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Vascular endothelial growth factor-A: A multifunctional molecular player in diabetic retinopathy
Authors:Xinyuan Zhang  Shisan Bao  Brett D Hambly  Mark C Gillies
Institution:1. Discipline of Pathology, School of Medical Sciences and Bosch Institute, The University of Sydney, Australia;2. Department of Forensic Medicine, The University of New South Wales, Glebe, New South Wales, Australia;3. Beijing Institute of Ophthalmology, Beijing Tongren Eye Centre, Beijing Tongren Hospital, Capital Medical University, Beijing, China;4. Department of Cardiology, Royal Prince Alfred Hospital, Central Clinical School, The University of Sydney, Australia
Abstract:Vascular endothelial growth factor-A (VEGF-A), first described as “vascular permeability factor”, is a critical molecule in the pathogenesis of diabetic retinopathy at several levels. Previous studies have outlined the importance of VEGF-A in mediating vascular pathology in both experimental models and clinical diabetic retinopathy, which are characterized by retinal vascular leakage, preretinal neovascularisation and neuronal degeneration. Paradoxically, recent reports have emphasized the potential neurotrophic effects of VEGF-A on the quiescent vasculature, as well as its direct and indirect protective effects on retinal neurons. VEGF-A has also been identified as an important signalling regulator in the normal central nervous system. Consequently, anti-VEGF therapy for diabetic retinopathy has become a controversal issue. This review outlines recently developed concepts relating to the role of VEGF-A in the pathogenesis of diabetic retinopathy, with particular emphasis on its implications for clinical practice.
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