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The effect of an angiostatic steroid on neovascularization in a rat model of retinopathy of prematurity.

PURPOSE: The inhibition of angiogenesis by angiostatic steroids has been demonstrated in a variety of systems, including rabbit and rat cornea. There is considerable interest in the therapeutic potential of this class of compounds for angiogenic ocular conditions such as diabetic retinopathy, macular degeneration, and retinopathy of prematurity (ROP). This study was designed to test the capacity of an angiostatic steroid, anecortave acetate, to inhibit retinal neovascularization using a rat model of ROP and to investigate the mechanism of the effect. METHODS: At birth, rats were placed in an atmosphere of varying oxygen that produces retinal neovascular changes that approximate human ROP. The rats then received intravitreal injections of either anecortave acetate or vehicle at varying times, and all were subsequently placed in room air. Retinas were assessed for plasminogen activator inhibitor (PAI)-1 mRNA level by RNase protection assay at 1, 2, and 3 days after injection and for normal and abnormal blood vessel growth 3 days later. RESULTS: A significant reduction in the severity of abnormal retinal neovascularization was observed in the steroid-treated eyes compared with vehicle-injected eyes in ROP rats, yet the extent of normal total retinal vascular area was not significantly different. The drug had no effect on either retinal vascular area or neovascularization when tested in room air-raised control rats. Drug-injected eyes demonstrated a six- to ninefold increase in PAI-1 mRNA at 1 to 3 days after injection. CONCLUSIONS: This study represents the first therapeutic effect of an angiostatic steroid in an animal model of neovascular retinopathy. Additionally, the induction of PAI-1 indicates a mechanism of action for this class of compounds, and this is a novel finding in vivo. Because anecortave acetate significantly inhibited pathologic retinal angiogenesis in this model, while not significantly affecting normal intraretinal vessels, it holds therapeutic potential for a number of human ocular conditions in which angiogenesis plays a critical pathologic role.

Angiogenesis Inhibitors↗

Captopril and vascular endothelial growth factor in a mouse model of retinopathy.

PURPOSE: Angiotensin converting enzyme (ACE) inhibition has been shown in animal models of retinopathy and in patients with diabetes to improve retinal neovascularization. The mechanism is not clearly identified, but could potentially be mediated via vascular endothelial growth factor modification. The objective of this study was to determine the effect of captopril, an angiotensin converting enzyme (ACE) inhibitor, on retinal VEGF, VEGF-R1, and VEGF-R2 expression in a mouse model of oxygen induced retinopathy (OIR). METHODS: A mouse model of OIR was used and retinal tissue was obtained at P7, prior to oxygen exposure, at P12, just after oxygen exposure, and at P17, the time of maximal retinal neovascularization for VEGF, VEGF-R1 and VEGF-R2 assessment. A group of animals were treated with captopril (0.5 mg/kg/d SC from P7 for five days). RESULTS: Captopril plus OIR treated animals had higher levels of retinal VEGF mRNA and protein at P12 (p < 0.05) and lower levels at P17 (p < 0.05) than OIR animals. VEGF-R1 mRNA expression increased 16 fold from P7 to P17 (p < 0.05) in room air reared animals. VEGF-R1 mRNA expression was unaffected by OIR and/or captopril treatment. VEGF-R2 mRNA expression decreased from P7 to P17 by 1.5-fold in room air reared animals (p = 0.001). Retinal VEGF-R2 mRNA and protein expression were significantly higher at P12 in OIR plus captopril treated animals than OIR animals (p = 0.01). CONCLUSIONS: In summary, captopril maintains VEGF and increases VEGF-R2 expression during the period of hyperoxia when VEGF expression is normally suppressed. Captopril treatment during oxygen exposure is associated with a reduction in the angiogenic response at day 17 as manifested by decreased VEGF and VEGF-R2 expression in retinal tissue. Angiotensin converting enzyme inhibition is associated with changes in expression of VEGF and VEGF-R2 in the evolution of retinal neovascularization in the mouse model of retinopathy.

Angiotensin-Converting Enzyme Inhibitors↗

An experimental model of preretinal neovascularization in the rabbit.

Although progressive retinal neovascularization is a potentially blinding complication of several diseases, there are no good animal models. The authors developed a consistent model of preretinal neovascularization in the rabbit by partially digesting the posterior vitreous with repeated injection and aspiration of 1 IU of hyaluronidase before injection of 250,000 homologous dermal fibroblasts. The evolution of the new preretinal vessels was monitored by indirect ophthalmoscopy, fundus photography, and fluorescein angiography. A grading system was devised using fundus photographs and fluorescein angiograms to describe the progression of new vessel growth and the extent of fluorescein leakage. Ninety-five percent of the eyes had vascular enlargement and hyperemia but no fluorescein leakage by day 1. Fifteen percent of the eyes had clinically evident new preretinal vessels, and 32% had severe fluorescein leakage by day 7. Ninety-five percent of the eyes had definite neovascularization by day 14. Severe fluorescein leakage peaked at day 14 (55% of the eyes) and decreased thereafter. Involution or atrophy of the vessels occurred in all eyes by day 42. This model will be useful for studying the pathogenesis of preretinal neovascularization and evaluating potential treatments for its prevention.

Animals↗

Conditional knockdown of tubedown-1 in endothelial cells leads to neovascular retinopathy.

PURPOSE: Identification of novel proteins involved in retinal neovascularization may facilitate new and more effective molecular-based treatments for proliferative retinopathy. Tubedown-1 (Tbdn-1) is a novel protein that shows homology to the yeast acetyltransferase subunit NAT1 and copurifies with an acetyltransferase activity. Tbdn-1 is expressed in normal retinal endothelium but is specifically suppressed in retinal endothelial cells from patients with proliferative diabetic retinopathy. The purpose of this study was to investigate the importance of Tbdn-1 expression in retinal blood vessels in vivo. METHODS: A bitransgenic mouse model that enables conditional knockdown of Tbdn-1 specifically in endothelial cells was produced and studied using molecular, histologic, and immunohistochemical techniques and morphometric analysis. RESULTS: Tbdn-1-suppressed mice exhibited retinal and choroidal neovascularization with intra- and preretinal fibrovascular lesions similar to human proliferative retinopathies. Retinal lesions observed in Tbdn-1-suppressed mice increased in severity with prolonged suppression of Tbdn-1. In comparison to normal retina, the retinal lesions displayed alterations in the basement membrane of blood vessels and in the distribution of glial and myofibroblastic cells. Moreover, the pathologic consequences of Tbdn-1 knockdown in endothelium were restricted to the retina and the choroid. CONCLUSIONS: These results indicate that the maintenance of Tbdn-1 expression is important for retinal blood vessel homeostasis and for controlling retinal neovascularization in adults. Restoration of Tbdn-1 protein expression and/or activity may provide a novel approach for treating proliferative retinopathies.

Acetyltransferases↗

Loss of the antiangiogenic pigment epithelium-derived factor in patients with angiogenic eye disease.

Retinal neovascularization characterizes proliferative diabetic retinopathy (PDR). Pigment epithelium-derived factor (PEDF) has been shown to be a major antiangiogenic growth factor in the mammalian eye. PEDF expression is suppressed by hypoxia, and changes in PEDF have been correlated to the development of retinal neovascularization in animal models of hypoxic eye disease. However, whether this concept of a reduced angiogenesis inhibitor holds true in humans is as yet unclear. In this study, we analyzed the in vivo regulation of PEDF in patients with and without hypoxic eye disease. We used immunoblots to measure PEDF in ocular fluids obtained from 64 nondiabetic and diabetic patients. In addition, immunohistochemistry of PEDF was carried out in specimens of normal human retinas and retinas with various degrees of diabetic retinopathy. The PEDF concentrations in patients with PDR (P < 0.001) or extensive nondiabetic retinal neovascularization caused by retinal-vein occlusion (P < 0.001) were lower than in control patients. Levels of PEDF were replenished in PDR patients with previous retinal scatter photocoagulation compared with PDR patients without previous photocoagulation (P = 0.01). Immunohistochemistry revealed an interstitial staining pattern as expected for a secreted protein, with an intense staining in retinas of patients without proliferative eye disease. However, in patients with PDR, little or no staining was detectable. Our data strongly support the concept that retinal angiogenesis is induced by loss of the major angiogenesis inhibitor in the eye, PEDF, in combination with an increased expression of angiogenic growth factors such as vascular endothelial growth factor. Our findings suggest that substitution of angiogenesis inhibitors may be an effective approach in the treatment of PDR.

Aged↗

Dexamethasone and critical effect of timing on retinopathy.

PURPOSE: Administration of corticosteroids soon after birth has been reported to have deleterious, protective, and no effect on retinopathy of prematurity. Conflicting results may be due to timing of corticosteroid administration. The goal of this study was to determine effects of pretreatment and late dexamethasone on retinopathy in a mouse model. METHODS: The C57BL6 mouse model of oxygen-induced retinopathy (by placing animals in 75% oxygen from postnatal days 7 through 12) was used to create retinal neovascularization. Dexamethasone at 0.5 mg/kg per day was administered from day 1 through day 5 in the pretreatment group. The late-treatment group received 5 days of dexamethasone at the same dose beginning on day 12. Mice were killed at days 17 through 20, and retinal vasculature was assessed by a retinal scoring system of wholemount preparation after high-molecular-weight fluorescein-labeled dextran perfusion. In addition, retinal neovascularization was assessed by quantification of extraretinal neovascular nuclei in retinal sections. Statistical significance was defined as P: < 0.05 and was determined by the Kruskal-Wallis test, Mann-Whitney test, and Student's t-test. RESULTS: Oxygen-exposed animals that received treatment with dexamethasone before oxygen exposure had an improvement in retinopathy, with a median score of 6 (5,7; 25th,75th quartiles) compared with 10 (8,11) in the untreated oxygen-exposed (P: < 0.05). The group treated late (after oxygen exposure) with dexamethasone had a median score of 10 (9,11). Pretreatment reduced extraretinal vascularization, when assessed by quantification of neovascular nuclei, to a mean +/- SEM of 19 +/- 9, significantly less than in the untreated oxygen-exposed group (55 +/- 12; P: < 0.05). No difference was observed in the late-treatment group when compared with the untreated oxygen-exposed group. Significant growth retardation, indicated by body weight, was observed in the pretreatment (P: < 0.01) and late-treatment (P: < 0. 05) groups when compared with the control group. CONCLUSIONS: Timing of dexamethasone administration was critical to the inhibition of development of retinopathy in the mouse model. Degree of growth retardation, measured by body weight, also appeared to be time dependent. These data may explain the different results of clinical observations with respect to corticosteroid treatment, timing, and development of retinopathy.

Animals↗

Macular fibrosis associated with talc retinopathy.

PURPOSE: To investigate a patient with talc retinopathy who developed macular fibrosis with resultant visual loss. METHODS: A 64-year-old intravenous drug abuser was evaluated for bilateral peripheral retinal neovascularization. He admitted to abusing oral methylphenidate intravenously. Funduscopy showed numerous intravascular talc particles in the macular area of both eyes. Over a period of next 4 years, visually significant macular fibrosis gradually developed in both eyes, the left eye more than the right eye. RESULTS: Fluorescein angiography confirmed the presence of bilateral peripheral retinal neovascularization with adjacent areas of ischemic retina. The patient was treated with peripheral laser treatment to the ischemic retina with resultant regression of peripheral retinal neovascularization. Bilateral macular fibrosis accounted for the reduced vision in our patient. CONCLUSION: Talc retinopathy can be associated with macular fibrosis with resultant visual loss.

Fibrosis↗

Inhibition of proliferative retinopathy by the anti-vascular agent combretastatin-A4.

Retinal neovascularization occurs in a variety of diseases including diabetic retinopathy, the most common cause of blindness in the developed world. There is accordingly considerable incentive to develop drugs that target the aberrant angiogenesis associated with these conditions. Previous studies have shown that a number of anti-angiogenic agents can inhibit retinal neovascularization in a well-characterized murine model of ischemia-induced proliferative retinopathy. Combretastatin-A4 (CA-4) is an anti-vascular tubulin-binding agent currently undergoing clinical evaluation for the treatment of solid tumors. We have recently shown that CA-4 is not tumor-specific but elicits anti-vascular effects in nonneoplastic angiogenic vessels. In this study we have examined the capacity of CA-4 to inhibit retinal neovascularization in vivo. CA-4 caused a dose-dependent inhibition of neovascularization with no apparent side effects. The absence of vascular abnormalities or remnants of disrupted neovessels in retinas of CA-4-treated mice suggests an anti-angiogenic mechanism in this model, in contrast to the anti-vascular effects observed against established tumor vessels. Importantly, histological and immunohistochemical analyses indicated that CA-4 permitted the development of normal retinal vasculature while inhibiting aberrant neovascularization. These data are consistent with CA-4 eliciting tissue-dependent anti-angiogenic effects and suggest that CA-4 has potential in the treatment of nonneoplastic diseases with an angiogenic component.

Angiogenesis Inhibitors↗

Retinal ischemia and risk of neovascularization following central retinal vein obstruction.

The predominant risk factor for the development of neovascular complications involving the retina (NVR), the optic disc (NVD), and iris (NVI) following central retinal vein obstruction (CRVO) is the extent, location, and duration of retinal ischemia (ischemic drive). The extent of retinal capillary nonperfusion (ischemic index) was quantitated by microcomputer analysis of 200 standard fundus-iris fluorescein angiograms. The results were correlated with the development of neovascularization in eyes not receiving prophylactic argon laser panretinal photocoagulation (PRP). Of the 85 eyes with intact capillary perfusion (hyperpermeable group), none developed NVR/NVD and only one eye (1%) developed neovascular glaucoma (NVG). Twenty-nine eyes exhibited moderate degrees of retinal ischemia (indeterminate group), and three eyes (10%) developed NVR/NVD, with two eyes (7%) developing NVG. Of the 86 eyes with extensive retinal capillary nonperfusion (ischemic group), 28 eyes (33%) developed NVR/NVD and NVG occurred in 39 eyes (45%). The inherent difficulties in following high risk patients clinically and angiographically at frequent intervals over extended periods of time, the tendency for rapid progression of early NVI to NVG, and the relatively poor results following treatment in advanced cases make the early recognition of eyes at high risk to develop NVG essential and the initiation of prophylactic PRP as the treatment of choice in this disorder.

Fluorescein Angiography↗

Erythropoietin as a retinal angiogenic factor in proliferative diabetic retinopathy.

BACKGROUND: Although vascular endothelial growth factor (VEGF) is a primary mediator of retinal angiogenesis, VEGF inhibition alone is insufficient to prevent retinal neovascularization. Hence, it is postulated that there are other potent ischemia-induced angiogenic factors. Erythropoietin possesses angiogenic activity, but its potential role in ocular angiogenesis is not established. METHODS: We measured both erythropoietin and VEGF levels in the vitreous fluid of 144 patients with the use of radioimmunoassay and enzyme-linked immunosorbent assay. Vitreous proliferative potential was measured according to the growth of retinal endothelial cells in vitro and with soluble erythropoietin receptor. In addition, a murine model of ischemia-induced retinal neovascularization was used to evaluate erythropoietin expression and regulation in vivo. RESULTS: The median vitreous erythropoietin level in 73 patients with proliferative diabetic retinopathy was significantly higher than that in 71 patients without diabetes (464.0 vs. 36.5 mIU per milliliter, P<0.001). The median VEGF level in patients with retinopathy was also significantly higher than that in patients without diabetes (345.0 vs. 3.9 pg per milliliter, P<0.001). Multivariate logistic-regression analyses indicated that erythropoietin and VEGF were independently associated with proliferative diabetic retinopathy and that erythropoietin was more strongly associated with the presence of proliferative diabetic retinopathy than was VEGF. Erythropoietin and VEGF gene-expression levels are up-regulated in the murine ischemic retina, and the blockade of erythropoietin inhibits retinal neovascularization in vivo and endothelial-cell proliferation in the vitreous of patients with diabetic retinopathy in vitro. CONCLUSIONS: Our data suggest that erythropoietin is a potent ischemia-induced angiogenic factor that acts independently of VEGF during retinal angiogenesis in proliferative diabetic retinopathy.

Animals↗

Endophotocoagulation.

A system was developed for transvitreal application of photocoagulation using a fiberoptic probe attached to a portable xenon arc coagulator (endophotocoagulation, EPC). The system is activated by a footswitch, and the probe tip is positioned near the retina after performing a pars plana vitrectomy. This technique can be used to treat posterior retinal breaks, stop retinal bleeding, coagulate retinal neovascularization, apply scatter retinal photocoagulation in certain diabetic eyes, treat some of the ciliary processes in eyes with neovascular glaucoma, and enlarge the pupil in eyes with iris neovascularization and miosis. Endophotocoagulation was used in 169 eyes for one or more of these indications and found to be safe and reliable.

Glaucoma↗

Vitrectomy prevents retinal hypoxia in branch retinal vein occlusion.

Vitrectomy has been shown to halt diabetic retinal neovascularization, but the mechanism of this process is unknown. We propose that vitrectomy improves the oxygen supply to ischemic inner retina by way of fluid currents in the vitreous cavity. In order to test this hypothesis, we induced branch retinal vein occlusion in cats and measured preretinal oxygen tension before and after branch retinal vein occlusion in ten nonvitrectomized and five vitrectomized eyes. Branch retinal vein occlusion caused a significant decrease in preretinal oxygen tension in nonvitrectomized eyes, in which the oxygen tension fell from 20 +/- 7 to 6 +/- 5 mmHg (P = 0.001). Conversely, in vitrectomized eyes the oxygen tension was not significantly reduced after branch retinal vein occlusion. The data demonstrate that branch retinal vein occlusion causes retinal hypoxia in nonvitrectomized eyes, whereas after vitrectomy the hypoxic effect of branch retinal vein occlusion is reduced. The relief of retinal hypoxia that follows vitrectomy may be responsible for halting retinal neovascularization after vitrectomy in diabetic patients.

Animals↗

Role for extracellular signal-responsive kinase-1 and -2 in retinal angiogenesis.

PURPOSE: Vascular endothelial growth factor (VEGF) is a potent mitogen for micro- and macrovascular endothelial cells (ECs). Evidence points to a possible role for two mitogen-activated protein (MAP) kinases, the extracellular-signal responsive kinases (ERK)-1 and -2, in VEGF signaling in ECs. This study was undertaken to begin to define the precise role of MAP kinases in VEGF signal transduction related to angiogenesis. METHODS: Bovine retinal microvascular endothelial cells (BRMECs) and a well-established rat model of retinopathy of prematurity (ROP) were used to investigate the role of ERK-1/2 in EC proliferation and tube formation and in retinal angiogenesis in vivo. RESULTS: Administration of VEGF to BRMEC cultures increased ERK-1/2 phosphorylation, cell proliferation, and tube formation in a dose-dependent manner. Phosphorylation of retinal ERK-1/2 also was increased in the ROP model. An inhibitor of ERK, AG126, and an inhibitor of ERK kinase (MEK), PD98059, exhibited a dose-dependent reduction of ERK phosphorylation and EC proliferation, but not tube formation, in VEGF-stimulated BRMECs. In the ROP model, intravitreous injection of 10 micro M AG126 or PD98059 reduced the retinal neovascular area by 71% and 48%, respectfully. No effect was seen on intraretinal blood vessel growth. CONCLUSIONS: These experiments point to a critical role for ERK and MEK in proliferation of ECs, but not in tube formation. Furthermore, inhibition of either of these two signal intermediates can significantly retard retinal neovascularization. This suggests that the MAPK pathway may provide rational targets for therapeutic intervention in ocular and other diseases with an angiogenic component.

Animals↗

Vascular targeting of ocular neovascularization with a vascular endothelial growth factor121/gelonin chimeric protein.

Tumors provide an extremely abnormal microenvironment that stimulates neovascularization from surrounding vessels and causes altered gene expression within vascular cells. Up-regulation of vascular endothelial growth factor (VEGF) receptors has allowed selective destruction of tumor vessels by administration of a chimeric protein consisting of VEGF121 coupled to the toxin gelonin (VEGF/rGel). We sought to determine whether there is sufficient up-regulation of VEGF receptors in endothelial cells participating in ocular neovascularization to permit a similar strategy. After intravenous injection of 45 mg/kg VEGF/rGel, but not uncoupled recombinant gelonin (rGel), there was immunofluorescent staining for rGel within choroidal neovascularization in mice and regression of the neovascularization occurred, demonstrating successful vascular targeting via the systemic circulation. Intraocular injection of 5 ng of VEGF/rGel also caused significant regression of choroidal neovascularization and regression of retinal neovascularization in two models, transgenic mice with expression of VEGF in photoreceptors and mice with ischemic retinopathy, whereas injection of 5 ng of rGel had no effect. These data suggest that the strategy of vascular targeting can be applied to nonmalignant neovascular diseases and could serve as the basis of a new treatment to reduce established ocular neovascularization.

Animals↗

Peripheral retinal nonperfusion associated with chronic myeloid leukemia.

PURPOSE: To report a case of peripheral retinal nonperfusion and chronic myeloid leukemia in a 23-year-old woman. DESIGN: Observational case report. METHODS: A complete ophthalmic and systemic evaluation was performed. RESULTS: Ophthalmic examination revealed peripheral retinal nonperfusion with retinal neovascularization in both eyes. Fluorescein angiography of both eyes showed a marked midperipheral and peripheral avascular retina temporally with arteriovenous anastomosis and seafan neovascularizations. Blood work showed no abnormalities, although marked leucocytosis (up to 750 x 10(9)/l) and thrombocytosis (646 x 10(9)/l) were present in 1998 when the patient was diagnosed with leukemia. Following treatment, the patient has been in remission. CONCLUSIONS: Peripheral retinal nonperfusion with retinal neovascularization may occur as a complication of chronic myeloid leukemia. In contrast to other studies describing this association, our patient had a bilateral peripheral retinal nonperfusion with seafan neovascularizations without relapse of the myeloid leukemia and without any of the other retinal signs associated with chronic myeloid leukemia, such as tortuosity of veins, intraretinal or preretinal hemorrhages, and cotton-wool exudates.

Adult↗

The clinical significance of venous filling time through panretinal photocoagulation in proliferative diabetic retinopathy.

PURPOSE: To verify the clinical correlation between retinopathy progression and the change of venous filling time (VFT), measured before and after panretinal photocoagulation (PRP), in proliferative diabetic retinopathy (PDR) patients. METHODS: We conducted this study on 32 patients (32 eyes) who received PRP for PDR. These patients were subdivided into two groups in accordance with the clinical course of PRP: the stabilized group in which retinal neovascularization was regressed and the progressed group in which retinal neovascularization was continued and a complication, such as vitreous hemorrhage or tractional retinal detachment, was developed within 12 months of laser treatment. Arteriovenous passage time (AVP) and VFT were measured by video fluorescein angiogram (FAG) using scanning laser ophthalmoscope (SLO) before and after PRP. VFT values were assigned by measuring by the time duration from start of venous lamina flow to the fullness of fluorescence on the vascular arch. RESULTS: In the stabilized group, AVP was decreased by 0.20 +/- 0.89 sec and VFT was decreased by 0.30 +/- 1.69 sec through PRP. In the progressed group, AVP was increased in 0.12 +/- 1.22 sec and VFT was increased by 0.99 +/- 1.60 sec through PRP. In both groups, the VFT changes were significant (P=0.04) but the AVP changes were not (P=0.34). CONCLUSIONS: VFT was significantly decreased in the stabilized group and significantly increased in the progressed group after PRP. Accordingly, we suggest that VFT changes after PRP can be utilized as a prognostic indicator for evaluating clinical course of diabetic retinopathy after performing PRP and for monitoring the clinical effect of PRP.

Diabetic Retinopathy↗

Decreased expression of the insulin-like growth factor 1 receptor by ribozyme cleavage.

PURPOSE: Insulin-like growth factor (IGF)-1 and its receptor (IGF-1R) are associated with abnormal retinal neovascularization. Ribozymes were designed that selectively decreased the expression of the IGF-1R and these ribozymes were tested in angiogenesis models in vitro and in vivo. METHODS: Two hammerhead ribozymes were designed that cleave the human IGF-1R mRNA. The ribozymes were cloned into recombinant adeno-associated viral vectors (rAAV). The rAAV constructs were transfected into human retinal endothelial cells (HRECs). IGF-1R mRNA and protein levels were examined and the modified Boyden chamber assay used to examine ribozyme effects on cell migration. These constructs were injected intravitreally into mice to determine the effect of the ribozymes on retinal neovascularization in a mouse model of oxygen-induced retinopathy. RESULTS: Relative quantitative RT-PCR analysis showed that IGF-1R Rz1 reduced IGF-1R mRNA levels by 40% +/- 10% (P = 0.003), and Western blot analysis showed a 41% +/- 5% (P = 4.6 x 10(-5)) reduction of IGF-1R protein, confirming that this ribozyme reduces IGF-1R expression. IGF-1R Rz1 also reduced IGF-1-induced cell migration by 90% +/- 5% (P = 2.9 x 10(-9)) showing that IGF-1R Rz1 reduces IGF-1R function in HRECs. IGF-1R Rz1 also reduced the amount of preretinal neovascularization by 65% +/- 6% (P = 2.7 x 10(-5)), as measured by the average number of endothelial preretinal nuclei per section. CONCLUSIONS: These studies demonstrate that the IGF-1R ribozymes are effective at reducing the expression and function of the IGF-1R in vitro and in vivo. Therefore, the IGF-1R ribozymes are an effective method for studying the process of angiogenesis and may ultimately be effective as gene therapy tools for the reduction of pathologic retinal angiogenesis.

Animals↗