抗血管内皮生长因子治疗无应答的遗传学因素研究现状

The genetic factors of non-response to anti-vascular endothelial growth factor therapy

抗血管内皮生长因子(VEGF)的疗效存在个体差异.根据功能及形态变化,抗VEGF治疗的应答程度可分为理想应答、弱应答、无应答3种情况.导致机体无应答的原因尚未明确,可能的影响因素包括年龄、基线视力、疾病病程、病灶特点及基因的多态性等.目前对于导致抗VEGF无应答遗传因素的研究主要集中在VEGF相关基因、补体因子H、年龄相关性黄斑病变易感因子2、高温必需因子A-1及白介素相关基因等.本文通过综合抗VEGF药物治疗无应答相关遗传学因素研究,进一步分析导致抗VEGF无应答的遗传机制,以期为临床制定个性化治疗方案和预测抗VEGF疗效研究提供参考.

The response to anti-vascular endothelial growth factor (VEGF) treatment is variable.It is generally measured in terms of changes in correlated functional and/or anatomical outcomes,and patients are then classified as optimal response,poor response and non-response.The precise cause of non-response remains undetermined.A variety of factors could account for poor or non-response to anti-VEGF therapy,such as age,baseline vision,disease course,lesion characteristics and genomic polymorphism.At the present time,many studies on the genetic factors of non-response or poor response to anti-VEGF treatment mainly focus on VEGF genes (VEGF-A,VEGFR-2),complement factor H (CFH),age-related maculopathy susceptibility 2 (LOC387715/ARMS2),high temperature factor A-1 (HTRA1),interleukin-related gene (IL-8 rs4073) and so forth.It is still worthy of further investigations that how to assess genetic reasons for non-response or poor response,so that we can provide individualized treatment sequences and predict the response to anti-VEGF therapy.