The Tie2 signaling pathway in retinal vascular diseases: a novel therapeutic target in the eye.

BACKGROUND

Retinal vascular diseases such as neovascular age-related macular degeneration, diabetic retinopathy and/or diabetic macular edema, and retinal vein occlusion with macular edema-share several key pathophysiologic aspects including neovascularization, vascular permeability, and inflammation. The role of vascular endothelial growth factor (VEGF) in these processes, and the therapeutic benefits of VEGF inhibition, have been well characterized. Anti-VEGF therapy is highly effective for many patients but is not uniformly effective in all patients and imposes a significant treatment burden. More recently, the role of the Tie2 signaling pathway in the pathophysiology of retinal vascular diseases has been investigated, and the Tie2 pathway represents a novel therapeutic target for these conditions.

AREAS COVERED

The index review describes the Tie2 pathway and its complementary role to the VEGF pathway in the angiogenesis cascade and will summarize studies of molecules in development to therapeutically modulate the Tie2 pathway in retinal vascular diseases.

CONCLUSIONS

Activation of the Tie2 pathway leads to downstream signaling that promotes vascular health and stability and decreases vascular permeability and inflammation. AXT107 is a collagen IV-derived synthetic peptide with a dual mechanism of action that involves suppression of VEGF signaling and activation of the Tie2 pathway; these actions are accomplished by AXT107 binding to and disrupting different integrin, leading to blockade of the VEGF receptor and rearrangement of cellular Tie2 rendering it susceptible to Ang2 agonism. Other Tie2 agonist compounds are also in development, including faricimab and razuprotafib. Tie2 activation only modestly impacts angiogenesis on its own but significantly potentiates VEGF suppression. Co-regulation of the VEGF and Tie2 signaling pathways has the potential to improve functional and structural outcomes in eyes with retinal vascular diseases.

Informations de copyright

© The Author(s) 2020.

Déclaration de conflit d'intérêts

Competing interestsQDN serves on the Scientific Advisory Board for AbbVie, Bayer, Genentech, Mallinckrodt, Regeneron, and Santen, among others and advises on Drug Safety for AsclepiX; QDN also chaired the Steering Committee for the RIDE/RISE and STOP-Uveitis Study and was on the Steering Committee for other studies sponsored by Genentech and Regeneron. JSH serves on the Scientific Advisory Board for 4DMT, Adverum, Aerie, Aerpio, Akros, Allegro, Apellis, Array, Asclepix, Bayer, Beaver-Visitec, BioMarin, Clearside, Corcept, Daiichi Sankyo, Galecto, Galimedix, Genentech/Roche, Helio, Hemera, Interface, iRenix, Janssen, Kanghong, Kodiak, Notal Vision, Novartis, Ocular Therapeutix, Optos, Orbit Biomedical, Quark, Ra Pharmaceuticals, Regeneron, REGENXBIO, Santen, Scifluor, Shire, Spark Therapeutics, Stealth, Thrombogenics, Tyrogenex. DVD serves on the Scientific Advisory Board for Allergan, AsclepiX, Genentech, Kodiak, Regeneron, and Santen and she has received research support from Genentech and Regeneron. ACM, NBP, HS, and TH are employees of AsclepiX Therapeutics.