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Usefulness of Liquid Biopsy Biomarkers from Aqueous Humor in Predicting Anti-VEGF Response in Diabetic Macular Edema: Results of a Pilot Study

1
Department of Ophthalmology, Hospital Universitari i Politècnic La Fe, 46009 Valencia, Spain
2
Diabetes and Metabolism Research Unit, Vall d’Hebron Research Institute, 08035 Barcelona, Spain
3
Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
4
Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ICSIII), 28029 Madrid, Spain
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(11), 1841; https://doi.org/10.3390/jcm8111841
Received: 26 September 2019 / Revised: 21 October 2019 / Accepted: 28 October 2019 / Published: 2 November 2019
(This article belongs to the Section Ophthalmology)
The objective was to investigate the usefulness of the “liquid biopsy” of aqueous humor (AH) to predict the clinical response after intravitreal injections (IVT) of anti-VEGF agents for treating diabetic macular edema (DME). For this purpose, AH samples obtained during the first anti-VEGF IVT from 31 type two diabetic patients were analyzed. Patients were classified into three groups according to their anti-VEGF response: rapid responders (n = 11), slow responders (n = 11), and non-responders (n = 9). In addition, patients (n = 7) who showed good response to corticosteroids but a delayed or no response to anti-VEGF therapy were analyzed. Levels of 17 different cytokines, chemokines, and growth factors in AH were measured using a multiplex immunoassay. We found higher concentrations of VEGF in rapid responders to anti-VEGF therapy compared to non-responders. In addition, slow responders to anti-VEGF treatment showed higher levels of inflammatory markers than rapid responders, but did not reach statistical significance. Finally, those patients who responded to corticosteroids but not to anti-VEGF therapy showed significantly lower levels of VEGF than patients with rapid response (p = 0.01). In conclusion, “liquid biopsy” of AH could be useful to determine whether the predominant pathogenic event is primarily angiogenic or inflammatory in nature. This approach would allow physicians to select a more rational and cost-effective treatment. Further studies to validate these preliminary results are warranted. View Full-Text
Keywords: diabetic macular edema; anti-VEGF agents; aqueous humor; biomarkers; VEGF; inflammation; personalized medicine diabetic macular edema; anti-VEGF agents; aqueous humor; biomarkers; VEGF; inflammation; personalized medicine
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Udaondo, P.; Hernández, C.; Briansó-Llort, L.; García-Delpech, S.; Simó-Servat, O.; Simó, R. Usefulness of Liquid Biopsy Biomarkers from Aqueous Humor in Predicting Anti-VEGF Response in Diabetic Macular Edema: Results of a Pilot Study. J. Clin. Med. 2019, 8, 1841.

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