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    Second blood-vessel-growth protein implicated in PDR


    While levels of VEGF tended to be higher in those with proliferative diabetic retinopathy, some of their fluid had less VEGF than did that of the healthy participants. But even the low-VEGF fluid from patients with proliferative diabetic retinopathy stimulated blood vessel growth in lab-grown cells. 

    “The results suggested to us that although VEFG clearly plays an important role in blood vessel growth, it’s not the only factor,” Dr. Sodhi said.

    A series of experiments in lab-grown human cells and mice revealed that when the researchers blocked the action of both VEGF and ANGPTL4 in fluid from the eyes of people with proliferative diabetic retinopathy, it markedly reduced blood vessel growth in lab-grown cells. 

    If a drug can be found that safely blocks the second protein’s action in patients’ eyes, it might be combined with the anti-VEGF drugs to prevent many cases of proliferative diabetic retinopathy, Dr. Sodhi suggested.

    The team is now investigating whether ANGPTL4 might also play a role in other eye diseases, such as macular degeneration, which destroys the central portion of the retina.

    The researchers said that although they cannot rule out a contribution from other angiogenic factors in the promotion of retinal neovascularization in patients with PDR, the results from this study suggest that targeting both ANGPTL4 and VEGF may be necessary for effective treatment or prevention of PDR. Accordingly, the next step should be the development of anti-ANGPTL4 therapies. They noted that this will require the identification of the relevant endothelial cell receptor through which ANGPTL4 mediates its pathological effects in the retina.

    The researchers added that this study demonstrated that aqueous fluid levels of ANGPTL4 correlate very well with the levels of ANGPTL4 in the vitreous, which suggests that ANGPTL4 levels in the aqueous fluid could serve as a diagnostic biomarker to help predict the level of diabetic eye disease in vulnerable populations.

    Next: "Relatively straightforward"

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