Abstract
The production of Vascular Endothelial Growth Factor (VEGF) in the retina is important to maintain the vasculature in the choroid and has protective function on the retinal pigment epithelium and the neuroretina. The expression of VEGF is mainly regulated by the presence of oxygen, a decline of oxygen partial pressure resulting in an activation of Hypoxia Inducible Factor 1α (HIF-1α), inducing the expression of VEGF. A plethora of other factors are also involved, including oxidative stress, hyperglycemia, or inflammatory cytokines. An increase in VEGF secretion can lead to pathological vascularization in the retina, as seen in exudative age-related macular degeneration (AMD), retinopathy of prematurity or in diabetic retinopathy. In order to treat pathological neovascularizations in the retina, VEGF antagonists have been introduced into the clinic and approved for the treatment of wet AMD. Recently, VEGF-antagonists have also been approved for the treatment of diabetic macular edema. New products are developed, e.g., VEGF-Trap Eye or VEGF receptor antagonists which are currently being tested in clinical trials. VEGF siRNAs are also being tested. VEGF-antagonists neutralize secreted VEGF by inhibiting the binding of VEGF to its receptor. Additional pathways are possible, e.g., interfering with autoregulatory pathways. VEGF-receptor antagonists inhibit the signal transduction induced by VEGF binding. Anti-VEGF-siRNA intracellularly inhibits the expression of VEGF and might also exert an RNA specific, VEGF-independent effect.
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Abbreviations
- AGE:
-
Advanced glycation end products
- AMD:
-
Age-related macular degeneration
- ARE:
-
AU-rich elements
- CLK1:
-
CDC-like kinase
- CNV:
-
Choroidal neovascularization
- PlGF:
-
Placental growth factor
- ECM:
-
Extracellular matrix
- ER:
-
Endoplasmic reticulum
- IGF:
-
Insulin-like growth factor
- IRES:
-
Internal ribosome entry site
- MAPK:
-
Mitogen activated kinase
- MMP:
-
Matrix metalloprotease
- NMDA:
-
N-methyl-d-aspartate
- NP:
-
Neuropilin
- PI3K:
-
Phosphoinositide 3-kinase
- PKC:
-
Protein kinase C
- PLC:
-
Phospholipase
- PlGF:
-
Placental growth factor
- RISC:
-
RNA-inducing silencing complex
- ROP:
-
Retinopathy of prematurity
- RPE:
-
Retinal pigment epithelium
- SELEX:
-
Systematic evolution of ligands by exponential enrichments
- SH-2:
-
Src homology-2
- Shh:
-
Sonic hedgehog
- SR:
-
Serine–arginine rich proteins
- TGFβ:
-
Transforming growth factor beta
- TLR:
-
Toll-like receptor
- UPR:
-
Unfolded protein response
- UTR:
-
Untranslated region
- VEGF:
-
Vascular endothelial growth factor
- VEGFR:
-
Vascular endothelial growth factor receptor
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Klettner, A., Roider, J. (2012). Mechanisms of Pathological VEGF Production in the Retina and Modification with VEGF-Antagonists. In: Stratton, R., Hauswirth, W., Gardner, T. (eds) Studies on Retinal and Choroidal Disorders. Oxidative Stress in Applied Basic Research and Clinical Practice. Humana Press. https://doi.org/10.1007/978-1-61779-606-7_13
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