Discrete expression and distribution pattern of TIMP-3 in the human retina and choroid

PURPOSE

Extracellular matrix homeostasis is dependent in part upon a family of matrix metalloproteinases and their specific inhibitors, the tissue inhibitors of metalloproteinases (TIMPs). Recently, gene defects in TIMP-3 have been identified in the affected individuals of several families with Sorsby's fundus dystrophy (SFD). Very little information is available regarding TIMP-3 function or even its existence in the retina or choroid.

METHODS

We used reverse transcription-polymerase chain reaction and Northern analysis to evaluate the expression of TIMP mRNA and Western immunoblots to evaluate TIMP protein produced by select cells of the human retina and choroid. We also used these methods and immunohistochemistry to localize the TIMPs in the retina and choroid.

RESULTS

TIMP-3 transcripts are found in cultured human retinal pigment epithelium (RPE), choroidal microcapillary endothelium and pericytes. RPE cells also express and secrete TIMP-3 protein, which is localized to the extracellular matrix and is not found in culture medium; TIMP-1 and -2 are found almost exclusively in the medium. Immunohistochemistry of human retina/choroid sections shows pronounced TIMP-3 immunostaining in Bruch's membrane, particularly near the surface of the RPE and endothelial cells, presumably in their basement membranes, with minimal staining in other portions of the retina. Immunostaining for TIMP-1 is absent and for TIMP-2 is much less prevalent, but detectable in Bruch's membrane.

CONCLUSIONS

TIMP-1, -2 and -3 exhibit distinctive expression patterns in the retina and choroid. This distribution and expression pattern partially explains why TIMP-3 mutations result in SFD, rather than other retinal pathologies, such as those associated with proliferative diabetic retinopathy.

Laser trabeculoplasty induces stromelysin expression by trabecular juxtacanalicular cells

PURPOSE

The mechanism by which laser trabeculoplasty reduces elevated intraocular pressure in primary open-angle glaucoma has been established. To test the hypothesis that trabecular extracellular matrix turnover is involved, stromelysin expression after laser treatment of anterior segment organ cultures was evaluated.

METHODS

Argon laser trabeculoplasty, using typical clinical treatment parameters, was applied to anterior segment organ cultures. Stromelysin levels and activity were then evaluated at various times by immunoblots of Western transfers and by zymography. Stromelysin mRNA levels were evaluated by dot blot and by reverse transcription, followed by polymerase chain reaction amplification. Stromelysin protein was localized by immunohistochemistry, and image analysis was used for quantitation. Stromelysin mRNA was localized by in situ hybridization.

RESULTS

Trabecular stromelysin protein, activity, and mRNA levels were detectably elevated by 8 hours and were several-fold higher by 24 hours after treatment. Stromelysin immunostaining was elevated dramatically in the juxtacanalicular and insert regions of the meshwork, but only modestly in other regions. Stromelysin mRNA increases also were localized primarily to these regions. The juxtacanalicular stromelysin immunostaining increase was sustained for at least 1 week, whereas the insert levels declined somewhat after day 2.

CONCLUSIONS

A stromelysin increase, localized primarily to the juxtacanalicular region of the meshwork, the putative site of the aqueous humor outflow resistance, should degrade trabecular proteoglycans, the putative outflow resistance source, and allow their uptake and further degradation by the juxtacanalicular cells. If diminished juxtacanalicular extracellular matrix turnover is responsible for the glaucomatous reduction in aqueous humor outflow, an increase in stromelysin in this specific area of the meshwork should ameliorate the problem. Thus, the observations support the working hypothesis and may explain the efficacy of this treatment for glaucoma.

Early changes in matrix metalloproteinases and inhibitors after in vitro laser treatment to the trabecular meshwork

Extracellular matrix turnover in the trabecular meshwork may play a role in regulating aqueous humor outflow. Laser trabeculoplasty is a common treatment for open-angle glaucoma. The mechanism of this treatment is not understood. We investigated changes in the levels and expression of the matrix metalloproteinases and their tissue inhibitors (TIMPs) in this tissue using cultured human anterior segment explants and standard clinical-parameter laser treatment. Medium gelatinase A activity levels are relatively high for sham-treated controls and are not changed dramatically following laser treatment. Medium gelatinase B and stromelysin activity levels are low in sham-treated explants and increase significantly by 24 h after treatment. TIMP1 levels, as assessed by immunoblots of Western transfers, are initially low. However, by 24 h TIMP1 levels have increased significantly. Using semi-quantitative reverse transcription and the polymerase chain reaction, mRNA levels of stromelysin, gelatinase B and TIMP1 are shown to increase after laser treatment, while gelatinase A and TIMP2 remain relatively constant. The increases in trabecular stromelysin and gelatinase B in response to laser trabeculoplasty may have important implications for the mechanism of action of this treatment for open-angle glaucoma.

Impaired splicing of phytochrome B pre-mRNA in a novel phyB mutant of Arabidopsis

Phytochrome is the red/far-red absorbing photoreceptor active in photomorphogenesis, the apoprotein of which is encoded by a small gene family (PHYA, PHYB, PHYC, PHYD and PHYE). A novel phytochrome B-deficient mutant, phyB-103, was isolated from a screen of EMS-mutagenised Arabidopsis M2 seed. phyB-103 carries a G-to-A base substitution at the 5' splice site +1 G nucleotide of intron 1 of PHYB. The phyB-103 PHYB transcript is larger than the wild-type PHYB transcript and DNA sequence analysis showed that the entire intron is retained in the mature PHYB transcript of phyB-103. Thus the phyB-103 G-to-A substitution prevents intron splicing. The retained intron contains within it an in-frame stop codon, and the predicted PHYB-003 apoprotein thus terminates prematurely. phyB-103 is therefore likely to be a null allele of PHYB, consistent with the observation that the phenotype conferred by phyB-103 is as severe as that conferred by previously described phyB null alleles.

The effect of dexamethasone on glycosaminoglycans of human trabecular meshwork in perfusion organ culture

The effect of dexamethasone treatment on glycosaminoglycans (GAG) in the human trabecular meshwork was studied by placing 20 pairs of eyes in perfusion organ culture. One eye received 550 nM dexamethasone in addition to culture medium; the fellow eye received culture medium only. 3H-glucosamine and 35S-sulfate were added to the medium for the final 48 hr of culture. The meshwork was then dissected, and the GAGs were isolated and subjected to sequential enzymatic degradation. Active labeling of hyaluronic acid, chondroitin sulfate, dermatan sulfate, keratan sulfate, and heparan sulfate was found in both control and steroid-treated eyes. Dexamethasone-treated eyes had an average 92% increase in the 3H-glucosamine incorporation rate in the undigestible GAG residue fraction after 14-21 days treatment (20.6% versus 10.7%, P = 0.03). This change was not apparent in eyes treated for 7 days. In this preliminary study, dexamethasone appeared to cause a time-dependent increase in the undigestible GAG incorporation profile in human trabecular meshwork.

Expression of matrix metalloproteinases and inhibitor by human retinal pigment epithelium

Extracellular matrix turnover is initiated, at least in part, by the regulated secretion of members of a family of matrix metalloproteinases. The authors show that interstitial collagenase, stromelysin, two gelatinases (the 72-kD and 92-kD type IV collagenases), and the tissue inhibitor of metalloproteinases (TIMP) are secreted into the culture medium of human retinal pigment epithelium (RPE). These enzymes and their inhibitor were identified by probing immunoblots of western transfers with specific polyclonal antibodies that were made against these proteins or against peptides containing unique sequences from these proteins. Stromelysin and the gelatinases are also active against substrates that are polymerized into polyacrylamide gel before electrophoresis and require metal ions (probably zinc and/or calcium) for activity. The phorbol mitogen, 12-tetradecanoylphorbol-13-acetate, differentially increases the levels of these metalloproteinases and TIMP found in retinal pigment epithelium culture medium with stromelysin and the 92-kD type IV collagenase responding most strongly and TIMP actually decreasing in certain cases. Additional changes in metalloproteinase profiles are observed after approximately 20 passage of several RPE lines in culture. Modulation of extracellular matrix turnover by changing RPE secretion of these matrix metalloproteinases and their TIMP, may play a central role in the normal function and in the pathology of the retina.

Acute lead poisoning in nursing home and psychiatric patients from the ingestion of lead-based ceramic glazes

To our knowledge, acute inorganic lead poisoning from single ingestions of lead compounds has been only rarely reported. During a 14-month period, we were contacted regarding eight instances of acute ingestions of liquid lead-based ceramic glazes by mentally impaired residents of nursing homes or psychiatric facilities participating in ceramic arts programs. While some ingestions did not cause toxic effects, some patients developed acute lead poisoning characterized by abdominal pain, anemia, and basophilic stippling of red blood cells. In the blood of several patients, lead concentrations were far above normal (4 to 9.5 mumol/L). Urinary lead excretions were tremendously elevated during chelation therapy, with one patient excreting 535.9 mumol/L of lead during a 6-day period, the largest lead excretion ever reported in a patient suffering from acute lead poisoning, to our knowledge. All patients recovered following supportive care and appropriate use of chelating agents. Lead-based glazes are commonly found in nursing homes and psychiatric facilities. We suspect that acute or chronic lead poisoning from the ingestion(s) of lead-based ceramic glazes may be an unrecognized but not uncommon problem among such residents. We urge physicians to take ingestions of lead-based glazes seriously and to consider the diagnosis of lead poisoning in nursing home and psychiatric patients who have participated in ceramic crafts programs.

Glycosaminoglycans of human trabecular meshwork in perfusion organ culture

The synthetic profile of glycosaminoglycans (GAGs) of human trabecular meshwork in perfusion organ culture was studied in a series of 34 human eyes. The anterior segments of these eyes were cultured for periods of two to 28 days and received medium containing 3H-glucosamine and 35S-sulfate during the final 48 hours of culture. The meshwork was then dissected and the GAGs isolated and subjected to sequential enzyme digestion. Active labelling of hyaluronic acid, chondroitin sulfate, dermatan sulfate, keratan sulfate, and heparan sulfate was found in all time periods. Eyes cultured seven and 14 days had similar incorporation profiles to "fresh" eyes (cultured 48 hours to allow for labelling). Eyes cultured 21 days showed an increase in dermatan sulfate labelling and a slight decrease in keratan sulfate labelling when compared with "fresh" eyes. Light microscopic autoradiography confirmed the trabecular meshwork incorporation of the radiolabelled precursors at all time periods. Thus, the trabecular meshwork remains metabolically active and GAG synthetic profiles remain reasonably similar to fresh eyes for up to three weeks in a perfusion organ culture system. This system may serve as a model for future studies of human trabecular meshwork GAGs.

Trabecular repopulation by anterior trabecular meshwork cells after laser trabeculoplasty

To study further the transient increase in trabecular cell division within the first two days after laser trabeculoplasty in human corneoscleral explant organ cultures, we used a pulse-chase protocol in which immediately after laser treatment 3H-thymidine was added to the culture medium for 48 hours (the pulse period). Fresh medium without radiolabel was then added for variable times (the chase period) before termination of the experiment. Autoradiography was used to follow changes in the regional distribution of the cells that divided during the pulse period and had 3H-thymidine-labeled DNA. Laser-treated explants, evaluated after a pulse with no chase, showed a fourfold increase in cell division (P less than .001) over nontreated controls. Nearly 60% of this cell division was localized to the anterior, nonfiltering region of the trabecular meshwork where it inserts into the cornea beneath Schwalbe's line. Trabecular cell division in other regions of the meshwork was not increased over controls at this time. After seven or 14 days of chase without radiolabel, the regional distribution of radiolabeled cells changed in laser-treated explants but not in controls. By 14 days, only 26% of the labeled cells remained in this anterior insert region, while 60% were found in the region of the burn sites. Macroautoradiography of whole explants corroborated these observations. Our data support the hypothesis that laser trabeculoplasty causes early cell division by a population of cells in the anterior meshwork; these new cells then migrate and repopulate the burn sites over the next few weeks.

Pharmacokinetics of doxapram in idiopathic apnea of prematurity

Pharmacokinetics of doxapram were determined in 13 infants with idiopathic apnea of prematurity uncontrolled by aminophylline and caffeine. Doxapram was maintained for 72-96 h at a constant infusion rate of 2-2.5 mg/kg/h. Plasma doxapram levels were measured by gas liquid chromatography. The infants studied had a birth weight of 1,247 +/- 240 g (mean +/- SD), a gestational age of 29.4 +/- 2 weeks and were 9.9 +/- 6 days old. Steady-state plasma doxapram levels reached by all infants averaged 5.8 +/- 1.8 mg/l. Half-life was 6.6 +/- 5.7 h, plasma clearance 0.44 +/- 0.1 litres/kg/h, and calculated volume of distribution 4 +/- 2.7 litres/kg. Doxapram controlled apnea successfully in 12 of 13 babies. A significant fall in PaCO2 and reduction in the rate of apnea was seen within 6-8 h with corresponding doxapram levels of 3.7 +/- 1.8 mg/l. The factors influencing the pharmacokinetics of doxapram in newborns are presently unknown.

Psychological factors associated with primary fibromyalgia syndrome

Forty-five ambulatory patients with primary fibromyalgia syndrome (PFS), 30 with rheumatoid arthritis, and 32 normal controls were administered 3 psychological tests: the Minnesota Multiphasic Personality Inventory (MMPI), the Life Events Inventory, and the Assertiveness-Aggressiveness Inventory. The PFS patients scored significantly higher on 8 MMPI scales when compared with the normal control group and on 4 MMPI scales when compared with the rheumatoid arthritis group. Further subgrouping of PFS patients according to MMPI scores showed that only 31% were "psychologically disturbed," 33% had a typical chronic pain profile, and 36% were within the normal range. The PFS patients scored higher than the rheumatoid arthritis and normal control groups on the Life Events Inventory but not the Assertiveness-Aggressiveness Inventory.

"Australian" methicillin-resistant Staphylococcus aureus in a London hospital?

The Royal Free Hospital in London has experienced the spread of a phage 85 methicillin-resistant Staphylococcus aureus (MRSA). An analysis of a sample has demonstrated that the plasmids carried by these strains, and the type and location of their drug-resistance determinants, are similar to those of MRSA strains which have been causing problems in some Australian hospitals.

Outbreak of necrotising enterocolitis caused by Clostridium butyricum

12 hospital-born babies had necrotising enterocolitis, of varying severity, within six weeks, 5 of them within ten days. The usually described predisposing causes were absent in most, though no baby was exclusively breast -fed. Evidence of the presence of Clostridium butyricum was found in the blood of 9 out of 10 babies examined. Cl. butyricum is probably a primary, not a secondary invader.