Intraocular neutralizing antibodies against aflibercept in patients with age related macular degeneration

BMC Ophthalmology

Research

Noémi Sándor¹  Mihály Józsi¹  Lilla István²  Miklós Resch²  Andrea Gyenes²  Zoltán Z. Nagy²  András Papp²  Fruzsina Benyó²  Illés Kovács³  Szilárd Kiss⁴ 

[1] Department of Immunology, ELTE Eötvös Loránd University, Budapest, Hungary;MTA-ELTE Complement Research Group, Eötvös Loránd Research Network (ELKH), Budapest, Hungary;Department of Ophthalmology, Semmelweis University, Budapest, Hungary;Department of Ophthalmology, Semmelweis University, Budapest, Hungary;Department of Ophthalmology, Weill Cornell Medical College, New York, USA;Department of Clinical Ophthalmology, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary;Department of Ophthalmology, Weill Cornell Medical College, New York, USA;

关键词: Age related macular degeneration;    anti-VEGF;    Treatment;   

DOI  :  10.1186/s12886-022-02761-9

 received in 2022-09-02, accepted in 2022-12-28,  发布年份 2022

来源: Springer

【 摘 要 】

PurposeTo detect immunoglobulins in aqueous humour of AMD patients after repeated administration of intravitreal aflibercept.Patients and methodsTwenty-one patients (age: 77.85 ± 9.21 years) previously treated with intravitreal aflibercept due to wet type age-related macular degeneration (AMD group) and 18 age-matched control subjects (age: 69.75 ± 12.67 years) were included in this study. Patients in the AMD group received a mean of 5 intravitreal injections (min: 1 max: 17) prior to the cataract surgery. Samples of aqueous humour (50 μl) were obtained by anterior chamber paracentesis as the first step of routine cataract surgery. The IgG content of the samples was analysed by an in-house developed ELISA system.ResultsA significant increase in nonspecific IgG levels in the AMD group was detected compared to the control group (13.37 ± 6.65 vs. 9.44 ± 6.55 μg/ml; p = 0.03). In 11 patients, intraocular anti-aflibercept immunoglobulins could be detected (0.05 ± 0.01 μg/ml) which was significantly higher than the limit of detection for anti-aflibercept (0.04 μg/ml; p = 0.001). No correlation was found between the number of injections or the type of CNV and the aqueous level of anti-aflibercept (r = 0.02; p = 0.95).ConclusionAccording to our results, penetration of non-specific systemic antibodies through the impaired blood-retinal barrier is higher in patients with neovascular AMD than in subjects with an intact structural barrier. Evaluation of neutralizing antibodies to anti-VEGF agents in the aqueous humour can lead us to understanding tachyphylaxis and changes in intraocular immune mechanisms due to AMD.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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Fig. 3