Intraocular Neutralizing Antibodies Against Aflibercept in Patients with Age Related Macular Degeneration

Overview

Journal BMC Ophthalmol

Publisher Biomed Central

Specialty Ophthalmology

Date 2023 Jan 10

PMID 36627583

Authors

Andrea Gyenes

Lilla Istvan

Fruzsina Benyo

Andras Papp

Miklos Resch

Noemi Sandor

Mihaly Jozsi

Zoltan Z Nagy

Illes Kovacs

Szilard Kiss

Affiliations

Soon will be listed here.

Abstract

Purpose: To detect immunoglobulins in aqueous humour of AMD patients after repeated administration of intravitreal aflibercept.

Patients And Methods: Twenty-one patients (age: 77.85 ± 9.21 years) previously treated with intravitreal aflibercept due to wet type age-related macular degeneration (AMD group) and 18 age-matched control subjects (age: 69.75 ± 12.67 years) were included in this study. Patients in the AMD group received a mean of 5 intravitreal injections (min: 1 max: 17) prior to the cataract surgery. Samples of aqueous humour (50 μl) were obtained by anterior chamber paracentesis as the first step of routine cataract surgery. The IgG content of the samples was analysed by an in-house developed ELISA system.

Results: A significant increase in nonspecific IgG levels in the AMD group was detected compared to the control group (13.37 ± 6.65 vs. 9.44 ± 6.55 μg/ml; p = 0.03). In 11 patients, intraocular anti-aflibercept immunoglobulins could be detected (0.05 ± 0.01 μg/ml) which was significantly higher than the limit of detection for anti-aflibercept (0.04 μg/ml; p = 0.001). No correlation was found between the number of injections or the type of CNV and the aqueous level of anti-aflibercept (r = 0.02; p = 0.95).

Conclusion: According to our results, penetration of non-specific systemic antibodies through the impaired blood-retinal barrier is higher in patients with neovascular AMD than in subjects with an intact structural barrier. Evaluation of neutralizing antibodies to anti-VEGF agents in the aqueous humour can lead us to understanding tachyphylaxis and changes in intraocular immune mechanisms due to AMD.

Citing Articles

Comparative Pharmacokinetic Analysis of Aflibercept and Brolucizumab in Human Aqueous Humor Using Nano-Surface and Molecular-Orientation Limited Proteolysis.

Nagaoka K, Kimura N, Inoda S, Takayama T, Arai Y, Yanagi Y Int J Mol Sci. 2025; 26(2).

PMID: 39859273 PMC: 11764841. DOI: 10.3390/ijms26020556.

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