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O. Tatar, K. Shinoda, A. Adam, V. Boeyden, G. Pertile, S. Bopp, E. Yoeruek, C. Eckardt, K. U. Bartz-Schmidt, S. Grisanti; Matrix Metalloproteinases in Human Choroidal Neovascular Membranes Excised Following Verteporfin Photodynamic Therapy. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1465.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the expression of the proangiogenic matrix metalloproteinases (MMP) 2 and 9 at distinct intervals after verteporfin photodynamic therapy (PDT) in human choroidal neovascular membranes (CNV) secondary to age-related macular degeneration (AMD).
Retrospective review of an interventional case series of forty-nine patients who underwent removal of CNV. Twenty-six patients were treated with PDT 3 to 383 days prior to surgery. Twenty-three CNV without previous treatment were used as controls. CNV were stained for CD34, cytokeratin18, endostatin, MMP-2 and MMP-9 by immunohistochemistry.
CNV without previous therapy disclosed MMP-2, MMP-9 in RPE-Bruch’s membrane, vessels and stroma in different intensities. Three days after PDT, MMP-9 expression was significantly weaker in stroma (p=0.0019). A significantly reduced expression was also found for endostatin in vessels (p=0.0005). At longer post-PDT intervals, a significant increase of MMP-9 expression in stroma (p=0.0373) and of endostatin expression in RPE-Bruch’s membrane (p=0.02), vessels (p=0.005) and stroma (p=0.0007) were disclosed. No significant changes in MMP-2 expression were detected.
PDT induced an early, temporary decrease in MMP-9 and endostatin expression. At longer intervals, MMP-9 increase is possibly associated with the angiogenic process responsible for recurrence after PDT. MMP-9, however, acts as a double-edged sword by concomitant induction of endostatin, an endogenous inhibitor of angiogenesis.
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