Radiolysis-induced oxidation of bovine alpha-crystallin

Radiolysis of water by ionizing radiation results in the production of pure hydroxyl radicals. This technique, combined with analysis by tandem mass spectrometry (MS/MS), has been used to study the effect of hydroxyl radicals on the intact bovine alpha-crystallin protein. After exposure to gamma-irradiation, the oxidized alpha-crystallin was digested with trypsin and the resulting peptides were fractionated by reverse-phase HPLC. The isolated fractions were analyzed by matrix-assisted laser desorption ionization and by MS/MS to determine the locations and identities of the modifications. Structural analysis revealed that methionine 1 of alpha A- and alpha B-crystallin and methionine 68 of alpha B-crystallin were oxidized to methionine sulfoxide. Hydroxytryptophan was formed from each tryptophan residue in alpha-crystallin, although only tryptophan 9 of alpha A-crystallin was converted into N-formylkynurenine. This study has, for the first time, identified the sites of modification and the structures produced in the intact alpha-crystallin protein by exposure to hydroxyl radicals. By determining the consequences of in vitro exposure of alpha-crystallin to pure hydroxyl radicals, the in vivo contribution of this reactive oxygen species to the overall oxidative stress of the lens will be achieved from the identification of the modifications to alpha-crystallin purified from intact human lenses.

The nitrite/elastin reaction: implications for in vivo degenerative effects

Nitrite ion is a by-product of nitrogen oxides (nitric oxide and nitrogen dioxide) from cigarette smoke and is used as a preservative for curing meats. Therefore, study of the reaction of nitrite with elastin in vitro was undertaken. By colorimetric assay, reactivity of nitrite with insoluble elastin at neutral pH, 37 degrees C, and physiologic concentration was confirmed. In histochemical studies on in situ human aortic elastin, nitrite-treated sections displayed marked structural disruptions. Determinations of fluorescence and absorbance on nitrite-treated soluble bovine elastin revealed marked alterations of fluorescence, and increased UV and visible absorbance. Amino acid analysis confirmed that it reacted with tyrosine. The findings indicate that non-enzymatic nitration by nitrite may have deleterious effects on elastin in vivo and may provide insights into the pathogenesis of chronic elastin degenerative processes, including aortic aneurysms, pulmonary emphysema, and premature skin wrinkling, all of which have been well known to have associations with cigarette smoking.

Identification of photooxidation sites in bovine alpha-crystallin

Because UV irradiation of proteins can produce reactive oxygen species and exposure to UV light has been implicated in cataractogenesis, the sites of photooxidation of bovine alpha-crystallin, a major lens protein with molecular chaperone activity, were identified using tandem mass spectrometry (MS/MS). Bovine alpha-crystallin was irradiated with UV light (> 293 nm) for 1, 4 and 8 h, digested with trypsin and analyzed by matrix-assisted laser desorption ionization, time-of-flight mass spectrometry (MALDI) to identify the oxidized sequences. Tryptic peptides were purified by reverse-phase HPLC and oxidized peptides were sequenced by MS/MS to determine the sites of oxidation. Tryptophan fluorescence decreased exponentially with increasing time of UV exposure and peptides containing residues 1-11 of alpha A-crystallin and 1-11, 12-22 and 57-69 of alpha B-crystallin were determined to be oxidized by shifts of 16 D or multiples of 16 Da above the mass of the unmodified peptide. The MALDI analysis revealed single oxidation of all four sequences, which increased with increasing time of UV exposure and possible double oxidation of alpha B 12-22. The specific sites of photooxidation indicate that the N-terminal regions of alpha A- and alpha B-crystallin are exposed to an aqueous environment and are in the vicinity of tryptophan residues from neighboring subunits.

Complete map and identification of the phosphorylation site of bovine lens major intrinsic protein

PURPOSE

To determine the complete primary structure, including posttranslational modifications, of bovine lens major intrinsic protein (MIP) using a recently developed combination of liquid chromatography and mass spectrometry.

METHODS

The MIP was isolated from bovine lenses by sucrose gradient centrifugation and was cleaved with cyanogen bromide (CNBr). A high-performance liquid chromatographic system, developed for hydrophobic protein analysis, was used to separate the cleavage fragments. Matrix-assisted laser desorption ionization and electrospray tandem mass spectrometry were employed to obtain molecular weight and sequence data from bovine MIP CNBr fragments, directly or after subsequent digestion with trypsin.

RESULTS

The complete sequence of bovine MIP was mapped by molecular weight measurements of CNBr fragments, confirming the reported DNA sequence. The C-terminal peptide (177 to 263) was fully sequenced and the major site of phosphorylation was determined to be at serine 235 rather than at the previously reported serine 243. The level of phosphorylation in the native protein was determined to be 25%. No other posttranslational derivatizations were observed with the exception of the previously detected deamidation of asparagine 246.

CONCLUSIONS

These results represent the first complete MIP sequence map at the amino acid level and identify the single major phosphorylation site at serine 235.

Spontaneous spinal epidural haemorrhage complicating transjugular intrahepatic portosystemic stent shunting

A patient with chronic liver disease and portal hypertension who developed acute spinal cord compression following transjugular intrahepatic portosystemic stent shunting is described. Radiological and pathological examinations revealed an epidural haematoma.

Effect of the UV modification of alpha-crystallin on its ability to suppress nonspecific aggregation

Recent studies have shown that structural modifications of alpha-crystallin during lens aging decrease it's effectiveness as a molecular chaperone. Some of these posttranslational modifications have been linked to UV radiation, and this study was undertaken to investigate the effect of UV irradiation on the ability of alpha-crystallin to suppress nonspecific aggregation. The effect of 3-hydroxykynurenine (3-HK) was also investigated as a model for its glucoside (3-HKG), a main lens chromophore that has been linked to photochemical changes in the human lens. Alpha- and gamma-crystallin solutions (1 mg/mL, 1:0.125 wt/wt) were photolyzed (transmission above 295 nm) for various time intervals. Thermal denaturation of gamma-crystallin with or without alpha-crystallin was carried out at 70 degrees C and increases in light scattering were measured at 360b nm. We found that (1) irradiation of gamma-crystallin increased its susceptibility to heat-induced scattering. The addition of alpha-crystallin protects it against thermal denaturation, although its ability to do so decreases the longer gamma-crystallin is irradiated and (2) irradiation of alpha-crystallin decreases its ability to suppress nonspecific aggregating and the presence of of 3-HK during irradiation decreases it further. Our results indicate that posttranslational modifications of alpha-crystallin due to UV irradiation affect the sites and mechanisms by which it interacts with gamma-crystallin. The kinetics of gamma-crystallin unfolding during thermal denaturation were also analyzed. We found that a simple two state model applies for nonirradiated gamma-crystallin. This model does not hold when gamma-crystallin is irradiated in the presence or absence of alpha-crystallin. In these cases, two step or multistep mechanisms are more likely.

Hypoxemia during diagnostic laparoscopy: a prospective study

BACKGROUND

Laparoscopic liver biopsy can be safely performed using local anesthesia and intravenous sedation, but the frequency of hypoxemia is unknown.

METHODS

We prospectively studied 68 patients undergoing diagnostic laparoscopy and liver biopsy managed by a standard protocol.

RESULTS

The mean duration of laparoscopy was 27 +/- 5.53 minutes; the mean dose of diamorphine administered was 6.9 +/- 2.7 mg; diazepam, 7.05 +/- 3.52 mg. The baseline arterial oxygen saturation was 95.6% +/- 2.5% and trough was 85% +/- 5.1%. A fall of greater than 4% saturation from the baseline occurred in 64 out of 68 patients (94%). The mean decrease in saturation was 10.1% +/- 5.4%. An arterial oxygen saturation of less than 85% was seen in 32 patients (47%). There was no correlation between the fall in oxygen saturation and the dose of diamorphine or diazepam, the duration of procedure, body mass index, hemoglobin, or volume of pneumoperitoneum induced. One-way analysis of the variance failed to show a significant relationship between the degree of oxygen saturation and Child's class, etiology of liver disease, or smoking habit.

CONCLUSIONS

In this study, we demonstrated that significant desaturation is common in diagnostic laparoscopy with liver biopsy and is likely due to a combination of different pharmacologic and physiologic effects. We recommend continuous monitoring of both arterial oxygen saturation and supplemental oxygen for all patients throughout laparoscopy.

The photochemistry of the retinoids as studied by steady-state and pulsed methods

The retina and retinal pigment epithelium contain a number of retinoids in a metabolic pathway that eventually forms the visual pigments. This study investigates the photochemistry of those retinoids that may contribute to light-induced damage to the retina. These include retinal (RAL), retinol (ROL), retinylpalmitate (ROLpal) and the protonated Schiff-base of retinal (RALsb). Their photochemistry was followed by both EPR spin-trapping techniques and the direct detection of singlet oxygen via its luminescence at 1270 nm. Irradiation (> 300 nm) of RAL, ROL in methanol (MeOH) or RALpal in dimethylformamide, produces free radicals from both solvents. Illumination of RALsb in MeOH containing NADH with light above 400 nm (and even above 455 nm) generates the superoxide radical. We also determined that the quantum yields for singlet oxygen sensitization by RAL, ROL or RALpal in MeOH are 0.05, 0.03 and < 0.01, respectively. These values are at least 75% less than those previously found using chemical methods. These observations indicate that a major photochemical process for these retinoids may be an electron (or hydrogen) process that will lead to radical products, and that the singlet oxygen mechanism is of relatively minor importance in protic solvents. These results may explain the action spectra obtained from light-induced damage to the retina.

Experimental model of light focusing of the peripheral cornea

PURPOSE

Epidemiologic studies have shown that the onset of cortical cataract occurs primarily in the inferonasal human lens and that the incidence of cortical cataract is correlated with ultraviolet light. Ray tracing analysis has suggested that the peripheral cornea concentrates light on the opposite peripheral lens and that the nose and orbit block peripheral light, except temporally, resulting in a relative concentration of light on the inferonasal lens. Studies were performed to test these theories.

METHODS

A model cornea and anterior chamber, set on a disc of light-sensitive paper, was placed in the orbit of a human skull coated with wax to simulate soft tissue. The "eye" was exposed to summer sunlight at various times of day, with and without sunglasses. Discs from the different experimental groups were scanned, and the digitized images were analyzed densitometrically using image analysis software.

RESULTS

With the head upright, the inferonasal section of the disc exhibited the most intense exposure under all lighting conditions. Sunglasses decreased the intensity of overall light exposure but did not eliminate the inferonasal bias. Only blocking the temple eliminated this effect.

CONCLUSIONS

This model supports the idea that the peripheral cornea focuses light on the inferonasal portion of the human lens. These results may explain the correlation between light and the location of cortical cataract.

Free radical reactions photosensitized by the human lens component, kynurenine: an EPR and spin trapping investigation

We have undertaken electron paramagnetic resonance and spin trapping investigations of the photochemistry of kynurenine (KN), a natural component of the human eye and close analog of the principal chromophore in the young human lens 3-OH-kynurenine O-glucoside (3HKG). 5,5-Dimethyl-1-pyrroline N-oxide (DMPO) was employed as a spin trap. We found that upon UV irradiation (> 300 nm) KN photoreduces oxygen to superoxide radical (in DMSO) and nitromethane (CH3NO2) to a nitromethane radical anion (CH3NO2.-) (in air-free buffers, pH 7 and 9.5). KN also sensitized photooxidation of cysteine, NADH, EDTA, azide, and ascorbate; oxygen greatly accelerated this process. Oxidation of cysteine, NADH, and EDTA was accompanied by superoxide radical formation. Cysteinyl and azidyl radicals were detected as DMPO adducts. We also observed that KN undergoes photodegradation to a product(s) whose photosensitizing capacity is greater than that of KN itself. We postulate that: (i) 3HKG may be able to photoinitiate free radical reactions in vivo, and (ii) oxygen is an important factor determining the yields of free radical processes initiated by lenticular chromophores.

The photochemistry of human retinal lipofuscin as studied by EPR

Fluorescent material generated in the human retina accumulates within lipofuscin (HLF) granules of the retinal pigment epithelium (RPE) during aging. We have been investigating the possible light-induced contribution of these fluorophores to various diseases including age-related macular degeneration. Our studies have shown that some of the fluorescent components of HLF are products of the reaction of retinaldehyde with ethanolamine and that synthetic mixtures of this reaction can serve as a useful model for photophysical studies. Previous research by us has demonstrated that irradiation of either natural or synthetic lipofuscin resulted in the formation of a triplet state and possibly a free radical. Here EPR studies were performed to verify the formation of that radical. The UV irradiation of either synthetic or natural human retinal lipofuscin extracts in oxygen-free methanol led to the formation of a 5,5-dimethylpyrroline-N-oxide (DMPO) spin-trapped carbon-centered radical resulting from either hydrogen atom or electron abstraction from solvent molecules. In the presence of oxygen superoxide was formed, which was observed as a DMPO adduct. It is concluded that certain components of the chloroform-soluble fluorophores of human RPE lipofuscin granules and the fluorescent reaction products of retinaldehyde and ethanolamine are photophysically similar but not the same. Electron or hydrogen abstraction from a substrate by these fluorophores in vivo and the resulting radical products may contribute to the age-related decline of RPE function and blue light damage in the retina.

Age-related changes in the human lens as monitored by detection of porphyrin excited states

Previous studies have shown that the triplet state lifetimes of various porphyrins are increased by several orders of magnitude when they are bound to lens protein. Flash photolysis studies of mesotetra (p-sulfonatophenyl)porphyrin (TPPS) on intact bovine lenses indicated a biexponential decay of the triplet state with lifetimes of 160 microsecond and 1.6 ms. Here we extend those measurements to TPPS associated with intact human lenses. Steady-state fluorescence measurements indicate that TPPS binds to both young and old human lenses. In an intact young human lens, the TPPS triplet state is observed to decay biexponentially with lifetimes of 50 and 680 microsecond. As the age of the lens increases, the lifetime of the shorter-lived component lengthens while that of the longer-lived component decreases slightly. In order human lenses, the two lifetimes coalesce and the triplet decay exhibits purely monoexponential behavior. These photophysical characteristics apparently are due to age-related modification(s) of the protein in the human lens resulting in an increasingly more homogeneous environment around the porphyrin.

Photophysical studies on human retinal lipofuscin

Fluorescent material generated in the human retina accumulates within lipofuscin granules of the retinal pigment epithelium (RPE) during aging. Its presence has been suggested to contributed to various diseases including age-related macular degeneration. Because this material absorbs light at wave lengths as long as 550 nm, photophysical studies were performed to determine whether lipofuscin could contribute to light damage and to determine if its composition is similar to a synthetically prepared lipofuscin. Time-resolved experiments were performed to monitor (1) fluorescence decay, (2) the UV-visible absorption of longer-lived excited states and (3) the formation and decay of singlet oxygen at 1270 nm. Steady-state and time-resolved fluorescence studies indicate that human and synthetic lipofuscin have fluorophores in common. Time-resolved absorption experiments on human retinal lipofuscin and synthetic lipofuscin showed the presence of at least two transient species, one absorbing at 430 nm (lifetime ca 7 microseconds) and a second absorbing at 580 nm, which decays via second order kinetics. In addition, there is a third absorbing species stable to several hundred milliseconds. The transient species at 430 nm is quenched by oxygen, suggesting that it is a triplet state. Subsequent studies showed the formation of singlet oxygen, which was monitored by its phosphorescence decay at 1270 nm. These studies demonstrate that lipofuscin can act as a sensitizer for the generation of reactive oxygen species that may contribute to the age-related decline of RPE function and blue light damage.

UV-B as a pro-aging and pro-cataract factor

One of the functions of the human lens is filter light between 300-400 nm from reaching the retina. The lens is therefore continually under photooxidative stress. In the young lens the primary absorbing species is the O-beta glucoside of 3-hydroxykynurenine (3-HKG) which has a maximum at 365 nm. Photophysical studies have demonstrated that absorptions by this compound in the short term are relatively benign to the lens, but in the long term can lead to the photochemical loss of 3-HKG with the concomitant yellowing of lens proteins. It will be proposed that part of this yellowing is due to the photochemically induced attachment of 3-HKG to lens proteins. The yellowing of lens proteins leads to a drastic increase in the number of photons absorbed by the lens. This, along with the age-related losses of antioxidants such as GSH will increase the photooxidative stress on the lens. Considering the foregoing and various epidemiological, model and biochemical studies, it can be concluded that light is most likely one of the causative factors in cataractogenesis.

Photoreactivity of biologically active compounds. VIII. Photosensitized polymerization of lens proteins by antimalarial drugs in vitro

The drugs commonly used in the treatment of malaria are photochemically unstable. Several of these compounds cause dermal and ocular toxic reactions that may be light induced. The in vitro photopolymerization of calf lens proteins in the presence of antimalarial drugs was studied as part of a screening of the photochemical properties and phototoxic capabilities of these compounds. The pseudo-first-order rate constant for the reaction was calculated, and related to the amount of light absorbed by the compounds in order to determine the relative photosensitizing effect of each drug. The reaction mechanisms were evaluated by adding a variety of quenchers to the reaction medium during irradiation. Based on the results obtained in this study and previous knowledge about the pharmacokinetic behavior of these compounds, several of the drugs investigated have to be considered as potential photosensitizers in the human lens, the retina and the skin.

Risk stratification for restenosis after coronary angioplasty by means of exercise echocardiography

To assess the prognostic contribution of exercise two-dimensional echocardiography in patients undergoing elective coronary angioplasty, 60 patients (44 males, 16 females, mean age 61 years) were enrolled in this study. The series included 31 patients with single-vessel disease, 23 with two vessel, and 5 with three vessel disease. After successful PTCA, they underwent stress echocardiographic testing either by treadmill (n = 23) or bicycle ergometry (n = 37), performed with digital continuous loop technique. A wall motion index (WMI) was calculated at rest and at peak stress. According to WMI values, the study population was divided into three groups: patients with normal WMI both at rest and stress (Group 1); patients with abnormal baseline WMI without change at stress (Group 2) and abnormal WMI diagnostic of stress-induced ischemia (Group 3). During the follow-up period, minimum of 1 year, 21 patients complaining of recurrent angina or chest discomfort, had repeat angiography: in 13 of these, typical restenosis of a previously dilated artery was found; 2 patients had progression of atherosclerotic plaque and in 6 the angiogram showed a good result of PTCA. Thirteen patients with restenosis or progressive disease underwent repeat PTCA. In this group, only 2 belonged to Group 1, 4 to Group 2, and 7 to Group 3. Thus, a linear correlation between the WMI value post-angioplasty and the clinical course could be documented (p = 0.001). Stress echocardiography was superior to stress ECG in both negative predictive value (88 and 77% respectively) and positive predictive value (73 versus 50%).(ABSTRACT TRUNCATED AT 250 WORDS)

Photolysis of intact young human, baboon and rhesus monkey lenses

Intact young human, baboon and rhesus monkey lenses were subjected to near-UV irradiation under identical conditions and fluorophore buildup was continuously monitored for several hours. The compositional changes occurring in the lenses were monitored by analyzing the ethanol extracts of the irradiated and control lenses using high-performance liquid chromatography and thin-layer chromatography (TLC). The chromatograms of the supernatant detected at 365 nm as well as the TLC scans showed the presence of 3-hydroxykynurenine glucoside (3-HKG) and two other kynurenine-type compounds. The 3-HKG and one of the compounds were found in all three species, while the remaining one was structurally different in the lower primates. A loss of 3-HKG as a result of irradiation was apparent in all the lenses and correlated with the buildup of the blue fluorophore, suggesting that the latter may be a photoproduct(s) of 3-HKG. The kinetic analysis of baboon and human lenses showed a slowdown in the fluorophore buildup as irradiation times increased. This was probably due to the competitive absorptions of 3-HKG and other chromophores present. Rhesus monkey lenses did not exhibit this slowdown.

Model studies on the photochemical production of lenticular fluorophores

With aging, human lens proteins accumulate fluorophores having blue and green emissions. Model studies were undertaken to determine the role of 3-hydroxykynurenine (3-HK) and its glucoside (3-HKG) in the photochemical production of those fluorophores. Experiments were carried out using 10(-3) M 3-HK solutions in the presence or absence of glycine (1 M), which was used to mimic the environment of the lens. The solutions were photolyzed (transmission above 295 nm) for various periods of time while the loss of starting material and the formation of fluorescent photoproducts (blue emission at 470 nm, and green emission at 520 nm) were monitored using fluorescence and UV-visible spectroscopy and thin-layer and high-pressure liquid chromatography analysis. Several parameters were varied such as oxygen tension and the addition of the free radical scavenger, penicillamine. The photolytic loss of 3-HK in the absence of glycine occurred approximately 5-10 times faster than in its presence. Conversely, blue and green fluorophores formed in irradiated solutions containing glycine but not with the photolysis of 3-HK alone. The blue fluorophore was formed first and appeared then to be photochemically converted to the green one, with the rate of formation of the latter increasing with an increase in UV dosage or oxidizing conditions. The addition of penicillamine drastically reduced the photochemical formation of both fluorophores. Both the blue and green fluorophores appear to result from the photochemically induced covalent attachment of 3-HK to glycine.(ABSTRACT TRUNCATED AT 250 WORDS)

A pulse radiolysis study of the reactions of 3-hydroxykynurenine and kynurenine with oxidizing and reducing radicals

Pulse radiolysis has been used to study the reactions of 3-hydroxykynurenine and kynurenine with solvated electrons, superoxide radicals, hydroxyl radicals and azide radicals. Both 3-hydroxykynurenine and kynurenine react with solvated electrons with diffusion controlled rate constants (k = 2.5 x 10(10) M-1 s-1 and 2.3 x 10(10) M-1s-1, respectively). Neither compound was observed to react with superoxide radicals under our experimental conditions, an upper limit of 1.2 x 10(5) M-1s-1 for the rate constant of this reaction was estimated for both compounds. However, we do observe that a stable product of autooxidation of 3-hydroxy-kynurenine reacts with superoxide radicals and we calculate a lower limit for the rate of this reaction of 5.8 x 10(6) M-1s-1. Reactions of 3-hydroxykynurenine and kynurenine with hydroxyl radicals proceed with diffusion controlled rate constants (1.2 x 10(10) M-1 s-1 and 1.3 x 10(10) M-1 s-1, respectively). The measured values for the rate constants for reaction of 3-hydroxykynurenine and kynurenine with azide radicals are 2.1 x 10(10) M-1s-1 and 4.8 x 10(9) M-1 s-1, respectively. The differences in these rate constants are attributed to differences in the measured oxidation potentials for 3-hydroxykynurenine (+1.0 V vs. NHE) and kynurenine (+1.15 V vs. NHE).

Molecular changes during the photooxidation of alpha-crystallin in the presence of uroporphyrin

Singlet oxygen reacts preferentially with three amino acids in proteins, His, Trp and Met. In order to study the specific molecular events that result from such oxidations, calf alpha-crystallin was photooxidized in the presence of uroporphyrin and the reactions were investigated by high performance liquid chromatography peptide mapping using a photodiode array detector followed by fast atom bombardment mass spectrometry (FAB-MS). From these studies, the following conclusions can be inferred: (1) Upon photooxidation residue Met-68 of the B chain is oxidized to Met sulfoxide, whereas residue Trp-60 remains intact. (2) Two of the 16 His residues in alpha-crystallin are photooxidized with an apparent pKa of ca 7.0 (3) FAB-MS analysis suggests that residue Lys-166 close to the C-terminal end of the A chain forms a cross-link with the His-7 residue close to the N-terminal end of the A chain. This may be either an inter- or intramolecular cross-link.

Committal procedures in Ireland

The study aims to describe current committal practice in an Irish public psychiatric service and to establish the role of 'dangerousness' in determining practice. A six month retrospective review was undertaken using casenotes and original temporary forms of all patients committed to St Brendan's Hospital, Dublin within a six month period in 1990. A total of 136 cases were examined. In 65% of cases the application for detention was initiated by a spouse or relative. The recommending physician was identified as a General Practitioner in 80% of cases, although most were locum GP's. The number of male and female patients were almost equal. There was a wide age range with the largest group (42%) in the range 26-40 years. Previous contact with the psychiatric service was found in 89% of cases. There was a wide range of diagnoses with the largest category (56%) suffering from schizophrenia. Of those not admitted with alcohol or drug related illness 66% showed evidence of acute psychotic symptoms. Length of admission was relatively short with 84% of patients being discharged within three months. A total of 43% showed evidence of being a danger to themselves or others. Significant differences were found between these patients and the non-dangerous group, the latter being more likely to be older and to suffer from a major psychotic illness. These findings indicate that a committal law based purely on 'dangerousness' criteria would be likely to significantly affect committal practice in Ireland. These findings are discussed in relation to proposed changes in mental health legislation in Ireland.

The potential ocular phototoxicity of antidepressant drugs

Light Therapy is a new treatment for patients with Seasonal Affective Disorder (SAD), a depressive state occurring during the winter as a result of decreased sunlight. The treatment involves placing the patient in front of a light box (2-10,000 lux) for approximately 30 min to 1 hour per day during the winter months. Although there have been no reports of damage to the eye from this treatment with light alone there is increased risk in light damage to the lens and retina if these depressed patients are being treated with antidepressant/neuroleptic drugs concurrently with their light therapy. As we have been previously reported certain drugs, having absorptions longer than 295 nm can act as photosensitizers resulting in enhanced light damage to the eye. Using a screening method developed by Roberts, we examined the potential phototoxicity of a variety of antidepressant and neuroleptic drugs.