Article
Early Effects of Triamcinolone Acetonide on Matrix Metalloproteinases and Endostatin in Human Choroidal Neovascularization
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Published: | June 29, 2009 |
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Objective: To evaluate the early effects of triamcinolone acetonide (TA) as either monotherapy or adjuvant to verteporfin photodynamic therapy (PDT) on expression of matrix metalloproteinases (MMP) -2, -9 and endostatin in human choroidal neovascularization (CNV) secondary to age related macular degeneration.
Methods: Retrospective review of interventional series of 38 patients who underwent CNV extraction. Eleven patients were treated with either intravitreal TA (4 mg) monotherapy (TA CNV, n=5) or PDT-TA combination therapy (PDT-TA CNV, n=6) 3 to 9 days preoperatively. Twenty-three CNV without previous therapy (control CNV) and 4 CNV excised 3 days after PDT (PDT CNV) were used as control. CNV were stained for cytokeratin18, CD34, MMP-2 and MMP-9.
Results: MMP-2 and MMP-9 expression in TA CNV was comparable to control CNV. MMP-9 and endostatin expression was significantly weaker in PDT CNV than control CNV (p=0.001; p=0.0035, respectively), TA CNV (p=0.012; p=0.0005, respectively) and PDT-TA CNV (p=0.002; p=0.0001, respectively). MMP-2 and endostatin expression in PDT-TA CNV was stronger than both PDT CNV (p<0.001; p=0.0001, respectively) and control CNV (p=0.001, p=0.02, respectively).
Conclusions: TA probably does not suppress MMP-2 or MMP-9 expression in CNV. PDT induces an early decrease in MMP-9 and endostatin expression. Administration of TA as adjuvant to PDT seems to induce MMP-2 expression and inhibit the decrease in MMP-9 expression after PDT. This correlates with enhanced endostatin expression in PDT-TA CNV.