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Peirovifar A, Gharehbaghi MM, Gharabaghi PM, Sadeghi K
Correspondence: Dr Manizheh Mostafa Gharehbaghi, firstname.lastname@example.org
INTRODUCTION Retinopathy of prematurity (ROP) can lead to severe visual impairment. This study was conducted to determine the levels of biochemical mediators (i. e. vascular endothelial growth f actor [VEGF] and insulin- like growth factor-1 [IGF-1]) in the blood of premature infants with proliferative ROP.
METHODS Blood samples from 71 preterm infants born at or before 32 weeks of gestation were obtained 6–8 weeks after birth. These infants were classified into two groups according to their eye examination results. The control group consisted of 41 infants who had no evidence of ROP, and the study group consisted of 30 infants with proliferative ROP at stage III or higher. Blood VEGF and IGF-1 levels were measured using enzyme-linked immunosorbent assay.
RESULTS The mean gestational ages of the infants at birth were 28.4 ± 1.6 and 28.8 ± 1.6 weeks in the study and control groups, respectively (p = 0.259). The mean postmenstrual age of the infants at the time of blood sampling was 34.9 ± 1.2 weeks in the study group and 34.6 ± 1.3 weeks in the control group (p = 0.339). The mean blood IGF-1 (18.48 ± 11.79 µg/L and 16.75 ± 13.74 µg/L in the study and control groups, respectively; p = 0.580) and VEGF (267.35 ± 103.43 pg/mL and 237.52 ± 130.92 pg/mL in the study and control groups, respectively; p = 0.305) levels of the infants were not significantly different between the two groups.
CONCLUSION At 6–8 weeks after birth, blood IGF-1 and VEGF levels were not found to be significantly different between premature infants with proliferative ROP and those without.
Keywords: insulin-like growth factor, retinopathy of prematurity, vascular endothelial growth factor
Singapore Med J2013; 54(12): 709-712; http://dx.doi.org/10.11622/smedj.2013246
|1. Phelps DL. Retinopathy of Prematurity. In: Martin RJ, Fanaroff AA, Walsh MC, eds. Fanaroff & Martin's Neonatal-Perinatal Medicine: Diseases of the Fetus and Infant. Vol 1 9th ed. Missouri: Elsevier Mosby, 2011: 1764-9.|
|2. Phelps DL. Retinopathy of prematurity: history, classification and pathophysiology. Neoreviews 2001; 2:e153-166.
|3. Askin DF, Diehl-Jones W. Retinopathy of prematurity. Crit Care Nurs Clin North Am 2009; 21:213-33.
|4. Wright KW, Sami D, Thompson L, et al. A physiologic reduced oxygen protocol decreases the incidence of threshold retinopathy of prematurity. Trans Am Ophthalmol Soc 2006; 104:78-84.|
|5. Chen J, Smith LE. Retinopathy of prematurity. Angiogenosis 2007; 10:133- 40.
|6. Senger DR, Galli SJ, Dvorak AM, et al. Tumor cells secrete a vascular permeability factor that promotes accumulation of ascites fluid. Science 1983; 219:983-5.
|7. Plate KH, Breier G, Weich HA, Risau W. Vascular endothelial growth factor is a potential tumor angiogenesis factor in human gliomas in vivo. Nature 1992; 359:845-8.
|8. Adamis AP, Shima DT, Tolentino MY, et al. Inhibition of vascular endothelial growth factor prevents retinal ischemia - associated iris neovascularization in a nonhuman primate. Arch Opthalmol 1996; 114:66-71.
|9. Reichelt M, Shi S, Hayes M, et al. Vascular endothelial growth factor-B and retinal vascular development in the mouse. Clin Experiment Ophthalmol, 2003; 31:61-5.
|10. Leske DA, Wu J, Fautsch MP, et al. The role of VEGF and IGF-1in a hypercarbic oxygen-induced retinopathy rat model of ROP. Mol Vis 2004; 10:43-50.|
|11. Hellstrom A, Perruzzi C, Ju M, et al. Low IGF-1 suppresses VEGFsurvival signaling in retinal endothelial cell: direct correlation with clinical retinopathy of prematurity. Proc Natl Acad Sci U S A 2001; 98:5804-8.
|12. Smith LE, Shen W, Perruzzi C, et al. Regulation of vascular endothelial growth factor-dependent retinal neovascularization by insulin-like growth factor-1 receptor. Nat Med 1999; 5:1390-5.
|13. International Committee for the Classification of Retinopathy of Prematurity. The International Classification of Retinopathy of Prematurity revisited. Arch Ophthalmol 2005; 123:991-9.
|14. Gilbert C, Foster A. Childhood blindness in the context of VISION 2020 - the right to sight. Bull World Health Organ 2001; 79:227-32.|
|15. Karna P, Muttineni J, Angell L, Karmaus W. Retinopathy of prematurity and risk factors: a prospective cohort study. BMC Pediatr 2005; 5:18.
|16. Romgagnoli C. Risk factors and growth factors in ROP. Early Hum Dev 2009; 85:s79-82.
|17. Pérez-Mu-uzuri A, Fernández-Lorenzo JR, Couce-Pico ML, Blanco-Teijeiro MJ, Fraga-Bermúdez JM. Serum levels of IGF-1 are a useful predictor of retinopathy of prematurity. Acta Paediatr 2010; 99:519-25.
|18. Villegas-Becerril E, González-Fernández R, Perula-Torres L, GallardoGalera JM. [IGF-I, VEGF and bFGF as predictive factors for the onset of retinopathy of prematurity (ROP)]. Arch Soc Esp Oftalmol 2006; 81:641-6. Spanish.|
|19. Engström E, Niklasson A, Wikland KA, Ewald U, Hellström A. The role of maternal factors, postnatal nutrition, weight gain, and gender in regulation of serum IGF-I among preterm infants. Pediatr Res 2005; 57:605-10.
|20. Kielczewski JL, Jarajapu YP, McFarland EL, et al. Insulin-like growth factor binding protein-3 mediates vascular repair by enhancing nitric oxide generation. Circ Res 2009; 105:897-905.
|21. Pau H. Hypothesis on the pathogenesis of retinopathy of prematurity - it is not VEGF alone but anatomical structures that are crucial. Graefes Arch Clin Exp Ophthalmol 2010; 248:1-3.
|22. Budd SJ, Hartnett ME, Increased angiogenic factors associated with peripheral avascular retina and intraviterous neovascularization: a model of retinopathy of prematurity. Arch Ophthalmol 2010; 128:589-95.
|23. Yingchuan F, Chuntao L, Hui C, Jianbin H. Increased expression of TGFbeta 1 and Smad 4 on oxygen-induced retinopathy in neonatal mice. Adv Exp Med Biol 2010; 664:71-7.
|24. Sonmez K, Drenser KA, Capone A Jr, Trese MT. Viterous levels of stromal cell-derived factor 1 and vascular endothelial growth factor in patients with retinopathy of prematurity. Ophthalmology 2008; 115:1065-1070.e1.|
|25. Machali?ska A, Modrzejewska M, Dziedziejko V, et al. [Evaluation of VEGF and IGF-1 plasma levels in preterm infants - potential correlation with retinopathy of prematurity, clinical implications]. Klin Oczna 2009; 111:302- 6. Polish.|
|26. Hellström A, Engström E, Hård AL, et al. Postnatal serum insulin-like growth factor I deficiency is associated with retinopathy of prematurity and other complications of premature birth. Pediatrics 2003; 112:1016-20.