title: Serum anti-endothelial cell antibodies in patients with age-related macular degeneration treated with intravitreal bevacizumab.
abstract: OBJECTIVE
  To analyse the prevalence and changes in circulating anti-endothelial cell antibodies (AECA) during anti-vascular endothelial growth factor (anti-VEGF) therapy.
  
  
  METHODS
  Ninety-eight patients with exudative age-related macular degeneration (AMD) were treated with intravitreal bevacizumab. Fifty sex- and age-matched healthy subjects were used as controls. Serum AECA were detected using indirect immunofluorescence on primate skeletal muscle and cultivated human umbilical vein endothelial cells (HUVEC). These investigations were repeated at 4-week intervals within 8 months of follow-up.
  
  
  RESULTS
  At baseline examination, 30 of the 98 patients (30.6%) were positive for AECA. The titres of AECA ranged from 1:10 to 1:320. In the control group, AECA were present in only nine sera (18%) with titres ranging between 1:20 and 1:80 (p = 0.0000). The greatest rates of reduction of AECA titres were observed during the 'loading' phase of therapy. During the 'maintenance' phase, the rates of changes in serum AECA levels were less significant and remained constant. In follow-up period in 13 patients (13.3%), serum AECA were detected de novo in titres of 1:10 to 1:80. Statistical analysis did not show any significant correlation between the presence of AECA and activity of the disease.
  
  
  CONCLUSIONS
  There is growing evidence that AMD is an immune-mediated disease, and thus it cannot be excluded that AECA may be involved in its pathogenesis and progression. We also speculate that AECA develop in response to retinal damage and anti-VEGF therapy.
authors.affiliation: Department of Ophthalmology and Ocular Oncology, Jagiellonian University Medical College, Krakow, Malopolska, Poland. akubicka@onet.pl.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Kubicka-Trząska
authors.affiliation: Division of Molecular Biology and Clinical Genetics, Jagiellonian University Medical College, Krakow, Malopolska, Poland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Wilańska
authors.affiliation: Department of Ophthalmology and Ocular Oncology, Jagiellonian University Medical College, Krakow, Malopolska, Poland.
authors.forename: Bożena
authors.initials: B
authors.lastname: Romanowska-Dixon
authors.affiliation: Division of Molecular Biology and Clinical Genetics, Jagiellonian University Medical College, Krakow, Malopolska, Poland.
authors.forename: Marek
authors.initials: M
authors.lastname: Sanak
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000818:Animals; D001323:Autoantibodies / Q000097:blood*; D000068258:Bevacizumab / Q000627:therapeutic use*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D061307:Human Umbilical Vein Endothelial Cells / Q000276:immunology; D006801:Humans; D058449:Intravitreal Injections; D008251:Macaca; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000276:immunology; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity; D057135:Wet Macular Degeneration / Q000188:drug therapy* / Q000276:immunology*
chemical_list: D020533:Angiogenesis Inhibitors; D001323:Autoantibodies; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; C087589:anti-endothelial cell antibody; D000068258:Bevacizumab
keywords: anti-endothelial cells autoantibodies; antiretinal antibodies, age-related macular degeneration; bevacizumab