1.
Association of VEGF Gene Polymorphisms with Susceptibility to Diabetic Retinopathy: A Systematic Review and Meta-Analysis.
Yang, Q, Zhang, Y, Zhang, X, Li, X, Liu, J
Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme. 2020;(5):264-279
Abstract
The associations between vascular endothelial growth factor (VEGF) gene polymorphisms and risk of type 2 diabetic retinopathy (DR) - proliferative diabetic retinopathy (PDR), and nonproliferative diabetic retinopathy (NPDR) - remain unclear. A systematic search and meta-analysis using odds ratio (OR) with 95% confidence interval (CI) was performed to evaluate the association. Our study concluded 26 studies containing 10 single nucleotide polymorphisms (SNPs). In Asian populations, rs3025039 polymorphism was associated with DR risk, while in overall populations and Caucasians, the DR risk was increased by association with rs2010963. There was a significant association between rs25648 and rs833061 and DR risk in Caucasians. DR risks were found to be significantly associated between rs3025021, rs13207351, and rs2146323 in either overall populations, Caucasians or Asians. Besides, in overall and Asian populations, rs699947 and rs3025039 were associated with PDR risk. rs1570360, rs3025039, and rs833061 played a key role in PDR etiology in Caucasians. rs2010963 was associated with increased risk of PDR in overall populations. A significant association between rs699947, rs3025039, and rs833061 and NPDR risk in overall populations and Asians was found. A significant association was observed between rs2010963 and increased NPDR risk in overall and Caucasian populations. This study provides a new insight into the parthenogenesis of diabetic retinopathy. Targeting VEGF SNPs may be a potential of therapeutic approach for the treatment of DR, PDR, and NPDR.
2.
Anti-Vascular Endothelial Growth Factor Injections: The New Standard of Care in Proliferative Diabetic Retinopathy?
Li, X, Zarbin, MA, Bhagat, N
Developments in ophthalmology. 2017;:131-142
Abstract
For decades, panretinal photocoagulation (PRP) has been the standard of care for the treatment of proliferative diabetic retinopathy (PDR). The relatively recent advent of anti-vascular endothelial growth factor (VEGF) formulations for intravitreal injection has provided a fresh perspective on PDR treatment, especially in eyes with concurrent diabetic macular edema (DME). The anti-VEGF agent ranibizumab has demonstrated a potentially protective effect on eyes with DME in terms of progression to PDR in the RIDE/RISE trials, as has aflibercept in the VIVID/VISTA trials. In 2015, these 2 agents were approved by the Food and Drug Administration for the treatment of PDR with DME, though PRP still remains the standard of care for eyes without baseline DME. Published results from Protocol S illustrate the non-inferiority of ranibizumab versus PRP in the treatment of PDR, the first prospective study to do so in eyes with and without baseline DME. These results also reveal that treatment with ranibizumab, when compared to standard treatment with PRP, may also lead to less peripheral visual field loss, reduced need for vitrectomy, and reduced chance for developing DME. Both PRP and intravitreal ranibizumab have very low rates of adverse events. However, treatment with anti-VEGF agents generally is associated with higher costs, increased need for follow-up, and the risk of potentially catastrophic ocular complications (e.g., endophthalmitis) and systemic side effects. Anti-VEGF agents should be considered in cases of media opacity preventing completion of PRP in compliant patients without recent cerebrovascular accident or myocardial infarction, though the long-term efficacy of these agents remains to be studied, especially after the discontinuation of injections.
3.
Prognostic Value of VEGF in Hepatocellular Carcinoma Patients Treated with Sorafenib: A Meta-Analysis.
Cao, G, Li, X, Qin, C, Li, J
Medical science monitor : international medical journal of experimental and clinical research. 2015;:3144-51
Abstract
BACKGROUND Hepatocellular carcinoma (HCC) is characterized by rich vascularization in the tumor, and vascular endothelial growth factor (VEGF) plays important roles in vascularization. The results of the roles of VEGF in predicting efficacy of sorafenib in HCC are conflicting. In this meta-analysis, we aimed to investigate the prognostic and predictive value of VEGF in HCC patients receiving sorafenib. MATERIAL AND METHODS PubMed, Embase, and Cochrane library electronic databases were systematically searched for eligible studies. The baseline characteristics were recorded and overall qualities of the eligible studies were assessed by 2 reviewers independently. VEGF levels and data relevant to efficacy of sorafenib were extracted and used for meta-analysis. RESULTS The comprehensive search yielded 9 studies that evaluated the relationship between VEGF level and clinical outcome in advanced HCC patients treated with sorafenib. Pooled estimates suggested that high level of VEGF was associated with poor overall survival (HR=1.85; 95% CI: 1.24-2.77; P=0.003) and poor progression-free survival (HR=2.09; 95% CI: 1.43-3.05; P<0.01) in HCC. Mutation of VEGF had a favorable effect on hand-foot skin reaction in HCC patients treated with sorafenib (P<0.05). CONCLUSIONS High level of VEGF is associated with poor outcomes in HCC patients treated with sorafenib, indicating that VEGF could be used as an indicator of clinical efficacy in patients with HCC. However, more well-designed studies are needed to strengthen our findings.