Rho kinase inhibition by fasudil ameliorates diabetes-induced microvascular damage

OBJECTIVE

Leukocyte adhesion in retinal microvasuculature substantially contributes to diabetic retinopathy. Involvement of the Rho/Rho kinase (ROCK) pathway in diabetic microvasculopathy and therapeutic potential of fasudil, a selective ROCK inhibitor, are investigated.

RESEARCH DESIGN AND METHODS

Localization of RhoA/ROCK and Rho activity were examined in retinal tissues of rats. Impact of intravitreal fasudil administration on retinal endothelial nitric oxide synthase (eNOS) and myosin phosphatase target protein (MYPT)-1 phosphorylation, intercellular adhesion molecule-1 (ICAM-1) expression, leukocyte adhesion, and endothelial damage in rat eyes were investigated. Adhesion of neutrophils from diabetic retinopathy patients or nondiabetic control subjects to cultured microvascular endothelial cells was quantified. The potential of fasudil for endothelial protection was investigated by measuring the number of adherent neutrophils and terminal transferase-mediated dUTP nick-end labeling-positive endothelial cells.

RESULTS

RhoA and ROCK colocalized predominantly in retinal microvessels. Significant Rho activation was observed in retinas of diabetic rats. Intravitreal fasudil significantly increased eNOS phosphorylation, whereas it reduced MYPT-1 phosphorylation, ICAM-1 expression, leukocyte adhesion, and the number of damaged endothelium in retinas of diabetic rats. Neutrophils from diabetic retinopathy patients showed significantly higher adhesion to cultured endothelium and caused endothelial apoptosis, which was significantly reduced by fasudil. Blockade of the Fas-FasL interaction prevented endothelial apoptosis. The protective effect of fasudil on endothelial apoptosis was significantly reversed by Nomega-nitro-l-arginine methyl ester, a NOS inhibitor, whereas neutrophil adhesion remained unaffected.

CONCLUSIONS

The Rho/ROCK pathway plays a critical role in diabetic retinal microvasculopathy. Fasudil protects the vascular endothelium by inhibiting neutrophil adhesion and reducing neutrophil-induced endothelial injury. ROCK inhibition may become a new strategy in the management of diabetic retinopathy, especially in its early stages.

Vascular endothelial growth factor expression by hyalocytes and its regulation by glucocorticoid

AIM

Tumour necrosis factor-alpha (TNF-alpha) is one of the major inflammatory cytokines involved in the pathogenesis of various vitreoretinal diseases. The authors investigated the effect of hypoxia, TNF-alpha and dexamethasone on vascular endothelial growth factor (VEGF) expression by cultured hyalocytes.

METHODS

Hyalocytes were isolated from bovine vitreous. Hypoxic and TNF-alpha-dependent effects on cultured hyalocytes were investigated using several assays to determine VEGF protein expression, hypoxia-inducible factor (HIF)-1alpha protein levels, HIF-1alpha-DNA-binding ability and VEGF mRNA stability. The effects of dexamethasone on VEGF expression and its intracellular signalling under hypoxic or TNF-alpha stimulated conditions were also examined.

RESULTS

Hypoxic conditions and TNF-alpha stimulation induce VEGF expression in hyalocytes. These stimuli also stabilise HIF-1alpha protein and increase its DNA-binding ability. Dexamethasone significantly inhibits both HIF-1alpha protein levels and HIF-1alpha-DNA-binding activity, and also decreases the hypoxic- and TNF-alpha -dependent induction of VEGF expression in hyalocyte. However, dexamethasone has no significant effect on the stability of VEGF mRNA.

CONCLUSIONS

Hyalocytes may be involved in various vitreoretinal diseases by increasing HIF-1alpha protein stability and HIF-1alpha-DNA binding, and thus increasing VEGF production under pathological conditions. Dexamethasone seems to be capable of inhibiting hypoxic and TNF-alpha dependent VEGF production, presumably via its inhibitory effects on HIF-1alpha protein levels and its DNA-binding activity.

Potent inhibition of cicatricial contraction in proliferative vitreoretinal diseases by statins

OBJECTIVE

Despite tremendous progress in vitreoretinal surgery, certain postsurgical complications limit the success in the treatment of proliferative vitreoretinal diseases (PVDs), such as proliferative diabetic retinopathy (PDR) and proliferative vitreoretinopathy (PVR). One of the most significant complications is the cicatricial contraction of proliferative membranes, resulting in tractional retinal detachment and severe vision loss. Novel pharmaceutical approaches are thus urgently needed for the management of these vision-threatening diseases. In the current study, we investigated the inhibitory effects of statins on the progression of PVDs.

RESEARCH DESIGN AND METHODS

Human vitreous concentrations of transforming growth factor-beta2 (TGF-beta2) were measured by enzyme-linked immunosorbent assay. TGF-beta2-and vitreous-dependent phosphorylation of myosin light chain (MLC), a downstream mediator of Rho-kinase pathway, and collagen gel contraction simulating cicatrical contraction were analyzed using cultured hyalocytes. Inhibitory effects of simvastatin on cicatrical contraction were assessed both in vitro and in vivo.

RESULTS

Human vitreous concentrations of TGF-beta2 were significantly higher in the samples from patients with PVD compared with those without PVD. Simvastatin inhibited TGF-beta2-dependent MLC phosphorylation and gel contraction in a dose- and time-dependent manner and was capable of inhibiting translocation of Rho protein to the plasma membrane in the presence of TGF-beta2. Vitreous samples from patients with PVD enhanced MLC phosphorylation and gel contraction, whereas simvastatin almost completely inhibited these phenomena. Finally, intravitreal injection of simvastatin dose-dependently prevented the progression of diseased states in an in vivo model of PVR.

CONCLUSIONS

Statins might have therapeutic potential in the prevention of PVDs.

Posterior vitreous cortex characteristics of an eye with asteroid hyalosis

PURPOSE

To describe both the clinical and the histological characteristics of the vitreoretinal interface of an eye with asteroid hyalosis (AH).

METHODS

A 76-year-old woman presented with a left eye with AH and an epiretinal membrane (ERM). Preoperative slit-lamp biomicroscopy revealed anatomical posterior vitreous detachment with a Weiss ring. Preoperative best-corrected visual acuity (BCVA) was 20/50. The patient underwent triamcinolone acetonide-assisted vitrectomy, along with peeling of the internal limiting membrane (ILM). The ERM and ILM were removed together with surgical ILM forceps. The excised ILM was analyzed with transmission electron microscopy (TEM). We also compared the histological characteristics of this tissue with those of tissue from a non-AH eye with idiopathic ERM.

RESULTS

A massive collagenous matrix with few cellular components, suggesting residual posterior vitreous but not ERM, was observed on the excised ILM of the AH eye. BCVA improved to 20/25 6 months after surgery. TEM of a non-AH eye with idiopathic ERM revealed a cellular rich component and extracellular matrix on the ILM.

CONCLUSION

We found evidence demonstrating a split in the posterior vitreous cortex, representing, to our knowledge, the first case report of this phenomenon in an eye with AH.

Design of a d(1)-analogue of cuprates: Sr(2)VO(4) and Ba(2)VO(4) under pressure

By means of a combination of the local density approximation and dynamical mean field theory (LDA + DMFT), we study the possibility of making a d(1) analogue of d(9) cuprates on the basis of Sr(2)VO(4). We calculate the electronic structure of Sr(2)VO(4) under pressure, and show that while the material is a 1/6-filled three-band system at ambient pressure with a small level splitting between the d(xy)- and d(yz/zx)-bands, an orbital polarization occurs under sufficiently high uniaxial pressure in the c-direction. While all energy scales are relatively small, the electronic structure of Sr(2)VO(4) under pressure is similar to that of La(2)CuO(4); it is a two-dimensional half-filled single-band system which has, relative to the nearest neighbour hopping, a similar Coulomb repulsion and next-nearest neighbour hopping. We also study the effect of substituting Sr by Ba, i.e., chemical pressure, and show that the pressure needed for the orbital polarization is considerably reduced.

Doped Mott insulator as the origin of heavy-fermion behavior in LiV2O4

We investigate the electronic structure of LiV2O4, for which heavy-fermion behavior has been observed in various experiments, by the combination of the local density approximation and dynamical mean field theory. To obtain results at zero temperature, we employ the projective quantum Monte Carlo method as an impurity solver. Our results show that the strongly correlated a 1g band is a lightly doped Mott insulator which, at low temperatures, shows a sharp (heavy) quasiparticle peak just above the Fermi level, which is consistent with recent photoemission experiments by Shimoyamada et al. [Phys. Rev. Lett. 96, 026403 (2006)10.1103/PhysRevLett.96.026403].