[About the Effects of VEGF-A Antagonists on Molecular and Cellular Level]

Anti-VEGF-A therapy is successfully established as a routine therapy to treat wet age-related macular degeneration. Indications have been extended to other retinal diseases. Three different substances have been demonstrated to be active. However, the efficacy of these substances is highly variable in heterogeneous groups of patients and may include non-responders and relapses, so that there may be very individual treatment effects. It is speculated that differences in the molecular properties or structures of the three substances might explain these observations. This article therefore summarises the recent publications on this topic and discusses their relevance. Apart from common features such as VEGF-A affinity, the substances exhibit differences, including the stability of the VEGF-A/molecule complexes and the ability to neutralise angiogenic molecules other than only VEGF-A. At the cellular level, a variety of different methods have been used and the results are often inconsistent. It is therefore not yet possible to predict the clinical properties of VEGF-A neutralising substances on the basis of their known molecular properties or cellular effects.