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  • Belated Call To Employ Resveratrol Along With Injected Anti-Growth Factor Medicine To Save Sight

    October 21, 2017: by Bill Sardi

    Eye researchers are calling for daily oral resveratrol capsules to be employed along with medicines injected into the eyes to shut off leaky blood vessels in the back of the eyes.

    Worldwide over $5 billion of anti-growth factor medicine is needle injected into the back of the eyes of patients with a severe form of macular degeneration.

    For background information, the macula is the visual center of the eye (retina) and when light receptor cells there become oxygen starved, new blood vessels outcrop to counter the problem but leak fluid that can result in legal blindness.  This is called wet macular degeneration.

    There was no effective treatment for this eye disease until 2004 when eye physicians began to inject anti-growth factor medicine directly into the eyes.  The medicine blocks a protein called vascular endothelial growth factor (VEGF) that is normally used in healing throughout the body.  Wet macular degeneration could be defined as an over-healing response.

    Writing in the journal Scientific Reports, researchers say combined anti-VEGF + resveratrol treatment would “pave the way for a combinatorial strategy to treat as well as prevent adverse effects of therapy in patients with wet macular degeneration.”

    Repeated injections are usually required to ensure adequate regression of leaky blood vessels.  “Despite the potential risks of repeated injections over prolonged periods of time,” researchers say, “the lack of an alternative makes it the most widely used treatment” for this form of the disease.

    In a lab dish anti-VEGF drugs completely block this growth factor.

    The major drawback of anti-VEGF therapy, say researchers, is that it “neutralizes all the secreted VEGF that is used in the eyes and systemically throughout the body in the wound healing process whereas resveratrol inhibits VEGF by ~50%.  When oral resveratrol accompanies anti-VEGF injections, the effect is reversed to allow normal wound healing to take place.

    Do anti-VEGF injections hasten the demise of patients?

    There is another troublesome report that is cause for concern.  Investigators report in the BMC Ophthalmology journal that there is a “worrying observation that patients who have medicine injected into their eyes may experience increased mortality.”

    This could be due to unrecognized confounding factors or just the fact that adults who have a vision-threatening retinal disease called macular degeneration are more likely to have other life-threatening health problems.

    Researchers in Israel examined the health records of 5385 patients who were treated with growth factor inhibitors (anti-vascular endothelial growth factor or anti-VEGF) and compared them 10,756 senior adults of the same age (mean ~80 years).

    Over a six-year period after receiving anti-VEGF injections to cause abnormal blood vessels to recede at the back of the eyes, 19.7% of the treated and 12.1% of the untreated subjects died, a 63% increased rate of mortality.

    VEGF need for normal wound healing

    Investigators note that VEGF is needed for normal healing throughout the body.  The injected anti-VEGF medicine is known to escape the eye and reach the general blood circulation where it could impair healing.  Anti-VEGF treatment reduces VEGF levels throughout the body (~77% reduced blood levels).

    The researchers write: “Impairment of normal healing rather than direct injury to vital organs seems to explain the long-term adverse effects observed for the anti-VEGF medicine.”

    Will any resveratrol pill do?

    While resveratrol pills have been safely marketed over the past decade, that doesn’t preclude all would be equally effective at saving sight.

    According to the Natural Medicines Comprehensive Database there are over 530 brands of resveratrol pills on the market.  Resveratrol has been demonstrated to inhibit VEGF in the eyes of laboratory animals.  However, only one brand (Longevinex®) has been put to the test in humans.

    Stuart Richer OD, PhD, director of ocular preventive medicine at the North Chicago Veterans Center and President of The Ocular Nutrition Society, is charged with rescuing vision of patients who have failed anti-VEGF treatment.  Dr. Richer has documented successful visual restoration among patients who failed anti-VEGF injections, even among the oldest old subjects.

    Longevinex® was selected because of its superior ability to inhibit VEGF via microRNA20b (six-fold greater inhibition than plain resveratrol).

    About 15% or 15,000 older adults fail to respond to injectable anti-VEGF therapy annually in the US and progress to legal blindness.

    Because of the urgency of this problem, a petition was filed with the Food & Drug Administration in 2012 to allow Longevinex® to proceed with a human clinical trial without having to submit a lengthy and costly new drug application (NDA) among patients who failed anti-VEGF treatment.

    Given that Longevinex® had been safely used for over a decade in the open market and was the only resveratrol-based nutraceutical that has undergone toxicity testing to prove safety as required for drugs, the petition asked the FDA to waive its NDA requirement.  The petition called for real-time adverse reaction reporting to be submitted directly to the FDA.  However, after three years of foot dragging, that petition was denied.

    Since then an estimated 60,000+ senior Americans have failed anti-VEGF treatment and have progressed to legal blindness (20/200 vision or worse).  The possibility anti-VEGF drug therapy hastens the demise of older Americans now adds to the problem.  It’s taken over a decade to realize Anti-VEGF drugs may be too strong.

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