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Wei R, Ren X, Kong H, Lv Z, Chen Y, Tang Y, Wang Y, Xiao L, Yu T, Hacibekiroglu S, Liang C, Nagy A, Bremner R, Chen D. Rb1/Rbl1/Vhl loss induces mouse subretinal angiomatous proliferation and hemangioblastoma. JCI Insight 2019; 4:127889. [PMID: 31613797 DOI: 10.1172/jci.insight.127889] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 10/10/2019] [Indexed: 02/05/2023] Open
Abstract
Von Hippel-Lindau (Vhl) protein inhibits hypoxia-inducible factor (Hif), yet its deletion in murine retina does not cause the extensive angiogenesis expected with Hif induction. The mechanism is unclear. Here we show that retinoblastoma tumor suppressor (Rb1) constrains expression of Hif target genes in the Vhl-/- retina. Deleting Rb1 induced extensive retinal neovascularization and autophagic ablation of photoreceptors in the Vhl-/- retina. RNA-sequencing, ChIP, and reporter assays showed Rb1 recruitment to and repression of certain Hif target genes. Activating Rb1 by deleting cyclin D1 induced a partial defect in the retinal superficial vascular plexus. Unexpectedly, removing Vhl suppressed retinoblastoma formation in murine Rb1/Rbl1-deficient retina but generated subretinal vascular growths resembling retinal angiomatous proliferation (RAP) and retinal capillary hemangioblastoma (RCH). Most stromal cells in the RAP/RCH-like lesions were Sox9+, suggesting a Müller glia origin, and expressed Lgals3, a marker of human brain hemangioblastoma. Thus, the Rb family limit Hif target gene expression in the Vhl-/- retina, and removing this inhibitory signal generates new models for RAP and RCH.
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Affiliation(s)
- Ran Wei
- Research Laboratory of Ophthalmology and Vision Sciences, State Key Laboratory of Biotherapy, and.,Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| | - Xiang Ren
- Research Laboratory of Ophthalmology and Vision Sciences, State Key Laboratory of Biotherapy, and.,Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| | - Hongyu Kong
- Research Laboratory of Ophthalmology and Vision Sciences, State Key Laboratory of Biotherapy, and.,Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| | - Zhongping Lv
- Research Laboratory of Ophthalmology and Vision Sciences, State Key Laboratory of Biotherapy, and.,Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| | - Yongjiang Chen
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, and Departments of Ophthalmology and Visual Science, and Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.,Lunenfeld-Tanenbaum Research Institute, Sinai Health System, and Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Yunjing Tang
- Research Laboratory of Ophthalmology and Vision Sciences, State Key Laboratory of Biotherapy, and.,Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| | - Yujiao Wang
- Research Laboratory of Ophthalmology and Vision Sciences, State Key Laboratory of Biotherapy, and.,Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| | - Lirong Xiao
- Research Laboratory of Ophthalmology and Vision Sciences, State Key Laboratory of Biotherapy, and
| | - Tao Yu
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, and Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Sabiha Hacibekiroglu
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, and Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Chen Liang
- Research Laboratory of Ophthalmology and Vision Sciences, State Key Laboratory of Biotherapy, and
| | - Andras Nagy
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, and Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Rod Bremner
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, and Departments of Ophthalmology and Visual Science, and Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.,Lunenfeld-Tanenbaum Research Institute, Sinai Health System, and Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Danian Chen
- Research Laboratory of Ophthalmology and Vision Sciences, State Key Laboratory of Biotherapy, and.,Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China.,Lunenfeld-Tanenbaum Research Institute, Sinai Health System, and Departments of Ophthalmology and Visual Science, and Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.,Lunenfeld-Tanenbaum Research Institute, Sinai Health System, and Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
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Sturzeneker G, Maia A, Morales M, N Belfort R. Vitreoretinal Surgery and Panretinal Photocoagulation in a Patient with Multiple Large Retinal Capillary Hemangiomas (von Hippel-Lindau Disease): A Novel Approach. Case Rep Ophthalmol 2019; 10:327-333. [PMID: 31762763 PMCID: PMC6873061 DOI: 10.1159/000502970] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 08/28/2019] [Indexed: 12/20/2022] Open
Abstract
The authors present a novel surgical approach for the treatment of retinal capillary hemangiomas (RCHs) secondary to von Hippel-Lindau (VHL) disease. This is a case report of a 23-year-old male patient with VHL that presented with multiple large RCHs and a thick epiretinal membrane (ERM) in his left eye, with best-corrected visual acuity (BCVA) of 20/80. This condition was surgically addressed with 23-gauge pars plana vitrectomy, ERM and internal limiting membrane peeling, and panretinal photocoagulation. Three monthly intravitreal injections of bevacizumab were administered after surgery. In a 14-month follow-up period, hemangiomas have regressed after laser therapy, macular anatomy has improved, retina remained completely attached, and there has been no development of new tumors or proliferative vitreoretinopathy. The patient achieved a BCVA of 20/40 in the treated eye. Panretinal photocoagulation combined with pars plana vitrectomy may be useful to reduce development of new capillary hemangiomas and reduce overall occurrence of complications in patients with VHL disease. Postoperative intravitreal injections of bevacizumab may have a role in this positive outcome.
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Affiliation(s)
- Guilherme Sturzeneker
- Ocular Oncology Service, Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of São Paulo, São Paulo, Brazil.,Retina Department, Retina Clinic, São Paulo, Brazil
| | - André Maia
- Retina Department, Retina Clinic, São Paulo, Brazil.,Retina Service, Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of São Paulo, São Paulo, Brazil
| | - Melina Morales
- Ocular Oncology Service, Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of São Paulo, São Paulo, Brazil
| | - Rubens N Belfort
- Ocular Oncology Service, Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of São Paulo, São Paulo, Brazil
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