Changes in Aqueous Cytokine Levels Following Intravitreal Aflibercept in Treatment-Naive Patients with Diabetic Macular Edema

Juncal, Verena R.; Mak, Michael; Bamakrid, Motaz; Muni, Rajeev H.

doi:10.1089/jop.2020.0038

Cited by 6 publications

(8 citation statements)

References 26 publications

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“…The findings can also explain why there was no difference in occurrence of early ME between Pre-IV or No-Pre-IV group in the present study. Interestingly, we found TNF-α and IP-10 were upregulated after IVC, which has also been reported in the study of Juncal et al (2020) . We supposed that the upregulation of TNF-α and IP-10 might contribute to the injection manipulation ( Agrawal et al, 2013 ).…”

Section: Discussionsupporting

confidence: 89%

“…However, with the sudden drop of VEGF-A level and the regression of angiogenesis, how inflammatory factors and chemokines response in the ocular microenvironment still remains unclear. To the best of our knowledge, previous studies usually measured the cytokines over weeks or months after IV-anti-VEGF treatment, and mainly for diabetic macular edema (DME) ( Jeon and Lee, 2012 ; Hillier et al, 2018 ; Mastropasqua et al, 2018 ; Cacciamani et al, 2019 ; Felfeli et al, 2019 ; Wei et al, 2019 ; Juncal et al, 2020 ; Imazeki et al, 2021 ; Xavier et al, 2021 ), few focused on the early-stage changes of cytokines after IV-anti-VEGF. In addition, the changes of cytokines seemed controversial among studies, some of which reported the cytokines decreased ( Cacciamani et al, 2019 ; Felfeli et al, 2019 ; Coughlin et al, 2020 ; Imazeki et al, 2021 ), while others found the opposite ( Jeon and Lee, 2012 ; Mastropasqua et al, 2018 ; Xavier et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

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Vitreous Inflammatory Cytokines and Chemokines, Not Altered After Preoperative Adjunctive Conbercept Injection, but Associated With Early Postoperative Macular Edema in Patients With Proliferative Diabetic Retinopathy

et al. 2022

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PurposeTo investigate the influence of preoperative adjunctive anti-VEGF drug (Conbercept) on vitreous inflammatory cytokines and chemokines profiles and whether those cytokines were associated with early macular edema (ME) after surgery for patients with proliferative diabetic retinopathy (PDR).MethodsIn this post hoc analysis of the CONCEPT clinical trial, subjects with PDR underwent vitrectomy were included and vitreous samples were collected at the start of vitrectomy. Levels of vitreous VEGF, 17 inflammatory cytokines, and 11 chemokines were measured using Luminex multiplex technology. Subjects were then divided into groups based on with (Pre-IV) or without (No-Pre-IV) preoperative intravitreous injection of Conbercept; with or without early ME after surgery.ResultsThere was no difference between Pre-IV (13/30) and No-Pre-IV (7/29) concerning the ratio of patients with early ME (p = 0.17). After preoperative intravitreous injection of Conbercept, VEGF level dramatically decreased (p = 0.001), TNF-α (p = 0.002), and IP-10 (p = 0.018) increased in Pre-IV group. In patients with early ME after surgery, however, a number of cytokines increased, including IL-1β (p = 0.008), IL-2 (p = 0.023), IL-4 (p = 0.030), IL-9 (p = 0.02), IL-10 (p = 0.002), IL-12 (p = 0.001), IL-13 (p = 0.031), IL-17A (p = 0.008), TNF-α (p = 0.012), CXCL9 (p = 0.023), G-CSF (p = 0.019), MCP-1 (p = 0.048), and RANTES (p = 0.016).ConclusionWe found the preoperative adjunctive Conbercept injection has limited influence on the levels of vitreous inflammatory cytokines and chemokines in PDR. The elevated levels of a series of cytokines might be associated with early inflammation after vitrectomy, which may lead to postoperative ME.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Vitreous Inflammatory Cytokines and Chemokines, Not Altered After Preoperative Adjunctive Conbercept Injection, but Associated With Early Postoperative Macular Edema in Patients With Proliferative Diabetic Retinopathy

et al. 2022

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“…We excluded nine articles since one of them was not available, and eight articles did not include eligible measurements. us, nine prospective studies were included in our systematic review and were eligible for meta-analysis [12][13][14][15][16][17][18][19] (Table 1). e literature selection process and reasons for exclusion are summarized in (Figure 1).…”

Section: Baseline Characteristics Of Included Studiesmentioning

confidence: 99%

The Change of Aqueous Humor Cytokine Levels after Anti-VEGF in Diabetic Macular Edema: A Systematic Review and Meta-Analysis

Wang

2022

Evidence-Based Complementary and Alternative Medicine

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Background. Diabetic macular edema (DME) is a vision-threatening complication that severely impairs vision, and VEGF has a certain improvement e ect on it as a growth factor. Objective. To assess the alterations of di erent aqueous humor cytokine concentrations after intravitreal antivascular endothelial growth factor (VEGF) treatment for diabetic macular edema (DME). Methods. We searched PubMed, EMBASE, and the Cochrane Library from inception up to May 2022 for studies evaluating the alterations of di erent aqueous humor cytokine concentrations after intravitreal anti-VEGF treatment for diabetic macular edema. e estimates from eligible studies were meta-analyzed by the Hartung-Knapp/Sidik-Jonkman random-e ects method. Egger's regression test was used to determine the publications' bias. A 95% con dence interval was calculated across studies. e analysis was performed using STATA ™ Version 15 software. Results. Nine eligible studies involving a total of 209 eyes for our systematic review were identi ed through our search strategy. e mean di erences in 1-month and 2-month changes of VEGF were 110.681 pg/ml (P < 0.001) and 283.474 pg/ml (P 0.003), respectively. e mean di erence in 2-month changes of interleukin 6 (IL-6) was −24.784 pg/ml (P 0.037). e mean di erence in 3-month changes of central macular thickness was 130.372 μm (P < 0.001). Conclusions. Intravitreal injection of anti-VEGF exerts a protective e ect on macular edema secondary to diabetic retinopathy by a ecting various cytokine concentrations, especially reducing aqueous VEGF concentrations and interleukin 6 in patients with DME.

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“…Chen et al reported that PlGF is a susceptibility gene for nAMD but not PCV in a Chinese population ( 17 ). Nevertheless, short-term aflibercept injection therapy not only leads to VEGF and PlGF suppression but results in reduction of IL-6 and platelet-derived growth factor ( 18 ).…”

Section: Discussionmentioning

confidence: 99%

Short-Term Efficacy in Polypoidal Choroidal Vasculopathy Patients Treated With Intravitreal Aflibercept or Conbercept

Yin

Cai

2022

Front. Med.

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PurposeTo compare the short-term efficacy in patients with polypoidal choroidal vasculopathy (PCV) treated using either aflibercept or conbercept.MethodsThis prospective study included 41 patients with treatment-naive PCV (42 eyes). All the patients were treated with either aflibercept or conbercept using an initial series of 3 monthly loading injections. Changes in the best-corrected logMAR visual acuity (BCVA) and anatomic outcomes were evaluated at 3 months.ResultsBCVA was improved with reduction in central choroidal thickness (CCT), central foveal thickness (CFT), and subretinal fluid (SRF) after 3 monthly loading injections in both aflibercept (IVA) and conbercept (IVC) groups. There was no significant difference in either visual or anatomic outcomes between the two groups after 3 months of treatment. However, compared with the IVC group, significantly higher BCVA improvement was observed in the patients in the IVA group with baseline BCVA better than 1. A visual outcome improved ≥3 lines in 13 patients in the IVA group (59%), and 9 patients in the IVC group (45%). A relatively high proportion of polyp regression was observed in the IVA group (63%) compared with the IVC group (55%) via OCTA.ConclusionsVisual and anatomic outcomes were significantly improved in both IVA and IVC groups, but the results suggest a potentially superior short-term response in the IVA group.

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Changes in Aqueous Cytokine Levels Following Intravitreal Aflibercept in Treatment-Naive Patients with Diabetic Macular Edema

Cited by 6 publications

References 26 publications

Vitreous Inflammatory Cytokines and Chemokines, Not Altered After Preoperative Adjunctive Conbercept Injection, but Associated With Early Postoperative Macular Edema in Patients With Proliferative Diabetic Retinopathy

Vitreous Inflammatory Cytokines and Chemokines, Not Altered After Preoperative Adjunctive Conbercept Injection, but Associated With Early Postoperative Macular Edema in Patients With Proliferative Diabetic Retinopathy

The Change of Aqueous Humor Cytokine Levels after Anti-VEGF in Diabetic Macular Edema: A Systematic Review and Meta-Analysis

Short-Term Efficacy in Polypoidal Choroidal Vasculopathy Patients Treated With Intravitreal Aflibercept or Conbercept

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