Comparison of the effects of subconjunctival and topical anti-VEGF therapy (bevacizumab) on experimental corneal neovascularization / Comparação do efeito da terapia anti-VEGF (bevacizumab) subconjuntival e tópica na neovascularização corneana experimental

Purpose: To compare the effects of bevacizumab applied either subconjunctivally or topically, in a rat model of corneal neovascularization induced by alkali burn. Methods: The right corneas of 24 Wistar-Albino rats were cauterized with silver nitrate sticks. The rats were divided randomly and equally into three groups: no treatment control (n=8), subconjunctival bevacizumab treatment (n=8), and topical bevacizumab treatment (n=8). Immediately following cauterization, the subconjunctival group was treated with a 0.05 ml (1.25 mg) bevacizumab subconjunctival injection. The topical group was treated with 10 mg/ml bevacizumab twice daily, and the control group received subconjunctival saline injections twice daily. The burn stimulus and neovascularization scores were evaluated using a technique previously described by Mahoney and Waterbury. Digital photographs were obtained before the eyes were enucleated and corneal sections were then analyzed by histopathology. Results: The mean burn stimulus score was 1.86 ± 0.6 and there was no statistical difference between the groups (p=0.730). The mean neovascularization scores in the subconjunctival and topical bevacizumab groups were statistically lower than the control group (p<0.05). The mean percentage area of corneal neovascularization was 82.5 ± 22.1 in the control group, 42.7 ± 15.0 in the subconjunctival group, and 55.8 ± 18.2 in the topical group. The differences between the control and treatment groups were statistically significant (p<0.05). Histopathology showed that the treatment groups presented less neovascularization, inflammation, and fibroblast activity than the control group (p<0.05). Conclusions: This study demonstrates that both subconjunctival and topical administrations of bevacizumab inhibit corneal neovascularization and decrease inflammation and fibroblast activity in a rat model of corneal neovascularization induced by alkali burn. .

Objetivo: Comparar o efeito de bevacizumab aplicado subconjuntival e topicamente em um modelo de neovascularização de córnea de ratos induzida por queimadura alcalina. Métodos: Córneas direitas de 24 ratos Wistar-Albino foram cauterizados por nitrato de prata. Os indivíduos foram divididos aleatoriamente e igualmente em três grupos: controle (n=8), o bevacizumab subconjuntival (n=8), o bevacizumab tópico (n=8). Imediatamente após a cauterização, 0,05 ml (1,25 mg) de bevacizumab foi injetado no grupo subconjuntival. Grupo tópico foi inculcado com 10 mg/ml de bevacizumab duas vezes por dia. O grupo controle recebeu solução salina normal, topicamente, duas vezes ao dia. A graduação do estímulo da queimadura e a graduação da neovascularização foram avaliados utilizando a técnica descrita por Mahoney e Waterbury. Fotografias digitais foram obtidas dos olhos serem enucleados. Seções da córnea foram analisadas por histopatologia. Resultados: A média da graduação do estímulo da queimadura foi de 1,86 ± 0,6 e não houve diferença estatisticamente entre os grupos (p=0,730). As médias das graduações da neovascularização no grupo bevacizumab subconjuntival e no grupo bevacizumab tópico foram estatisticamente menores do que o grupo controle (p<0,05). A percentagem média de área de neovascularização da córnea foi de 82,5 ± 22,1 no grupo controle, 42,7 ± 15,0 no grupo subconjuntival e 55,8 ± 18,2 no grupo tópico. As diferenças entre os grupos de tratamento e grupo de controlo foram estatisticamente significativos (p<0,05). A histopatologia mostrou que os grupos de tratamento apresentavam menos neovascularização, inflamação e atividade de fibroblastos do que o grupo controle (p<0,05). ...

Utilización del bevacizumab en la neovascularización corneal / Use of Bevacizumab in corneal neovascularization

La neovascularización corneal es causa de pérdida de su transparencia y también es un factor de riesgo para el rechazo secundario de trasplantes en esa estructura. El bevacizumab es un anticuerpo monoclonal humanizado que bloquea selectivamente la cascada de formación del VEGF y con esto disminuye la formación de vasos sanguíneos...

Neovascularization of the cornea is a cause of loss of transparency of the same and is also a risk factor for secondary rejection corneal transplants. Bevacizumab is a humanized monoclonal antibody that selectively blocks the formation of the VEGF cascade and, with this, decreases the formation of blood vessels...

The effects of the subconjunctival injection of bevacizumab (Avastin®) on angiogenesis in the rat cornea

The purpose of this study was to evaluate the effects of the use of the subconjunctival injection of bevacizumab (Avastin®) on angiogenesis in the rat cornea. Corneas of 20 Wistar male rats were cauterized with silver nitrate crystal. Animals were divided in four groups: control group (GC) that received subconjunctivally 0.02 ml of 0.9 percent saline solution on the day of the lesion; group GO that received subconjunctivally 0.02 ml of bevacizumab just after the lesion; group G3 that received bevacizumab on day 3 and group G5 that received bevacizumab on day 5 after lesion. Animals were euthanized on day 7. The newly formed vessels were quantified after China Ink perfusion and photographs were obtained and analyzed in a computerized system (Image Pro-Plus®). In the control group, neovascularization covered 53.56 percent ± 15.11 (mean ± SD) of the corneal surface, compared with 35.57 percent ± 18.80 (mean ± SD) in the G0 group, 30.60 percent±11.82 (mean±SD) in the G3 and 35.86 percent±0.07 (mean±SD) in the G5. The results showed an inhibition of angiogenesis when the control group was compared with all treated groups. These results suggest that subconjunctival injection of bevacizumab is able to inhibit corneal angiogenesis independently of the day of treatment.

O objetivo deste estudo foi avaliar os efeitos da aplicação subconjuntival de bevacizumab (Avastin®) na angiogênese corneal em ratos. Vinte ratos Wistar, machos, foram submetidos a cauterização química com cristal de nitrato de prata. Os animais foram divididos em 4 grupos: O grupo controle (GC), recebeu injeção de 0,02 ml de solução fisiológica pela via subconjuntival no momento da lesão. O grupo G0 recebeu 0,02 ml de bevacizumab (Avastin®) imediatamente depois da lesão. O grupo G3 recebeu 0,02 ml de bevacizumab no terceiro dia após a lesão.O grupo G5 recebeu 0,02 ml de bevacizumab no quinto dia após a lesão. Os animais foram eutanasiados 7 dias após a cauterização. Os vasos neoformados foram quantificados após preenchimento do leito vascular com Tinta da China e imagens foram obtidas e analisadas em sistema computadorizado (Image Pro-Plus®). No grupo controle a neovascularização ocupou 53,56 por cento ± 15,11 (média ± DP) da superfície corneal comparando a 35,57 por cento ± 18,80 no grupo G0, 30,60 por cento ± 11,82 (média ± DP) no G3 e 35,86 por cento ± 0,07 (média ± DP) no G5. Os resultados mostram uma inibição da angiogênese quando se compara GC com os grupos tratados. Os resultados sugerem que a injeção subconjuntival de Bevacizumab é capaz de inibir a angiogênese corneal independentemente do dia de aplicação.

Angiogenesis effects of nerve growth factor (NGF) on rat corneas

This study was performed to evaluate the effects of nerve growth factor (NGF) upon angiogenesis in the rat cornea, to examine its possible application as an alternative angiogenic inducer and to provide basic data for further studies. Angiogenesis was induced by cornea micropocket assay, as previously described. Eight of thirty two eyes of Sprague-Dawley rats were randomly assigned to one of four groups, namely, a non-NGF group (Group 0), a 0.5 ng of NGF group (Group 0.5), a 1.0 ng of NGF group (Group 1.0) and a 5.0 ng of NGF group (Group 5.0). Pellets made of poly-2-hydroxylethylmethacrylate and sucralfate were implanted into the corneal stroma no closer than 1 mm from the limbus. After the implantation, the number of new vessels, vessel length and circumferential neovascularization were examined daily under the surgical microscope over a period of 7 days. The area of neovascularization was determined using a mathematical formula. Although new vessels in Group 0 and Group 0.5 were first observed at day 5, those of Groups 1.0 and 5.0 were first noted on days 4 and 3, respectively. However, the growth rates of new vessels in Groups 1.0 and 5.0 were higher than those of Groups 0 and 0.5 with the passage of time. The number, length, circumferential neovascularization and areas covered by the vessels in Groups 1.0 and 5.0 were significantly more than in Group 0 and Group 0.5 (p<0.05). This study showed that NGF had a dose-dependent angiogenic effects on the rat cornea and that the minimal effective dose of NGF was 1.0 ng per cornea. Also, it showed that NGF would be useful in angiogenic studies as an alternative angiogenic inducer.

Efecto de la ciclosporina sobre la neovascularización corneal / Cyclosporine effect in corneal neovascularization

Las investigaciones en humanos y animales a partir de los años 70's han demostrado la efectividad de la ciclosporina (CsA) como agente inmunsupresor. Nosostros pretendimos determinar si la ciclosporina podría suprimir la neovascularización coreal inducida por las interleukinas-2. Estudiamos 40 ratas de laboratorio con inyección IM diaria de ciclosporina (25 mg/kg en aceite de oliva) tres días previos y dos semanas después de la inyección intraestromal de 0.5 µl (5 UI) solución recombinante interleukina-2. Los animales del grupo control recibieron inyecciones IM de aceite de oliva. La zona promedio de neovascularización corenal a las 4, 8 y 12 semanas posterior a la inyección fue de 9.2, 9.1 y 9.2 mm² respectivamente para el grupo control y de 4.9, 5.3 y 5.2 mm² para el grupo de ratas tratado con ciclosporina (P<0.02; prueba T Students). La ciclosporina provoca un disminución significativa en la neovascularización corenal inducida por interlelukina-2, esto podría contribuir a su habilidad para prolongar la sobrevida del injerto corneal especialmente en aquellos pacientes de alto riesgo