recruited. Each patient received monthly IVR injection (0.5 mg/0.05 mL) until CMT was reduced to below 300 mu m. Additional IVR was given to maintain CMT below 300 mu m during the clinical course of 6 months with monthly follow-up. Aqueous concentrations of cytokines/chemokines and growth factors were measured using samples obtained just before first IVR injection. CMT and VA were monitored monthly for up to 6 months. The number of monthly IVR injections given during the 6-month study period was also recorded.Results Twenty-four eyes showed CMT < 300 mu m soon after the first IVR injection (good responders), while 12 eyes did not reach the goal after six consecutive injections (poor responders). Baseline CMT and VA were not significantly different between the two groups. However, the good responders showed significant increases in baseline aqueous concentrations of vascular endothelial growth factor (VEGF), placenta growth factor, soluble VEGF receptor-1 (sVEGFR1), monocyte chemoattractant protein-1, intercellular adhesion molecule-1, interleukin 6 and inducible protein-10, but not of sVEGFR2, compared with poor responders.Conclusions Response to ranibizumab treatment for DME appears to be associated with aqueous concentrations of VEGFR1 family and certain inflammatory cytokines, but not with clinical parameters.