Abstract：
The aim of this study is to investigate the relationship between age-related macular degeneration (AMD) and lymphangiogenesis biomarkers, namely LYVE-1, Podoplanin, VEGF-C, VEGFR-2 and VEGFR-3. This prospective and interventional study includes 30 patients with AMD which may be dry or wet type and 30 controls for whom vitrectomy and phacoemulsification was indicated due to additional pathologies (epiretinal membrane, macular hole, retinal detachment, and cataract). 0.1-0,2 ml of aqueous humor and 0.5-1 ml of vitreous sample was taken during the operations. Before the operations 1 tube serum was also taken. All the lymphangiogenesis biomarkers in the study are examined by ELISA method. LYVE-1 (p = 0.001) and Podoplanin (p = 0.004) levels in the vitreous for the patient group are found to be significantly lower than the control group. Serum (p = 0.019), vitreous (p = 0.001), aqueous (p < 0.001) levels of VEGF-C for the patient group are significantly higher than the control group. VEGF-C/VEGFR-2 (p < 0.001), VEGF-C/VEGFR-3 (p < 0.001) ratios in the vitreous for the patient group are found to be significantly higher than the control group. Especially in wet AMD patients, LYVE-1 level is significantly lower in the vitreous (p = 0.002) and aqueous (p = 0.002) than the control group. In addition, Podoplanin level is observed as significantly lower in the vitreous (p = 0.014) and serum (p = 0.002) in comparison to control group. In the wet AMD group, VEGF-C level in the vitreous (p < 0.001), aqueous (p < 0.001) and serum (p = 0.001) is higher than the control group. The result of this study indicates a valid relationship between the weakening of lymphangiogenesis and the pathophysiology of AMD, especially for the wet type. It is observed that the levels of receptors that bind VEGF-C (VEGFR-2 and VEGFR-3) do not increase at the same rate as VEGF-C to compensate for the increase in VEGF-C. The absence of an increase in VEGFR-3, which is especially necessary for lymphangiogenesis, also suggests that lymphangiogenesis is weakened or decreased in AMD. In the future interventional studies with larger series, examination of lymphangiogenic biomarkers in inflammatory retinal diseases and glaucoma may reveal unexplored details.
摘要：
这项研究的目的是探讨年龄相关性黄斑变性（AMD）与淋巴管生成生物标志物之间的关系，即LYVE-1，Podoplanin，VEGF-C,VEGFR-2和VEGFR-3。这项前瞻性和介入性研究包括30例AMD患者，这些患者可能是干型或湿型，以及30例对照，由于其他病理（视网膜前膜，黄斑裂孔,视网膜脱离,和白内障）。手术期间取0.1-0.2ml房水和0.5-1ml玻璃体样品。手术前也取1管血清。通过ELISA方法检查研究中的所有淋巴管生成生物标志物。发现患者组玻璃体中的LYVE-1（p=0.001）和Podoplanin（p=0.004）水平显着低于对照组。血清（p=0.019），玻璃体（p=0.001），患者组的VEGF-C的水性水平(p<0.001)显著高于对照组。VEGF-C/VEGFR-2（p<0.001），发现患者组的玻璃体中VEGF-C/VEGFR-3(p<0.001)比率显著高于对照组。尤其是湿性AMD患者，玻璃体（p=0.002）和房水（p=0.002）中的LYVE-1水平明显低于对照组。此外,与对照组相比，玻璃体（p=0.014）和血清（p=0.002）中的足无蛋白水平显着降低。在湿性AMD组中，玻璃体中VEGF-C水平（p<0.001），水(p<0.001)和血清(p=0.001)高于对照组。这项研究的结果表明，淋巴管生成的减弱与AMD的病理生理之间存在有效的关系，特别是湿型。观察到结合VEGF-C的受体（VEGFR-2和VEGFR-3）的水平没有以与VEGF-C相同的速率增加，以补偿VEGF-C的增加。VEGFR-3没有增加，这对于淋巴管生成是特别必要的，也提示在AMD中淋巴管生成减弱或减少。在未来更大系列的介入研究中，检查炎性视网膜疾病和青光眼中的淋巴管生物标志物可能会揭示未探索的细节。
