Letter to the Editor
Comment on “Cellular and molecular aspects of diabetic nephropathy; the role of VEGF-A”
Comentario a “Cellular and molecular aspects of diabetic nephropathy; the role of VEGF-A”
Erol Arslan
, Adem Aydın, Şeref Demirbaş, Kenan Sağlam
Corresponding author
Department of Internal Medicine, Gülhane Military Medical Academy, Ankara, Turkey
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Monoclonal antibodies that bind the VEGF has long been used in systemic treatment protocol of solid tumors. Recently, by ophthalmologists, intravitreal administration of anti-VEGF agents seen as the primary treatment method in conditions of age- related macular degeneration, diabetic retinopathy, retinal vein occlusion.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a> Although systemic side effects are well known with the high dose intravenous use in cancer therapy, almost local side effects were reported associated with intraocular anti-VEGF treatment. However, despite the blood retinal barrier, anti-VEGF agents are detectable in systemic circulation after intraocular administration through uveal vessels or by aqueous humor outflow and might constitutes systemic adverse effect like nephropathy by antagonizing to VEGF-dependent pathway in glomeruli.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">We describe a case of nephrotic syndrome that were unable to detect significant findings for etiology in first research. But with detailed history we found that she had received intravitreal anti-VEGF due to diabetic retinopathy 10 days before the occurrence of symptoms. After the exclusion of other possible causes. We thought anti-VEGF agents might be responsible. In the literature, we found only 3 cases associated with renal toxicity of intraocular anti-VEGF therapy.<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">4–6</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">We would like to remind that even at the small quantities used in the practice of ophthalmology, anti-VEGF agents may able to cause serious systemic effects including nephropathy.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:6 [ 0 => array:3 [ "identificador" => "bib0035" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cellular and molecular aspects of diabetic nephropathy; the role of VEGF-A" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "K. Carranza" 1 => "D. Veron" 2 => "A. Cercado" 3 => "N. Bautista" 4 => "W. Pozo" 5 => "A. Tufro" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.nefro.2015.05.013" "Revista" => array:6 [ "tituloSerie" => "Nefrologia" "fecha" => "2015" "volumen" => "35" "paginaInicial" => "131" "paginaFinal" => "138" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26300505" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0040" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Intravitreal bevacizumab (Avastin) treatment of proliferative diabetic retinopathy complicated by vitreous hemorrhage" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R.F. Spaide" 1 => "Y.L. 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