抗血管內皮生長因子藥物Bevacizumab對抑制角膜新生血管之影響

Abstract

正常眼角膜構造為透明無血管生長，當發生感染、炎症、乾眼症等角膜疾病時，眼角膜常會出現許多新生血管生成，過多的新生血管會導致炎症反應加劇，且導致眼角膜的透明度降低或喪失。血管內皮生長因子(vascular endothelium growth factor, VEGF) 在其中扮演了非常重要的角色，我們實驗以抗血管內皮生長因子(Anti-VEGF)藥物來拮抗血管內皮生長因子的作用進而阻斷角膜新生血管作用。實驗使用紐西蘭白兔進行體內試驗，我們以三種模式來建立角膜新生血管：角膜微晶格模式、角膜輪狀部幹細胞缺損模式及角膜化學灼傷模式。抗血管內皮生長因子藥物選擇Bevacizumab (Avastin

The cornea is an avascular transparent structure normally. Corneal neovascularization may be initiated following infection, trauma, and inflammation, leading to decreased corneal transparency. Additionally, corneal neovascularization is a risk factor for graft rejection after allograft corneal transplantation. Vascular endothelium growth factor (VEGF) is known to have an important role in angiogenesis in the body. The anti-VEGF drugs have been proved to inhibit VEGF in previous reports on cancers and retina. In this study, we investigated the effects of anti-VEGF drug on corneal neovascularization in a rabbit model. Three models of corneal neovascularization in rabbits were used in this study, namely corneal micropocket, limbal stem cell insufficiency, and chemical burn. The anti-VEGF drug, bevacizumab (Avastin), was injected subconjunctivally for treating corneal neovascularization in these rabbit models. The maximal length and area of corneal neovascularization were measured and recorded. Histology analysis and immunochemical staining of the rabbit cornea were performed. Bevacizumab revealed inhibitory effect of corneal neovascularization in all of the three models. The treatment group showed lesser corneal neovascularization, inflammatory cells infiltration, and vascular endothelium cells by histology. Immunochemical stain revealed the expressions of the vascular endothelial cells and bevacizuzmab in cornea. In conclusion, subconjunctival injection of anti-VEGF drug, bevacizumab, can effectively suppress corneal neovascularization with no significant side effects based on this study. The dosage, administration routes, and efficacy in corneal diseases and allografts remains to investigate in the future.