Intravitreal itraconazole inhibits laser-induced choroidal neovascularization in rats

Choroidal neovascularization (CNV) is a major cause of severe visual loss in patients with age-related macular degeneration (AMD). Recently, itraconazole has shown potent and dose-dependent inhibition of tumor-associated angiogenesis. We evaluated the anti-angiogenic effect of itraconazole in a rat...

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Veröffentlicht in:PloS one 2017-06, Vol.12 (6), p.e0180482-e0180482
Hauptverfasser: Bae, Jeong Hun, Hwang, Ah Reum, Kim, Chan Yun, Yu, Hyeong Gon, Koh, Hyoung Jun, Yang, Woo Ick, Chang, Hae Ran, Lee, Sung Chul
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creator Bae, Jeong Hun
Hwang, Ah Reum
Kim, Chan Yun
Yu, Hyeong Gon
Koh, Hyoung Jun
Yang, Woo Ick
Chang, Hae Ran
Lee, Sung Chul
description Choroidal neovascularization (CNV) is a major cause of severe visual loss in patients with age-related macular degeneration (AMD). Recently, itraconazole has shown potent and dose-dependent inhibition of tumor-associated angiogenesis. We evaluated the anti-angiogenic effect of itraconazole in a rat model of laser-induced CNV. After laser photocoagulation in each eye to cause CNV, right eyes were administered intravitreal injections of itraconazole; left eyes received balanced salt solution (BSS) as controls. On day 14 after laser induction, fluorescein angiography (FA) was used to assess abnormal vascular leakage. Flattened retinal pigment epithelium (RPE)-choroid tissue complex was stained with Alexa Fluor 594-conjugated isolectin B4 to measure the CNV area and volume. Vascular endothelial growth factor receptor 2 (VEGFR2) mRNA and protein expression was determined 1, 4, 7, and 14 days after intravitreal injection by quantitative RT-PCR or Western blot. VEGF levels were analyzed by enzyme-linked immunosorbent assay (ELISA). Intravitreal itraconazole significantly reduced leakage from CNV as assessed by FA and CNV area and volume on flat mounts compared with intravitreal BSS (p = 0.002 for CNV leakage, p
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Recently, itraconazole has shown potent and dose-dependent inhibition of tumor-associated angiogenesis. We evaluated the anti-angiogenic effect of itraconazole in a rat model of laser-induced CNV. After laser photocoagulation in each eye to cause CNV, right eyes were administered intravitreal injections of itraconazole; left eyes received balanced salt solution (BSS) as controls. On day 14 after laser induction, fluorescein angiography (FA) was used to assess abnormal vascular leakage. Flattened retinal pigment epithelium (RPE)-choroid tissue complex was stained with Alexa Fluor 594-conjugated isolectin B4 to measure the CNV area and volume. Vascular endothelial growth factor receptor 2 (VEGFR2) mRNA and protein expression was determined 1, 4, 7, and 14 days after intravitreal injection by quantitative RT-PCR or Western blot. VEGF levels were analyzed by enzyme-linked immunosorbent assay (ELISA). Intravitreal itraconazole significantly reduced leakage from CNV as assessed by FA and CNV area and volume on flat mounts compared with intravitreal BSS (p = 0.002 for CNV leakage, p&lt;0.001 for CNV area and volume). Quantitative RT-PCR showed significantly lower expression of VEGFR2 mRNA in the RPE-choroid complexes of itraconazole-injected eyes than those of BSS-injected eyes on days 7 and 14 (p = 0.003 and p = 0.006). Western blots indicated that VEGFR2 was downregulated after itraconazole treatment. ELISA showed a significant difference in VEGF level between itraconazole-injected and BSS-injected eyes on days 7 and 14 (p = 0.04 and p = 0.001). Our study demonstrated that intravitreal itraconazole significantly inhibited the development of laser-induced CNV in rats. Itraconazole had anti-angiogenic activity along with the reduction of VEGFR2 and VEGF levels. Itraconazole may prove beneficial for treating CNV as an alternative or adjunct to other therapies.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0180482</identifier><identifier>PMID: 28666022</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Age ; Angiogenesis ; Angiography ; Animals ; Antifungal agents ; Biology and Life Sciences ; Care and treatment ; Cell growth ; Choroidal Neovascularization - etiology ; Choroidal Neovascularization - prevention &amp; control ; Dosage and administration ; Drug therapy ; Engineering and Technology ; Enzyme-Linked Immunosorbent Assay ; Epithelium ; Eye ; Eye (anatomy) ; Flattening ; Fluorescein ; Fluorescein Angiography ; Gene expression ; Intravitreal Injections ; Itraconazole ; Itraconazole - administration &amp; dosage ; Itraconazole - therapeutic use ; Kinases ; Laser Coagulation - adverse effects ; Lasers ; Leakage ; Macular degeneration ; Male ; Medicine and Health Sciences ; mRNA ; Neovascularization ; Physicians ; Polymerase chain reaction ; Rats ; Real-Time Polymerase Chain Reaction ; Research and Analysis Methods ; Retina ; Retinal pigment epithelium ; Rodents ; Salts ; Vascular endothelial growth factor ; Vascular Endothelial Growth Factor A - metabolism ; Vascular endothelial growth factor receptor 2 ; Vascular Endothelial Growth Factor Receptor-2 - genetics ; Vascular Endothelial Growth Factor Receptor-2 - metabolism ; Vascularization ; Visual perception ; Western blotting</subject><ispartof>PloS one, 2017-06, Vol.12 (6), p.e0180482-e0180482</ispartof><rights>COPYRIGHT 2017 Public Library of Science</rights><rights>2017 Bae et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. 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dosage</subject><subject>Itraconazole - therapeutic use</subject><subject>Kinases</subject><subject>Laser Coagulation - adverse effects</subject><subject>Lasers</subject><subject>Leakage</subject><subject>Macular degeneration</subject><subject>Male</subject><subject>Medicine and Health Sciences</subject><subject>mRNA</subject><subject>Neovascularization</subject><subject>Physicians</subject><subject>Polymerase chain reaction</subject><subject>Rats</subject><subject>Real-Time Polymerase Chain Reaction</subject><subject>Research and Analysis Methods</subject><subject>Retina</subject><subject>Retinal pigment epithelium</subject><subject>Rodents</subject><subject>Salts</subject><subject>Vascular endothelial growth factor</subject><subject>Vascular Endothelial Growth Factor A - metabolism</subject><subject>Vascular endothelial growth factor receptor 2</subject><subject>Vascular Endothelial Growth Factor Receptor-2 - genetics</subject><subject>Vascular Endothelial Growth Factor Receptor-2 - metabolism</subject><subject>Vascularization</subject><subject>Visual perception</subject><subject>Western blotting</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNkl1rFDEUhgdRbK3-A9EFQfRi13xNJrkRSvFjoVBQ623I5GM3S3ayJplF--vNdKdlR3ohc3GG5Dlvkve8VfUSggXEDfywCX3spF_sQmcWADJAGHpUnUKO0ZwigB8f_Z9Uz1LaAFBjRunT6gSVQgFCp9X1sstR7l2ORvpZKVKFTt4Eb2auW7vW5TTzMpk4d53uldEztQ4xOF3ozoS9TKr3MrobmV3oSs8sypyeV0-s9Mm8GOtZdf3504-Lr_PLqy_Li_PLuWpqlucasxbUgNEGSMSRRYQ00DaAWtNyC6QCSHHdatYiXLdKQ9IioFpNlG2YJRifVa8PujsfkhgdSQJySDhjhKNCLA-EDnIjdtFtZfwjgnTidiHElZAxO-WNAFTVtsWMQIqI4o1kTU2NooCThlE5nPZxPK1vt0YrM1jnJ6LTnc6txSrsRU04JoAWgXejQAy_epOy2LqkjPeyWNnf3rvGhNeQFPTNP-jDrxuplSwPcJ0NwwAHUXFOeEM4xGDQWjxAlU-brSvjNtaV9UnD-0lDYbL5nVeyT0ksv3_7f_bq55R9e8SuS-LyOgXfD9FJU5AcQBVDStHYe5MhEEP679wQQ_rFmP7S9up4QPdNd3HHfwGv1QAG</recordid><startdate>20170630</startdate><enddate>20170630</enddate><creator>Bae, Jeong Hun</creator><creator>Hwang, Ah Reum</creator><creator>Kim, Chan Yun</creator><creator>Yu, Hyeong Gon</creator><creator>Koh, Hyoung Jun</creator><creator>Yang, Woo Ick</creator><creator>Chang, Hae Ran</creator><creator>Lee, Sung Chul</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0001-9438-2385</orcidid></search><sort><creationdate>20170630</creationdate><title>Intravitreal itraconazole inhibits laser-induced choroidal neovascularization in rats</title><author>Bae, Jeong Hun ; 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Recently, itraconazole has shown potent and dose-dependent inhibition of tumor-associated angiogenesis. We evaluated the anti-angiogenic effect of itraconazole in a rat model of laser-induced CNV. After laser photocoagulation in each eye to cause CNV, right eyes were administered intravitreal injections of itraconazole; left eyes received balanced salt solution (BSS) as controls. On day 14 after laser induction, fluorescein angiography (FA) was used to assess abnormal vascular leakage. Flattened retinal pigment epithelium (RPE)-choroid tissue complex was stained with Alexa Fluor 594-conjugated isolectin B4 to measure the CNV area and volume. Vascular endothelial growth factor receptor 2 (VEGFR2) mRNA and protein expression was determined 1, 4, 7, and 14 days after intravitreal injection by quantitative RT-PCR or Western blot. VEGF levels were analyzed by enzyme-linked immunosorbent assay (ELISA). Intravitreal itraconazole significantly reduced leakage from CNV as assessed by FA and CNV area and volume on flat mounts compared with intravitreal BSS (p = 0.002 for CNV leakage, p&lt;0.001 for CNV area and volume). Quantitative RT-PCR showed significantly lower expression of VEGFR2 mRNA in the RPE-choroid complexes of itraconazole-injected eyes than those of BSS-injected eyes on days 7 and 14 (p = 0.003 and p = 0.006). Western blots indicated that VEGFR2 was downregulated after itraconazole treatment. ELISA showed a significant difference in VEGF level between itraconazole-injected and BSS-injected eyes on days 7 and 14 (p = 0.04 and p = 0.001). Our study demonstrated that intravitreal itraconazole significantly inhibited the development of laser-induced CNV in rats. Itraconazole had anti-angiogenic activity along with the reduction of VEGFR2 and VEGF levels. Itraconazole may prove beneficial for treating CNV as an alternative or adjunct to other therapies.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>28666022</pmid><doi>10.1371/journal.pone.0180482</doi><tpages>e0180482</tpages><orcidid>https://orcid.org/0000-0001-9438-2385</orcidid><oa>free_for_read</oa></addata></record>
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identifier ISSN: 1932-6203
ispartof PloS one, 2017-06, Vol.12 (6), p.e0180482-e0180482
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subjects Age
Angiogenesis
Angiography
Animals
Antifungal agents
Biology and Life Sciences
Care and treatment
Cell growth
Choroidal Neovascularization - etiology
Choroidal Neovascularization - prevention & control
Dosage and administration
Drug therapy
Engineering and Technology
Enzyme-Linked Immunosorbent Assay
Epithelium
Eye
Eye (anatomy)
Flattening
Fluorescein
Fluorescein Angiography
Gene expression
Intravitreal Injections
Itraconazole
Itraconazole - administration & dosage
Itraconazole - therapeutic use
Kinases
Laser Coagulation - adverse effects
Lasers
Leakage
Macular degeneration
Male
Medicine and Health Sciences
mRNA
Neovascularization
Physicians
Polymerase chain reaction
Rats
Real-Time Polymerase Chain Reaction
Research and Analysis Methods
Retina
Retinal pigment epithelium
Rodents
Salts
Vascular endothelial growth factor
Vascular Endothelial Growth Factor A - metabolism
Vascular endothelial growth factor receptor 2
Vascular Endothelial Growth Factor Receptor-2 - genetics
Vascular Endothelial Growth Factor Receptor-2 - metabolism
Vascularization
Visual perception
Western blotting
title Intravitreal itraconazole inhibits laser-induced choroidal neovascularization in rats
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