Leading academic and pharmaceutical researchers and clinicians from many disciplines synthesize and summarize current clinical and basic knowledge concerning abnormal growth of blood vessels in the eye, the cause of major neovascular eye diseases. The authors also identify and assess the most promising approaches with potential for commercial exploitation and discuss the challenges encountered in developing therapeutics for ocular neovascular diseases. Highlights include illuminating chapters on gene therapy and novel drug delivery systems and excellent summaries of the newest therapeutic approaches.
Ocular angiogenesis, or the abnormal growth of blood vessels in the eye, is the cause of major neovascular eye diseases. With the new era of anti-angiogenic therapies, ophthalmologists have started treating many ocular diseases including macular degeneration, diabetic retinopathy, and retinal vascular occlusion using anti-angiogenic drugs. This book covers the basic pathophysiology of ocular angiogenesis and strategies for inhibition. The authors discuss the "Principles" of anti-angiogenic therapy, pre-clinical studies, future drugs on the horizon, drug delivery, and the "Practice" of the therapy in many ocular diseases. The book also includes chapters on diabetic macular edema, and various therapeutic options for this condition. A companion website includes the fully searchable text and an image bank.
This book provides a concise overview over the pathology of retinal angiogenic diseases and explains why anti-angiogenic therapy is effective in so many patients. The reader is guided through the various clinical indications for anti-angiogenic therapy and made aware of its merits as well as current challenges and limitations. It is explained how, since its introduction for the treatment of exudative age-related macular degeneration in 2006, anti-angiogenic therapy has revolutionized the way in which we treat a range of ocular diseases. All of the authors are established experts in their respective fields who share their extensive knowledge and clinical experience with the reader. This book is both a valuable introduction to anti-angiogenic therapy in ophthalmology and a day-to-day companion for all ophthalmologists seeing patients with some of the most prevalent retinal diseases.
Angiogenesis, the development of new blood vessels from the existing vasculature, is essential for physiological growth and over 18,000 research articles have been published describing the role of angiogenesis in over 70 different diseases, including cancer, diabetic retinopathy, rheumatoid arthritis and psoriasis. One of the most important technical challenges in such studies has been finding suitable methods for assessing the effects of regulators of eh angiogenic response. While increasing numbers of angiogenesis assays are being described both in vitro and in vivo, it is often still necessary to use a combination of assays to identify the cellular and molecular events in angiogenesis and the full range of effects of a given test protein. Although the endothelial cell - its migration, proliferation, differentiation and structural rearrangement - is central to the angiogenic process, it is not the only cell type involved. the supporting cells, the extracellular matrix and the circulating blood with its cellular and humoral components also contribute. In this book, experts in the use of a diverse range of assays outline key components of these and give a critical appraisal of their strengths and weaknesses. Examples include assays for the proliferation, migration and differentiation of endothelial cells in vitro, vessel outgrowth from organ cultures, assessment of endothelial and mural cell interactions, and such in vivo assays as the chick chorioallantoic membrane, zebrafish, corneal, chamber and tumour angiogenesis models. These are followed by a critical analysis of the biological end-points currently being used in clinical trials to assess the clinical efficacy of anti-angiogenic drugs, which leads into a discussion of the direction future studies should take. This valuable book is of interest to research scientists currently working on angiogenesis in both the academic community and in the biotechnology and pharmaceutical industries. Relevant disciplines include cell and molecular biology, oncology, cardiovascular research, biotechnology, pharmacology, pathology and physiology.
This book provides a comprehensive, in-depth review of our current understanding of the growth of blood vessels within the eye. Novel therapeutic strategies for the treatment of ocular angiogenesis are discussed, as are the unique challenges presented by delivery of drugs to the eye. The book emphasizes basic principles rather than specific experimental results, although recently acquired data is frequently cited to illustrate points of broader theoretical significance.
Dr. Judah Folkman is considered the "father of angiogenesis." Because of Folkman's discovery and research, the possibilities of angiogenic therapy have broadened beyond cancer to many noncancerous diseases. Angiogenesis: An Integrative Approach from Science to Medicine is a comprehensive, concise summary of tumor angiogenesis. It is an up-to-date and authoritative reference for the angiogenesis field as it relates to oncology. This book represents the first collection in a volume of which Folkman is co-editor. Folkman has authored nearly 400 original papers and more than 100 book chapters.
Ocular Disease—a newly introduced companion volume to the classic Adler's Physiology of the Eye—correlates basic science and clinical management to describe the how and why of eye disease processes and the related best management protocols. Editors Leonard A. Levin and Daniel M. Albert—two of the world's leading ophthalmic clinician-scientists—have recruited as contributors the most expert and experienced authorities available in each of the major areas of ophthalmic disease specific to ophthalmology: retina, cornea, cataract, glaucoma, uveitis, and more. The concise chapter structure features liberal use of color—with 330 full-color line artworks, call-out boxes, summaries, and schematics for easy navigation and understanding. This comprehensive resource provides you with a better and more practical understanding of the science behind eye disease and its relation to treatment. - Covers all areas of disease in ophthalmology including retina, cornea, cataract, glaucoma, and uveitis for the comprehensive information you need for managing clinical cases. - Presents a unique and pragmatic blend of necessary basic science and clinical application to serve as a clinical guide to understanding the cause and rational management of ocular disease. - Features 330 full-color line artworks that translate difficult concepts and discussions into concise schematics for improved understanding and comprehension. - Provides the expert advice of internationally recognized editors with over 40 years of experience together with a group of world class contributors in basic science and clinical ophthalmology.
Ocular Therapeutics: Eye on New Discovery focuses on emerging areas in ocular research, from new approaches to dry eye to gene therapy in the management of retinal diseases. This comprehensive book features more than 25 chapters of information that will be vital for ocular investigators and ophthalmologists bringing them new information on promising therapeutics. It is the intent of this book to provide not only information on current approaches to treatment, but also in giving the reader a greater understanding as to what may become available for treating a number of important eye diseases. Each chapter features some new aspect of treatment that holds great promise for the future. The approach has been to concentrate on those areas of ocular diseases that are more prevalent. It also features new insight for drug delivery and for managing devasting diseases, such as macula edema and glaucoma, two of the leading causes of blindness in the United States. This book will serve as an important resource as it contains a number of relevant references highlighted for their importance to the field. New investigators will be able to obtain an historical perspective for each of the topics and to develop an understanding of the new research directions that are underway. Ocular Therapeutics: Eye on New Discovery is more than a reference book, as it also provides an important glimpse into the near future.* Contains information that is vital for ocular investigators and ophthalmologists bringing them new information on promising therapeutics.* Provides not only information on current approaches to treatment, but also gives the reader a greater understanding as to what may become available for treating a number of important eye diseases.* Historical perspective for each of the topics as well as an important glimpse into the near future to develop an understanding of the new research directions underway.* New insight for drug delivery and for managing devastating diseases, such as macula edema and glaucoma, two of the leading causes of blindness in the United States
The development of therapy with anti-angiogenics or vascular endothelial growth factor inhibitors (anti-VEGF) has marked the beginning of a new era in neovascularization and macular edema treatment. Its main goals are the inhibition of growth and development of new vessels along with the reduction of vascular permeability. The advantages over conventional laser photocoagulation are evident as laser treatment always leaves scars and causes a retinal sensitivity deterioration. Starting with an outline of treatment principles, this volume covers all aspects of anti-VEGF therapy for ophthalmological disorders. In particular, specific chapters are dedicated to age-related macular degeneration, degenerative myopia, angioid streaks, inflammatory diseases, hereditary dystrophies, retinal vein occlusion, diabetic retinopathy, ocular tumors, as well as anterior segment neovascularization. The book gives an update on the application of anti-VEGF in ocular diseases to general ophthalmologists as well as retina specialists.
Inflammation and angiogenesis, the growth of new blood vessels from pre-existing ones, are involved in tumor growth, ocular diseases and wound healing. In ocular angiogenesis, new pathological vessels grow into a specific eye tissue, leak fluid, and disrupt vision. The development of safe and effective therapies for ocular angiogenesis is of great importance for preventing blindness, given that current treatments have limited efficacy or are associated with undesirable side effects. The search for alternative treatment targets requires a deeper understanding of inflammation and how it can lead to angiogenesis in the eye in pathologic situations. This thesis provides new insights into the regulation of inflammation and angiogenesis, particularly at the gene expression and phenotypic levels, in different situations characterized by angiogenesis of the cornea, often called corneal neovascularization. For instance, specific genes and pathways are either endogenously activated or suppressed during active inflammation, wound healing, and during resolution of inflammation and angiogenesis, serving as potential targets to modulate the inflammatory and angiogenic response. In addition, as part of the healing response to restore corneal transparency, inflammation and angiogenesis subside with time in the cornea. In this context, LXR/RXR signaling was found to be activated in a time-dependent manner, to potentially regulate resolution of inflammation and angiogenesis. During regression of new angiogenic capillaries, ghost vessels and empty basement membrane sleeves are formed, which can persist in the cornea for a long time. Here, ghost vessels were found to facilitate subsequent revascularization of the cornea, while empty basement membrane sleeves did not revascularize. The revascularization response observed here was characterised by vasodilation, increased inflammatory cell infiltration and by sprouting at the front of the reperfused vessels. Importantly, reactive oxygen species and nitrous oxide signaling among other pro-inflammatory pathways were activated, and at the same time anti-inflammatory LXR/RXR signaling was inhibited. The interplay between activation and inhibition of these pathways highlights potential mechanisms that regulate corneal revascularization. When treating corneal neovascularization clinically, corticosteroids are in widespread use due to their effectiveness. To minimize the many undesirable side effects associated with corticosteroid use, however, identifying new and more selective agents is of great importance. Here, it was observed that corticosteroids not only suppressed pro-inflammatory chemokines and cytokines, but also activated the classical complement pathway. Classical complement may represent a candidate for further selective therapeutic manipulation to investigate its effect on treatment of corneal neovascularization. In summary, this thesis identifies genes, pathways, and phenotypic responses involved in sprouting and remodeling of corneal capillaries, highlights novel pathways and factors that may regulate inflammation and angiogenesis in the cornea, and provides insights into regulation of capillary regression and reactivation. Further investigation of these regulatory mechanisms may offer alternative and effective treatment targets for the treatment of corneal inflammation and angiogenesis.
