Inflammatory mediators and angiogenic factors in choroidal neovascularization: pathogenetic interactions and therapeutic implications.
Choroidal neovascularization (CNV) is a common and severe complication in heterogeneous diseases affecting the posterior segment of the eye, the most frequent being represented by age-related macular degeneration. Although the term may suggest just a vascular pathological condition, CNV is more properly definable as an aberrant tissue invasion of endothelial and inflammatory cells, in which both angiogenesis and inflammation are involved. Experimental and clinical evidences show that vascular endothelial growth factor is a key signal in promoting angiogenesis. However, many other molecules, distinctive of the inflammatory response, act as neovascular activators in CNV. These include fibroblast growth factor, transforming growth factor, tumor necrosis factor, interleukins, and complement. This paper reviews the role of inflammatory mediators and angiogenic factors in the development of CNV, proposing pathogenetic assumptions of mutual interaction. As an extension of this concept, new therapeutic approaches geared to have an effect on both the vascular and the extravascular components of CNV are discussed.
Campa
Claudio
C
Department of Ophthalmology, University of Ferrara, 44121 Ferrara, Italy.
Costagliola
Ciro
C
Incorvaia
Carlo
C
Sheridan
Carl
C
Semeraro
Francesco
F
De Nadai
Katia
K
Sebastiani
Adolfo
A
Parmeggiani
Francesco
F
D043925:Angiogenesis Inducing Agents / Q000378:metabolism*; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000818:Animals; D020256:Choroidal Neovascularization / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D018836:Inflammation Mediators / Q000378:metabolism*; D008268:Macular Degeneration / Q000150:complications / Q000378:metabolism / Q000473:pathology
D043925:Angiogenesis Inducing Agents; D020533:Angiogenesis Inhibitors; D018836:Inflammation Mediators