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Charles H. Weber, David G. Telander, Lawrence S. Morse, Charles E. Thirkill; Presence of Serum Antibodies Reactive to Human Retinal Pigment Epithelium and Human Embryonic Vascular Endothelial Cells in a Population of Patients with Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2011;52(14):2291.
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Age-Related Macular Degeneration (AMD) patients failing to respond to conventional therapies may be experiencing complications unresponsive to the primary care they receive. Our studies on the AMD patients failing to respond favorably to anti-Vascular Endothelial Growth Factor (VEGF) therapies (Lucentis/Avastin), lead to inquiry into the possibility of additional retinal complications. We sought evidence of any demonstrable form of retinal hypersensitivity involving vasculature through an investigation into the immunologic status of 45 patients with AMD.
Each of the 45 patient’s antibody activity was evaluated on Western blots of retina, in vitro cultivated human Retinal Pigment Epithelium (RPE), and in vitro Human Embrionic Vascular Endothelial Cells (HUVEC).
Nine of the 45 patient’s sera were found on blots of retina to exhibit antibody with a 55 kd protein component. Further evaluation on blots of HUVEC revealed similar activity with a 55 kd protein component of these cells in the sera of these same nine patients. No comparable reaction was apparent in blots of RPE. None of the remaining 36 patients were reactive with the 55 kd retina and HUVEC components.
One of the superimposed, secondary complications of AMD can include vascular inflammations probably initiated at some site within the host, distant from the eye, such as that seen in some cases of atherosclerosis. Recognition of complicating factors enables an improved therapeutic approach to the treatment of AMD, recognizing that the malady may be accompanied by occult, potentially pathologic complications.
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