Anti-vascular endothelial growth factor (VEGF) drugs were hailed as the great hope for patients with age-related macular degeneration (AMD) when they were first offered a decade ago – yet for a fraction of patients, they have no effect on the disease.
A new international collaboration, between the University of Bristol and The Scripps Research Institute in the US, is seeking to discover why these patients continue to lose their sight.
There is a link between VEGF and a protein known as CFH, which acts as a “protective molecule” in the body, explained Scripps Research Institute principal investigator, Professor Martin Friedlander.
His research has found that animals that cannot produce VEGF also cannot create CFH.
Some people have a mutation that means they are less able to make CFH, leaving them more vulnerable to cellular damage. If these people are given anti-VEGF drugs, this could compound the issue, Professor Friedlander highlighted.
His studies, published in The Journal of Clinical Investigation, also found that retinal pigment epithelium cells created from people with the CFH mutation responded differently to normal cells when treated with anti-VEGF drugs.
Professor Friedlander emphasised that more work was needed to determine if this interaction explained why anti-VEGF treatment did not work for some patients, but added that doctors may want to screen AMD patients for the mutation, if treatment fails to yield results.
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