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Plasmin-assistierte Vitrektomie — Stand der Forschung und klinische Evaluation

Microplasmin-assisted vitrectomy — Basic research and clinical studies

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Zusammenfassung

Hintergrund

Microplasmin (Thrombo-Genics Ltd., Dublin, Irland) ist ein rekombinanter Wirkstoff, bestehend aus der katalytischen Domäne von humanem Plasmin. Wir untersuchten post mortem et in vivo, ob Microplasmin eine hintere Glaskörperabhebung induzieren kann, und ob mit morphologischen oder funktionellen Netzhautveränderungen zu rechnen ist.

Methode

In humanen Spenderaugen und in vivo bei Kaninchen, Minipig, Katze und Primaten wurde Microplasmin intravitreal appliziert und der Grad der vitreoretinalen Separation standardisiert mittels Rasterelektronenmikroskopie bestimmt. Zusätzlich wurden die Techniken der Transmissionselektronenmikroskopie, der konfokalen Mikroskopie und der Elektroretinographie (ERG) angewandt.

Resultate

Microplasmin kann post mortem et in vivo eine vollständige und dosisabhängige hintere Glaskörperabhebung induzieren. Morphologische oder immunzytochemische Netzhautveränderungen finden sich nicht. Dauerhafte ERG-Veränderungen sind nicht nachzuweisen.

Schlussfolgerung

Microplasmin trennt den Glaskörper von der Netzhaut ohne morphologische oder funktionelle Netzhautveränderungen zu induzieren. Mit diesen präklinischen Ergebnissen führen wir derzeit die ersten klinischen Studien zur Microplasmin-assistierten Vitrektomie durch.

Summary

Background

Microplasmin (ThromboGenics Ltd., Dublin, Ireland) is a recombinant molecule consisting of the catalytic domain of human plasmin. We investigated the cleaving effect of microplasmin at the vitreoretinal interface in post mortem eyes and in vivo.

Methods

Microplasmin was injected into the vitreous of post mortem eyes and in different animal models. The vitreoretinal interface was investigated by scanning and transmission electron microscopy and by laser scanning microscopy. In vivo, electroretinography was also performed.

Results

Microplasmin separates the vitreous from the retina in a dose-dependent fashion. The retinal architecture including the ultrastructure of the inner and outer retina is well preserved. There are no alterations of retinal morphology and immunocytochemistry between treated eyes and control eyes.

Conclusion

Microplasmin cleaves the vitreoretinal junction and helps to completely separate the vitreous from the retina. Several clinical trials are currently underway.

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Authors and Affiliations

  1. Augenklinik der Ludwig-Maximilians-Universität, Mathildenstraße 8, 80336, München, Deutschland

    A. Gandorfer & A. Kampik

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  1. A. Gandorfer
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  2. A. Kampik
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Correspondence to A. Gandorfer.

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Gandorfer, A., Kampik, A. Plasmin-assistierte Vitrektomie — Stand der Forschung und klinische Evaluation. Spektrum Augeheilkd 19, 221–224 (2005). https://doi.org/10.1007/BF03163401

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  • DOI: https://doi.org/10.1007/BF03163401

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