抗血管内皮生长因子药物治疗糖尿病视网膜病变的研究进展

Research progress of anti-vascular endothelial growth factor drugs in the treatment of diabetes retinopathy

糖尿病视网膜病变(DR),是糖尿病患者眼部最严重的微血管并发症,严重影响患者的视功能,是全球糖尿病患者失明的主要原因。血管内皮生长因子(VEGF)在DR的发病机制中起着关键作用,是诱导视网膜新生血管形成的主要血管生成因子。目前家族成员有7个,包括VEGF-A、VEGF-B、VEGF-C、VEGF-D、VEGF-E、VEGF-F和胎盘生长因子(PLGF),这些配体通过激活酪氨酸激酶受体,即血管内皮生长因子受体(VEGFR)-1和VEG-FR-2来引发一系列生理活动,并进一步加速DR的病程进展。玻璃体腔内注射抗VEGF药物是目前治疗DR的有效措施,通过与VEGF特异性结合,可明显消退视网膜新生血管,减轻黄斑水肿。常用的抗VEGF药物包括贝伐单抗、雷珠单抗、康柏西普、阿柏西普等。但抗VEGF药物半衰期较短,需要在一定时间后再次注射,长期反复应用的安全性仍需进一步研究。现将抗VEGF治疗DR的研究进展进行综述。

Diabetic retinopathy(DR)is the most serious microvascular complication of the eyes in diabetic patients,which seriously affects the visual function of patients,and it is also the leading cause of blindness in diabetic patients worldwide.Vascular endothelial growth factor(VEGF)plays a key role in the pathogenesis of DR and is the main angiogenic factor that induces retinal neovascularization.There are currently 7 family members,including VEGF-A,VEGF-B,VEGF-C,VEGF-D,VEGF-E,VEGF-F and placental growth factor(PLGF),which trigger a series of physiological activities by acti-vating tyrosine kinase receptors,namely vascular endothelial growth factor receptors(VEGFR)-1 and VEGFR-2,and fur-ther accelerate the progression of DR.Intravitreal injection of anti-VEGF drugs is currently an effective measure for the treatment of DR,and by specific binding to VEGF,retinal neovascularization and reduction of macular edema can be signif-icantly resolved.Commonly used anti-VEGF drugs include bevacizumab,ranibizumab,compacept,aflibercept and so on.However,anti-VEGF drugs have a short half-life and need to be injected again after a certain period of time,and the safety of long-term repeated application still needs further study.The research progress of anti-VEGF in the treatment of DR has been reviewed.