scholarly journals Non-immediate drug hypersensitivity reactions secondary to intravitreal anti-vascular endothelial growth factors

2021 ◽  
Author(s):  
E. Moret ◽  
A. Ambresin ◽  
C. Gianniou ◽  
J. Bijon ◽  
C. Besse-Hayat ◽  
...  
Keyword(s):  
Growth Factors ◽  
Drug Hypersensitivity ◽  
Clinical Manifestations ◽  
Drug Discontinuation ◽  
Vascular Endothelial Growth Factors ◽  
Vascular Endothelial ◽  
Hypersensitivity Reactions ◽  
Anti Vegf ◽  
Drug Hypersensitivity Reactions ◽  
Endothelial Growth Factors

Abstract Purpose To describe a series of non-immediate drug hypersensitivity reactions after intravitreal anti-vascular endothelial growth factors (anti-VEGFs). Patients and methods Retrospective report of 6 patients with cutaneous non-immediate drug hypersensitivity reactions following intravitreal anti-VEGF injections, 4 after ranibizumab, 1 after bevacizumab and 1 after aflibercept. Results Clinical manifestations ranged from mild maculopapular rash, purpura to severe generalized erythroderma, with or without systemic involvement such as microscopic hematuria and proteinuria or fever. In two out of the six patients, reintroduction of either the same or an alternative anti-VEGF drug did induce a recurrence of the drug hypersensitivity reaction, while 4 patients showed no recurrence. Conclusion Cutaneous non-immediate drug hypersensitivity reactions secondary to intravitreal anti-VEGF may occur. Continuation of the same drug or switch to another anti-VEGF may either induce recurrence or be well supported by the patient. The decision of drug discontinuation should be guided by the severity of the disease.

Pediatric choroidal neovascularization: Etiology and treatment outcomes with anti-vascular endothelial growth factors

2021 ◽  
pp. 112067212110487
Author(s):  
Ratnesh Ranjan ◽  
Romit Salian ◽  
Shishir Verghese ◽  
George J Manayath ◽  
Palmeera D’Souza ◽  
...  
Keyword(s):  
Growth Factors ◽  
Treatment Outcomes ◽  
Choroidal Neovascularization ◽  
Case Series ◽  
Final Visit ◽  
Vascular Endothelial Growth Factors ◽  
Vascular Endothelial ◽  
Anti Vegf ◽  
The Mean ◽  
Endothelial Growth Factors

Purpose: To describe the etiology and treatment outcomes of choroidal neovascularization (CNV) in a pediatric population with intravitreal anti-vascular endothelial growth factors (VEGF) Methods: Retrospective single center interventional case series. A total of 26 eyes of 23 consecutive pediatric patients with CNV of various etiologies were treated with intravitreal injection of anti-VEGF agents. Results: There were 15 males (65.2%) and eight females (34.8%), diagnosed with CNV during the study period. The mean age at presentation with CNV was 11.7 ± 3.3 years, (range 4–16 years) and the mean follow was 28.1 ± 18 months, (range 8–72 months). Inflammatory CNV was the most common etiology. The mean best corrected visual acuity (BCVA) and mean central macular thickness (CMT) at presentation, were logMAR 0.8 ± 0.3 and 367.6 ± 134.8 µm respectively. At the final visit, CNV in all eyes remained regressed with significant improvement in mean BCVA to logMAR 0.4 ± 0.4 ( p < 0.0001) and mean CMT to 242.5 ± 82.4 µm ( p < 0.0001). A mean of two intravitreal injections per eye was required for CNV regression. Conclusion: Intravitreal anti-VEGF therapy for pediatric CNV is an effective treatment in majority of affected eyes.

Early Biomarkers for Severe Drug Hypersensitivity Reactions

2019 ◽  
Vol 25 (36) ◽  
pp. 3829-3839 ◽  
Author(s):  
Adriana Ariza ◽  
Maria J. Torres ◽  
Carmen Moreno-Aguilar ◽  
Rubén Fernández-Santamaría ◽  
Tahia D. Fernández
Keyword(s):  
Drug Exposure ◽  
Drug Hypersensitivity ◽  
Clinical Manifestations ◽  
Skin Tests ◽  
Time Interval ◽  
Hypersensitivity Reactions ◽  
Early Biomarkers ◽  
Immunological Mechanisms ◽  
Drug Hypersensitivity Reactions ◽  
Delayed Reactions

Drug hypersensitivity reactions (DHRs) are typically classified into immediate and delayed reactions based on the time interval between drug exposure and onset of symptoms. Clinical manifestations range from mild to severe and life-threatening reactions. The most severe clinical entities are anaphylaxis and anaphylactic shock for immediate reactions, and severe cutaneous adverse reactions such as Steven Johnson Syndrome and Toxic Epidermal Necrolysis for delayed reactions. The diagnosis is complex and challenging, as drug provocation tests and even skin tests can be very risky procedures, which makes them not recommended. Therefore, it is necessary to search for useful early biomarkers to manage the diagnosis of these reactions. These biomarkers could be useful to determine the clinical entity, but not to identify the culprit drug. Some of the currently available biomarkers are few genetic associations of drug allergy with polymorphisms of human leukocyte antigen (HLA), the detection of inflammatory and lipid mediators in serum, or the detection of cytokines, chemokines, and cytotoxic markers in skin biopsies. In this literature review, it has been summarize the immunological mechanisms involved in severe reactions, both immediate and delayed, and different early biomarkers: those currently used for the diagnosis of these reactions as well as possible early biomarkers that could be useful with further studies to standardize their clinical use.

scholarly journals Proteolytic Cleavages in the VEGF Family: Generating Diversity among Angiogenic VEGFs, Essential for the Activation of Lymphangiogenic VEGFs

Biology ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 167
Author(s):  
Jaana Künnapuu ◽  
Honey Bokharaie ◽  
Michael Jeltsch
Keyword(s):  
Growth Factors ◽  
Molecular Level ◽  
Specific Antigen ◽  
Receptor Activation ◽  
Vascular Endothelial Growth Factors ◽  
Vascular Endothelial ◽  
Turn On ◽  
C And N ◽  
Proteolytic Cleavages ◽  
Endothelial Growth Factors

Specific proteolytic cleavages turn on, modify, or turn off the activity of vascular endothelial growth factors (VEGFs). Proteolysis is most prominent among the lymph­angiogenic VEGF-C and VEGF-D, which are synthesized as precursors that need to undergo enzymatic removal of their C- and N-terminal propeptides before they can activate their receptors. At least five different proteases mediate the activating cleavage of VEGF-C: plasmin, ADAMTS3, prostate-specific antigen, cathepsin D, and thrombin. All of these proteases except for ADAMTS3 can also activate VEGF-D. Processing by different proteases results in distinct forms of the “mature” growth factors, which differ in affinity and receptor activation potential. The “default” VEGF-C-activating enzyme ADAMTS3 does not activate VEGF-D, and therefore, VEGF-C and VEGF-D do function in different contexts. VEGF-C itself is also regulated in different contexts by distinct proteases. During embryonic development, ADAMTS3 activates VEGF-C. The other activating proteases are likely important for non-developmental lymphangiogenesis during, e.g., tissue regeneration, inflammation, immune response, and pathological tumor-associated lymphangiogenesis. The better we understand these events at the molecular level, the greater our chances of developing successful therapies targeting VEGF-C and VEGF-D for diseases involving the lymphatics such as lymphedema or cancer.

scholarly journals Study of Microvessel Density and the Expression of Vascular Endothelial Growth Factors in Adrenal Gland Pheochromocytomas

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Magdalena Białas ◽  
Grzegorz Dyduch ◽  
Joanna Dudała ◽  
Monika Bereza-Buziak ◽  
Alicja Hubalewska-Dydejczyk ◽  
...  
Keyword(s):  
Growth Factors ◽  
Microvessel Density ◽  
Antiangiogenic Therapy ◽  
Prognostic Significance ◽  
Operation Technique ◽  
Vascular Endothelial Growth Factors ◽  
Vascular Endothelial ◽  
Vascular Architecture ◽  
Laparoscopic Operation ◽  
Endothelial Growth Factors

Angiogenesis (neoangiogenesis), a process of neovascularization, is an essential step for local tumor growth and distant metastasis formation. We have analysed angiogenesis status: vascular architecture, microvessel density, and vascular endothelial growth factors expression in 62 adrenal pheochromocytomas: 57 benign and 5 malignant. Immunohistochemical evaluation revealed that vascular architecture and vessel density are different in the central and subcapsular areas of the tumor. Furthermore, we have observed a strong correlation between number of macrophages and microvessel density in the central and subcapsular areas of the tumor and between the expression of VEGF-A in tumor cells and microvessel density in central and subcapsular areas of the tumor. Secondary changes in these tumors influence the results and both vascular architecture and microvessel density are markedly disturbed by hemorrhagic and cystic changes in pheochromocytomas. These changes are partially caused by laparoscopic operation technique. However, no differences in vascular parameters were found between pheochromocytomas with benign and malignant clinical behavior. Our observation showed that analysis of angiogenesis, as a single feature, does not help in differentiating malignant and benign pheochromocytomas and has no independent prognostic significance. On the other hand, high microvessel density in pheochromocytoma is a promising factor for antiangiogenic therapy in malignant cases.

scholarly journals An observational study of plasma vascular endothelial growth factors (VEGF) A and D expression in non-localized prostate cancer

2012 ◽  
Vol 9 (3) ◽  
pp. 182-189 ◽  
Author(s):  
Brandon P. Verdoorn ◽  
Changyong Feng ◽  
William A. Ricke ◽  
Deepak M. Sahasrabudhe ◽  
Deepak Kilari ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Growth Factors ◽  
Observational Study ◽  
Localized Prostate Cancer ◽  
Vascular Endothelial Growth Factors ◽  
Vascular Endothelial ◽  
Endothelial Growth Factors
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