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Human Platelets Take up Anti-VEGF Agents.

B Sobolewska1, B Fehrenbacher2, P Münzer3

  • 1Center for Ophthalmology, Eberhard Karls University Tuebingen, Tuebingen, Germany.

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|July 5, 2021
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Summary
This summary is machine-generated.

Platelets internalize anti-vascular endothelial growth factor (anti-VEGF) agents, potentially increasing local anti-VEGF exposure and contributing to thromboembolic events. Different transport mechanisms for bevacizumab versus ranibizumab and aflibercept were observed.

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Area of Science:

  • Ophthalmology
  • Hematology
  • Pharmacology

Background:

  • Repeated intravitreal injections of anti-vascular endothelial growth factor (anti-VEGF) agents lead to systemic exposure.
  • Anti-VEGF agents can penetrate the vascular barrier, raising questions about their interaction with non-resident platelets.

Purpose of the Study:

  • To investigate whether platelets uptake anti-VEGF agents (ranibizumab, aflibercept, bevacizumab) using visualization techniques.
  • To understand the interaction between platelets and systemically available anti-VEGF agents.

Main Methods:

  • Immunofluorescence and immunogold staining were used to examine anti-VEGF uptake in human platelets.
  • The roles of actin filaments and clathrin-coated vesicles in anti-VEGF transport were assessed using staurosporine and cytochalasin D inhibitors.

Main Results:

  • All three anti-VEGF agents (ranibizumab, aflibercept, bevacizumab) were internalized by platelets and colocalized with VEGF.
  • Ranibizumab and aflibercept primarily localized to alpha-granules, while bevacizumab was found in both alpha-granules and platelet vesicles.
  • Staurosporine and cytochalasin D inhibited aflibercept uptake and reduced ranibizumab and bevacizumab transport, with bevacizumab showing greater colocalization in clathrin-coated vesicles.

Conclusions:

  • Platelet uptake and alpha-granule internalization of anti-VEGF agents may increase local anti-VEGF exposure upon platelet activation, potentially contributing to arterial thromboembolic events.
  • Clathrin-coated vesicles appear more involved in bevacizumab transport compared to ranibizumab and aflibercept.
  • Further research is needed to determine if observed differences in bevacizumab localization and transport relate to specific receptor-mediated endocytosis mechanisms.