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. 2019 Nov 2;8(11):1841.
doi: 10.3390/jcm8111841.

Usefulness of Liquid Biopsy Biomarkers from Aqueous Humor in Predicting Anti-VEGF Response in Diabetic Macular Edema: Results of a Pilot Study

Patricia Udaondo  1 , Cristina Hernández  2   3   4 , Laura Briansó-Llort  5   6   7 , Salvador García-Delpech  8 , Olga Simó-Servat  9   10   11 , Rafael Simó  12   13   14
Affiliations

Usefulness of Liquid Biopsy Biomarkers from Aqueous Humor in Predicting Anti-VEGF Response in Diabetic Macular Edema: Results of a Pilot Study

Patricia Udaondo et al. J Clin Med. .

Abstract

The objective was to investigate the usefulness of the "liquid biopsy" of aqueous humor (AH) to predict the clinical response after intravitreal injections (IVT) of anti-VEGF agents for treating diabetic macular edema (DME). For this purpose, AH samples obtained during the first anti-VEGF IVT from 31 type two diabetic patients were analyzed. Patients were classified into three groups according to their anti-VEGF response: rapid responders (n = 11), slow responders (n = 11), and non-responders (n = 9). In addition, patients (n = 7) who showed good response to corticosteroids but a delayed or no response to anti-VEGF therapy were analyzed. Levels of 17 different cytokines, chemokines, and growth factors in AH were measured using a multiplex immunoassay. We found higher concentrations of VEGF in rapid responders to anti-VEGF therapy compared to non-responders. In addition, slow responders to anti-VEGF treatment showed higher levels of inflammatory markers than rapid responders, but did not reach statistical significance. Finally, those patients who responded to corticosteroids but not to anti-VEGF therapy showed significantly lower levels of VEGF than patients with rapid response (p = 0.01). In conclusion, "liquid biopsy" of AH could be useful to determine whether the predominant pathogenic event is primarily angiogenic or inflammatory in nature. This approach would allow physicians to select a more rational and cost-effective treatment. Further studies to validate these preliminary results are warranted.

Keywords: VEGF; anti-VEGF agents; aqueous humor; biomarkers; diabetic macular edema; inflammation; personalized medicine.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
VEGF levels in aqueous humor according to response. Individual data points, median (horizontal bar symbols) and p values are shown.
Figure 2
Figure 2
Correlation between aqueous and vitreous levels of VEGF.
See this image and copyright information in PMC

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