Oxidative stress on lens and cataract formation: role of light and oxygen

Role of ultraviolet irradiation and oxidative stress in cataract formation-medical prevention by nutritional antioxidants and metabolic agonists

PURPOSE

Cataract is a significant cause of visual disability with relatively high incidence. It has been proposed that such high incidence is related to oxidative stress induced by continued intraocular penetration of light and consequent photochemical generation of reactive oxygen species, such as superoxide and singlet oxygen and their derivatization to other oxidants, such as hydrogen peroxide and hydroxyl radical. The latter two can also interact to generate singlet oxygen by Haber-Weiss reaction. It has been proposed that in addition to the endogenous enzymatic antioxidant enzymes, the process can be inhibited by many nutritional and metabolic oxyradical scavengers, such as ascorbate, vitamin E, pyruvate, and xanthine alkaloids, such as caffeine.

METHODS

Initial verification of the hypothesis has been done primarily by rat and mouse lens organ culture studies under ambient as well as ultraviolet (UV) light irradiation and determining the effect of such irradiation on its physiology in terms of its efficiency of active membrane transport activity and the levels of certain metabolites such as glutathione and adenosine triphosphate as well as in terms of apoptotic cell death. In vivo studies on the possible prevention of oxidative stress and cataract formation have been conducted by administering pyruvate and caffeine orally in drinking water and by their topical application using diabetic and galactosemic animal models.

RESULTS

Photosensitized damage to lens caused by exposure to visible light and UVA has been found to be significantly prevented by ascorbate and pyruvate. Caffeine has been found be effective against UVA and UVB. Oral or topical application of pyruvate has been found to inhibit the formation of cataracts induced by diabetes and galactosemia. Caffeine has also been found to inhibit cataract induced by sodium selenite and high levels of galactose. Studies with diabetes are in progress.

CONCLUSIONS

Various in vitro and in vivo studies summarized in this review strongly support the hypothesis that light penetration into the eye is a significant contributory factor in the genesis of cataracts. The major effect is through photochemical generation of reactive oxygen species and consequent oxidative stress to the tissue. The results demonstrate that this can be averted by the use of various antioxidants administered preferably by topical route. That they will be so effective is strongly suggested by the effectiveness of pyruvate and caffeine administered topically to diabetic and galactosemic animals.

Vitex negundo modulates selenite-induced opacification and cataractogensis in rat pups

Recently, much interest has been generated in the search for phytochemical therapeutics, as they are largely free from adverse side effects and economical. The goal of this study was to determine the efficacy of Vitex negundo in modulating the selenite-induced oxidative stress in vivo model. Sprague-Dawley rat pups of 8 days old were used for the study and divided into control (G I), selenite induced (G II), and selenite + V. negundo treated (G III). Cataract was induced by the single subcutaneous injection of sodium selenite (4 mg/kg body weight) on the tenth day and V. negundo (2.5 mg/Kg body weight) administered intraperitoneally from eighth to 15th day. Morphological examination of the rat lenses revealed no opacification in G I and mild opacification in G III whereas dense opacification in G II (stages 4-6). Levels of selenium in G II and G III showed no significant changes. The activities of superoxide dismutase, catalase, and Ca(2+)ATPase were significantly increased in G III compared to G II (p < 0.05), while lower level of reactive oxygen species, Ca(2+), and thiobarbituric acid reactive substances were observed in G III compared G II (p < 0.05). These results indicate the therapeutic potential of methanolic extract of V. negundo on modulating biochemical parameters against selenite-induced cataract, which have been reported in this paper for the first time.

Evolution of light scattering and redox balance in the rat lens after in vivo exposure to close-to-threshold dose ultraviolet radiation

PURPOSE

To investigate the evolution of cataract development and glutathione redox balance in the rat lens after in vivo close-to-threshold dose exposure to ultraviolet radiation (UVR) around 300 nm.

METHODS

Three groups of 10 Sprague-Dawley rats were unilaterally exposed to 8 kJ/m² UVR-300 nm for 15 min, and a fourth group of 10 rats was kept without UVR exposure as nonexposed control animals. The exposed animals were killed at 1, 3 and 7 days after exposure. Both lenses from all animals were extracted and photographed and the intensity of forward light scattering was measured quantitatively. Thereafter, the lenses were homogenized. The concentration of reduced glutathione (GSH) and oxidized glutathione (GSSG), and the activity of glutathione reductase (GR) and glutathione peroxidase (GPx), respectively, were determined spectrophotometrically. The mean paired differences between exposed and nonexposed lenses were used as primary data in the statistical analyses.

RESULTS

All exposed lenses developed cataract. Lens light scattering increased throughout the 7 days after UVR exposure. GSH concentration and GPx rate transiently increased at 1 day after exposure and then decreased throughout follow-up, with GSH concentration having a negative balance at the end. GSSG concentration and GR activity did not change after UVR exposure.

CONCLUSION

In vivo close-to-threshold UVR exposure induces a gradual increase in rat lens opacification/cataract development and time dependently alters the redox balance in the lens.

Inhibition of selenite-induced cataract by caffeine

PURPOSE

The objective of the investigation was to study possible inhibition of oxidative stress and cataract formation by caffeine in vivo.

METHODS

Oxidative stress and consequent cataract formation was induced by intraperitoneal administration of a single dose of sodium selenite (1.16 μmol) to Sprague-Dawley rat pups on day 9 postnatally. In experiments designed to inhibit such cataract formation, the pups were pretreated intraperitoneally with caffeine (5.15 μmol), starting 2 days prior to the administration of selenite and continuing such treatment till day 21, when the experiments were terminated. The extent of tissue damage caused by the selenite was assessed biochemically by measurements of the levels of GSH and ATP in the isolated lenses. Cataract formation and its prevention were monitored by examining the eye with pen light illumination and subsequent photography of the isolated lenses.

RESULTS

Injection of selenite led to a significant loss of lens clarity because of cataract formation. In the group treated with caffeine, the formation of cataract was significantly prevented. In the caffeine-untreated group, the levels of lens GSH and ATP were substantially lower than in the caffeine-treated group. The levels of GSH decreased from a value of ∼8.2 μmol to ∼2 μmol/g wet weight of the lens. The content of ATP decreased from ∼2.5 μmol to about ∼ 1 μmol. In the case of caffeine-treated group, these decreases were significantly prevented from taking place, the corresponding values of GSH and ATP being ∼5.8 and ∼1.6 μmol/g, respectively.

CONCLUSION

Over all, the results suggest that caffeine can exert a significant preventive effect against cataract formation induced by agents generating reactive oxygen species such as sodium selenite.

Antioxidant supplementation improves platelet membrane fluidity in idiopathic retinal periphlebitis (Eales' disease)

PURPOSE

Oxidative damage to cellular membranes plays an important role in the pathobiology of tissue injury. Retinal photoreceptors and platelets are an easy target of oxidants because of high proportion of polyunsaturated fatty acids. A tertiary-care center-based prospective study was undertaken to study the effect of antioxidant supplementation over membrane fluidity in platelets in idiopathic retinal periphlebitis (Eales' disease) for the first time.

METHODS

Assay of thiobarbituric acid reactive substances (TBARS) levels was done following a standard protocol and membrane fluidity in platelets was estimated using a fluorescent probe, 1,6-diphenyl-1,3,5-hexatrience, in 15 cases and 12 healthy controls. Prednisolone (1 mg/kg) in a weekly tapering dose for 6 weeks and a commercially available antioxidant preparation [lutein 3.2 mg (containing zeaxanthin 256 mcg), L-glutathione 5 mg, vitamin E 15 IU, vitamin C 150 mg, zinc 40 mg, copper 2 mg, selenium 40 mcg, and manganese 5 mg] was administered once a day for 3 months to all the cases. Pre- and postantioxidant supplementation platelet TBARS and membrane fluidity levels were assessed in all the cases.

RESULTS

Significant increase was observed in TBARS levels in the cases when compared with controls (P = 0.01). Platelet fluorescence polarization was significantly higher in cases, indicating decreased membrane fluidity, when compared with controls (P = 0.005). Antioxidant supplementation led to marked decrease in TBARS levels (P = 0.01) and improved levels of platelet membrane fluidity (P = 0.001).

CONCLUSION

Antioxidant supplementation leads to significant decrease in oxidative stress and a significant improvement in platelet membrane fluidity, thereby helping to prevent retinal photoreceptor dysfunction.

Lipids and the ocular lens

The unusually high levels of saturation and thus order contribute to the uniqueness of human lens membranes. In addition, and unlike in most biomembranes, most of the lens lipids are associated with proteins, thus reducing their mobility. The major phospholipid of the human lens is dihydrosphingomyelin. Found in significant quantities only in primate lenses, particularly human ones, this lipid is so extremely stable that it was reported to be the only lipid remaining in a frozen mammoth 40,000 years after its death. Unusually high levels of cholesterol add peculiarity to the composition of lens membranes. Beyond the lateral segregation of lipids into dynamic domains known as rafts, the high abundance of cholesterol in the human lens leads to the formation of patches of pure cholesterol. Changes in human lens lipid composition with age and disease as well as differences among species are greater than those observed for any other biomembrane. The relationships among lens membrane composition, structure, and lipid conformation reviewed in this article are unique to the mammalian lens and offer exciting insights into lens membrane function. This review focuses on findings reported over the last two decades that demonstrate the uniqueness of mammalian lens membranes regarding their morphology and composition. Because the membranes of human lenses do undergo the most dramatic changes with age and cataractogenesis, the final sections of this review address our current knowledge of the unusual composition and organization of adult human lens membranes with and without opacification. Finally, the questions that still remain to be answered are presented.

Prevention of selenite-induced cataractogenesis by Origanum vulgare extract

The present study sought to assess antioxidant effect of Origanum vulgare extract in preventing selenite-induced cataractogenesis. This study was performed on Young white rats received sodium selenite (30 nmol g(-1) birth weight) subcutaneously on day 13 post partum during two months in 2009. Cataract formation and intensity was detected and measured by slit-lamp. Origanum vulgare (Ov) extract (2 g kg(-1)) was given (1-2 times) intraperitoneal at different times with respect to the selenite administration lens opacification was analyzed in selenite, selenite-Ov, Ov and control groups on day 7 after selenite administration. Ov extract have revealed a significant protective effect against selenite induced cataract when injected 1 and 2 day (2 times) before selenite injection. There is a protective effect of Ov against selenite induced cataract formation. It is supposed that the anticataract effect of Ov extract could be based on direct or indirect antioxidant mechanisms.

Prevention of oxidative damage to lens by caffeine

PURPOSE

The primary objective of this study was to examine the possibility of inhibiting oxidative damage to the lens in vitro by caffeine.

METHODS

Oxidative damage was inflicted by incubating mouse lenses in Tyrode medium containing 0.1 mM Fe(8)Br(8), an iron complex soluble in aqueous medium. Parallel incubations were conducted in the presence of caffeine (5 mM).

RESULTS

Lenses incubated in the medium containing Fe(8)Br(8) undergo oxidative stress, as evidenced by the inhibition of Na(+)-K(+) ATPase-driven rubidium transport and the loss of tissue glutathione and ATP. These effects were prevented in presence of caffeine. That the effects are due to the oxyradicals produced was ascertained further by parallel studies with Tempol (5 mM), a well-known scavenger of reactive oxygen species (ROS) with its activity being more pronounced with hydroxyl radicals as compared to other ROS.

CONCLUSIONS

Caffeine was found to be effective in preventing oxidative stress to the lens induced by iron under ambient conditions. The protective effect is attributable to its ability to scavenge ROS, particularly the hydroxyl radical.

Effect of curcumin on selenite-induced cataractogenesis in Wistar rat pups

PURPOSE

The present study was aimed at investigating the possible antioxidant potential of curcumin at a dose of 75 mg/kg body weight on selenite-induced cataract in experimental rat pups.

METHODS

Group I: Control rat pups receiving physiological saline; Group II: Selenite-induced group (15 microM/kg body wt); Group III: Selenite-induced group co-treated with curcumin (single dose of curcumin orally 75 mg/kg body wt); Group IV: Selenite-induced animals post-treated (after 24 hrs) with curcumin at a dose mentioned for group III; Group V: Rat pups were pretreated with curcumin (dose as mentioned in Group III), 24 hrs before the administration of selenite. Encapsulated lenses liver, kidney, and serum were analyzed for antioxidant enzymes and malondialdehyde, a marker of lipid peroxidation.

RESULTS

Intraperitoneal injection of sodium selenite (15 microM/kg body wt) to 8-10-day-old rat pups led to severe oxidative stress in eye lens as evidenced by enhanced LPO levels that led to cataract formation. Sodium selenite also led to decrease in activities of SOD, GST, GPx, CAT with simultaneous decrease in the levels of GSH, vitamin C, and vitamin E. Treatment with curcumin (75 mg/kg body wt) led to a significant decrease in the levels of LPO, enzymic antioxidants, and nonenzymic antioxidants, which were similar to that of control.

CONCLUSIONS

Curcumin suppressed selenite-induced oxidative stress and cataract formation in rat pups. The presence of oxidative stress in selenite cataract development and its prevention by curcumin support the possibility that the natural consumption of curcumin in food can help prevent the onset of senile cataract.

Kynurenine-induced photo oxidative damage to lens in vitro: protective effect of caffeine

Photochemical generation of reactive species of oxygen in the lens and aqueous and consequent physiological damage to the tissue has been implicated in the genesis of human cataracts. The present studies were undertaken to examine the feasibility of possible prevention of such damage to the lens initiated by UV activation of kynurenine, a well-known photosensitizer in the human lens. The studies were done by organ culturing intact mouse lenses in medium containing kynurenine and exposed to UVA. Tissue damage was assessed by the inhibition of its ability to carry active transport of rubidium ions and the associated decrements in the levels of GSH and ATP. These deleterious effects were significantly prevented by caffeine, an alkaloid present in many common beverages and known to chemically deactivate the said oxygen derivatives. Further studies on the pharmacological significance of the findings are hence in progress.

Anti-cataractogenic effect of curcumin and aminoguanidine against selenium-induced oxidative stress in the eye lens of Wistar rat pups: An in vitro study using isolated lens

The aim of this study was to investigate whether curcumin and aminoguanidine (AG) prevent selenium-induced cataractogenesis in vitro. On postpartum day 8, transparent isolated lens were incubated in 24 well plates containing Dulbecco's Modified Eagle Medium (DMEM). Isolated lens of group I were incubated with DMEM medium alone. Group II: lenses incubated in DMEM containing 100microM sodium selenite; group III: lenses incubated in DMEM containing 100microM sodium selenite and 100microM curcumin; group IV: lenses incubated in DMEM containing 100microM sodium selenite and 200microM curcumin; group V: lenses incubated in DMEM containing 100microM sodium selenite and 100microM AG; group V: lenses incubated in DMEM containing 100microM sodium selenite and 200microM AG. On day 12, cataract development was graded using an inverted microscope and the lenses were analyzed for enzymic as well as non-enzymic antioxidants, lipid peroxidation (LPO), nitric oxide (NO), superoxide anion (O(2)(-)) and hydroxyl radical generation (OH) and inducible nitric oxide synthase (iNOS) activity by Western blotting and RT-PCR. All control lenses in group I were clear (0). In groups II and III, all isolated lenses developed cataract with variation in levels (+++ or ++), whereas isolated lenses from groups IV, V and VI were clear (0). In agreement to this, a decrease in antioxidants and increased free radical generation and also iNOS expression were observed in selenium exposed lenses when compared to other groups. AG (100microM) was found to be more effective in anti-cataractogenic effect than curcumin (200microM). Curcumin and AG suppressed selenium-induced oxidative stress and cataract formation in isolated lens from Wistar rat pups, possibly by inhibiting depletion of enzymic as well as non-enzymic antioxidants, and preventing uncontrolled generation of free radicals and also by inhibiting iNOS expression. Our results implicate a major role for curcumin and AG in preventing cataractogenesis in selenite-exposed lenses, wherein AG was found to be more potent.

Modulation of Cx46 hemichannels by nitric oxide

Gap-junction hemichannels are composed of six protein subunits (connexins). Undocked hemichannels contribute to physiological autocrine/paracrine cell signaling, including release of signaling molecules, cell-volume regulation, and glucose uptake. In addition, hemichannels may be pathologically activated by dephosphorylation and cell-membrane depolarization. Such hemichannel opening may induce and/or accelerate cell death. It has been suggested that connexin43 (Cx43) hemichannels are sensitive to redox potential changes and that one or more intracellular cysteines is/are important for this process. Cx46 is expressed in the lens, and its dysfunction induces cataract formation. It contains six cysteines in the extracellular loops, one in the fourth transmembrane helix, and two in the COOH-terminal domain. The latter may be susceptible to oxidation by nitric oxide (NO), which could be involved in cataract formation through cysteine S-nitrosylation. Here we report studies of the effects of the NO donor S-nitrosoglutathione (GSNO) on the electrical properties and fluorescent-dye permeability of wild-type Cx46 and mutant hemichannels expressed in Xenopus laevis oocytes. GSNO enhanced hemichannel voltage sensitivity, increased tail-current amplitude, and changed activation and closing kinetics in Cx46 and Cx46-CT43 (Cx46 mutant in which the COOH terminus was replaced with that of Cx43), but not in Cx46-C3A (Cx46 in which the intracellular and transmembrane helix 4 cysteines were mutated to alanine). We conclude that Cx46 hemichannels are sensitive to NO and that the NO effects are mediated by modification of one or more intracellular cysteines. However, it is unlikely that NO induces cataract formation due to the hemichannel activation, because at normal resting potential, NO had no major effects on Cx46 hemichannel permeability.

UV-B-induced damage to the lens in vitro: prevention by caffeine

Ultraviolet (UV) irradiation is one of the significant risk factors in the genesis of cataracts. Pathogenetically, the process can be triggered by the intraocular generation of various reactive species of oxygen that are well known to be initiated by the penetration of light, especially of the UV frequencies. The contribution of UV exposure in the etiology of this disease is likely to increase further due to ozone depletion in the upper atmosphere. The present studies were undertaken to examine if the UV effects can be attenuated with the xanthine-based alkaloids primarily present in tea and coffee. We have examined this possibility by in vitro lens culture studies with caffeine. As expected, mice lenses incubated in Tyrode solution exposed to UV at 302 nm are physiologically damaged, as evidenced by the inhibition of the active transport of (86)Rb(+), an ion acting as a surrogate of the K(+). There was a simultaneous decrease in the levels of adenosine triphosphate and glutathione. The addition of caffeine to the medium prevented such deleterious effects. That caffeine and perhaps other xanthinoids have a protective effect against cataract formation induced by UV has hence been demonstrated for the first time.

Quercetin attenuates UV- and H(2)O(2)-induced decrease of collagen type I in cultured human lens epithelial cells

Ultraviolet (UV) radiation is related to cataract formation. The dynamics of matrix proteins play crucial roles in cell proliferation, cell migration, and the remodeling of lens capsule and, possibly, cataract formation. However, the change of dynamics of matrix proteins, such as collagens, in lens cells in response to UV radiation has not been investigated. Using cultured human lens epithelial cells, we, for the first time, demonstrate that UV radiation induces a decrease of collagen type I in a time- and dose-dependent manner. Hydrogen peroxide (H(2)O(2)) also induces a collagen type I decrease in a similar pattern. We observed that UV and H(2)O(2) induce JNK and its downstream component, c-Jun, activation in both a time- and dose-dependent manner. The pharmacologic inhibitor of JNK or JNKi inhibits UV-induced JNK and c-Jun activation and attenuates a UV-induced decrease of collagen type I. Quercetin, a well known antioxidant, also protects against a UV- and H(2)O(2)-induced decrease of collagen type I in a dose-dependent manner. Quercetin inhibits UV- and H(2)O(2)-induced JNK and c-Jun activation. Collectively, we conclude that quercetin attenuates both a UV- and H(2)O(2)-induced decrease of collagen type I via the inhibiting of JNK/c-Jun activity. Understanding the cellular-signaling pathways involved in the UV- and H(2)O(2)-induced decrease of collagen type I may reveal potential therapeutic targets for the UV-induced cataract.

Antioxidant nutrient intake and the long-term incidence of age-related cataract: the Blue Mountains Eye Study

BACKGROUND

Oxidative stress has been implicated in cataractogenesis. Long-term intake of antioxidants may offer protection against cataract.

OBJECTIVE

We investigated relations between antioxidant nutrient intakes measured at baseline and the 10-y incidence of age-related cataract.

DESIGN

During 1992-1994, 3654 persons aged >or=49 y attended baseline examinations of the Blue Mountains Eye Study (82.4% response). Of these persons, 2464 (67.4%) participants were followed >or=1 time after the baseline examinations (at either 5 or 10 y). At each examination, lens photography was performed and questionnaires were administered, including a 145-item semiquantitative food-frequency questionnaire. Antioxidants, including beta-carotene, zinc, and vitamins A, C, and E, were assessed. Cataract was assessed at each examination from lens photographs with the use of the Wisconsin Cataract Grading System. Nuclear cataract was defined for opacity greater than standard 3. Cortical cataract was defined as cortical opacity >or= 5% of the total lens area, and posterior subcapsular (PSC) cataract was defined as the presence of any such opacity.

RESULTS

Participants with the highest quintile of total intake (diet + supplements) of vitamin C had a reduced risk of incident nuclear cataract [adjusted odds ratio (OR): 0.55; 95% CI: 0.36, 0.86]. An above-median intake of combined antioxidants (vitamins C and E, beta-carotene, and zinc) was associated with a reduced risk of incident nuclear cataract (OR: 0.51; 95% CI: 0.34, 0.76). Antioxidant intake was not associated with incident cortical or PSC cataract.

CONCLUSION

Higher intakes of vitamin C or the combined intake of antioxidants had long-term protective associations against development of nuclear cataract in this older population.

Oxidative stress and the eye

Oxidative and particularly photo-oxidative processes are critical factors many ocular conditions but are often poorly recognized by those investigating ocular disease. The author discusses oxidative stress in inflammatory processes of the conjunctiva, cornea, and uvea; in cataract formation in the lens; in retinal degeneration; and in optic nerve pathologic conditions, inflammatory in optic neuritis and degenerative in glaucoma.

Induction of ultraviolet cataracts in vitro: prevention by pyruvate

Ultraviolet (UV) radiation is one of the important cataract risk factors. The present studies examined the hypothesis that this effect is due to the UV penetration through the cornea and subsequent induction of a photochemical generation of reactive species of oxygen (ROS) in the aqueous and lens. The hypothesis was ascertained by rat lens organ culture studies conducted under UV (365 nm), with media containing micromolar levels of riboflavin, with and without pyruvate, the latter acting as an ROS scavenger. The implication of ROS in the UV-induced damage was confirmed by measurements of peroxide generation. Damage to the lens was assessed physiologically by measuring the decrease in its active transport of rubidium ions. Biochemically, it was assessed by measuring the lowering of adenosine triphosphate and glutathione. The incorporation of pyruvate in the medium protected the lens against these deleterious effects. That the beneficial effect of pyruvate is attributable to its ROS-scavenging property was proven by the peroxide depletion in its presence, commensurate with its own utilization in parallel. A protective effect of this keto acid against UV-induced tissue damage has been shown for the first time, suggesting its clinical usefulness against UV irradiation-induced pathologies. Hence, further studies on the possible protective effects of such alpha-keto acids against UV damage are in progress.

Acetyl-L-carnitine prevents selenite-induced cataractogenesis in an experimental animal model

PURPOSE

To investigate whether acetyl-L-carnitine (ALCAR) retards selenite-induced cataractogenesis in vivo.

METHODS

On postpartum day 10, group I pups received intraperitoneal saline and group II and group III pups received subcutaneous sodium selenite; Group III pups also received intraperitoneal ALCAR once daily on postpartum days 9-14. Both eyes of each pup were examined up to postpartum day 30. After sacrifice, extricated pup lenses were analyzed for antioxidant and redox system components.

RESULTS

There was dense lenticular opacification in all group II pups, minimal opacification in 33% of group III pups, and no opacification in 67% of group III and in all group I pups. Group II lenses exhibited significantly lower values of antioxidant and redox system components and higher malondialdehyde concentrations than group I or group III lenses.

CONCLUSION

ALCAR prevents selenite-induced cataractogenesis in Wistar rat pups, possibly by inhibiting depletion of antioxidant enzyme and redox system components and inhibiting lipid peroxidation.

Protection against selenite cataract in rat lens by drevogenin D, a triterpenoid aglycone from Dregea volubilis

Dregea volubilis is a woody climbing plant commonly found in the hotter parts of India. The leaves are edible and used as a green vegetable, while the plant extract has been used traditionally to treat several diseases including eye ailments. Drevogenin D is a triterpenoid aglycone that has been isolated, purified, and characterized as an active component from the leaves of D. volubilis. In this study, drevogenin D was evaluated for antioxidant and potential anticataractogenic activity in an in vitro model. 1,1-Diphenyl-2-picrylhydrazyl radical and superoxide radical scavenging activities of drevogenin D were studied and found to exhibit a 50% inhibitory concentration of 43 microg/mL and 200.6 microg/mL, respectively. Normal rat lenses cultured in 0.1 mM sodium selenite-supplemented medium were used as the experimental model for this study. Selenite-induced models are excellent mimics of oxidative stress induced cataract. Treatment with drevogenin D at a concentration of 50 microg/mL medium was found to reverse the level of activity of superoxide dismutase, catalase, glutathione peroxidase, and glutathione reductase, elevate the level of reduced glutathione and protein sulfhydryl, and lower the level of lipid peroxidation as indicated by the concentration of thiobarbituric acid-reacting substances. These results indicate good antioxidant activity and potential anticataractogenic activity for drevogenin D against selenite-induced cataractous changes, which have been reported for the first time.

Susceptibility of the ocular lens to nitric oxide: implications in cataractogenesis

Oxides of nitrogen, such as nitric oxide (NO), are now biologically referred to as reactive nitrogen species. The generation of NO gives rise to several other reactive species, such as NO+, NO-, NO2, N2O3, and ONOO- and so forth, which are all capable of inflicting tissue damage. Indeed, NO generation is known to be associated with retinal degeneration and glaucoma. Its level has also been found to increase in the aqueous and vitreous humors in diabetes. We hypothesize that such an increase would have a detrimental effect on the biochemistry and metabolism of tissues, including the lens, bathed by the aqueous containing elevated levels of NO. The primary aim of our investigations was, therefore, to examine the susceptibility of the lens to damage by NO in vitro in the presence of nitroaspirin, a novel NO donating agent. The extent of physiologic damage to the lens was initially assessed by determining the integrity of its active transport mechanism. The overall status of tissue metabolism was determined by measuring the adenosine triphosphate (ATP) levels. The levels of glutathione (GSH) and glutathione disulfide, reflecting the status of its antioxidant reserve, were also determined. That NO is indeed deleterious to the lens was apparent by the inhibition of the active transport of Rb(+). This was associated with a substantial decrease in the contents of ATP and GSH, the decrease in the latter directly suggesting that the NO effects are caused by oxidative stress. That the effects are caused by NO generated from nitroaspirin was proven by a substantial increase in NO level in the medium during incubation of the lenses with nitroaspirin, as compared to the controls. The results, therefore, were highly suggestive of a contribution of the oxides of nitrogen in cataract formation associated with diabetes and other aging diseases.

Prevention of selenite-induced cataractogenesis by acetyl-l-carnitine: An experimental study

Several studies have suggested that antioxidants retard the process of cataractogenesis by scavenging free oxygen radicals. The present study sought to assess the efficacy of the antioxidant acetyl-L-carnitine (ALCAR) in preventing selenite-induced cataractogenesis in an experimental setting. The first, in vitro phase of the study was performed on lenses from Wistar rats incubated for 24 h at 37 degrees C in Dulbecco's Modified Eagle Medium (DMEM) alone (control, Group I), or in DMEM containing 100 microM of selenite (Group II) or in DMEM containing 100 microM of selenite and 200 microM/ml ALCAR added at the same time as selenite (Group IIIa) or 30 min, 1 h or 2 h later (Groups IIIb, IIIc and IIId, respectively). Gross morphological examination of these lenses revealed dense opacification (cataract formation) in Group II, minimal opacification in some Group IIIa lenses and no opacification in Group I. The mean activities of the antioxidant enzymes catalase and glutathione peroxidase were significantly lower in Group II than in Group I or Group IIIa lenses, while malondialdehyde concentration (an indicator of lipid peroxidation) was significantly higher in Group II lenses than that in Group I or Group IIIa lenses. The second, in vivo phase of the study revealed dense opacification (cataract formation) in 100% of Wistar rat pups receiving subcutaneous sodium selenite alone (19 microM/kg body weight) but in only 37.5% of those receiving subcutaneous selenite and intraperitoneal ALCAR. These data suggest that ALCAR is able to significantly retard experimental selenite-induced cataractogenesis.

Awareness of eye diseases and risk factors: identifying needs for health education and promotion in Canada

BACKGROUND

Little is known about the level of general public knowledge in Canada regarding the risk factors, prevention, and treatment of major blinding eye diseases.

METHODS

The study was a cross-sectional survey using self-administered questionnaires of patients presenting to 33 family practitioners' offices in British Columbia. We asked patients' opinions on the "value" of preventing blindness; the possibility of preventing cataract, glaucoma, and macular degeneration; the possibility of treating these conditions; and their knowledge of risk factors.

RESULTS

A total of 882 adults completed the questionnaires. Preventing vision loss was reported as one of 2 top health priorities in 28% of the questionnaires, more commonly by those with higher education and non-European ancestry. Overall, 69.2% reported familiarity with cataract as a cause of vision loss, 41.2% with glaucoma, and 20.2% with macular degeneration. Of these, 97.5% recognized the possibility of treatment for cataract, 91.5% for glaucoma, and 77.0% for macular degeneration, yet few respondents knew risk factors (amenable to intervention) for specific eye diseases. Men and younger respondents were more likely to report not knowing risk factors. Chinese-Canadians were least familiar with the association between smoking and cataract. Family history, probably the most important factor to help diagnose glaucoma, was recognized by only 23% of respondents.

INTERPRETATION

Although loss of vision was reported as a major medical concern, there is little understanding of the risk factors for different eye diseases. The association of non-European ancestry and low educational attainment with poor knowledge of eye diseases suggests that innovative education programmes in primary and secondary schools and in non-English languages are needed to improve knowledge, attitudes, and practices.

Oxidation-induced changes in human lens epithelial cells. 1. Phospholipids

Lipid compositional changes in lens epithelial cells (HLE B-3) grown in a hyperoxic atmosphere were studied to determine if oxidation could cause changes in the amount and type of phospholipid similar to those found in vivo with age and cataract. The phosphatidylcholines in HLE B-3 cells were 8 times more unsaturated than the sphingomyelins. Cell viability was the same for cells grown for up to 48 h in a normoxic or hyperoxic atmosphere. Lipid oxidation was about three times higher after growth in a hyperoxic atmosphere compared with cells grown in a normoxic atmosphere. The lack of change in the relative amount of sphingomyelin and the decrease in phosphatidylcholine coupled with the increase in lysophosphatidylcholine support the idea that similar mechanisms may be responsible for the lipid compositional changes in both lens epithelial and fiber cells. It is postulated that lipases eliminate oxidized unsaturated glycerolipids, leaving a membrane increasingly composed of more ordered and more saturated sphingolipids. Oxidative stress leads to changes in membrane composition that are consistent with those seen with age in human epithelial cells. Oxidation-induced epithelial phospholipid change is an area of research that has gone virtually unexplored in the human lens and could be relevant to all cell types and may be important to lens clarity.

Decreased platelet membrane fluidity in retinal periphlebitis in Eales' disease

PURPOSE

Oxidative damage to cellular membranes plays an important role in the pathobiology of tissue injury. Free radical-induced peroxidation of membrane lipid and protein is associated with alterations in cellular, morphological, biochemical, and physical dynamics, which are related to the mobility of lipid molecules. Retinal photoreceptors and platelets have been shown to be an easy target of oxidants because of their high proportion of polyunsaturated fatty acids. This study was undertaken, for the first time, to investigate membrane fluidity in the platelets of patients with Eales' disease.

METHODS

Assays of malonaldialdehyde levels and the enzymes superoxide dismutase and catalase and fluorescence polarization, for estimating membrane fluidity, were carried out on platelets from 20 patients with Eales' disease (stage 1 characterized by periphlebitis of small (1a) and large (1b) caliber vessels with superficial retinal hemorrhages) and 15 healthy controls.

RESULTS

A significant increase was observed in the malonaldialdehyde levels. A significant decrease in the activity of superoxide dismutase and catalase was also observed. Platelet fluorescence polarization was significantly higher in the patients, indicating decreased membrane fluidity compared to controls (p<0.01).

CONCLUSION

A decrease in platelet membrane fluidity occurs as a result of oxidative stress in retinal periphlebitis in Eales' disease. The decreased membrane fluidity suggests alterations in the physiological events, which may result in alterations in the functioning of retinal photoreceptors.

Effect of methylglyoxal modification and phosphorylation on the chaperone and anti-apoptotic properties of heat shock protein 27

Heat shock protein 27 (Hsp27) is a stress-inducible protein in cells that functions as a molecular chaperone and also as an anti-apoptotic protein. Methylglyoxal (MGO) is a reactive dicarbonyl compound produced from cellular glycolytic intermediates that reacts non-enzymatically with proteins to form products such as argpyrimidine. We found considerable amount of Hsp27 in phosphorylated form (pHsp27) in human cataractous lenses. pHsp27 was the major argpyrimidine-modified protein in brunescent cataractous lenses. Modification by MGO enhanced the chaperone function of both pHsp27 and native Hsp27, but the effect on Hsp27 was at least three-times greater than on pHsp27. Phosphorylation of Hsp27 abolished its chaperone function. Transfer of Hsp27 using a cationic lipid inhibited staurosporine (SP)-induced apoptotic cell death by 53% in a human lens epithelial cell line (HLE B-3). MGO-modified Hsp27 had an even greater effect (62% inhibition). SP-induced reactive oxygen species in HLE-B3 cells was significantly lower in cells transferred with MGO-modified Hsp27 when compared to native Hsp27. In vitro incubation experiments showed that MGO-modified Hsp27 reduced the activity of caspase-9, and MGO-modified pHsp27 reduced activities of both caspase-9 and caspase-3. Based on these results, we propose that Hsp27 becomes a better anti-apoptotic protein after modification by MGO, which may be due to multiple mechanisms that include enhancement of chaperone function, reduction in oxidative stress, and inhibition of activity of caspases. Our results suggest that MGO modification and phosphorylation of Hsp27 may have important consequences for lens transparency and cataract development.

Modulation of selenite cataract by the flavonoid fraction ofEmilia sonchifolia in experimental animal models

The purpose of the study was to investigate the role of flavonoids from Emilia sonchifolia (ES) on the progression of selenite-induced cataract. The antioxidant property of the flavonoids isolated from ES was assessed by measuring its capacity to inhibit superoxide production and serum oxidation in vitro in comparison with quercetin. Based on these experiments, an in vivo study was conducted to evaluate the modulatory effects of the flavonoids against selenite cataract. Cataract was induced by a single subcutaneous injection of sodium selenite (4 mg/kg body weight). The treatment group received flavonoids from ES (1 mg/kg) and this was compared with the quercetin treated group. Lens opacification was monitored by a slit lamp microscope and classified into six stages. Activity of the antioxidant enzymes - superoxide dismutase and catalase - and the level of lipid peroxidation products thiobarbituric acid reacting substances and reduced glutathione were studied. Slit lamp examination showed that the flavonoid fraction from ES could modulate the progression of cataract. Activities of superoxide dismutase, catalase and reduced glutathione were found to be increased in the ES treated groups, while thiobarbituric acid reacting substances were decreased compared with the selenite-induced group. The results suggest that flavonoids from ES can modulate lens opacification and oxidative stress in selenite-induced cataract.

Attenuation and delay of diabetic cataracts by antioxidants: effectiveness of pyruvate after onset of cataract

Cataract is one of the most significant vision-impairing complications of diabetes. The present study examined the feasibility of inhibiting cataract formation by treatment with pyruvate, a metabolite known to effectively scavenge reactive species of oxygen and inhibit protein glycation, both known to be involved in the genesis of diabetic cataracts. In addition, pyruvate stimulates tissue metabolism, which is depressed with the onset of cataract formation. The objective of our experiments was to determine if this compound could be effective in offsetting the progress of cataract, specifically if administered after the diabetes-induced lens changes have begun, as opposed to the previous reports wherein it has been reported to delay cataract formation if administered prophylactically with the immediate onset of diabetes. Diabetes was induced by intraperitoneal administration of streptozotocin to mice. Lens transparency was assessed by slit lamp examination and its photography. ATP was determined enzymatically by reacting it with luciferin-luciferase mixture and measuring the fluorescence intensity. The findings described herein are in accordance with this possibility. The incidence of cataract in the group of diabetic animals, where treatment with pyruvate was initiated after the initial lens changes set in, was significantly lower at all times of observation in comparison to the untreated diabetic group. In addition, the severity of opacities in the pyruvate-treated group, when present, was much minor, the transparency of these cases being close to that in the control animals. The ophthalmic findings are supported biochemically by ATP levels, which were significantly higher in the pyruvate group in comparison to the untreated group. The present findings emphasize the clinical usefulness of initiating treatment with anti-oxidants and metabolic agonists even when the lens changes are detected at the time of the diabetes diagnosis. The latter usually comes much later than the onset of visual aberrations. Prophylaxis is not an absolute requirement.

Prevention of cataract by pyruvate in experimentally diabetic mice

Previous studies have demonstrated that administration of pyruvate prevents cataract formation in diabetic rats. It is known that the induction of cataractous process in this case is initiated by aldose reductase (AR) catalyzed synthesis and accumulation of excessive sorbitol in the lens fibres and epithelium and their consequent osmotic hydration. Synthesis of this and other polyols is competitively inhibited by pyruvate. The objective of the present investigations was hence to determine whether pyruvate would have a similar protective effect in species where cataract formation is relatively independent of sorbitol synthesis such as in humans where the lens AR activity is extremely low, especially with glucose as a substrate. The Km of AR for glucose is known to be very high. The possible protective effect of pyruvate in the low AR models was conceived on the basis of our previous findings suggesting that it can also exert substantial antiglycating as well as antioxidant effects. The present studies have hence been conducted with mice, a species known to be low in lens AR, similar to that in humans. As stipulated, pyruvate administration has indeed been found to offer a significant protection against development of diabetic cataract in this model also. The effect correlated with the inhibition of protein glycation as well as of oxidative stress. The latter was apparent by the prevention of the loss of glutathione known to be associated with diabetes. Although there was a small but noticeable increment in the sorbitol content of the diabetic lenses, this was osmotically insignificant. Even this increase was prevented by pyruvate. The magnitude of the elevation in the contents of glycated proteins and the depression in the level of glutathione were, on the contrary, highly pronounced, suggesting a more prominent role of the latter factors. In addition, the possibility of a direct metabolic support it could offer to the tissue is also imminent by its effect on the maintenance of ATP, as shown earlier. The present studies are therefore considered more relevant to the pathogenesis of cataract in human diabetics and its possible prevention by endogenous compounds with antiglycating and antioxidant properties. Inhibition of cataract formation by pyruvate in an animal model with low lens AR, similar to that in humans, has been shown for the first time.

Oxidative DNA modifications

Oxidative DNA modifications are frequent in mammalian DNA and have been suggested an important mechanism in carcinogenesis, diabetes and ageing. The foundations for this suggestion are: Evidence for the importance of oxidative DNA modifications in cancer development is: high levels of oxidative lesions in cancer tissue; highly conserved and specific DNA repair systems targeting oxidative lesions; high levels of oxidative DNA lesions in oxidative DNA repair knock-out animals; defective repair of oxidative lesions in cancer-prone progeria syndromes; reduced cancer incidence in populations with high dietary antioxidant intake; and increased oxidative stress to DNA in tobacco smokers. Conflicting evidence for a relation between oxidative stress to DNA and cancer is: disagreement about the true levels and occurrence of the oxidative lesions in vivo; failure to identify the localization of oxidative lesions in important genes, e.g. tumor suppressor and oncogenes; lack of evidence that the oxidative lesions induce mutations in vivo; no cancer development in animals knocked-out for specific DNA repair enzymes in spite of high tissue levels of oxidative lesions; and unchanged cancer rates after antioxidant interventions in large clinical controlled and randomized trials. The rate of DNA oxidation has been estimated from urinary excretion of repair products and it is evident that if these lesions were not repaired, a large part of DNA would be oxidized to a degree not compatible with living. The methodologies by which oxidative DNA modifications are measured cover a wide and different range, advantages and disadvantages will be presented. One particular problem is artificial oxidation, and methods to prevent such artifacts will be presented together with results from a large interlaboratory standardization program. The methodology by which the lesions can be measured is complicated and prone to artifacts during DNA isolation, digestion, derivatization and maybe even during the separation procedure proper prior to detection. A large effort from 20+ laboratories supported by a grant from the EU has reduced artifacts considerably and work towards interlaboratory standardization of the methodology is in progress. The presently agreed "normal" levels of the most frequent known lesion 8-oxodG is about 5 per million dG's in DNA. A comprehensive evaluation of the evidence, from chemistry to clinical and epidemiological trials, linking oxidative modifications to cancer will be given. Finally, an estimate of the quantitative role oxidative DNA modifications play among the multiplicity of other insults is given. While there is no question that all of these oxidative mechanisms do exist, quantitative data on their importance for the human situation do not exist. Prospective human studies that can provide such quantitative data on different mechanisms are underway.

Morphogenetic and apoptotic changes in diabetic cataract: prevention by pyruvate

Studies have been conducted to ascertain the preventive effect of pyruvate against diabetes induced damage to DNA and associated morphogenetic changes in the mouse lens. Such changes were characterized by DNA nicks as well as by gross morphological changes in the nuclei, evident respectively by TUNEL and Hoechst staining procedures. Morphogenetic changes were also apparent by abnormal diferentiation of the germinal epithelial cells and errors in their migratory pathway. These changes were prevented by simultaneous administration of pyruvate to the diabetic animals. The preventive effect of this agent is attributable to its property of scavenging oxy-radicals generated by high levels of the sugars.

Effect of alpha-ketoglutarate against selenite cataract formation

We have previously shown that pyruvate protects against reactive oxygen species (ROS) induced damage to lens in vitro. It has also a significant effect against cataract development. Its effectiveness has been ascribed to the presence of alpha-keto-carboxylate group in the molecule, acting as a scavenger of ROS. Hence, it was felt desirable to determine if other alpha-keto-acids could have similar effects. These studies have hence been conducted with alpha-ketoglutarate (alpha-KG), a compound with greater stability and without any known significant effect on the glycolysis. Its effectiveness has been assessed by monitoring cataract development in rat pups given sodium selenite. A large percentage of such animals (about 80%) developed nuclear opacity 7-8 days after its administration. In animals treated with alpha-ketoglutarate, the incidence of cataracts was only 23%. The agent therefore has a very substantial anticataractogenic effect, as apparent by direct slit lamp examination followed by photography, as well as by examination of the isolated lenses through transillumination. The significance of the ophthalmologic findings was apparent also by better physiological maintenance of the tissue, reflected by higher levels of ATP and GSH. In view of these in vivo beneficial effects, studies are in progress to identify the biochemical and metabolic sites of its action. Whether the effectiveness is related only to its action as a ROS scavenger or it could be contributed also by some metabolic effects independent of ROS remains to be determined.

Analysis of Lipid Peroxidation and??Electron Microscopic Survey of??Maturation Stages during Human Cataractogenesis

Morphological and biophysical techniques described in this study have shown that membrane derangement occurs in human cataractous lenses. The data suggest that these disruptions were globules, vacuoles, multilamellar membranes and clusters of highly undulating membranes. Deleterious structural damage of the lens fibre cell plasma membranes serve as the primary light-scattering centres that cause the observed lens opacity. Nuclear cataract, a major cause of loss of lens transparency in the aging human, has been thought to be associated with oxidative damage, particularly at the site of the nuclear plasma membrane. Phospholipid molecules modified by oxygen accumulate in the lipid bilayer, change its geometry and impair lipid-lipid and protein-lipid interactions in lenticular fibre membranes. Lipid peroxidation (LPO) is a causative and pathogenic factor in cataract. Increased concentrations of primary molecular LPO products (diene conjugates, lipid hydroperoxides, oxy-derivatives of phospholipid fatty acids) and end-fluorescent LPO products have been detected in the lipid moieties of aqueous humour samples and human lenses obtained from patients with senile and complicated cataracts as compared with normal donors. In the present study, a rapid and simple high-performance liquid chromatographic (HPLC) assay for determination of imidazole-containing dipeptides in the aqueous humour of the eye was developed. The method was applied to determine the pharmacokinetic parameters and the time-course of N-acetylcarnosine and L-carnosine-related product in the eye, following a single dosage of topical ocular administration of peptide. Utilising data from pharmacokinetic studies and the specific purity of the N-acetylcarnosine (NAC) ingredient as a source of the pharmacological principle L-carnosine, we have created an ophthalmic time-release prodrug form including the US FDA-approved carboxymethylcellulose lubricant and other essential ingredients (Can-C, private label Nu-Eyes). This formulation increases the intraocular absorption of L-carnosine in the aqueous humour and optimises its specific antioxidant activity in vivo while reducing the toxic effects of lipid peroxides on the crystalline lens. L-carnosine that enters the aqueous humour can accumulate in the lens tissue for a reasonable period of time. The presence of L-carnosine in transparent crystalline lenses during normal aging was detected and its concentration in this case was about 25 microM. At different stages of cataract development, the level of L-carnosine drastically decreased, reaching about 5 microM in ripe human cataracts. However, administration of pure L-carnosine (1% solution) to the rabbit eye (instillation or subconjunctival injection) does not lead to accumulation of this natural compound in the aqueous humour at the time level over 30 minutes at a concentration exceeding that in placebo-treated matched eyes, and its effective concentration is exhausted more rapidly. Use of NAC prodrug eye drops optimises the clinical effects of L-carnosine in the treatment of ophthalmic disorders (such as prevention and reversal of cataracts in human and animal [canine] eyes). The data provided predict a clinical effect with NAC ophthalmic prodrug, and show that the magnitude and duration of this effect are directly related to the bioavailability of L-carnosine released from NAC in the aqueous humour of the anterior eye segment. The ophthalmic NAC drug shows promise in the treatment of a range of ophthalmic disorders that have a component of oxidative stress in their pathogenesis (including cataract, glaucoma, dry eye, vitreous floaters, inflammatory disorders, and corneal, retinal and systemic diseases [such as diabetes mellitus and its ophthalmic complications]). There is a need for further and better collaboration between Innovative Vision Products' cataract control and ophthalmic services, improved education of people affected by cataract, a commitment that N-acetylcarnosine eye drops will be the preferred treatment before orthodox cataract surgery is attempted, and consideration of outcomes and a possible role of the NAC drug cataract treatment as source of referral for orthodox surgical, ophthalmic and optometric services.

Xanthophylls and alpha-tocopherol decrease UVB-induced lipid peroxidation and stress signaling in human lens epithelial cells

Epidemiological studies suggest that consumption of vegetables rich in the xanthophylls lutein (LUT) and zeaxanthin (ZEA) reduces the risk for developing age-related cataract, a leading cause of vision loss. Although LUT and ZEA are the only dietary carotenoids present in the lens, direct evidence for their photoprotective effect in this organ is not available. The present study examined the effects of xanthophylls and alpha-tocopherol (alpha-TC) on lipid peroxidation and the mitogen-activated stress signaling pathways in human lens epithelial (HLE) cells following ultraviolet B light (UVB) irradiation. When presented with LUT, ZEA, astaxanthin (AST), and alpha-TC as methyl-beta-cyclodextrin complexes, HLE cells accumulated the lipophiles in a concentration- and time-dependent manner with uptake of LUT exceeding that of ZEA and AST. Pretreatment of cultures with either 2 micromol/L xanthophyll or 10 micromol/L alpha-TC for 4 h before exposure to 300 J/m(2) UVB radiation decreased lipid peroxidation by 47-57% compared with UVB-treated control HLE cells. Pretreatment with the xanthophylls and alpha-TC also inhibited UVB-induced activation of c-JUN NH(2)-terminal kinase (JNK) and p38 by 50-60 and 25-32%, respectively. There was substantial inhibition of UVB-induced JNK and p38 activation for cells containing <0.20 and approximately 0.30 nmol xanthophylls/mg, respectively, whereas >2.3 nmol alpha-TC/mg protein was required to significantly decrease UVB-induced stress signaling. These data suggest that xanthophylls are more potent than alpha-TC for protecting human lens epithelial cells against UVB insult.

Lens lipids and maximum lifespan

Unlike in most organs, the lipid composition of lenses varies dramatically among species and with age. The focus of this study is to assess how these changes relate to lifespan. Studies on cataract suggest that the lens may serve as a window into the processes leading to accelerated mortality. As a first step toward elucidating cellular processes in the lens that may serve as markers for accelerated mortality, we examined the correlation between species-dependent and age-related lens lipid compositional differences and maximum life span. We included data from camels, which, even in old age, rarely develop cataracts although they live under adverse conditions. Camel lens lipids were mainly composed of sphingolipids (77%) and phosphatidylcholines (23%). Bovine lens lipid composition was comparable to a previous study, and both bovine lens sphingolipids, phosphatidylcholines and camel lens phosphatidylcholines content fit well (within the 95% confidence limits) in the curve obtained by plotting maximum life spans of other species with sphingolipids and phosphatidylcholines. Lifespan was directly related to lens sphingolipid content and indirectly related to lens phosphatidylcholine content. The camel lens sphingolipid value was significantly above the curve for other species. Except for the camel lens nucleus, lipid order and sphingolipid content were linearly related, p < 0.005 with a slope of 0.85+/-0.07, and intercept of 6.9+/-3.8. Lipid phase transition temperature and sphingolipid content were also linearly related, p = 0.01 with a slope of 0.20+/-0.07, and intercept of 21.7+/-5.3. Our data support the hypothesis that humans have adapted so that their lens membranes have a high sphingolipid content that confers resistance to oxidation, allowing these membranes to stay clear for a relatively longer time than is the case in many other species. Age-related changes in human lens lipid composition may serve as a marker for oxidative stress and may reflect systemic oxidative insult, providing a window into the health of an individual.

Isolation of ascorbate free radical reductase from rabbit lens soluble fraction

Ascorbate free radical (AFR) reductase with diaphorase activity was isolated from the rabbit lens soluble fraction to characterise some molecular properties of the enzyme. The isolation was accomplished using gel filtration (Sephadex G-75 superfine or Sephacryl S-200 HR), affinity chromatography (Affi-Gel Blue), native isoelectric focusing and two-dimensional gel electrophoresis. A major soluble AFR reductase was found at an isoelectric point of 8.4 and a molecular weight of 31 kDa, and a few minor enzymes were also detected in the range of pI 7.0-8.6. An unknown N-terminal partial amino acid sequence was determined in one peptide fragment prepared from the major enzyme fraction. From the sequence analysis, it is discussed that the lens soluble AFR reductase may differ from NADH-cytochrome b5 reductase reported to be involved in the membrane-bound AFR reductase activity of mitochondria, microsomes and plasma membrane.

Pharmacological prevention of diabetic cataract

Cataract--opacification of the lens--is closely related to diabetes as one of its major late complications. This review deals with three molecular mechanisms that may be involved in the development of diabetic cataract: nonenzymatic glycation of eye lens proteins, oxidative stress, and activated polyol pathway in glucose disposition. Implications resulting from these mechanisms for possible pharmacological interventions to prevent diabetic cataract are discussed. The article reviews research on potential anticataract agents, including glycation inhibitors, antioxidants, and aldose reductase inhibitors. Information on possible benefits of putative anticataract agents comes from a variety of approaches, ranging from laboratory experiments, both in vitro and in vivo, to epidemiological studies in patients.

Function of the ubiquitin proteolytic pathway in the eye

The ubiquitin pathway (UP) is involved in regulation of many essential cellular processes usually by the degradation of regulators of these processes. For example the UP is involved in regulation of cell cycle, proliferation, differentiation, organogenesis, development, and signal transduction in the lens and retina. A functional UP has also been documented in the cornea. Upon aging or exposure to stress there is an accumulation of damaged proteins, including ubiquitinated proteins, in the lens and retina. Some of these proteins may be cytotoxic. Thus, an active UP may be required to avoid such age and disease-related accumulation of damaged proteins. In this review we will explain the biochemistry of the UP and we will document the most important studies regarding UP function in the lens, retina and cornea.

Protection by iodide of lens from selenite-induced cataract

BACKGROUND

Iodide has been used empirically against different age-related eye diseases, including cataract. The purpose of the present study was to investigate the effect of iodide on selenite-induced cataract in rat lens.

METHODS

Young white rats received subcutaneously sodium selenite (20 and 30 nmol/g b.w.) on day 13 post partum (p.p.). Cataract development was measured by expert estimation and image data analysis. Potassium iodide (1.5 nmol/g b.w.) was given (1-5 times) i.p. at different times with respect to the selenite administration. Lens opacification was analyzed in selenite, selenite-iodide, iodide and control groups on day 7 after selenite administration.

RESULTS

Iodide showed a significant protective effect against selenite cataract when injected 2 days (2 times) before selenite injection, i.e., on days 11 and 12 p.p. No significant effects on lens opacity were found: (1) after only one iodide injection (on day 12 p.p.), (2) after an initial iodide administration 1 h before selenite and (3) after injections of iodide once a day for 5 consecutive days. The protective effect of iodide was the same (about 50%) for both selenite doses used.

CONCLUSIONS

There is a time-dependent protective influence of iodide against selenite cataract development. It is supposed that the anticataract effect of iodide could be based on direct or indirect antioxidant mechanisms.

Establishment of mouse as an animal model for study of diabetic cataracts: biochemical studies

AIM

The primary aim of this study was to understand the pathogenesis of diabetic cataracts at biochemical level in an animal model where lens aldose reductase (AR) activity is low, similar to that in the human lens.

METHODS

Mouse, which is known to have low lens AR, was selected for these studies. Diabetes was induced by intraperitoneal administration of streptozotocin. Biochemical changes in the lens were monitored in freshly isolated lenses with standard chromatographic, enzymatic and culture experiments described in the section on methods.

RESULTS

The present studies provide evidence of significant biochemical changes associated with such cataract formation despite very low levels of aldose reductase. The level of glycated proteins increased to 9 mg/100 mg of total water-soluble lens protein in the diabetic lenses, as compared with the normal lenses where it was only about 1.3 mg/100 mg of total protein. Glutathione (GSH), the major antioxidant in the lens, decreased from 2.35 micro mol/g in the normal lenses to about 1.17 micro mol/g in the diabetic lenses. Malonadehyde, a product of lipid peroxidation, increased from 50 micro mol/100 g in the normal to 70 micro mol/100 g in the diabetic lens. The level of adenosine triphosphate (ATP), an indicator of the overall metabolic status of the tissue, also decreased from 962 +/- 154 nmol/g in the normal to 487 +/- 130 nmol/g in the diabetic lenses. The function of the Na+-K+ ATPase was also adversely affected in diabetes, as indicated by the ability of the lens to accumulate (86)rubidium ions against its concentration gradient. The transport activity, expressed as CL/CM, was 24 in the normal lens, whereas it was only 12 in the diabetic lens. The level of sorbitol in the diabetic lens was only in the micromolar region. Hence, it was considered osmotically insignificant.

CONCLUSION

Overall, the results suggest that induction of cataracts in diabetes can be related to multiple biochemical effects such as oxidative stress and glycation. Sorbitol accumulation in low aldose reductase situations, being minor, could, however, act synergistically with other factors.

Efficacy of N-acetylcarnosine in the treatment of cataracts

PURPOSE

To evaluate the effects of 1% N-acetylcarnosine (NAC) solution on lens clarity over 6 and 24 months in patients with cataracts.

TRIAL DESIGN

Randomised, placebo-controlled study.

PARTICIPANTS

49 subjects (76 affected eyes) with an average age of 65.3 +/- 7.0 years with a diagnosis of senile cataract with minimum to advanced opacification in various lens layers.

METHODS

26 patients (41 eyes) were allocated to topical NAC 1% eyedrops twice daily. The control group consisted of 13 patients (21 eyes) who received placebo eyedrops and 10 patients (14 eyes) who did not receive eyedrops.

MAIN OUTCOME MEASURES

All patients were evaluated at entry and followed up every 2 months for a 6-month period (trial 1), or at 6-month intervals for a 2-year period (trial 2), for best-corrected visual acuity and glare testing. In addition, cataract was measured using stereocinematographic slit-images and retro-illumination examination of the lens. Digital analysis of lens images displayed light scattering and absorbing centres in two- and three-dimensional scales.

RESULTS

The overall intra-reader reproducibility of cataract measurements (image analysis) was 0.830, and glare testing 0.998. After 6 months, 90% of NAC-treated eyes showed improvement in best corrected visual acuity (7 to 100%) and 88.9% showed a 27 to 100% improvement in glare sensitivity. Topographic studies indicated fewer areas of posterior subcapsular lens opacity and 41.5% of treated eyes had improvement in image analysis characteristics. The overall ratios of image analysis characteristics at 6 months compared with baseline measures were 1.04 and 0.86 for the control and NAC-treated group, respectively (p < 0.001). The apparent benefits of treatment were sustained after 24 months' treatment. No treated eyes demonstrated worsening of vision. The overall visual outcome in the control group showed significant worsening after 24 months in comparison with both baseline and the 6-month follow-up examination. The overall clinical results observed in the NAC-treated group by the 24-month period of examination differed significantly (p < 0.001) from the control group in the eyes with cortical, posterior subcapsular, nuclear or combined lens opacities. Tolerability of NAC eyedrops was good in almost all patients, with no reports of ocular or systemic adverse effects.

CONCLUSION

Topical NAC shows potential for the treatment and prevention of cataracts.