The role of PDGF receptor inhibitors and PI3-kinase signaling in the pathogenesis of corneal neovascularization

PURPOSE

Corneal neovascularization remains an unsolved therapeutic problem. Platelet-derived growth factor (PDGF) is directly linked to vessel formation and stabilization. This study was undertaken to elucidate the mechanisms by which PDGF exerts its effects on corneal angiogenesis.

METHODS

Corneal neovascularization was induced in C57 mice by removal of the limbal epithelium. When mature vessels appeared after 7 days, mice were treated with the PDGF receptor-beta inhibitor AG 1296 or the phosphatidylinositol 3-kinase (PI3-K)-inhibitors wortmannin and LY294002, respectively, using an intraperitoneally implanted miniosmotic pump. At day 14 after scraping, corneas of treated and untreated (control) mice were dissected and immunostained with FITC-CD31 antibody for endothelial cells and with Cy3-SMA (smooth muscle actin) for pericytes. VEGF (vascular endothelial growth factor), ang1/2 (angiopoietin 1 and 2), and PDGF mRNA levels of treated and untreated corneas were determined by real-time RT-PCR.

RESULTS

Mice treated with the PDGF inhibitor AG 1296 showed an inhibition of corneal neovascularization of 21.1% and a reduction of pericytes of 52% in the newly formed vessels compared with untreated animals. VEGF, ang1, ang2, and PDGF mRNA expression was reduced in the corneas of AG 1296-treated mice compared with the respective control. Treatment with the PI3-K inhibitors wortmannin and LY29002 had similar effects, inducing a decrease in corneal neovascularization and a reduction of VEGF, ang1, ang2, and PDGF mRNA levels.

CONCLUSIONS

Inhibition of the PDGF signal pathway results in loss of pericytes and a reduction in vessel density in the neovascularized cornea that correlates with reduced expression of PDGF, ang1/2, and VEGF mRNA. Furthermore, PI3-K was shown to be involved in the regulation of VEGF, ang1, and PDGF, as the PI3-K inhibitors wortmannin or LY294002 had similar effects. Because PDGF is a known stimulus for PI3-K activation, it can be postulated that the observed decrease in VEGF, ang1/2, and PDGF mRNA levels on administration of the PDGF inhibitor is caused by the decreased activation of the PI3-K signaling cascade.

The Effect of Combinations of Flurbiprofen, Low Molecular Weight Heparin, and Doxycycline on the Inhibition of Corneal Neovascularization

PURPOSE

To determine the efficacy of various combinations of flurbiprofen, low molecular weight heparin (LMWH), and doxycycline on the inhibition of corneal neovascularization in rats.

METHODS

Chemical cauterization of the cornea in 32 eyes of 32 rats was performed using silver nitrate/potassium nitrate sticks. The animals were divided into 4 groups. Topical instillation of 0.015% flurbiprofen with 5 mg/mL LMWH (group 1); flurbiprofen with 10 mg/mL doxycycline (group 2); doxycycline with LMWH (group 3), and saline (group 4; control) was performed twice a day for 7 days. Slit-lamp photography was used to determine the percent areas of cornea covered by neovascularization and also by scar in each group. The means were compared to find any significant (P < 0.05) difference between groups. The animals were euthanized and the eyes enucleated for histological evaluation.

RESULTS

The mean of percent area of corneal neovascularization 5 in group 1 was 48.5 +/- 13.1; group 2, 6.6 +/- 5.5; group 3, 22.0 +/- 27.6 and group 4, 64.6 +/- 9. The means of percent area of neovascularization in groups 2 and 3 were significantly lower compared with control and group 1. There was no significant difference in the percent corneal neovascularization between groups 2 and 3 or between group 1 and the control group. Histological findings were consistent with slit-lamp evaluations.

CONCLUSIONS

Topical instillation of combinations of doxycycline with either flurbiprofen or LMWH can effectively inhibit corneal neovascularization made by chemical cauterization of the cornea in rats.

Inhibition of ocular angiogenesis by diced small interfering RNAs (siRNAs) specific to vascular endothelial growth factor (VEGF)

The effects of diced small interfering RNAs (siRNAs) designed for vascular endothelial growth factor (VEGF) on the expression of VEGF in human retinal pigment epithelial cell line ARPE-19 cells in vitro and on corneal angiogenesis in vivo were examined. The exposure to diced siRNAs significantly reduced the VEGF mRNA expression in ARPE-19 cells with minimal toxicity. In suture-induced corneal angiogenesis models, diced siRNAs minimized the severity of angiogenesis. Histological analysis displayed no particular tissue damage in the conjunctiva where siRNA was injected. The approach using diced siRNAs can be a new tool for various neovascular ocular diseases.

[Sustained rapamycin drug delivery system in prevention of high risk corneal allograft rejection and neovascularization in rabbits]

OBJECTIVE

To evaluate the immunosuppressive and antiangiogenesis effects of rapamycin drug delivery system (RAPA DDS) in high risk rabbit model of penetrating keratoplasty (PK).

METHODS

(1) RAPA DDS preparation: 50 mg of PGLC and 50 mg of RAPA were mixed as a RAPA drug delivery system. (2) High risk rabbit model: Corneal vascularization was induced in 45 New Zealand white rabbits (45 eyes) by passing 5 - 0 silk sutures in corneal stroma in each quadrant. (3) 40 rabbits with corneal neovascularization beyond three quadrants were received a unilateral 7 mm diameter central PK. The 40 were divided into four treatment groups: Group A, control group and received no therapy; Group B, 1 mg PGLC carrier was implanted in the anterior chamber; Group C, 1% RAPA eye drops was applied four times daily; Group D, 0.5 mg RAPA DDS was implanted in the anterior chamber. (4) Postoperative examination: The cornea allografts (opacity, edema and neovascularization) were examined by the slit-lamp biomicroscopy for ninety days. Rejection index (RI) and neovascularization index (NI) of these animal models were recorded. RAPA concentration in the aqueous humor was detected on 2, 4, 8 and 12 weeks in group C and D after surgery; the expressions of IL-2R, MCP-1, Fas/FasL in samples were detected with in situ hybridization; TNF-alpha and VEGF were detected with immuno-histochemical technique three weeks after the operation in all groups. Histochemical method was carried out on the procured specimens of cornea, retina, liver and kidney at ninety days.

RESULTS

(1) Allografts rejection: Mean survival times in 4 trial groups were (16.5 +/- 2.5), (16.0 +/- 2.6), (47.1 +/- 13.2), (87.6 +/- 5.8) d respectively (P = 0.000). (2) Corneal neovascularization: Mean NI was 2.4 +/- 0.7, 2.1 +/- 0.5, 0.6 +/- 0.5, 0.3 +/- 0.5 (P = 0.000) 2 weeks after the operation, and the NI value was 3.8 +/- 0.5, 3.8 +/- 0.4, 0.8 +/- 0.7, 0.4 +/- 0.8 (P = 0.000) 12 weeks after the operation in groups A, B, C and D respectively. (3) RAPA concentration in aqueous humor: Mean RAPA concentration in aqueous humor was 10.7, 12.0, 9.2, 7.0 ng/ml in group D in the 2, 4, 8 and 12 weeks after the operation respectively. RAPA can not be detected in group C. (4) Cytokine expression: IL-2R, MCP-1, TNF-alpha and VEGF were overexpression in group A and B, and undetectable in group C and D. Fas and FasL were negative in all groups. (5) No inflammatory cell infiltration was found in retina, liver and kidney tissue ninety days after the surgery.

CONCLUSIONS

Sustained RAPA DDS and eyedrops can prolong allograft survival and inhibit cornea neovascularization in rabbit model. However, RAPA DDS is better than eyedrops.

Anti-angiogenic activities of hypericin in vivo: potential for ophthalmologic applications

Hypericin, a perihydroxylated dianthraquinone is shown here to be a highly potent inhibitor of angiogenesis in several ocular models examined in rat eyes. Extensive angiogenesis induced in the cornea and iris by intra-ocular administration of FGF-2 was effectively inhibited by a minimum of four dose regimens of hypericin (2 mg/kg) administered via the intraperitoneal route at 48 h intervals. Maximal inhibition was achieved when animal treatment with hypericin was initiated 48 h prior to inoculation of FGF-2. The molecular basis for the hypericin-mediated inhibition of angiogenesis in the anterior eye compartment appears to involve several sites in the cascade leading to angiogenesis. We show that the activating phosphorylation of extracellular signal-regulated MAP kinases (ERK1/2) is inhibited by hypericin in human retinal pigment epithelial cells and in EA.hy926 cells, an endothelial hybridoma expressing endothelial cell properties. ERK1/2 activity is required for the transactivation of hypoxia-inducible factor 1 alpha (HIF-1alpha) and in VEGF-induced blood vessel sprouting. MT1-MMP activity in human microvascular endothelial cells was also inhibited. The findings identify hypericin as a potentially useful agent in the treatment of ophthalmic neovascularization pathogeneses.

Downregulation of IRS-1 expression causes inhibition of corneal angiogenesis

PURPOSE

The antiangiogenic effect of an antisense oligodeoxynucleotide (ODN) targeting insulin receptor substrate (IRS)-1 was evaluated on rat corneal neovascularization.

METHODS

Eyes with neovessels were treated with subconjunctival injections of IRS-1 antisense oligonucleotide (ASODN), IRS-1 sense ODN (SODN), or PBS. At 8 and 24 hours after the first subconjunctival injection, the expression of IRS-1, VEGF, and IL-1beta mRNA was evaluated. IRS-1 protein levels were also measured at 8 hours by Western blot analysis (n = 4/group). On day 10, corneal neovascularization was quantified in flatmount corneas of rats treated daily from days 4 to 9.

RESULTS

On day 10, new vessels covered 95.5% +/- 4% of the corneal area in PBS-treated eyes, 92% +/- 7% in SODN-treated eyes and 59% +/- 20% in ASODN-treated eyes (P < 0.001). In the ASODN-treated group, the expression and synthesis of IRS-1 were significantly downregulated when compared with the control groups. ASODN did not significantly affect the expression of VEGF but significantly decreased the expression of IL-1beta at 24 hours (P = 0.04).

CONCLUSIONS

Subconjunctival injections of IRS-1 antisense ODN significantly inhibit rat corneal neovascularization. This effect may be mediated by a downregulation of IL-1beta. IRS-1 proteins may be interesting targets for the regulation of angiogenesis mediated by insulin, hypoxia, or inflammation.

[Inhibition of rat corneal neovascularization by inhibitor of nuclear factor-kappaB]

OBJECTIVE

To observe the effects and mechanism of pyrrolidine dithiocarbamate (PDTC) on inhibiting corneal neovascularization.

METHODS

The corneal neovascularization was induced by alkali burn in 48 Sprague-Dawley rats. The rats were randomly divided into 4 groups, 12 rats in each group. The PDTC eye drops with different concentrations were applied four times daily during days 0 - 28 in each group: 0.5 mg/ml in group A, 1 mg/ml in group B, 2 mg/ml in group C and 0.9% sodium chloride in group D (control). The development of corneal neovascularization and corneal opacity were observed daily with slit lamp. Corneas were excised at day 4 and 28 (six eyes were selected randomly in each group per time) for histopathological examinations. The expression of nuclear factor-kappaB (NF-kappaB) in the cornea was examined by Western Blot.

RESULTS

The corneal neovascularization area in groups B and C were significantly smaller than that in the control group (P < 0.01). The corneal opacification and inflammation level in groups B and C were also lower than that in the control group. No significant difference was found in corneal neovascularization areas and corneal opacification levels between group A and group D (P > 0.05). The activity of NF-kappaB in groups B and C was significantly lower than that of group D. No significant difference in NF-kappaB could be detected between group A and group D.

CONCLUSION

Topical application of PDTC has significant effects on the inhibition of activation of NF-kappaB and cornea neovascularization.

[Examination of the local antioxidative system of the eye in experimental corneal burn injury and the prospects for pharmacological correction of its parameters]

The present paper deals with the study of the efficiency of oral use of the antioxidative drug Immugen (a complex of alpha-tocopherol, oubichinone, selenium aspartate, methionine, and soyabean phospholipids) on a rabbit model of severe alkaline-induced corneal burn. The investigations have indicated that addition of Immugen to the rabbit feed exerts a significant positive effect on the parameters of the local antioxidative system of the eye and causes an increase in the activity of superoxide dismutase and catalase, and, on day 14, in antioxidative activity. The early experimental periods were marked by a slight rise in the frequency of deep corneal ulcerations. Moreover, the long-term clinical effect of use of Immugen appears as a significant increase in the area of the transparency-preserving affected cornea. The findings suggest that the antioxidants can show their optimal effect in the complex therapy for burn processes, including the use of proteinase inhibitors.

[Experimental study on the effects of rapamycin in prevention of rat corneal allograft rejection]

OBJECTIVE

To investigate the effects of rapamycin on prevention of corneal allograft rejection in murine corneal transplantation.

METHODS

The outbred strain SD and Wistar rats were used as donors and recipients, respectively. Sixty-eight Wistar rats were divided into four groups: Group A, autograft control; Group B, allograft control (the control groups were given placebo only); Group C and D, allograft groups, were treated with orally RAPA (3 mg.kg(-1).d(-1)) and CsA (10 mg.kg(-1).d(-1)), respectively. The drugs were delivered for 12 days beginning at the day of transplantation. Each animal was examined by operating microscopy. The grafts were evaluated clinically by means of Holland's scoring system and graft survival was assessed by Kaplan-Meier analysis. The neovascular indexes of rejection were compared among different groups. Histological examination on ocular tissues was performed on day 14 to confirm the clinical diagnosis of rejection.

RESULTS

The average transplant survival time in the allogenic control (Group B) was (11.0 +/- 1.5) d. Treatment with RAPA (Group C) led to a statistically significant prolongation of transplant survival to (36.1 +/- 14.9) d (P < 0.05). Treatment with RAPA 3 mg.kg(-1).d(-1) prolonged transplant survival as compared with treatment with CsA (Group D), but the difference was not statistically significant (P > 0.05). Corneal neovascularization was induced after the surgery. In RAPA group, corneal neovascularization was markedly reduced as compared with allograft control (Group B) (P < 0.05) and CsA group (Group D) (P < 0.05). Fewer inflammatory cells were found in the corneal stroma of the RAPA group.

CONCLUSION

These results show that oral immunosuppression with RAPA can prevent corneal graft rejection and corneal neovascularization.

Inhibitory effect of triamcinolone acetonide on corneal neovascularization

BACKGROUND

Corneal neovascularization (NV) plays an important role in the pathogenesis of corneal disorders. Recently, triamcinolone acetonide (TA) has been reported as a potential treatment for ocular angiogenesis. However, there are no reports on the inhibitory effect of TA on the corneal NV.

METHODS

Triamcinolone acetonide (2 mg) was administered to four rabbits' eyes by a subconjunctival injection immediately after a basic fibroblast growth factor (bFGF)-pellet was placed into the cornea. As a control, four eyes received an injection of distilled water. Four weeks later, the inhibition of corneal NV was evaluated as the percentage ratio of the vessel invasion area to the area that was sandwiched between the pellet and the limbus cornea. To identify the characteristic appearance of new corneal vessels, the control cornea was examined by using the antibody of vascular endothelial growth factor (VEGF). To confirm TA concentration in TA-treated corneas, the TA level was measured using high-performance liquid chromatography.

RESULTS

Neovascularization from the limbus to the pellet was detected in control eyes 4 weeks after the bFGF pellet implantation. TA-treated eyes demonstrated the inhibition of the neovascular response to the pellet. The severity of NV as compared between control and TA-treated eyes was statistically significant (P<0.05). Morphologically, new vessel growth was shown in the control cornea, and endothelial cells of new vessels were positively stained with the antibody of VEGF. TA concentration in TA-treated corneas at 2 weeks showed 63.5+/-42.8 microg/g (n=4, mean +/- SD), while TA was not detected in control and TA-treated corneas at 4 weeks. The level of TA was effectively maintained for at least 2 weeks after the subconjunctival injection.

CONCLUSION

We have demonstrated that subconjunctival TA administration inhibited rabbit corneal NV. This agent may prove useful in the treatment of corneal angiogenic disorders.

Flt-1 intraceptors inhibit hypoxia-induced VEGF expression in vitro and corneal neovascularization in vivo

PURPOSE

To determine whether subunits of VEGF receptor-1 coupled with an endoplasmic reticulum retention signal can block hypoxia-induced upregulation of VEGF secretion in corneal epithelial cells and block murine corneal angiogenesis induced by corneal injury.

METHODS

Human corneal epithelial cells, transfected with plasmids encoding Flt23K or Flt24K (the VEGF-binding domains of the Flt-1 receptor coupled with the endoplasmic reticulum retention peptide KDEL), were subjected 2 days after transfection to 5% hypoxia for 24 hours. Supernatant was sampled at 24 hours and assayed for VEGF by ELISA. For in vivo models, mouse corneas underwent intrastromal injections of plasmids encoding Flt23K or Flt24K, and 2 days later, sustained injury induced by topical NaOH and mechanical scraping. Corneas were assessed 2 days later for VEGF ELISA and leukocyte counting or 1 week later for quantification of neovascularization.

RESULTS

Hypoxia induced VEGF by human corneal epithelial cells was sequestered by both Flt23K and Flt24K; Flt-1 23K suppressed VEGF secretion as well. Intrastromal delivery of plasmid Flt23K suppressed VEGF by 40.4% (P = 0.009), leukocytes by 49.4% (P < 0.001), and neovascularization by 66.8% (P = 0.001). Flt24K suppressed VEGF expression by 30.8% (P = 0.042), leukocytes by 25.8% (P < 0.001), and neovascularization by 49.5% (P = 0.015).

CONCLUSIONS

Flt-1 intraceptors, which are endoplasmic reticulum retention signal-coupled VEGF receptors, significantly suppress hypoxia-induced VEGF secretion by corneal epithelial cells in vitro. In vivo, delivery of naked plasmids expressing these intraceptors inhibits injury-induced upregulation of VEGF, leukocyte infiltration, and corneal neovascularization.

Inhibition of corneal neovascularization by a peroxisome proliferator-activated receptor-gamma ligand

PURPOSE

To determine the efficacy of the peroxisome proliferator-activated receptor gamma agonist, pioglitazone, in inhibiting corneal neovascularization.

METHODS

Twenty-six adult male Sprague-Dawley rats were randomly divided into three groups. Each group received intrastromal polymer micropellets containing one of the following: Group 1, no active ingredient (n=10); Group 2, vascular endothelial growth factor (VEGF) (n=7); Group 3, VEGF and pioglitazone (n=9). Neovascularization was evaluated 7 days after pellet implantation. After systemic India ink injection, digital photographs of the eyes were taken. The area and density of neovascularization were measured using imaging software.

RESULTS

Mean area of neovascularization was 0.43+/-0.18 mm2 for Group 1, 2.87+/-0.48 mm2 for Group 2 and 2.10+/-0.22 mm2 for Group 3. Statistical analysis showed significant differences between Groups 1 and 2 and Groups 1 and 3. There was no significant difference between Groups 2 and 3. Mean density of neovascularization was 2.16+/-0.66 for Group 1, 27.14+/-2.93 for Group 2 and 12.02+/-2.24 for Group 3. All comparisons between groups were statistically significant (P<0.01).

CONCLUSIONS

Pioglitazone is effective in decreasing the density of angiogenesis in a VEGF-induced neovascular rat cornea model. There is possibility of even greater effect with higher doses of the drug. Pioglitazone is a promising drug for the treatment of ocular neovascularization.

Corneal neovascularization suppressed by TIMP2 released from human amniotic membranes

PURPOSE

To investigate the effects of culture medium of human amniotic membrane (AM) on corneal neovascularization (CNV) induced by basic fibroblast growth factor (bFGF) in mice.

METHODS

Culture medium of amniotic membrane was prepared by cultivating AM (with epithelium side up) in EGM basic medium for 3 days, and was collected separately to three groups, e.g. control (EGM only), AM with epithelium (AM) and AM without epithelium (De-AM). Corneal neovascularization was induced in mice by using micropocket assay with Hydron polymer pellets containing 100 ng bFGF. Migration and proliferation of human umbilical cord vein endothelial cells (HUVEC) were performed in Boyden chambers and by using the CyQUANT fluorescence binding assay respectively. The levels of tissue inhibitors of metalloproteinase 1 and 2 (TIMP1, TIMP2) in culture medium were determined by ELISA assay.

RESULTS

CNV induced by bFGF was significantly suppressed by culture medium of amniotic membrane. When the medium was applied as an eyedrop 4 times a day for 7 days, the area of CNV was (2.48+/-0.76) mm(2),(0.64+/-0.52) mm(2) and (1.96+/-0.65) mm(2) in control, AM and De-AM group respectively. The migration and proliferation of HUVEC were strongly inhibited by culture medium of AM with epithelium, while the De-AM had no effect on the migration of HUVEC cells. The high level of TIMP2 was found in AM group, but not in De-AM group, while there was no difference in the amount of TIMP1 in medium among three groups.

CONCLUSION

Culture medium of amniotic membrane significantly suppresses the corneal nevovascularization induced by bFGF. The mechanism of which at least in part is that high level of TIMP2 protein secreted or released into the culture medium of AM and inhibition of migration and growth of vascular endothelial cells.

Inhibitory Effect of Rapamycin on Corneal Neovascularization In Vitro and In Vivo

PURPOSE

To examine the effect of rapamycin on the proliferation and the migration of human umbilical vein endothelial cells (HUVECs) and on the corneal neovascularization in the corneal alkaline burn murine model.

METHODS

HUVEC proliferation, migration, and apoptosis were examined after treatment with rapamycin. The effect of rapamycin on the mRNA expression of FK506 binding protein (FKBP)-12 and mammalian target of rapamycin (mTOR) was also evaluated in vitro. Corneal neovascularization was induced in vivo by an alkaline burn of the cornea with 1 N NaOH on BALB/c mice. Rapamycin was given intraperitoneally at 2 mg/kg body weight once a day for 12 days after the corneal alkaline burn. Growth factors and cytokines related with neovascularization and inflammation were evaluated in the corneal tissue and the peripheral blood by reverse transcription-polymerase chain reaction (RT-PCR) and enzyme-linked immunosorbent assay (ELISA), respectively. The corneal neovascularization was evaluated by a slit lamp biomicroscopy.

RESULTS

Rapamycin at the concentration of 1000 ng/mL for >48 hours' exposure significantly inhibited the growth of HUVECs. The double chamber assay showed that rapamycin dramatically inhibited the migration of HUVECs at concentrations of 10 and 100 ng/mL and that these concentrations did not affect endothelial cell growth. When TUNEL assays were performed, the number of apoptotic cells increased 1.9-, 2.1-, and 2.6-fold compared with the control at 10, 100, and 1000 ng/mL, respectively, of rapamycin at 48 hours of exposure. RT-PCR showed that the expression of mTOR was suppressed in the HUVECs after rapamycin treatment; however, FKBP-12 expression was not affected. Among the angiogenic factors, gene expression of substance P and hypoxia inducible factor (HIF)-1 alpha was inhibited by rapamycin earlier (1-3 days), with vascular endothelial growth factor (VEGFR)-1 gene expression being suppressed for the first 7 days in the corneal tissue. The protein level of substance P and vascular endothelial growth factor (VEGF) was significantly decreased--more in mice treated with rapamycin than the control mice--as shown by ELISA assay of peripheral blood. Furthermore, rapamycin significantly inhibited corneal neovascularization in the alkaline-burned cornea.

CONCLUSIONS

Rapamycin strongly inhibited HUVEC migration at doses that did not cause cytotoxicity and apoptosis in this in vitro model. Rapamycin also suppressed corneal neovascularization, possibly by inhibiting proinflammatory cytokines, as shown by the in vivo study. Therefore, rapamycin may be useful as an angiogenic regulator in the treatment of corneal diseases that manifest with neovascularization.

Inhibition of corneal angiogenesis by local application of vasostatin

PURPOSE

This study was designed to investigate the effects of the locally supplied endogenous angiogenesis inhibitor vasostatin (VS) on corneal angiogenesis.

METHODS

Recombinant VS was expressed and purified. The effects of VS on the proliferation of endothelial cells were investigated using the methyl thiazolyl tetrazolium (MTT) assay in the absence or presence of angiogenic factors such as basic fibroblast growth factor (bFGF) or vascular endothelial growth factor (VEGF). Corneal neovascularization was induced by implantation of hydron pellets containing bFGF in rat corneal micropockets. The potency of VS to inhibit corneal angiogenesis was investigated by incorporation of VS with bFGF in hydron pellets or topical application of VS containing eye drops to rat eyes implanted with bFGF pellets. The extent of corneal neovascularization was evaluated by microscopic and histological analyses.

RESULTS

VS potently inhibited the growth of endothelial cells in the absence or presence of angiogenic factors such as bFGF or VEGF. In the rat corneal micropocket assay, concurrent incorporation of VS abolished the bFGF induced neovascularization. When formulated in a methylcellulose eye drop, VS remained intact and functional in a 4 degrees C solution for more than 7 days. Topical application of VS eye drops potently inhibited bFGF induced neovascularization in rat corneas.

CONCLUSIONS

The present study effectively demonstrated the potential feasibility of local application of VS for treatment of corneal angiogenesis.

Inhibition of ocular angiogenesis by siRNA targeting vascular endothelial growth factor pathway genes: therapeutic strategy for herpetic stromal keratitis

Ocular neovascularization often results in vision impairment. Frequently vascular endothelial cell growth factors (VEGFs) are mainly responsible for the pathological neovascularization as in the case in neovascularization induced by CpG oligodeoxynucleotides and herpes simplex virus infection in this report. siRNAs targeting either VEGFA, VEGFR1, VEGFR2, or a mix of the three were shown to significantly inhibit neovascularization induced by CpG when given locally or systemically. The efficacy of systemic administration was facilitated by the use of a polymer delivery vehicle. Additional experiments showed a significant inhibitory effect of the siRNAs mix when given either locally or systemically in vehicle against herpes simplex virus-induced angiogenesis as well as against lesions of stromal keratitis. These results indicate that the use of VEGF pathway-specific siRNAs represents a useful therapy against neovascularization-related eye diseases.

Platelet-activating factor (PAF) induces corneal neovascularization and upregulates VEGF expression in endothelial cells

PURPOSE

Platelet-activating factor (PAF) is a potent proinflammatory mediator that accumulates in the cornea after injury and induces the expression of genes related to inflammation and wound healing. The current study was conducted to investigate the direct effect of PAF on corneal neovascularization and on the expression of angiogenic growth factors in vascular endothelial cells.

METHODS

Pellets containing carbamyl-PAF (cPAF) were implanted in corneas of wild-type or PAF-receptor (PAF-R)-knockout mice, and the progression of angiogenesis was monitored by microscope. In some experiments, mice were treated with a daily intraperitoneal injection of the PAF-R antagonist LAU8080. Migration assays of human umbilical cord vein endothelial cells (HUVECs) and human dermal microvascular endothelial cells (HMVECs) were performed in a Boyden chamber after addition of various concentrations of cPAF or bovine fibroblast growth factor (FGF-2). Cell proliferation was assessed by fluorescence-binding assay in the presence of cPAF or FGF-2 for 8 days. Vascular endothelial growth factor (VEGF) and FGF-2 expression was studied by RT-PCR and Northern- and Western-blot analyses in cells stimulated with cPAF at different concentrations and for different times.

RESULTS

Six days after cPAF pellet implantation, there were new vessels growing from the limbus to the center of the cornea. The PAF-induced neovascularization was significantly reduced in PAF-R-knockout mice and in mice treated with the PAF antagonist. cPAF added to the lower well of the Boyden chamber produced a dose-dependent migration of HUVECs and HMVECs that was inhibited in cells preincubated with LAU8080 or with a VEGF-blocking antibody. In contrast, cPAF did not stimulate proliferation of endothelial cells. cPAF induced VEGF mRNA and protein expression but not FGF-2 expression in HUVECs and HMVECs.

CONCLUSIONS

PAF stimulates corneal neovascularization by a receptor-mediated mechanism. Induction of VEGF expression and stimulation of vascular endothelial cell migration are initial events in PAF-promoted corneal angiogenesis.

Effect of COX inhibitors on VEGF-induced retinal vascular leakage and experimental corneal and choroidal neovascularization

The primary objective of this study was to evaluate the effect of cyclooxygenase (COX) inhibitors, non-steroidal anti-inflammatory drugs (NSAIDs), in two in vivo models of VEGF-dependent corneal and choroidal angiogenesis and two in vivo models of VEGF-mediated vascular leakage. Non-selective COX inhibitors (the NSAIDs indomethacin and flunixin, p.o. or i.p.), the COX-1 selective inhibitor SC-560 (s.c. or i.p.), and the COX-2 selective inhibitor NS-398 (s.c. or i.p.) were evaluated in four experimental models. Choroidal neovascularization was induced in Brown Norway rats by argon laser photocoagulation and measured after ten days. Corneal neovascularization was induced by alkaline cautery in Sprague-Dawley rats and measured after four days. VEGF protein levels in the cornea were quantified by ELISA. VEGF-induced intradermal extravasation of Evans blue dye (EBD)-albumin was assayed in Hartley guinea pigs. Intravitreal VEGF-induced blood-retinal barrier breakdown was assayed by scanning ocular fluorophotometry in Dutch Belt rabbits. Indomethacin (1 or 3 mg kg(-1) day(-1), p.o.), SC-560 (20 mg kg(-1) day(-1), s.c.), and NS-398 (20 mg kg(-1) day(-1), s.c.) failed to inhibit laser-induced CNV. CNV was inhibited, however, by the corticosteroid dexamethasone (0.5 mg kg(-1) day(-1); p.o. or s.c.; 99% or 90% inhibition; p<0.01 or p<0.001, respectively). In contrast, cautery-induced corneal angiogenesis was inhibited partially by the NSAID indomethacin and the COX-2 selective inhibitor NS-398. Indomethacin, 3.5 or 7 mg kg(-1) day(-1), inhibited corneal neovascularization by 56% (p<0.001) or 68% (p<0.001) respectively. Similar partial inhibition of angiogenesis in the cornea model was observed with NS-398 (10 or 20 mg kg(-1) day(-1), s.c. or i.p.; 54% inhibition, p<0.001), but not with the COX-1 selective SC-560 (10 or 20 mg kg(-1) day(-1), s.c.). In the cornea, VEGF protein is dramatically upregulated 24 and 48 hr after cautery, and both indomethacin and NS-398-but not SC-560-significantly inhibited this VEGF upregulation. In experimental models of VEGF-induced vascular leakage, COX inhibitors had no effect on dermal or retinal vascular responses to VEGF. The NSAIDs indomethacin (7.5 or 20 mg kg(-1), p.o. or i.p.) and flunixin (12.5 mg kg(-1), i.p.) failed to inhibit VEGF-induced dermal extravasation of EBD-albumin in guinea pigs. In contrast, L-NAME (25 or 50 mg kg(-1), p.o.)-an anti-vasodilatory inhibitor of nitric oxide synthase-dose-dependently inhibited up to 64% (p<0.001) of this dermal vascular leakage. VEGF-mediated retinal vascular leakage was not blocked by COX inhibition. Intravitreal VEGF-induced BRB breakdown--which was completely blocked by VEGF neutralizing s-Flt-1/Fc protein (intravitreal co-administration; p<0.001)--was not inhibited by indomethacin (20 mg kg(-1) day(-1), s.c.). Although COX inhibitors were ineffective at blocking experimental CNV, both non-selective and COX-2 selective inhibitors partially blocked severe inflammatory corneal angiogenesis and its concurrent upregulation of VEGF protein. These results suggest that eicosanoids produced by inducible COX-2 are among multiple mediators that modulate VEGF expression as a stimulus in inflammation-associated angiogenesis. The lack of effect with COX inhibitors on either VEGF-mediated dermal extravasation or VEGF-mediated blood-retinal barrier breakdown indicates that COX activity is not required for vascular leakage responses to VEGF.

[Effects of 1alpha, 25-dihydroxyvitamin D3 on the acute immune rejection and corneal neovascularization in high-risk penetrating keratoplasty in rats]

OBJECTIVE

To investigate the effects of 1,25-dihydroxyvitamin D(3) (1,25(OH)(2)D(3)), a hormone that has immunosuppressive properties, on acute rejection and corneal neovascularization in rat keratoplasty model, so as to assess the therapeutic effects and explore the mechanism of 1,25(OH)(2)D(3) as an immunosuppressant in corneal transplantation.

METHODS

High risk corneal transplantation was performed orthotopically in SD rat models of high risk penetrating keratoplasty established by placing three 10-0 nylon sutures in the central corneas for two weeks, with the Wistar rats as the donors. The SD rat models were randomly assigned into 5 groups and treated with 1,25(OH)(2)D(3) at varied concentrations and cyclosporine A (CsA). The expressions of interleukin (IL)-1alpha, tumor necrosis factor (TNF)-alpha, and vascular endothelial growth factor (VEGF) mRNA were detected by in situ hybridization (ISH).

RESULTS

1,25(OH)(2)D(3) significantly suppressed acute graft rejection and inhibited corneal neovascularization as compared with saline. 1,25(OH)(2)D(3) showed better immunomodulatory effects when administered along with CsA in rat corneal allotransplants. ISH study demonstrated that 1,25(OH)(2)D(3) strongly suppressed mRNA and protein expressions of the cytokines IL-1alpha and TNF-but not those of VEGF.

CONCLUSION

Topical administration of 1,25(OH)(2)D(3) can be effective in suppressing acute corneal graft rejection by inhibiting the expression of proinflammatory cytokines (IL-1alpha and TNF-alpha).

Counteracting corneal immunoinflammatory lesion with interleukin-1 receptor antagonist protein

Herpetic stromal keratitis (HSK) is a T cell-orchestrated, immunoinflammatory lesion that results from corneal Herpes simplex virus infection. Previous reports indicate an essential role for proinflammatory cytokine interleukin (IL)-1 in HSK pathogenesis. The present study evaluates the efficacy of IL-1 receptor antagonist (IL-1 ra) protein in the management of HSK. Mice receiving IL-1 ra had diminished disease severity. The administration of IL-1 ra was shown to reduce the influx into the cornea of cells of the innate and adaptive immune response. In addition, the treatment diminished corneal vascular endothelial growth factor levels, resulting in reduced angiogenic response. Our results show the importance of targeting early proinflammatory molecules such as IL-1 to counteract HSK and advocate IL-1 ra as an effective agent to achieve this.

Suppression of corneal neovascularization by PEDF release from human amniotic membranes

PURPOSE

Human amniotic membrane (HAM) transplantation is commonly used in corneal surface reconstruction and is known to inhibit neovascularization of this tissue. The purpose of the present study is to reveal the molecular basis underlying antiangiogenic activity of HAM.

METHODS

The effects of HAM protein on proliferation of vascular endothelial cells and corneal epithelial cells were determined by quantifying viable cells using the MTT assay. The presence of pigment epithelium-derived factor (PEDF) in HAM was demonstrated at the protein level by Western blot analysis and immunohistochemistry using a monoclonal antibody specific to human PEDF. The PEDF concentration was measured by a specific ELISA. The expression of PEDF in HAM was confirmed at the RNA level by RT-PCR and DNA sequencing.

RESULTS

Soluble proteins from HAM inhibited proliferation of human umbilical vein endothelial cells and bovine retinal capillary endothelial cells (BRCECs) while promoting proliferation of bovine cornea epithelial cells. Moreover, the HAM-induced inhibition of BRCECs was neutralized by a specific anti-PEDF antibody. PEDF protein was identified with an abundance of 103.84 +/- 33.21 ng/mg of soluble proteins, which is comparable to that in the retina, a PEDF-rich tissue. PEDF expression was predominantly localized in the basement membrane of HAM. RT-PCR using specific PEDF primers amplified a single product from HAM RNA. The PCR product has a sequence identical with that of human PEDF.

CONCLUSION

HAM specifically inhibits endothelial cell growth and thus suppresses neovascularization in the cornea. PEDF in HAM has a major role in eliciting this antiangiogenic activity.

Mice Transgenic for IL-1 Receptor Antagonist Protein Are Resistant to Herpetic Stromal Keratitis: Possible Role for IL-1 in Herpetic Stromal Keratitis Pathogenesis

Ocular infection with HSV may result in the blinding immunoinflammatory lesion stromal keratitis (SK). This represents a CD4+ T cell-mediated immunopathologic lesion in both humans and a mouse model. Early events in the pathogenesis that set the stage for SK are poorly understood. The present study evaluates the role of IL-1 using a transgenic mouse that overexpresses the IL-1 receptor antagonist (IL-1ra) protein. Such transgenic mice were markedly resistant to SK compared with IL-1ra(-/-) and C57BL/6 control animals. The resistance was shown to be the consequence of reduced expression of molecules such as IL-6, macrophage-inflammatory protein-2, and vascular endothelial growth factor, normally up-regulated directly or indirectly by IL-1. A critical event impaired in IL-1ra transgenic mice was vascular endothelial growth factor production with a consequent marked reduction in angiogenesis, an essential step in SK pathogenesis. Targeting IL-1 could prove to be a worthwhile therapeutic approach to control SK, an important cause of human blindness.

[Suppression of corneal neovascularization by conditioned culture medium of human amniotic membrane]

OBJECTIVE

To investigate the effects of the conditioned culture medium (CCM) of human amniotic membrane (AM) on corneal neovascularization (CNV) induced by basic fibroblast growth factor (bFGF) in mice.

METHODS

AM (with epithelium side up) was cultured in EGM basic medium for 3 days, and the CCM was collected. The CCM consisted of three groups: control (EGM only), AM with epithelium (AM) and AM without epithelium (De-AM). Corneal neovascularization was induced in mice by using micropocket assay with Hydron polymer pellets containing 100 ng bFGF. Migration and proliferation of human umbilical cord vein endothelial cells (HUVEC) were measured in Boyden chambers and by CyQUANT fluorescence binding assay, respectively. The levels of tissue inhibitors of metalloproteinase 1 and 2 (TIMP-1, TIMP-2) in the CCM were determined by ELISA assay.

RESULTS

CNV induced by bFGF was significantly suppressed by the CCM of amniotic membrane. When CCM was applied as an eyedrop 4 times a day for 7 days, the area of CNV was (2.48 +/- 0.76) mm(2), (0.64 +/- 0.52) mm(2) and (1.96 +/- 0.65) mm(2) in control, AM and De-AM groups, respectively. The migration and proliferation of HUVEC were strongly inhibited by the CCM of AM with epithelium, while the De-AM had no effect on the migration of HUVEC cells. A high level of TIMP-2 was found in AM group, but not in De-AM group. There were no differences in the amount of TIMP-1 in medium among these three groups.

CONCLUSIONS

CCM of amniotic membrane significantly suppresses the CNV induced by bFGF. One of the mechanisms of CCM-mediated suppression is that a high level of TIMP-2 protein is secreted or released into the CCM by AM, which can inhibit the migration and growth of vascular endothelial cells.

Gene transfer of kringle 5 of plasminogen by electroporation inhibits corneal neovascularization

PURPOSE

To test the efficacy of naked plasmid that expresses human kringle 5 of plasminogen (K5) in suppressing experimental corneal neovascularization in a rat model.

METHODS

A eukaryotic expression plasmid encoding human K5 (pSecK5) was constructed. COS cells were transiently transfected with pSecK5 using a lipid-based transfection reagent. K5 secretion was confirmed by Western blot analysis. The effect of the secreted K5 on the proliferation of human umbilical vein endothelial cells (HUVECs) was investigated colorimetrically. Forty-three Sprague-Dawley rats were used for a corneal neovascularization suppression experiment. Corneal injury was induced by placing a disk of filter paper (immersed in 1 mol/l NaOH, 3.0 mm in diameter) on the corneal surface for 2 min. The cornea was immediately washed with saline. pSecK5 and empty plasmids were injected subconjunctivally, and square-wave electric pulses were immediately applied to the eyes. The expression of K5 was analyzed by reverse transcription polymerase chain reaction (RT-PCR) and immunohistochemistry. The extent of corneal neovascularization was evaluated by scores.

RESULTS

The constructed plasmid could express itself in COS cells. Conditioned medium from K5-transfected COS cells apparently inhibited HUVEC proliferation, compared with conditioned medium from COS cells transfected with empty plasmid or nontransfected cells. RT-PCR and immunohistochemistry confirmed the expression of K5 in the conjunctiva and cornea. Corneal neovascularization was significantly suppressed by K5 gene transfer in rats' eyes.

CONCLUSION

In a rat model, K5 gene transfer by subconjunctival injection and electroporation can effectively inhibit corneal neovascularization induced by an alkali burn.