Cardiovascular and renal toxicity during angiogenesis inhibition: clinical and mechanistic aspects

被引:62
作者
Kappers, Mariette H. W. [1 ]
van Esch, Joep H. M. [1 ]
Sleijfer, Stefan [2 ]
Danser, A. H. Jan [1 ]
van den Meiracker, Anton H. [1 ]
机构
[1] Erasmus MC, Dept Internal Med, Div Pharmacol Vasc & Metab Dis, NL-3015 CE Rotterdam, Netherlands
[2] Erasmus MC, Dept Med Oncol, NL-3015 CE Rotterdam, Netherlands
关键词
angiogenesis inhibition; cardiac disease; hypertension; proteinuria; renal disease; vascular endothelial growth factor; ENDOTHELIAL GROWTH-FACTOR; TYROSINE-KINASE INHIBITOR; COHERENCE TOMOGRAPHY FINDINGS; PHASE-I TRIAL; BEVACIZUMAB AVASTIN(R); BLOOD-PRESSURE; INTRAVITREAL INJECTION; MOLECULAR-MECHANISMS; DEPENDENT RELAXATION; SUNITINIB TREATMENT;
D O I
10.1097/HJH.0b013e3283309b59
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
Inhibition of angiogenesis with humanized monoclonal antibodies to vascular endothelial growth factor (VEGF) or with tyrosine kinase inhibitors targeting VEGF receptors has become an established treatment for various tumor types. Contrary to expectations, angiogenesis inhibition by blocking VEGF-mediated signaling is associated with serious side effects including hypertension and renal and cardiac toxicity in a substantial proportion of patients. Fortunately, most of these side effects as discussed in this paper seem to be manageable, but likely become more problematic when survival increases. Although several hypotheses regarding the etiology of angiogenesis inhibition-related cardiovascular and renal side effects have been postulated, many of the underlying pathophysiological mechanisms remain to be elucidated. This may lead to the development of more specific angiogenesis inhibitors, better management of their side effects and may potentially provide new insights into the pathogenesis of cardiovascular disease in general. J Hypertens 27:2297-2309 (c) 2009 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.
引用
收藏
页码:2297 / 2309
页数:13
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