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The therapeutic potential of VEGF inhibition in diabetic microvascular complications

yucloud 添加于 2012-8-14 10:44 | 1571 次阅读 | 0 个评论

作者
Tremolada G, Lattanzio R, Mazzolari G, Zerbini G
摘要
During the last few years, the incidence of microvascular complications in diabetes mellitus has rapidly increased as a consequence of both an increase in incidence of type 2 and type 1 diabetes mellitus. The pathogenesis of diabetic microvascular complications is still largely unknown. Among the many hypotheses, a dysfunction in angiogenesis has been suggested as a common origin for retinopathy, nephropathy, and neuropathy. Based on this hypothesis, inhibition of vascular endothelial growth factor (VEGF) has been tested as a potential therapeutic approach to prevent and cure diabetic microvascular complications. Several VEGF inhibitors are currently under evaluation or are approved for the treatment of wet age-related macular degeneration and macular edema. These include inhibitors of intracellular transcription of VEGF (e.g. bevasiranib), inhibitors of extracellular VEGF (e.g. pegaptanib), inhibitors of VEGF receptor expression (e.g. aflibercept [VEGF-TRAP]) and inhibitors of the intracellular signaling cascade activating VEGF (e.g. midostaurin). According to the existing evidence base, although inhibition of VEGF results in a better outcome in the case of diabetic retinopathy and also, despite some discrepant results, in the case of diabetic nephropathy, there is no final confirmation that VEGF inhibition is a valid approach for diabetic neuropathy. The latter complication actually, in line with other chronic neuropathies, seems to improve with stimulation of angiogenesis through increased expression of VEGF.
详细资料
- 关键词: Angiogenesis Inhibitors/*therapeutic use; Diabetes Mellitus, Type 1/complications; Diabetes Mellitus, Type 2/complications; Diabetic Nephropathies/*drug therapy/etiology; Diabetic Neuropathies/*drug therapy/etiology; Diabetic Retinopathy/*drug therapy/etiology; Humans; Neovascularization, Pathologic/drug therapy; Vascular Endothelial Growth Factors/*antagonists & inhibitors
- 文献种类:期刊
- 期刊名称: American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions
- 期刊缩写: Am J Cardiovasc Drugs
- 期卷页: 2007年第7卷第6期 393-398页
- 地址: Department of Ophthalmology and Visual Sciences, San Raffaele Scientific Institute, Milan, Italy
- ISBN: 1175-3277
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