目的：采用常压间歇性低氧(intermittent hypoxia,IH)大鼠的动物模型，观察间歇性常压低氧预处理的促血管生成作用。方法:成年雄性Wistar大鼠25只，体重210～215 g，随机分为2大组:对照组(C组，n=5)和间歇性低氧预处理组(IH组，n=20)。IH组动物进行间歇性低氧预处理(4 h/d，间歇缺氧1 d者为IH1组，7 d者为IH2组，14 d者为IH3组，28 d者为IH4组)，按计划完成实验后测定心肌血管内皮生长因子(VEGF) 蛋白表达及毛细血管密度。结果：间歇性低氧预处理大鼠心肌VEGF蛋白表达增加，心肌毛细血管密度增高。结论：间歇性低氧预处理能促进大鼠心肌内的血管生成，其机制可能与心肌VEGF表达增高有关。
Objective To observe the effect of Chinese Herbal Preparation -Mingjing Granule on the recruitment and adhesion of bonemarrow derived cells (BMCs) to choroidal neovascu1arization (CNV) in mice induced by laser photocoagulation. Methods A total of 75 C57BL/6 mice were divided into treatment group (30 mice), control group (30 mice) and normal control group (15 mice). CNV was induced by krypton laser in the mice of treatment group and control group. BMCs from GFPtransgenic mice were injected through tail vein to those mice 0.5 -1.0 hours after laser surgery. On day one after laser surgery, the mice of treatment group were gavaged with 0.3 ml Mingjing Granule solution every day［30 g/(kg?d)］, while the control group mice were gavaged with distilled water. The mice of normal group fed with normal cereals. 7, 14, 28 days after treatment, choroidal flatmount were prepared to measure the CNV severity and BMCs recruitment. The choroidal histopathological change was observed by optical microscope. CXCR4 level in peripheral blood was measured by enzymelinked immuno sorbent assay (ELISA). Stromal cell derived factor1alpha; (SDF-1alpha;), vascular cell adhesion molecule-1 (VCAM-1), inter-cellular adhesion molecule 1 (ICAM-1) were detected by immunofluorescent staining. Results Choroidal flatmount showed that CNV developed in treatment group and control group, but not in normal group. On day seven and 14, CNV lesions in the treatment group showed less incorporation of BMCs and smaller CNV in size compared with the control group (t=10, 9; P=0.007, 0.024), histologic sections also showed less severe lesions in the treatment group. CXCR4 level in peripheral blood in the treatment group was less than that in the control group and normal control group on day seven and day 14（t=8.107, 2.747;P＜0.05). The expression of SDF-1alpha;, ICAM-1 and VCAM-1 in the treatment group was lower compared with the control group. Conclusions Mingjing Granule could inhibit the recruitment and adhesion of BMCs in peripheral blood to CNV at the early stage. The mechanism may be related with the action of Mingjing Granule in lowing chemokines levels in peripheral blood and expression of adhesion molecules around CNV.
Objective The observe the effects of interferon-inducible protein-10 (IP-10) on proliferation, migration and capillary tube formation of human retinal vascular endothelial cells (HREC) and human umbilical vein endothelial cells (HUVEC). Methods The chemokine receptor (CXCR3) mRNA of HREC and HUVEC were quantified by reverse transcriptase polymerase chain reaction (RT-PCR). In the presence of the different concentrations of IP-10, the difference in proliferation capacity of HREC and HUVEC were analyzed by cell counting kit-8 (CCK-8) methods. Wound scratch assay and threedimensional in vitro matrigel assay were used for measuring migration and capillary tube formation of HREC and HUVEC, respectively. Results RT-PCR revealed both HREC and HUVEC expressed CXCR3. The proliferation of HREC in the presence of IP-10 was inhibited in a dosagedependent manner (F=6.202,P＜0.05), while IP-10 showed no effect on the inhibitory rate of proliferation of HUVEC (F=1.183,P＞0.05). Wound scratch assay showed a significant reduction in the migrated distance of HREC and HUVEC under 10 ng/ml or 100 ng/ml IP-10 stimulation (F=25.373, 23.858; P＜0.05). There was no effect on the number of intact tubules formed by HREC in the presence of 10 ng/ml or 100 ng/ml IP-10. The number of intact tubules formed by HREC in the presence of 1000 ng/ml IP-10 was remarkably smaller. The difference of number of intact tubules formed by HREC among 10, 100, 1000 ng/ml IP-10 and nonintervention group was statistically significant (F=5.359,P＜0.05). Conclusion IP-10 can inhibit the proliferation, migration and capillary tube formation ability of HREC and the migration of HUVEC.
Objective To observe the inhibition of LipofectamineTM2000 (LF2000)mediated pSUPER recombinant plasmid expressing small interference RNA targeting hypoxia-induced factor (HIF)-1alpha;(pSUPERsiHIF-1alpha;) on retinal neovascularization in mice. Methods pSUPERsiHIF-1alpha; recombinant plasmid was created. Forty-eight (seven-day-old) C57BL/6J mice were randomly divided into a normal group, the control group, empty vector group and gene therapy group with 12 mice in each group. Mice in the normal group were kept in normal room air, while the other three groups retinal neovascularization was induced by hypoxia. The mice in control group were not treated. The mice in the vector group received intravitreous injection of pSUPER and LF2000 (1 mu;l), and the gene therapy group received pSUPERsiHIF-1alpha; and LF2000 (1 mu;l)one day before being returned to normal room air．Fluorescent angiography was used to assess the vascular pattern. The proliferative neovascular response was quantified by counting the nuclei of new vessels extending from the retina into the vitreous in cross-sections．HIF-lalpha;and vascular endothelial growth factor (VEGF) levels in retinas were measured by immune histochemical staining method and reverse transeriptase-polymerase chain reaction (RT-PCR). Results Fluorescent angiography showed radial branching pattern vessels in the normal group and distorted large vessels, obstructed capillaries, many neovascular tuffs, fluorescence leakage in the peripheral retina in the control group and vector group. The gene therapy group demonstrated a significant reduction in neovascular tufts and fluorescence leakage compared with the control group and the vector group. The number of vascular cell nuclei extending breaking through the internal limiting membrane(ILM) of control group and vector group increased significantly compared with normal group (F=5850.016,P＜0.05), while obviously decreasing in the gene therapy group compared with control group (F=3012.469,P＜0.05). Immunohistochemical staining showed the expression of HIF-1alpha; protein in nucleus and VEGF protein in cytoplasm. The expression of HIF-1alpha; protein in retina was negative, while VEGF protein was weakly positive in normal group. The expression of HIF-1alpha; and VEGF protein were both positive in control group and vector group, while weakly positive in gene therapy group. The Results of RT-PCR showed that the expression of HIF-1alpha; mRNA in retina was increased significantly in control group and vector group as compared with normal group (F=3102.326,P＜0.05), while decreasing significantly in gene therapy group as compared with control group (F=3336.425,P＜0.05). Conclusion Retinal neovascularization in the mice is significantly inhibited by intravitreal injection of LF2000-mediated recombinant plasmid pSUPERsiHIF-1alpha;.
Objective To investigate the inhibitory effects of 15-lipoxygenase-1 (15-LOX-1) gene transfer on oxygen-induced retinal neovascularization in mice. Methods Ninety-six 7-day-old C57BL/6J mice were randomly divided into normal control group, oxygeninduced retinopathy (OIR) model group, gene treated group and empty vector group. The mice with their mothers were kept in (75plusmn;2) % 02 environment for 5 days and then returned to normoxia for 5 days to establish the OIR model. At postnatal day 12, the gene treated group received intravitreous injection of recombinant adenovirus (Ad) vector containing both enhanced green fluorescent protein (EGFP) and mouse 15-LOX-1 genes (Ad-15-LOX-1-EGFP) at 1 l, while the empty vector group received the same volume of recombinant Ad vector containing EGFP (Ad-EGFP). The expression of EGFP was observed on flat-mounted retina by fluorescence microscopy 2 days after intravitreous injection of Ad-15-LOX-1-EGFP. At postnatal day 17, the efficacy of 15-LOX-1 gene transfer on retinal tissue was detected by immunofluorescence staining, real-time polymerase chain reaction and Western blot. The changes of retinal vessels, relative retinal non-perfusion and neovascularization areas were evaluated by fluorescein isothiocyanate-dextran fluorescein angiography on flatmounted retina. The number of endothelium cell nuclei breaking through the inner limiting membrane (ILM) was counted on hematoxylin and eosin-stained retinal section. Results Two days after intravitreous injection of Ad-15-LOX-1-EGFP, the expression of EGFP had been seen by fluorescence microscopy on Flat-mounted retina. Immunofluorescence staining of retinal section revealed that 15-LOX-1 expression was primarily in the outer plexiform layer, inner nuclear layer and ganglion cell layer of retina. The 15-LOX-1 protein and mRNA expression levels were higher in gene treated group than those in OIR model group and empty vector group (tprotein=22.74 and 24.13 respectively.tmRNA=12.51 and 13.40 respectively; P＜0.01). The relative retinal non-perfusion and neovascularization areas were significantly smaller in gene treated group than those in OIR model group and empty vector group (tnon-perfusion=16.22 and 14.31 respectively.tneovascularization=9.97 and 9.07 respectively; P＜0.01), and the number of endothelium cell nuclei breaking through the ILM in gene treated group was obviously lower than the other two groups (t=14.25 and 11.62 respectively，P＜0.01). Conclusion 15-LOX-1 gene transfer can decrease the oxygen-induced retinal non-perfusion areas and inhibit the retinal neovascularization in mice.
Objective To investigate the effect of photodynamic therapy (PDT) combined with intravitreal bevacizumab on wet age-related macular degeneration (AMD). Methods In this retrospective study, 34 eyes (28 cases) diagnosed with wet AMD received PDT combined intravitreal injection of bevacizumab, including 25 eyes with classic CNV and 9 eyes with minimally classic CNV by fluorescein angiography; On optical coherence tomography (OCT), 23 eyes showed intraretinal fluid (IRF) and 11 eyes presented subretinal fluid (SRF). After signing informed consent, all patients underwent initial standard PDT followed by intravitreal bevacizumab (1.25 mg) within succeeding 3 to 7 days. Best corrected visual acuity (BCVA) and OCT with routine eye examinations were evaluated monthly. Additional bevacizumab (1.25 mg) was injected intravitreally if new or increasing fluid appreciated on OCT, or BCVA lowered more than 5 letters even with stabilized fluid. Injection was discontinued if no fluid was showed on OCT (quot;dry macularquot;), or BCVA was stabilized even with fluid after two consecutive injections. BCVA and central retinal thickness (CRT) were analyzed and compared between baseline and 6 month follow-up. The correlation between parameters such as baseline BCVA, greatest linear dimension (GLD), type of CNV, SRF or IRF and posttreatment BCVA will be analyzed. The injection number of bevacizumab and complications were recorded. Results Compared to baseline, BCVA improved (9.4plusmn;10.2) letters and reach 44.9plusmn;21.3 letters (t=5.438，P＜0.01) and CRT decreased (184.6plusmn;214.6) mu;m (t=4.810，P＜0.01) at 6 month visit. The average of injection number was 1.9plusmn;0.9 (including initial injection of combination therapy). With multiple lineal regression analysis, only baseline BCVA correlated to posttreatment BCVA at 6 month visit (r=0.802.P＜0.01). The type of CNV, GLD, SRF or IRF on OCT and CRT at baseline were not associated to post-treatment BCVA (r=0.053, -0.183, 0.139 and 0.053, respectively.P＞0.05). BCVA of eyes with SRF (14.7 letters) increased more than eyes with IRF (6.9 letters) on OCT (t=-2.207，P=0.035). The change of BCVA after treatment (t=-0.076), change of CRT (t=-1.028) and number of injections (Z=-1.505) were not different between classic CNV and minimally classic CNV (P＞0.05). The change of CRT (t=-0.020) and number of injections (Z=-0.237) did not present difference between SRF and IRF (P＞0.05). The change of BCVA (t=1.159) and number of injections (Z=-1.194) were not correlated to whether residual fluid or not at 6 month visit (P＞0.05). No severe complications were noticed during follow-up.Conclusion For wet AMD patients, PDT combined intravitreal bevacizumab could improve visual acuity, reduce retinal thickness and control CNV progress in a short-term.
Ovjective To observe the surgically excised specimens from eyes with hemorrhagic age-related macular degeneration (AMD). Methods Thirty-six surgically excised specimens were captured from 36 patients with hemorrhagic AMD, 26 specimens were diagnosed as occult choroidal neovascular membrane (CNVM), 10 specimens were diagnosed as polypoidal choroidal vasculopathy (PCV). All specimens were routinely processed by hematoxylin and eosin, periodic acidSchiffprime;s stain and Masson stainings. At the maximum horizontal and vertical slice of the specimens, the category and amount of the cells in the specimen were recorded, as well as the relationship between the specimens and the surrounding tissue. Results The 36 specimens are categorized as neovascular membrane dominant (19/36), collagen fiber dominant (6/36), blood clot dominant (8/36) and degenerated thickened Bruch`s membrane dominant (3/36). Eighteen occult CNVM specimens and 1 PCV specimen are categorized as neovascular membrane dominant; all 6 collagen fiber dominant specimens are occult CNVM; 1 occult CNVM and 7 PCV specimens are categorized as blood clot dominant; and 1 occult CNVM and 2 PCV specimens are categorized as degenerated thickened Bruch`s membrane dominant. The occult CNVM categorized as neovascular membrane dominant present as small blood vessel with single endothelium cell attached; the PCV specimen categorized as neovascular dominant presents as big blood vessel with thick vessel wall under the Bruch`s membrane, retinal pigment epithelium and choroidal melanocyte are both observed in the PCV specimens. Conclusion The components of the specimens captured from eyes with hemorrhagic AMD are diversified.
Objective To compare the clinic therapeutic effect of intravitreal ranibizumab injection versus photodynamic therapy (PDT) combined with intravitreal ranibizumab injection for idiopathic choroidal neovascularizatio (ICNV), and to investigate the clinical effect and safety of treatment. Methods A randomized controlled clinical prospective study was performed for 27 patients (27 eyes) diagnosed as ICNV. Fourteen patients were assigned to receive PDT and intravitreal ranibizumab injection (combination roup.n=14); the control group was treated with only intravitreal ranibizumab injection (single group, n=13).The combination group was treated with an intravitreal injection of ranibizumab (0.5 mg/0.05 ml) 1 week after PDT. The bestcorrected visual acuity (BCVA) (logMAR), examination of the ocular fundus, fluorescence fundus angiography (FFA), indocyanine green angiography (ICGA) and optical coherence tomography (OCT) were performed respectively at 1, 2, 3, 6 and 12 months after treatment. If choroidal neovascularization (CNV) was only partially regressed or the leakage went on during follow-up, those patients were re-injected with ranibizumab. Results After 12 months, the average vision is 0.22plusmn;0.11 in single group, and 0.21plusmn;0.12 in combination group, and the differences were not significant (t=0.187, P=0.853). In single group FFA and ICGA showed completely closed CNV in 10 eyes (77.92%), and almost closed CNV in 3 eyes (23.08%) with obvious reduction of fluorescence leakage. In combination group FFA and ICGA showed completely closed CNV in 12 eyes (85.71%), and almost closed CNV in 2 eyes (14.29%) with obvious reduction of fluorescence leakage; OCT showed the subretinal fluid absorption and reduction of CNV. The average macular retinal thickness (MRT) in single groups is （167.96plusmn;10.69） m, and in combination groups is （171.64plusmn;11.30）m. In single and combination groups MRT decreased significantly at the final follow-up, but no significant differences in both groups (t=-0.887.P=0.389). The average number of intravitreal injection was （1.5plusmn;0.7） in combination group and （2.4plusmn;1.0） in single group (t=2.821，P=0.009). There were no ocular or systemic adverse events observed except for one patient with subconjunctival hemorrhage in the single group.Conclusions Intravitreal ranibizumab injection and PDT combined with intravitreal bevacizumab injection are both effective and safe for the patients with ICNV. The combined therapy can induce CNV regression, fundus hemorrhage and exudation absorption more effectively, and have less recurred CNV and side effects.