Vegf (in Situ Macular Edema & Uveitis
Vegf(原位黄斑水肿
基本信息
- 批准号:6968522
- 负责人:
- 金额:--
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:
- 资助国家:美国
- 起止时间:至
- 项目状态:未结题
- 来源:
- 关键词:
项目摘要
Increased intraocular and systemic levels of the angiogenic factor vascular endothelial growth factor (VEGF) is associated with new vessel growth in the eye, such as diabetic retinopathy. Recent work using immunopathologic techniques have shown that VEGF is upregulated in both experimentally induced uveitis and in uveitis eyes as well, with no evidence of neovascularization. This pilot study evaluated the level of VEGF in the blood of uveitic patients with and without cystoid macular edema. This level was determined also in the ocular fluid of those patietns undergoing ocular surgery. We measured the VEGF concentration in the aqueous humor of 20 uveitis patients (9 with and 11 without CME), and in the plasma of 40 uveitis patients (20 with and 20 without CME) and 20 healthy volunteers. Results: Mean aqueous humor VEGF concentrations for uveitis patients with and without CME were 152.3 and 109.5 pg/mL, p=0.048. Mean plasma VEGF concentrations in uveitis patients with and without CME and in healthy volunteers were 32.2, 29.6, and 55.0 pg/mL. Uveitis patients had lower plasma VEGF levels than healthy volunteers, p=0.002. Conclusions: VEGF concentration is elevated in the aqueous humor of uveitis patients with CME. Plasma VEGF concentration is reduced in uveitis patients on systemic immunosuppression. Because of these observations, we have begun testing the efficacy of ???-tocopherol (vitamin E), a potent inhibitor of the protein kinase C pathway in vascular endothelial growth factor (VEGF) induced vascular permeability, for the treatment of uveitis-associated macular edema. This is performed using a double-masked, randomized study in which uveitis patients with macular edema will receive either ???-tocopherol or placebo. Patients will receive 1600IU/day of Vitamin E or placebo for 4 months. The primary outcome will be a visual acuity increase of 10 letters or more from baseline to month 4. Secondary outcomes are total area of leakage and macular height as determined by fluorescein angiography, changes in CME as measured by stereoscopic color photographs, optical coherence tomography (OCT), the need for periocular injections or additional systemic immunomodulatory medications, and the NEI VFQ summary score.
Results: Patients tolerated the therapy well but the study was terminated early because of no improvement in visual acuity nor in macular thickening in either group.
Conclusion: Four month oral supplementation with 1600IU/day of vitamin E had no effect on
血管生成因子血管内皮生长因子(VEGF)的眼内和全身水平增加与眼睛中的新血管生长有关,如糖尿病视网膜病变。最近使用免疫病理学技术的研究表明,VEGF在实验诱导的葡萄膜炎和葡萄膜炎眼中都上调,没有新血管形成的证据。这项初步研究评估了伴有和不伴有黄斑囊样水肿的葡萄膜炎患者血液中VEGF的水平。在接受眼部手术的患者的眼液中也测定了该水平。我们测定了20例葡萄膜炎患者(9例有CME,11例无CME)的房水中VEGF浓度,以及40例葡萄膜炎患者(20例有CME,20例无CME)和20例健康志愿者的血浆中VEGF浓度。结果:葡萄膜炎伴和不伴CME患者的平均房水VEGF浓度分别为152.3和109.5 pg/mL,p=0.048。葡萄膜炎伴和不伴CME患者以及健康志愿者的平均血浆VEGF浓度分别为32.2、29.6和55.0 pg/mL。葡萄膜炎患者的血浆VEGF水平低于健康志愿者,p=0.002。结论:葡萄膜炎合并CME患者房水中VEGF浓度升高。葡萄膜炎患者全身免疫抑制时血浆VEGF浓度降低。由于这些观察结果,我们已经开始测试?-生育酚(维生素E)是血管内皮生长因子(VEGF)诱导的血管通透性中蛋白激酶C途径的有效抑制剂,用于治疗葡萄膜炎相关性黄斑水肿。这是一项双盲、随机研究,在这项研究中,伴有黄斑水肿的葡萄膜炎患者将接受以下两种治疗之一:生育酚或安慰剂。患者将接受1600 IU/天的维生素E或安慰剂治疗4个月。主要结局将是从基线至第4个月视力增加10个字母或更多。次要结果是通过荧光素血管造影确定的渗漏总面积和黄斑高度,通过立体彩色照片测量的CME变化,光学相干断层扫描(OCT),眼周注射或额外的全身免疫调节药物的需求,以及NEI VFQ汇总评分。
结果如下:患者对治疗耐受良好,但由于两组视力和黄斑增厚均无改善,研究提前终止。
结论:4个月口服补充1600 IU/天维生素E对
项目成果
期刊论文数量(0)
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ROBERT B. NUSSENBLATT其他文献
ROBERT B. NUSSENBLATT的其他文献
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{{ truncateString('ROBERT B. NUSSENBLATT', 18)}}的其他基金
Nucleotide Polymorphisms In Primary Intraocular Lymphoma
原发性眼内淋巴瘤的核苷酸多态性
- 批准号:
6507404 - 财政年份:
- 资助金额:
-- - 项目类别:
The Use Of An Anti-il2 Receptor Antibody In The Treatmen
抗IL2受体抗体在治疗中的应用
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6507392 - 财政年份:
- 资助金额:
-- - 项目类别:
cDNA Microarrays In Gene Expression Of Uveitis Patients
葡萄膜炎患者基因表达的 cDNA 微阵列
- 批准号:
6968560 - 财政年份:
- 资助金额:
-- - 项目类别:
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