Being the organ responsible for vision, the human eye comprises a complex structure. Out of all the parts of the eye, the retina, and especially the centre of it, the macula, is of utmost importance for clear central vision. However, the macula is prone to pathological disorders, which would cause damage to retinal cells and ultimately permanent loss of vision. The most common disorders of the macula are diabetic macular edema (DME), as a consequence of general diabetic retinopathy (DR); as well as age-related macular degeneration (AMD).
The development of DME is due to pre-existing diabetes mellitus (DM), where hyperglycemic conditions lead to chronic inflammation of the macula. Eventually a series of cytokines and growth factors are upregulated, leading to downstream effects such as increased vascular permeability and neovascularization, resulting in fluid exudation in the retinal extracellular space. Retinal cells are compressed and damaged leading to permanent vision loss. AMD develops in a similar manner, where atrophy occurs in retinal tissues at the macula area, stimulating neovascularization, followed by bleeding, fluid exudation, compression of tissues and loss of vision.
Vascular endothelial growth factor (VEGF-A) is a growth factor responsible for several physiological processes, such as angiogenesis, bone growth and organ development. Yet, it demonstrates pathophysiological actions as well, especially in malignancies and intraocular neovascular syndromes, namely DME and AMD as mentioned above. VEGF-A binds to several receptors, but most importantly VEGFR-2 where it exerts downstream effects related to DME and AMD, increase in vascular permeability and neovascularization.
Numerous anti-VEGF treatments have been developed, indicated to treat the above macular diseases via such pathophysiology. Most of these drugs are macromolecules and antibody based biologics, mostly monoclonal antibodies and antibody derivatives, administered via intraocular injections, along with a risk for infection and inflammation.
Attempts are now being made to synthesise small-molecule compounds against VEGF to treat macular diseases, to reduce the risk during administration and improve the convenience of administration. In this thesis project, eleven of such small-molecule test compounds were synthesised, analysed and purified for in vitro and in vivo testing, in a two-step reaction process. The first step involves a Suzuki-Miyaura coupling between two aryl groups, followed by diversification at the second step, by nucleophilic aromatic substitution with different primary amines.