收稿日期: 2020-01-11
网络出版日期: 2021-05-14
基金资助
国家自然科学基金(81700828);国家重点研发计划(2016YFC0904800);国家科技重大专项(2017ZX09304010)
Review and prospect of anti-vascular endothelial growth factor treatment for wet age-related macular degeneration
Received date: 2020-01-11
Online published: 2021-05-14
Supported by
National Natural Science Foundation of China(81700828);National Key R&D Program of China(2016YFC0904800);National Science and Technology Major Project of China(2017ZX09304010)
自雷珠单抗2006年上市以来，抗血管内皮生长因子（vascular endothelial growth factor，VEGF）药物一直是治疗湿性年龄相关性黄斑变性（age-related macular degeneration，AMD）的一线药物。然而，临床研究显示，抗VEGF药物治疗若干年后患者视力回到基线水平，甚至伴视网膜纤维化和地图样萎缩发生，凸显了抗VEGF治疗的局限性。为了改善疗效，针对传统抗VEGF药物的替代和补充治疗相继出现。基因治疗通过介导腺相关病毒载体递送治疗性蛋白实现了长期稳定的抗VEGF效果；联合抗血小板衍生生长因子治疗可能通过周细胞弥补抗VEGF治疗的局限性；补体相关的基因治疗则是基于患者对抗VEGF治疗反应性差而开拓的又一新领域。该文就抗VEGF治疗湿性AMD的研究进展做一综述。
王雅芳 , 刘洋 , 罗学廷 . 抗VEGF治疗湿性年龄相关性黄斑变性的回顾与展望[J]. 上海交通大学学报（医学版）, 2021 , 41(4) : 530 -534 . DOI: 10.3969/j.issn.1674-8115.2021.04.019
Anti-vascular endothelial growth factor (VEGF) has been the first choice in the treatment of wet age-related macular degeneration (AMD), since ranibizumab went on sale in 2006. However, clinical studies have suggested that the visual acuity returned to a baseline level several years after anti-VEGF therapy, with the occurrence of retinal fibrosis and geomorphologic atrophy, highlighting the limit of this treatment. In order to improve the efficacy, replacement and supplementation of traditional anti-VEGF emerged successively. Gene therapy achieved long-term and stable anti-VEGF effect by mediating therapeutic proteins delivered by adeno-associated virus vectors. Treatment combined with anti-platelet-derived growth factor may compensate for the limitations of anti-VEGF therapy through peripheral cells. Complement-related gene therapy is a new field based on the poor reactivity of patients against VEGF. This article reviews the progress of anti-VEGF in the treatment of wet AMD.
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