Potential antiedematous effects of intravitreous anti-VEGF, unrelated to VEGF neutralization

• Published in: Drug discovery today Vol. 24; no. 8; pp. 1436 - 1439
• Main Authors: Behar-Cohen, Francine, Dernigoghossian, Marilyn, Andrieu-Soler, Charlotte, Levy, Rinath, Cohen, Raphaël, Zhao, Min
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-08-2019; Elsevier
• Subjects: Angiogenesis Inhibitors - therapeutic use; Diabetic Retinopathy - drug therapy; Diabetic Retinopathy - metabolism; Humans; Life Sciences; Macular Degeneration - drug therapy; Macular Degeneration - metabolism; Macular Edema - drug therapy; Macular Edema - metabolism; Ophthalmic Solutions - therapeutic use; Retinal Vein Occlusion - drug therapy; Retinal Vein Occlusion - metabolism; Vascular Endothelial Growth Factor A - antagonists & inhibitors
• ISSN: 1359-6446; 1878-5832
• DOI: 10.1016/j.drudis.2019.05.034

•Intraocular anti-VEGF drugs dominate the market of macular edema.•In retinal diseases, anti-VEGFs are primarily anti-edematous drugs.•The anti-edematous mechanisms of anti-VEGF are not fully understood.•There is evidence that anti-edematous is independent from VEGF neutralization.•Intravitreous proteins regulate genes encoding anti-edematous proteins.
The intravitreous injection of therapeutic proteins that neutralize vascular endothelial growth factor (VEGF) family members is efficient to reduce macular edema associated with wet age-related macular degeneration (AMD), retinal vein occlusion (RVO) and diabetic retinopathy (DR). It has revolutionized the visual prognosis of patients with macular edema. The antiedematous effect is dependent on an intravitreous dose of drug, which varies between patients and requires frequent and repeated injections to maintain its effects. At the time when optimizing the duration of anti-VEGF effects is a major challenge, understanding how anti-VEGF reduces macular edema is crucial. We discuss herein how anti-VEGF exerts antiedematous effects and raise the hypothesis that mechanisms, unrelated to VEGF neutralization, might have been underestimated.