Effects of ranibizumab on microRNA-126 and vascular endothelial growth factor-A and its clinical efficacy in patients with wet age-related macular degeneration
Zhang Lili, Gao Ziqing, Dai Qing
Department of Ophthalmology, the First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China
Abstract:Objective To investigate the effects of the intravitreal injection of ranibizumab on the expression levels of microRNA-126 (miRNA-126) and vascular endothelial growth factor A (VEGF-A) and its clinical efficacy in patients with wet age-related macular degeneration (wAMD).Methods A total of 40 cases (40 eyes) of wAMD patients, including 17 males and 23 females, aged 50-86 years, who were admitted to the First Affiliated Hospital of Bengbu Medical College from June 2018 to June 2019 were included in this prospective study as the wAMD group. Meanwhile, the control group consisted of 40 middle-aged and elderly patients, including 18 males and 22 females, aged 53-81 years, who underwent physical examination in the Physical Examination Center of the First Affiliated Hospital of Bengbu Medical College. All the patients in the wAMD group received a single intravitreal injection of ranibizumab (0.05 mL). Real-time fluorescence quantitative polymerase chain reaction method was used to detect the relative expression levels of miRNA-126 in the control and wAMD groups before treatment and 1 month after treatment, and plasma VEGF-A level was measured via enzyme-linked immunosorbent assay. (1) The expression levels of miRNA-126 and VEGF-A before treatment in the control and wAMD groups were compared. (2) Plasma miRNA-126 and VEGF-A expression levels and changes in best corrected visual acuity (BCVA), central macular retinal thickness (CMT), and choroidal angiogenesis (CNV) area in the wAMD group were compared before treatment and 1 month after treatment. (3) The correlations of the relative plasma miRNA-126 expression and VEGF-A levels with the CMT and CNV area of the patients in the wAMD group before treatment and 1 month after treatment were analyzed.Results (1) The relative expression of miRNA-126 in the wAMD group (0.86±0.11) was significantly lower than that in the control group (1.04±0.09) (t=8.010, P<0.01). The VEGF-A level in the wAMD group (329.09±17.58) pg/mL was significantly higher than that in the control group (295.74±14.80)pg/mL (t=9.179, P<0.01). (2) The relative expression of miRNA-126 in the wAMD group was significantly higher 1 month after treatment (1.47±0.27) than before treatment (0.86±0.11) (t=19.410, P<0.01), and the VEGF-A level of the wAMD group 1 month after treatment (315.36±15.44) pg/mL was significantly lower than that before treatment (329.09±17.58) pg/mL (t=8.048, P<0.01). BCVA was significantly increased 1 month after treatment (0.45±0.11) compared with before treatment (0.83±0.16) (t=12.667, P<0.01). The CMT and CNV areas of the wAMD group 1 month after treatment were (296.53±21.52)μm and(0.58±0.18)mm2, respectively, which were significantly reduced compared with those prior to treatment[(311.88±37.25) μm and(0.70±0.17)mm2, respectively], and the differences were statistically significant (t=3.602, 4.906, all P values<0.01). (3) The relative expression level of plasma miRNA-126 was negatively correlated with the VEGF-A, CMT, and CNV of the patients in the wAMD group before treatment and 1 month after treatment (r=-0.706, -0.0.723, -0.552, respectively, before treatment; r=-0.783, -0.709, -0.620, respectively, 1 month after treatment; all P values<0.01). The linear regression equations between the area of VEGF-A, CMT, and CNV and the relative expression of miRNA-126 before treatment were as follows: $\hat{Y}$VEGF-A=-112XmiRNA-126+426, $\hat{Y}$CMT=-243XmiRNA-126+522, and $\hat{Y}$CNV=-0.84XmiRNA-126+1.42. Their linear regression equations after treatment were as follows: $\hat{Y}$VEGF-A=-45.64XmiRNA-126+382, $\hat{Y}$CMT=-57.53XmiRNA-126+381, and $\hat{Y}$CNV=-0.41XmiRNA-126+1.18.Conclusions Ranibizumab can effectively improve BCVA by reducing the expression of VEGF-A and the areas of CMT and CNV. Ranibizumab may slow down the development of wAMD by enhancing the expression activity of the miRNA-126 gene while achieving clinical efficacy.
张丽丽, 高自清, 戴青. 雷珠单抗治疗湿性年龄相关性黄斑变性的疗效观察及其对患者血浆miRNA-126、VEGF-A表达的影响[J]. 中华解剖与临床杂志, 2020, 25(3): 315-321.
Zhang Lili, Gao Ziqing, Dai Qing. Effects of ranibizumab on microRNA-126 and vascular endothelial growth factor-A and its clinical efficacy in patients with wet age-related macular degeneration. Chinese Journal of Anatomy and Clinics, 2020, 25(3): 315-321.
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