Second blood-vessel-growth protein implicated in PDR

Targeting the blood-vessel-growth protein angiopoietin-like 4 (ANGPTL4) along with anti-vascular endothelial growth factor (VEGF) therapy could increase the effectiveness of treatments for the prevention of proliferative diabetic retinopathy (PDR), according to researchers at The Johns Hopkins University and the University of Maryland. A summary of their study appeared online in Proceedings of the National Academy of Sciences.

Diabetic retinopathy is the most common cause of vision loss in working-age adults in the United States. According to the National Eye Institute, 40 to 45% of Americans with diabetes have diabetic retinopathy.

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Laser-sealing eye blood vessels can save central vision, but can also sacrifice peripheral and night vision, according to Akrit Sodhi, MD, Ph.D., an assistant professor of ophthalmology at the Johns Hopkins University School of Medicine. Several recently developed drugs - bevacizumab, ranibizumab and aflibercept - work by blocking the action of VEGF, a growth factor released as part of a chain of signals in response to low oxygen levels, which stimulates the growth of new, often abnormal, blood vessels. But studies have shown that although these drugs slow progression to PDR, they do not always reliably prevent it. In addition, the anti-VEGF therapies have shown some success delaying the development of PDR, but they don’t work for all patients.

Reporting on a study with lab-grown human cells, researchers say that blocking a second blood vessel growth protein - ANGPTL4  -together with VEGF could increase the effectiveness of the treatment for these patients.

The researchers tested levels of VEGF in samples of fluid from the eye taken from healthy people, people with diabetes who did not have diabetic retinopathy, and people with diabetic retinopathy of varying severity. 

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