Implications of bevacizumab on VEGF and endostatin in human choroidal neovascularization
- Olcay Tatar (olcaytatar{at}yahoo.com),
- Kei Shinoda,
- Edwin Kaiserling,
- Carl Claes,
- Claus Eckardt,
- Tillmann Eckert,
- Vicky Boeyden,
- Grazia Pertile,
- Efdal Yoeruek,
- Peter Szurman,
- Karl U Bartz-Schmidt,
- Salvatore Grisanti (salvatore.grisanti{at}med.uni-tuebingen.de)
- University Eye Clinic at the Centre for Ophthalmology of Eberhard-Karls University, Tuebingen, Germany
- Laboratory of Visual Physiology, National Institute of Sensory Organs, Tokyo, Japan
- Department of Pathology, Eberhard-Karls University, Tuebingen, Germany
- AZ- Sint Augustinus Hospital, Department Achtersegment, Antwerp, Belgium
- Augenklinik der Staedtischen Kliniken, Frankfurt am Main, Germany
- Augenklinik der Staedtischen Kliniken, Frankfurt am Main, Germany
- AZ- Sint Augustinus Hospital, Department Achtersegment, Antwerp, Belgium
- Ospedale Sacro Cuore, Italy
- University Eye Hospital at the Centre for Ophthalmology of the Eberhard-Karls University, Tuebingen, Germany
- University Eye Clinic at the Centre for Ophthalmology of the Eberhard-Karls-University, Tuebingen, Germany
- University Eye Clinic at the Centre for Ophthalmology of the Eberhard-Karls-University, Tuebingen, Germany
- Department of Ophthalmology at the University of Luebeck, Luebeck, Germany
- Published Online First 6 October 2008
Abstract
Aim: To evaluate implications of intravitreal bevacizumab on proangiogenic vascular endothelial growth factor (VEGF) with regard to the endogenous angiogenesis inhibitor endostatin in human choroidal neovascularization (CNV) secondary to age-related macular degeneration.
Methods: Retrospective review of an interventional case series of forty-eight patients who underwent full macular translocation surgery with removal of CNV. Twenty five patients were treated with intravitreal bevacizumab injection 1 to 154 days prior to surgery (bevacizumab CNV). Twenty-three CNV without any kind of previous treatment were used as controls (control CNV). CNV were stained for CD34, cytokeratin18, VEGF, endostatin and E-selectin. "Predominance score of VEGF over endostatinâ" (PS) was defined by the difference between VEGF and endostatin staining scores.
Results: Bevacizumab CNV disclosed weaker VEGF expression in endothelial cells (p=0.0245) but significantly more intense endostatin in retina pigment epithelium (RPE) (p=0.0001) and stroma (p<0.0001). Consequently, PS was significantly lower in RPE (p=0.02), vessels (p=0.03) and stroma (p=0.0004) in bevacizumab CNV. Intensity of E-selectin expression in bevacizumab CNV was comparable to that in control CNV.
Conclusions: A shift within the angiogenic balance in terms of decreased VEGF predominance over endostatin is detected in human CNV treated with bevacizumab.
