Titel | Inhibition of Vascular Endothelial Growth Factor Reduces Scar Formation after Glaucoma Filtration Surgery |
Doel | In 30-50% of cases, glaucoma filtration surgery fails due to excessive post-operative scarring. In this study, we investigated whether glaucoma and filtration surgery are associated with increased levels of vascular endothelial growth factor (VEGF) and whether the humanized monoclonal VEGF-antibody bevacizumab (AvastinTM, Genentech) can reduce post-operative scar formation and improve surgical outcome. |
Methodes | VEGF levels in aqueous humor samples were measured by ELISA. Expression of VEGF-receptors Flt-1 and KDR was analyzed in cultured Tenon fibroblasts by real-time RT-PCR and Western blot. The effect of VEGF and bevacizumab on Tenon fibroblasts in vitro was determined using a proliferation assay. The effect of the antibody in vivo was investigated in a rabbit trabeculectomy model by measuring the intra-ocular pressure (IOP) and the bleb area and by immunohistological analysis of vascularity, inflammation and fibrosis. |
Resultaten | VEGF was significantly increased in the aqueous humor of glaucoma patients as well as in operated rabbits. Both VEGF-receptors were expressed on Tenon fibroblasts. The proliferation of Tenon fibroblasts in vitro was significantly stimulated by VEGF-delivery and inhibited by bevacizumab-administration. The antibody also significantly reduced vascularity and collagen deposition and improved glaucoma surgery outcome. |
Conclusie | VEGF is up-regulated in aqueous humor of glaucoma patients and operated rabbits and stimulates in vitro fibroblast proliferation, suggesting that it plays a role in the scarring process after filtration surgery. Bevacizumab reduces in vitro fibroblast proliferation and improves in vivo surgical outcome. |
Naam | VAN BERGEN |
Initialen | TVB |
Instituut | KUL |
Stad | Leuven |
Naam | VAN DE VEIRE |
Initialen | SVDV |
Instituut | KUL |
Stad | Leuven |
Naam | MOONS |
Initialen | LM |
Instituut | KUL |
Stad | Leuven |
Naam | STALMANS |
Initialen | IS |
Instituut | KUL |
Stad | Leuven |