Anti-Vascular endothelial growth factor therapy impairs endothelial function of retinal microcirculation in colon cancer patients – an observational study

Experimental & Translational Stroke Medicine

Tjalf Ziemssen¹  Focke Ziemssen³  Heinz Reichmann¹  Gerhard Ehninger²  Karolin Trautmann²  Rocco Haase¹  Gunnar Folprecht²  Manja Reimann¹ 

[1] Department of Neurology, University Hospital Carl Gustav Carus, Dresden, Germany;Department of Internal Medicine I, University Cancer Center, University Hospital Carl Gustav Carus, Dresden, Germany;Center for Ophthalmology, Eberhard Karl University Tuebingen, Tuebingen, Germany

关键词: Nitric oxide;    Cerebral hemodynamics;    Microcirculation;    Endothelium;    Angiogenesis;   

Others  :  861586
DOI  :  10.1186/2040-7378-5-7

 received in 2013-04-03, accepted in 2013-05-09,  发布年份 2013

【 摘 要 】

Background

To assess acute effects of bevacizumab (anti-VEGF therapy) on cerebral microvessels and systemic cardiovascular regulation.

Design and subjects

20 consecutive patients with colorectal cancer (median age: 60.4 years, range 45.5-73.9 years) received bevacizumab intravenously (5 mg/kg) uncoupled of chemotherapy. Prior to and within the first 24 hours after bevacizumab infusion, patients were investigated for retinal endothelial function. A series of a triple 24-hour ambulatory blood pressure measurement was conducted. Retinal endothelial function was determined as flicker light-induced vasodilation. The integrity of baroreflex arc and autonomic cardiovascular control was examined by stimulatory manoeuvres.

Results

Bevacizumab therapy significantly reduced the vasodilatory capacity of retinal arterioles in response to flicker light. A slight decrease in diastolic pressure and heart rate was observed after bevacizumab infusion but this was unrelated to changes in retinal function. The pressure response upon nitroglycerin was largely preserved after bevacizumab infusion. The proportion of patients with abnormal nocturnal blood pressure regulation increased under anti-angiogenic therapy. Autonomic blood pressure control was not affected by bevacizumab treatment.

Conclusions

Bevacizumab acutely impairs microvascular function independent of blood pressure changes. Imaging of the retinal microcirculation seems a valuable tool for monitoring pharmacodynamic effects of bevacizumab.

Trial registration

NCT ID: NCT00740168

【 授权许可】

   
2013 Reimann et al.; licensee BioMed Central Ltd.

【 图 表 】

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