实验研究
ENGLISH ABSTRACT
球结膜下注射康柏西普对兔角膜新生血管和淋巴管的抑制作用
陈孝霞
李旌
辜臻晟
作者及单位信息
·
DOI: 10.3760/cma.j.cn115989-20190327-00149
Inhibiting effect of subconjuctivally injected conbercept on experimental corneal neovascularization and lymphangiogenesis in rabbit
Chen Xiaoxia
Li Jing
Gu Zhencheng
Authors Info & Affiliations
Chen Xiaoxia
Department of Ophthalmology, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
Li Jing
Department of Ophthalmology, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
Gu Zhencheng
Department of Ophthalmology, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
·
DOI: 10.3760/cma.j.cn115989-20190327-00149
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摘要

目的观察康柏西普对兔碱烧伤诱导角膜新生血管(CNV)、新生淋巴管生成的作用。

方法44只2~3 kg成年雄性新西兰大白兔按照随机数字表法分为康柏西普注射组9只、雷珠单抗注射组9只、生理盐水对照组9只、模型对照组9只和正常对照组8只。以左眼为实验眼,采用碱烧伤方法制作炎症性CNV动物模型,直径8 mm的滤纸片浸润1 mol/L NaOH,放至角膜中央烧灼30 s。造模后第1天,康柏西普注射组球结膜下注射康柏西普0.1 ml/1 mg,雷珠单抗注射组同法注射雷珠单抗0.1 ml/1 mg,生理盐水对照组同法注射0.1 ml质量分数0.9% NaCl溶液,模型对照组碱烧伤后不做任何处理,正常对照组不行碱烧伤和球结膜下注射药物处理。分别于造模后第4、7、14和21天计算CNV面积,每组耳缘静脉空气栓塞处死一定数量动物,抽取房水,检测血管内皮生长因子(VEGF);取角膜组织行苏木精-伊红染色,进行组织病理学检查;免疫组织化学检测淋巴管内皮透明质酸受体-1(LYVE-1)含量。

结果造模后第4天,康柏西普注射组、雷珠单抗注射组、生理盐水对照组和模型对照组新生血管芽长入角膜边缘,角膜水肿减轻;第7天,康柏西普注射组、雷珠单抗注射组新生血管较生理盐水对照组、模型对照组稀疏。造模后第4天可见各造模组角膜上皮细胞增多,上皮层存在空泡,基质内大量炎性细胞,上皮层下可见小的血管腔。造模后第7天,新生血管浸润浅层基质,基质内有大量炎性细胞。造模后第14天,康柏西普注射组CNV面积为(15.20±9.16)mm 2,小于雷珠单抗注射组的(28.21±5.17)mm 2,差异有统计学意义( P<0.05);康柏西普注射组VEGF质量浓度为(7.75±6.56)pg/ml,低于雷珠单抗注射组的(16.98±2.17)pg/ml,差异有统计学意义( P<0.05)。正常对照组角膜组织无淋巴管生长,无LYVE-1阳性细胞。造模后第4天,康柏西普注射组、雷珠单抗注射组、生理盐水对照组和模型对照组角膜组织中出现新生淋巴管,与新生血管平行生长。造模后第7天,康柏西普注射组、雷珠单抗注射组角膜新生淋巴管计数分别为(4.33±0.58)个和(4.67±0.58)个,少于生理盐水对照组的(10.67±0.58)个和模型对照组的(12.33±0.58)个,差异均有统计学意义(均 P<0.05)。

结论碱烧伤后早期球结膜下注射康柏西普能有效抑制CNV、新生淋巴管,其抑制作用可能与降低VEGF的质量浓度密切相关。

角膜新生血管;角膜新生淋巴管;康柏西普;雷珠单抗;血管内皮生长因子
ABSTRACT

ObjectiveTo investigate the value of conbercept in experimental corneal nevascularization (CNV) and lymphangiogenesis in rabbit model.

MethodsForty-four adult New Zealand rabbits were randomly divided into a conbercept injected group (9 rabbits), a ranibizumab injected group (9 rabbits), a normal saline control group (9 rabbits), a model control group (9 rabbits) and a normal control group (8 rabbits) by random number table method, take the left eyes as the experimental eye.Whatman filter papers (8 mm in diameter) were soaked in 1 mol/L NaOH solution and then applied on the middle surface of the cornea for 30 seconds.On day 1st after alkali burning, the eyes in the conbercept injected group were treated with 0.1 ml/1 mg of conbercept, the eyes in the ranibizumab injected group were treated with 0.1 ml/1 mg of ranibizumab, the eyes in the normal saline control group were treated with 0.1 ml 0.9% NaCl, the eyes in the model control group just received alkali burning, and the eyes in the normal control group received neither alkali burns nor subconjunctival injection any drugs.All rabbits were monitored daily after alkali burning.Digital pictures were taken on day 4th, 7th, 14th and 21th after modeling.Image analysis was performed on the area of neovascularization, a ascertain number of rabbits were killed respectively.Aqueous humor was collected for the concentration of vascular endothelial growth factor (VEGF) assay.Corneal specimens were analyzed by histopathologically and immunohistochemical staining of lymphatic endothelial cells hyaluronic acid receptor 1(LYVE-1). The use and care of the animals complied with the Statement of the Association for Research in Vision and Ophthalmology (ARVO).

ResultsOn the 4th day after alkali burning, the neovascularization buds grew into the edge of the cornea in the conbercept injected group, the ranibizumab injected group, the normal saline control group and the model control group, and the corneal edema decreased.On day 7th, the neovascularization of the conbercept injected group and the ranibizumab injected group was less than that of the normal saline control group and the model control group; On day 4th after alkali burning, corneal epithelial cells were increased, vacuoles were found in the epithelium, a large number of inflammatory cells were found in the matrix, and small vascular lumens were seen below the epithelium.On day 7th after modeling, neovascularization infiltrated the shallow matrix with a large number of inflammatory cells.Surface areas of induced CNV in conbercept injected group were (15.20±9.16)mm 2, which were significantly less than those in ranibizumab injected group ([28.21±5.17]mm 2) on day 14th ( P<0.05). The concentration of VEGF in the conbercept injected group was (7.75±6.56)pg/ml, which was significantly lower than that in the ranibizumab injected group ([16.98±2.17]pg/ml on day 14th ( P<0.05). The normal control group had no lymphatic growth in the corneal tissue and no LYVE-1 positive particles.On day 4th after the alkil burning, corneal lymphatic vessels appeared in the corneal tissue of the conbercept injected group, the ranibizumab injected group, the normal saline control group and the model control group, which grew in parallel with the neovascularization.Lymphatic vessels counting in the conbercept injected group and ranibizumab injected group were 4.33±0.58 and 4.67±0.58 on day 7th and 14th, which were reduced significantly compared with normal saline control group (10.67±0.58) and the model control group (12.33±0.58) (all at P<0.05).

ConclusionsEarly subconjunctival administration of conbercept may successfully inhibit alkali-induced corneal neovascularization and corneal lymphangiogenesis in alkali burning animal model.The inhibit effect is related with the reduces of VEGF levels.

Corneal neovascularization;Corneal lymphangiogenesis;Conbercept;Ranibizumab;Vascular endothelial growth factor
Gu Zhencheng, Email: nc.defmoabc.demauhnixgnehcnehzug
引用本文

陈孝霞,李旌,辜臻晟. 球结膜下注射康柏西普对兔角膜新生血管和淋巴管的抑制作用[J]. 中华实验眼科杂志,2020,38(07):581-588.

DOI:10.3760/cma.j.cn115989-20190327-00149

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正常角膜处于无血管状态,以维持其透明性。透明角膜对维持视功能至关重要。在感染、外伤、免疫反应、移植排斥反应等病理条件下,毛细血管由角膜缘向角膜内生长,进入角膜周边部1~2 mm以上即为角膜新生血管(corneal neovascularization,CNV)。CNV破坏角膜正常微环境,改变了眼前节免疫赦免状态,是角膜移植排斥反应的高危因素。CNV结构较脆弱,易渗漏,常因出血、渗出及继发纤维化等致盲。抗血管内皮生长因子(vascular endothelial growth factor,VEGF)药物在治疗CNV的动物实验以及临床研究中也取得良好的疗效 [ 1 , 2 ]。康柏西普由血管内皮生长因子受体1(vascular endothelial growth factor receptor 1,VEGFR-1)细胞外与VEGF结合的免疫球蛋白样区域2,VEGFR-2免疫球蛋白样区域3、4以及人类免疫球蛋白的Fc部分组合而成,能与VEGF-A所有亚型、VEGF-B及胎盘生长因子高亲和力结合 [ 3 ]。康柏西普增加了VEGFR-2细胞外免疫球蛋白样区域4的表达。VEGFR-2细胞外免疫球蛋白样区域4是形成受体二聚所必需的结构,且能提高VEGF与受体结合的比率 [ 4 ],因此康柏西普与VEGF有更高的亲和力,且作用时间更长。CNV与新生淋巴管生长既相互独立,又彼此关联。抗VEGF药物对CNV作用的相关研究较多,但其应用对新生淋巴管作用的研究甚少。本研究中采用碱烧伤法建立炎症性CNV动物模型,观察康柏西普对CNV和新生淋巴管生成的作用。
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