Evaluation of Blood Coagulation Parameters and ADMA, NO, IL-6, and IL-18 Serum Levels in Patients with Neovascular AMD before, during, and after the Initial Loading Phase of Intravitreal Aflibercept

Michał Wiciński; Małgorzata Seredyka-Burduk; Sławomir Liberski; Daria Marczak; Magdalena Pol; Bartosz Malinowski; Katarzyna Pawlak-Osińska; Bartlomiej J Kaluzny

doi:10.3390/life11050441

Evaluation of Blood Coagulation Parameters and ADMA, NO, IL-6, and IL-18 Serum Levels in Patients with Neovascular AMD before, during, and after the Initial Loading Phase of Intravitreal Aflibercept

Life (Basel). 2021 May 14;11(5):441. doi: 10.3390/life11050441.

Authors

Michał Wiciński¹, Małgorzata Seredyka-Burduk², Sławomir Liberski¹, Daria Marczak¹, Magdalena Pol², Bartosz Malinowski¹, Katarzyna Pawlak-Osińska³, Bartlomiej J Kaluzny²

Affiliations

¹ Department of Pharmacology and Therapeutics, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, M. Curie 9, 85-090 Bydgoszcz, Poland.
² Division of Ophthalmology and Optometry, Department of Ophthalmology, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, M. Curie 9, 85-090 Bydgoszcz, Poland.
³ Division of Human Anatomy and Physiology, Institute of Health Sciences, Pomeranian University of Słupsk, K. Arciszewskiego 22A, 76-200 Słupsk, Poland.

Abstract

We evaluated the effect of intravitreal injections of aflibercept (IVA) on blood coagulation parameters including prothrombin time (PT), activated partial thromboplastin time (APTT), and thrombin time (TT), as well as asymmetric dimethylarginine (ADMA), nitric oxide (NO), interleukin 6 (IL-6), and interleukin 18 (IL-18) serum levels in patients with neovascular AMD (nAMD). Twenty-two eyes of 22 patients with nAMD were included. Parameters were evaluated before and 2-3 days after the first IVA injection, and then immediately before and 2-3 days after the third IVA injection. We revealed prolongation of the TT after the initial loading phase of IVA (p = 0.041) and a significant increase in IL-18 serum concentration immediately before the third IVA administration compared to baseline (p = 0.037). There were no statistically significant differences of other parameters and PT, APTT, ADMA, NO, and IL-6 values remained within the normal range at each of the time points of the study. Our results suggest that repeated IVA administration may affect the common blood coagulation pathway, which manifests as a prolongation of the TT value. Furthermore, we showed a significant increase in serum concentration of the pro-inflammatory cytokineIL-18during the initial loading phase of IVA.

Keywords: aflibercept; age-related macular degeneration; anti-VEGF; asymmetric dimethylarginine; coagulation parameters; interleukin 18; interleukin 6; intravitreal treatment; nitric oxide.