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Heiduschka P, Plagemann T, Li L, Alex AF, Eter N. Different effects of various anti-angiogenic treatments in an experimental mouse model of retinopathy of prematurity. Clin Exp Ophthalmol 2018; 47:79-87. [PMID: 30073769 DOI: 10.1111/ceo.13368] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 07/19/2018] [Accepted: 07/31/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Anti-vascular endothelial growth factor (VEGF) drugs are an option for the treatment of retinopathy of prematurity (ROP). Blocking of other angiogenic factors is also of interest. We therefore investigated in which effects would result blocking of placental growth factor (PlGF). METHODS C57BL/6 mice were exposed to 75% oxygen from P7 to P12. Intravitreal injections were performed at P12. Mice of control groups remained untouched after oxygen treatment, or phosphate buffered saline or neutral IgG molecules were injected. In the treatment groups, antibodies against VEGF or PlGF, a mixture of anti-VEGF and anti-PlGF, aflibercept or sunitinib were injected. On P17, electroretinographic (ERG) measurements were performed. Avascular zones and neovascularization were evaluated in retinal flat-mounts. Results are expressed as percent of total retinal area (median with median absolute deviation, MAD). RESULTS Eyes of control groups showed similar neovascularization (1.4-3.3%, MAD 0.4-0.9%). Neovascularization was significantly less (0.5-0.7%, MAD 0.1-0.3%) in all treatment groups. Avascular zones in the retinas of control groups showed similar values (18.3-25.7%, MAD 4.8-8.8%). Avascular zones were significantly reduced down to 3.6 ± 1.3% after anti-VEGF injection, but they were not reduced significantly in the other treatment groups (13.3-22%, MAD 3.6-6.1%). ERG measurements did not reveal significant differences between the controls and the treatment groups. CONCLUSIONS Blocking of PlGF or injection of sunitinib results in a similar inhibition of neovascularization as by anti-VEGF treatment in the mouse model of ROP. However, physiological angiogenesis that occurs after anti-VEGF treatment is blocked by anti-PlGF or sunitinib treatment, indicating that pathological neovascularization may follow different pathways than physiological angiogenesis.
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Affiliation(s)
- Peter Heiduschka
- Department of Ophthalmology, University of Münster Medical School, Münster, Germany
| | - Tanja Plagemann
- Department of Ophthalmology, University of Münster Medical School, Münster, Germany
| | - Lu Li
- Department of Ophthalmology, University of Münster Medical School, Münster, Germany.,Renmin Hospital of Wuhan University, Department of Ophthalmology, Wuhan, China
| | - Anne F Alex
- Department of Ophthalmology, University of Münster Medical School, Münster, Germany.,Argus Centre of Ophthalmology/Argus Augenzentrum Mittelhessen, Giessen, Germany
| | - Nicole Eter
- Department of Ophthalmology, University of Münster Medical School, Münster, Germany
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Affiliation(s)
- Julia Termühlen
- Department of Ophthalmology; University Medical Center; Muenster Germany
| | - Anne F. Alex
- Department of Ophthalmology; University Medical Center; Muenster Germany
| | | | - Ulrich Kellner
- Rare Retinal Disease Center; AugenZentrum Siegburg; Siegburg Germany
| | - Barbara Fiedler
- Department of Neuropediatrics; University Children's Hospital; Muenster Germany
| | - Nicole Eter
- Department of Ophthalmology; University Medical Center; Muenster Germany
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Li L, Heiduschka P, Alex AF, Niekämper D, Eter N. Behaviour of CD11b-Positive Cells in an Animal Model of Laser-Induced Choroidal Neovascularisation. Ophthalmologica 2017; 237:29-41. [PMID: 28092911 DOI: 10.1159/000453550] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 11/10/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIM Immune cells, e.g. microglial cells of the retina, appear to be involved in pathological processes in neovascular age-related macular degeneration. Therefore, the purpose of this study was to immunohistochemically check the expression of various factors and cytokines by CD11b-positive (CD11b+) immune cells in an animal model of choroidal neovascularisation (CNV). METHODS We used the animal model of laser-induced CNV in mice. Eyes were isolated at 1, 4, 7, and 14 days after laser treatment. Cryosections were prepared and checked immunohistochemically for the presence of different growth factors and cytokines on microglial cells and other immune cells identified by CD11b immunoreactivity. RESULTS We found that the number of CD11b+ cells at the laser spots increased dramatically 4 days after laser treatment, the majority of them entering the laser spot most probably by migration. CD11b+ cells in the laser spot were positive for a variety of pro-angiogenic factors, such as PDGF-β, FGF-1, FGF-2, and TGF-β1. They were also positive for some inflammatory cytokines, in particular TNF-α, IL-6, and CXCL1. In non-treated retinas, CD11b+ cells showed almost no immunoreactivity for these proteins. CONCLUSION Microglial cells, macrophages, and other CD11b+ cells may promote the neovascularisation in the laser spot and show a moderate inflammatory behaviour. Immunoreactivity for most of these molecules was found to decrease during the time of observation. Modulation of immune cell activity may thus be a tool to reduce the extent of CNV.
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Affiliation(s)
- Lu Li
- Department of Ophthalmology, University of Münster Medical School, Münster, Germany
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Walz JM, Bemme S, Pielen A, Aisenbrey S, Breuß H, Alex AF, Wagenfeld L, Schiedel S, Krohne TU, Stahl A. The German ROP Registry: data from 90 infants treated for retinopathy of prematurity. Acta Ophthalmol 2016; 94:e744-e752. [PMID: 27197876 DOI: 10.1111/aos.13069] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Accepted: 02/27/2016] [Indexed: 11/30/2022]
Abstract
PURPOSE The German retinopathy of prematurity (ROP) Registry collects data on treated ROP in a multicentre approach to analyse epidemiology and treatment patterns of severe ROP. METHODS Nine centres entered data from 90 treated ROP infants (born between January 2011 and December 2013) into a central database. Analysis included incidence rate of severe ROP, demographic data, stage of ROP, treatment patterns, recurrence rates, relevant comorbidities and ophthalmological or systemic complications associated with treatment. RESULTS Treatment rate for ROP was 3.2% of the screened population. The most frequent ROP stage at time of treatment was zone II, stage 3 + (137 eyes). Treatment was bilateral in 97% of infants. Treatment patterns changed over time from 7% anti-vascular endothelial growth factor (VEGF) monotherapy in 2011 to 32% in 2014. Overall, laser treatment was the predominant treatment. However, all infants with zone I disease received anti-VEGF treatment. About 19% of infants required retreatment (16% of laser-treated and 21% of anti-VEGF treated infants). Mean time between first and second treatment was 3.8 weeks (± 11 days) for laser-treated and 10.4 weeks (± 60 days) for anti-VEGF-treated infants. CONCLUSION This study is the first multicentre analysis of severe ROP in Germany. The identified treatment patterns find laser as the most prevalent form of therapy, with an increasing use of anti-VEGF therapy over recent years. Recurrence rates were relatively high overall with slightly higher recurrence rates and later recurrence times in the anti-VEGF group. Anti-VEGF was predominantly used for high-risk stages like AP-ROP and zone I disease.
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Affiliation(s)
- Johanna M. Walz
- Eye Center; University of Freiburg; Freiburg Germany
- Department of Pharmacology and Toxicology; University of Regensburg; Regensburg Germany
| | - Sebastian Bemme
- Department of Ophthalmology; University Medical Center Göttingen; Göttingen Germany
| | - Amelie Pielen
- University Eye Hospital; Hannover Medical School; Hannover Germany
| | - Sabine Aisenbrey
- University Eye Hospital; Eberhard-Karl University Tübingen; Tübingen Germany
- University Eye Hospital; University of Oldenburg; Oldenburg Germany
| | - Helge Breuß
- Department of Ophthalmology; HELIOS Klinikum Berlin-Buch; Berlin Germany
| | - Anne F. Alex
- Department of Ophthalmology; University of Muenster Medical Center; Muenster Germany
| | - Lars Wagenfeld
- Department of Ophthalmology; University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - Susanne Schiedel
- Department of Ophthalmology; Vivantes Klinikum Neukölln; Berlin Germany
| | - Tim U. Krohne
- Department of Ophthalmology; University of Bonn; Bonn Germany
| | - Andreas Stahl
- Eye Center; University of Freiburg; Freiburg Germany
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Alnawaiseh M, Rosentreter A, Hillmann A, Alex AF, Niekämper D, Heiduschka P, Pap T, Eter N. OCT angiography in the mouse: A novel evaluation method for vascular pathologies of the mouse retina. Exp Eye Res 2016; 145:417-423. [PMID: 26946073 DOI: 10.1016/j.exer.2016.02.012] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Revised: 02/26/2016] [Accepted: 02/29/2016] [Indexed: 11/26/2022]
Abstract
PURPOSE To investigate the application of optical coherence tomography (OCT) angiography in the retinas of healthy mice and to evaluate choroidal neovascularization (CNV) in a mouse model of laser-induced CNV. METHODS C57BL/6J mice aged 18-25 weeks were examined using the spectral-domain optical coherence tomography device RTVue XR Avanti (Optovue, Inc, Fremont, California, USA). Blood flow in different retinal layers was detected using the split-spectrum amplitude-decorrelation angiography algorithm. Fluorescein angiography (FA) images were obtained using the Heidelberg Spectralis device (Heidelberg, Germany). RESULTS Using the RTVue XR Avanti, we were able to obtain high-quality OCT angiography images of normal vasculature in the superficial, deep capillary and choriocapillary layers in laser-treated mice and untreated controls. Whereas no blood flow was detectable in the outer retina of untreated mice, blood flow and hence neovascular vessels were found in laser-treated mice. CONCLUSIONS OCT angiography can clearly visualize the normal vascular plexus in the different retinal layers in the mouse retina and choroid. With OCT angiography, it is possible to verify the choroidal neovascularization induced by laser treatment. Thus, OCT angiography is a helpful imaging tool for non-invasive, in vivo evaluation of laser-induced CNV in the mouse.
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Affiliation(s)
- Maged Alnawaiseh
- Dept. of Ophthalmology, University of Muenster Medical Center, Muenster, Germany; Institute of Experimental Musculoskeletal Medicine, University of Muenster Medical Center, Muenster, Germany.
| | - André Rosentreter
- Dept. of Ophthalmology, University of Muenster Medical Center, Muenster, Germany; Dept. of Ophthalmology, University of Würzburg, Würzburg, Germany
| | - Anja Hillmann
- Institute of Experimental Musculoskeletal Medicine, University of Muenster Medical Center, Muenster, Germany
| | - Anne F Alex
- Dept. of Ophthalmology, University of Muenster Medical Center, Muenster, Germany
| | - Daniel Niekämper
- Dept. of Ophthalmology, University of Muenster Medical Center, Muenster, Germany
| | - Peter Heiduschka
- Dept. of Ophthalmology, University of Muenster Medical Center, Muenster, Germany
| | - Thomas Pap
- Institute of Experimental Musculoskeletal Medicine, University of Muenster Medical Center, Muenster, Germany
| | - Nicole Eter
- Dept. of Ophthalmology, University of Muenster Medical Center, Muenster, Germany
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Uhlig CE, Frings C, Rohloff N, Harmsen-Aasman C, Schmitz R, Kiesel L, Eter N, Busse H, Alex AF. Long-term efficacy of glycerine-processed amniotic membrane transplantation in patients with corneal ulcer. Acta Ophthalmol 2015; 93:e481-7. [PMID: 25773445 DOI: 10.1111/aos.12671] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 01/01/2015] [Indexed: 12/27/2022]
Abstract
PURPOSE The aim of this study was to determine the long-term treatment efficacy of glycerine-preserved human amniotic membrane transplantation in patients suffering from corneal ulcers. METHODS This was a retrospective, non-controlled, monocentric analysis. Included were patients with corneal ulcers that were non-responsive to ointment or contact lenses and had been treated by amniotic membrane transplantation with either the overlay or sandwich procedure. Analysis parameters were visual acuity before and following treatment, recurrence rate and subjective comfort at the last follow-up. RESULTS Of the 371 amniotic membrane transplantations that were conducted, 135 surgical treatments in 108 patients (51.9% male, 48.1% female; mean age 63.7 years) met the inclusion criteria. In total, 99 overlay and 36 multilayer amniotic membrane transplantations were performed. The follow-up period was 47.5 ± 66.7 weeks (mean ± SD). The recurrence rate at the last follow-up was 47.8% with overlay membranes and 51.8% with the sandwich technique. There was no significant change in best-corrected visual acuity following treatment with overlays (p = 0.219) or sandwich procedure (p = 0.703). At the last follow-up, 72.1% (overlay) and 78.3% (sandwich) of the patients reported either no pain or increased comfort. CONCLUSION The recurrence rates and changes in visual acuity following overlay or sandwich amniotic membrane transplantation in patients suffering from corneal ulcer were lower than reported elsewhere in the literature. More than half of the patients profited from each of the amniotic membrane transplantation techniques with respect to recurrence and postoperative comfort.
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Affiliation(s)
| | - Charlotte Frings
- Department of Ophthalmology; University Medical Center; Muenster Germany
| | - Nadine Rohloff
- Department of Ophthalmology; University Medical Center; Muenster Germany
| | | | - Ralf Schmitz
- Department of Gynecology and Obstetrics; University Medical Center; Muenster Germany
| | - Ludwig Kiesel
- Department of Gynecology and Obstetrics; University Medical Center; Muenster Germany
| | - Nicole Eter
- Department of Ophthalmology; University Medical Center; Muenster Germany
| | - Holger Busse
- Department of Ophthalmology; University Medical Center; Muenster Germany
| | - Anne F. Alex
- Department of Ophthalmology; University Medical Center; Muenster Germany
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Krause TA, Alex AF, Engel DR, Kurts C, Eter N. VEGF-production by CCR2-dependent macrophages contributes to laser-induced choroidal neovascularization. PLoS One 2014; 9:e94313. [PMID: 24714223 PMCID: PMC3979804 DOI: 10.1371/journal.pone.0094313] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Accepted: 03/15/2014] [Indexed: 12/24/2022] Open
Abstract
Age-related macular degeneration (AMD) is the most prevalent cause of blindness in the elderly, and its exsudative subtype critically depends on local production of vascular endothelial growth factor A (VEGF). Mononuclear phagocytes, such as macrophages and microglia cells, can produce VEGF. Their precursors, for example monocytes, can be recruited to sites of inflammation by the chemokine receptor CCR2, and this has been proposed to be important in AMD. To investigate the role of macrophages and CCR2 in AMD, we studied intracellular VEGF content in a laser-induced murine model of choroidal neovascularisation. To this end, we established a technique to quantify the VEGF content in cell subsets from the laser-treated retina and choroid separately. 3 days after laser, macrophage numbers and their VEGF content were substantially elevated in the choroid. Macrophage accumulation was CCR2-dependent, indicating recruitment from the circulation. In the retina, microglia cells were the main VEGF+ phagocyte type. A greater proportion of microglia cells contained VEGF after laser, and this was CCR2-independent. On day 6, VEGF-expressing macrophage numbers had already declined, whereas numbers of VEGF+ microglia cells remained increased. Other sources of VEGF detectable by flow cytometry included in dendritic cells and endothelial cells in both retina and choroid, and Müller cells/astrocytes in the retina. However, their VEGF content was not increased after laser. When we analyzed flatmounts of laser-treated eyes, CCR2-deficient mice showed reduced neovascular areas after 2 weeks, but this difference was not evident 3 weeks after laser. In summary, CCR2-dependent influx of macrophages causes a transient VEGF increase in the choroid. However, macrophages augmented choroidal neovascularization only initially, presumably because VEGF production by CCR2-independent eye cells prevailed at later time points. These findings identify macrophages as a relevant source of VEGF in laser-induced choroidal neovascularization but suggest that the therapeutic efficacy of CCR2-inhibition might be limited.
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Affiliation(s)
- Torsten A Krause
- Institute of Experimental Immunology, Rheinische Friedrich-Wilhelms-University, Bonn, Germany
| | - Anne F Alex
- Department of Ophthalmology, University of Münster, Münster, Germany
| | - Daniel R Engel
- Institute of Experimental Immunology, Rheinische Friedrich-Wilhelms-University, Bonn, Germany
| | - Christian Kurts
- Institute of Experimental Immunology, Rheinische Friedrich-Wilhelms-University, Bonn, Germany
| | - Nicole Eter
- Department of Ophthalmology, University of Münster, Münster, Germany
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Alex AF, Spitznas M, Tittel AP, Kurts C, Eter N. Inhibitory effect of epigallocatechin gallate (EGCG), resveratrol, and curcumin on proliferation of human retinal pigment epithelial cells in vitro. Curr Eye Res 2011; 35:1021-33. [PMID: 20958191 DOI: 10.3109/02713683.2010.506970] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE To investigate potential inhibitory effects of three polyphenolic agents, epigallocatechin gallate (EGCG; from green tea), resveratrol (from red wine), and curcumin (from turmeric), on the proliferation of human retinal pigment epithelial (RPE) cells and to elucidate unwanted effects. METHODS ARPE19 cells and primary human RPE cells were cultured in the presence of various concentrations of EGCG, resveratrol, or curcumin, and compared with controls. The number of viable cells was determined after 24, 48, and 72 hr by flow cytometrical enumeration. Furthermore, cell division was measured by dye dilution assay using carboxyfluorescein succinimidyl ester (CFSE), cell death by Hoechst 33258 staining, and apoptosis by staining for active caspase 3/7 and 8. RESULTS The three drugs inhibited the increase of RPE cell numbers at all time points, with resveratrol being the most efficient and curcumin being the least efficient. EGCG inhibited cell proliferation with intermediate efficiency, and showed little induction of cell death. Resveratrol almost completely suppressed cell proliferation, and induced RPE cell necrosis and caspase 3/7- and caspase 8-dependent apoptosis. Curcumin inhibited RPE cell increase exclusively by inducing caspase 3/7-dependent but caspase 8-independent cell death and necrosis. CONCLUSIONS All three polyphenols tested reduced the absolute number of cells, but had different effects on cell proliferation, apoptosis, and necrosis. Resveratrol was most potent and EGCG induced the least cell death. These polyphenols may aid treatment of proliferative vitreoretinopathy (PVR).
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Affiliation(s)
- Anne F Alex
- Department of Ophthalmology, University of Bonn Medical Center, Bonn, Germany
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