Elevated Levels of Serum IL-17A Secondary to Repeated Intravitreal Injections of Aflibercept in Treatment-Naive Patients with Neovascular Age-Related Macular Degeneration

Małgorzata Seredyka-Burduk,Bartosz Malinowski,Daria Marczak,Magdalena Pol,Michał Wiciński,Bartlomiej J Kaluzny,Sławomir Liberski

doi:10.3390/app10124109

Małgorzata Seredyka-Burduk, Bartosz Malinowski + Show 5 more

Open Access

https://doi.org/10.3390/app10124109

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Abstract

We evaluated the effect of three monthly intravitreal injections of aflibercept on the serum concentration of interleukin 17A (IL-17A), monocyte chemoattractant protein 1 (MCP-1/CCL2), vascular endothelial growth factor (VEGF) and placental growth factor (PlGF) in treatment-naive patients with neovascular age-related macular degeneration (nAMD). Twenty-two eyes of twenty-two patients with nAMD scheduled for the initial loading phase of intravitreal aflibercept (2 mg/0.05 mL) were included. Serum VEGF, PlGF, MCP-1/CCL2 and IL-17A levels were determined four times in each individual—just before the first injection, 2–3 days after the first injection, just before the third injection, and then 2–3 days after the third aflibercept injection. A statistically significant difference was found between the serum PlGF and IL-17A levels measured before the first injection and after the initial loading phase, with a mean value (MV) of 440.884 vs. 302.151 (p = 0.023) for PlGF and MV = 139.088 pg/mL vs. 151.233 pg/mL (p = 0.016) for IL-17A, respectively. There were no statistically significant differences for VEGF and MCP-1/CCL2 between any of the compared measurements. We reveal that repeated injections of aflibercept promote an increase in serum IL-17A concentration, which may lead to a systemic inflammatory response mediated by IL-17A, but not by MCP-1.

Highlights

Age-related macular degeneration (AMD) is a chronic neurodegenerative disease leading to loss of central vision due to the progressive degeneration of photoreceptor cells located in the central point of the retina—macula [1]
Aflibercept, known as “vascular endothelial growth factor (VEGF)-Trap Eye”, is a human recombinant glycoprotein designed by combining portions of VEGF receptor (VEGFR) and human IgG1 Fc region [10]
Due to its characteristic molecular structure, aflibercept has the ability to bind VEGF-A, VEGF-B, placental growth factor (PlGF)-1, and Aflibercept, known as “VEGF-Trap Eye”, is a human recombinant glycoprotein designed by combining portions of VEGF receptor (VEGFR) and human IgG1 Fc region [10]

Summary

Introduction

Age-related macular degeneration (AMD) is a chronic neurodegenerative disease leading to loss of central vision due to the progressive degeneration of photoreceptor cells located in the central point of the retina—macula [1]. AMD is a major cause of central vision loss among the elderly population [2]. There are two main types of age-related macular degeneration—dry and wet (nAMD). AMD typically begins as a dry form, and in 10% of the affected population, transforms into a wet form (nAMD) [1], which is characterized by the presence of choroidal neovascularization (CNV)—abnormal and excessive growth of choroid vessels in the submacular area [2,3].

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