Vascular endothelial growth factor-A: a multifunctional molecular player in diabetic retinopathy.
Vascular endothelial growth factor-A (VEGF-A), first described as "vascular permeability factor", is a critical molecule in the pathogenesis of diabetic retinopathy at several levels. Previous studies have outlined the importance of VEGF-A in mediating vascular pathology in both experimental models and clinical diabetic retinopathy, which are characterized by retinal vascular leakage, preretinal neovascularisation and neuronal degeneration. Paradoxically, recent reports have emphasized the potential neurotrophic effects of VEGF-A on the quiescent vasculature, as well as its direct and indirect protective effects on retinal neurons. VEGF-A has also been identified as an important signalling regulator in the normal central nervous system. Consequently, anti-VEGF therapy for diabetic retinopathy has become a controversal issue. This review outlines recently developed concepts relating to the role of VEGF-A in the pathogenesis of diabetic retinopathy, with particular emphasis on its implications for clinical practice.
Zhang
Xinyuan
X
Retinal Therapeutics Research Group, Save Sight Institute, Department of Clinical Ophthalmology, The University of Sydney, Level 2, South Block, Sydney Eye Hospital, Macquarie St, Sydney, NSW 2000, Australia. xzhang@eye.usyd.edu.au
Bao
Shisan
S
Hambly
Brett D
BD
Gillies
Mark C
MC
D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D000818:Animals; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D002199:Capillary Permeability / Q000276:immunology; D019610:Cytoprotection / Q000276:immunology; D003930:Diabetic Retinopathy / Q000188:drug therapy* / Q000276:immunology*; D006801:Humans; D007167:Immunotherapy; D009389:Neovascularization, Pathologic / Q000276:immunology; D055351:Retinal Neurons / Q000276:immunology*; D042461:Vascular Endothelial Growth Factor A / Q000276:immunology / Q000378:metabolism*
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab