In the special issue of the Journal of Molecular Medicine, dedicated to "Advances in Endothelial Biology, Angiogenesis, and Vascular Remodelling', Dr Campochiaro of Johns Hopkins University in Baltimore published a review on ocular neovascularisation.
Retinal and choroidal vascular diseases can be subdivided into retinal vascular diseases, in which there is leakage and/or neovascularisation (NV) from retinal vessels, and Subretinal NVin which neovases develop in the normally avascular outer retina and in the subretinal space. To the first group belong diabetic retinopathy, retinal venous occlusions and retinopathy of the premature, while the second category includes neovascular AMD, ocular histoplasmosis, pathological myopia and other related pathologies.
Retinal hypoxia is a key aspect of the first group of diseases and results in elevated levels of HIF-1 (Hypoxia-Inducible Factor-1), which stimulates the expression of VEGF (Vascular Endothelial Growth Factor), PDGF-B (Platelet-Derived Growth Factor-B), PGF (Placental Growth Factor) and SDF-1 (Stromal-Derived Growth Factor)-1 and their receptors, as well as other hypoxia-regulating gene products such as angiopoietin-2. Although hypoxia has not been shown to play a role in the second group of diseases, HIF-1 levels are elevated and thus the same group of hypoxia-regulating gene products plays a part.
Clinical trials have shown clear benefits of VEGF antagonists in patients with subretinal NV due to AMD, and even greater benefits are obtained by combining VEGF and PDGF-B antagonists. Other therapeutic approaches could target HIF-1 directly or use gene transfer to express endogenous or engineered anti-angiogenic proteins.
See the Journal of Molecular Medicine of March 2013
Dr. Carmelo Chines
Direttore responsabile
English 
Italian