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Zola M, Mejlachowicz D, Gregorio R, Naud MC, Jaisser F, Zhao M, Behar-Cohen F. Chronic Systemic Dexamethasone Regulates the Mineralocorticoid/Glucocorticoid Pathways Balance in Rat Ocular Tissues. Int J Mol Sci 2022; 23:ijms23031278. [PMID: 35163201 PMCID: PMC8836134 DOI: 10.3390/ijms23031278] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/20/2022] [Accepted: 01/20/2022] [Indexed: 02/04/2023] Open
Abstract
Central serous chorioretinopathy (CSCR) is a retinal disease affecting the retinal pigment epithelium (RPE) and the choroid. This is a recognized side-effect of glucocorticoids (GCs), administered through nasal, articular, oral and dermal routes. However, CSCR does not occur after intraocular GCs administration, suggesting that a hypothalamic-pituitary-adrenal axis (HPA) brake could play a role in the mechanistic link between CSCR and GS. The aim of this study was to explore this hypothesis. To induce HPA brake, Lewis rats received a systemic injection of dexamethasone daily for five days. Control rats received saline injections. Baseline levels of corticosterone were measured by Elisa at baseline and at 5 days in the serum and the ocular media and dexamethasone levels were measured at 5 days in the serum and ocular media. The expression of genes encoding glucocorticoid receptor (GR), mineralocorticoid receptors (MR), and the 11 beta hydroxysteroid dehydrogenase (HSD) enzymes 1 and 2 were quantified in the neural retina and in RPE/ choroid. The expression of MR target genes was quantified in the retina (Scnn1A (encoding ENac-α, Kir4.1 and Aqp4) and in the RPE/choroid (Shroom 2, Ngal, Mmp9 and Omg, Ptx3, Plaur and Fosl-1). Only 10% of the corticosterone serum concentration was measured in the ocular media. Corticosterone levels in the serum and in the ocular media dropped after 5 days of dexamethasone systemic treatment, reflecting HPA axis brake. Whilst both GR and MR were downregulated in the retina without MR/GR imbalance, in the RPE/choroid, both MR/GR and 11β-hsd2/11β-hsd1 ratio increased, indicating MR pathway activation. MR-target genes were upregulated in the RPE/ choroid but not in the retina. The psychological stress induced by the repeated injection of saline also induced HPA axis brake with a trend towards MR pathway activation in RPE/ choroid. HPA axis brake causes an imbalance of corticoid receptors expression in the RPE/choroid towards overactivation of MR pathway, which could favor the occurrence of CSCR.
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Affiliation(s)
- Marta Zola
- Centre de Recherche des Cordeliers, Sorbonne Université, Université de Paris, Inserm, From Physiopathology of Retinal Diseases to Clinical Advances, 75006 Paris, France; (M.Z.); (D.M.); (R.G.); (M.-C.N.); (F.J.); (M.Z.)
- Assistance Publique-Hôpitaux de Paris, Department of Ophthalmology, Ophtalmopôle, Hôpital Cochin, 75014 Paris, France
| | - Dan Mejlachowicz
- Centre de Recherche des Cordeliers, Sorbonne Université, Université de Paris, Inserm, From Physiopathology of Retinal Diseases to Clinical Advances, 75006 Paris, France; (M.Z.); (D.M.); (R.G.); (M.-C.N.); (F.J.); (M.Z.)
| | - Raquel Gregorio
- Centre de Recherche des Cordeliers, Sorbonne Université, Université de Paris, Inserm, From Physiopathology of Retinal Diseases to Clinical Advances, 75006 Paris, France; (M.Z.); (D.M.); (R.G.); (M.-C.N.); (F.J.); (M.Z.)
| | - Marie-Christine Naud
- Centre de Recherche des Cordeliers, Sorbonne Université, Université de Paris, Inserm, From Physiopathology of Retinal Diseases to Clinical Advances, 75006 Paris, France; (M.Z.); (D.M.); (R.G.); (M.-C.N.); (F.J.); (M.Z.)
| | - Frédéric Jaisser
- Centre de Recherche des Cordeliers, Sorbonne Université, Université de Paris, Inserm, From Physiopathology of Retinal Diseases to Clinical Advances, 75006 Paris, France; (M.Z.); (D.M.); (R.G.); (M.-C.N.); (F.J.); (M.Z.)
| | - Min Zhao
- Centre de Recherche des Cordeliers, Sorbonne Université, Université de Paris, Inserm, From Physiopathology of Retinal Diseases to Clinical Advances, 75006 Paris, France; (M.Z.); (D.M.); (R.G.); (M.-C.N.); (F.J.); (M.Z.)
| | - Francine Behar-Cohen
- Centre de Recherche des Cordeliers, Sorbonne Université, Université de Paris, Inserm, From Physiopathology of Retinal Diseases to Clinical Advances, 75006 Paris, France; (M.Z.); (D.M.); (R.G.); (M.-C.N.); (F.J.); (M.Z.)
- Assistance Publique-Hôpitaux de Paris, Department of Ophthalmology, Ophtalmopôle, Hôpital Cochin, 75014 Paris, France
- Correspondence:
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Corticosteroids usage and central serous chorioretinopathy: a meta-analysis. Graefes Arch Clin Exp Ophthalmol 2019; 258:71-77. [DOI: 10.1007/s00417-019-04486-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 09/10/2019] [Accepted: 09/15/2019] [Indexed: 01/11/2023] Open
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Liang ZQ, Huang LZ, Qu JF, Zhao MW. Association between endogenous cortisol level and the risk of central serous chorioretinopathy: a Meta-analysis. Int J Ophthalmol 2018; 11:296-300. [PMID: 29487822 DOI: 10.18240/ijo.2018.02.19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2017] [Accepted: 12/15/2017] [Indexed: 11/23/2022] Open
Abstract
AIM To assess the association between endogenous cortisol level and the risk of central serous chorioretinopathy (CSC). METHODS Case-control studies were systematically searched on PubMed, Embase, Cochrane, China National Knowledge Infrastructure (CNKI) for publishes between January 1990 and July 2017 to assess the association between endogenous cortisol level and CSC. The main endpoints were serum cortisol level at 8 a.m. and 24-hour urine 17-hydroxysteroids level. We assessed pooled data using a random-effects model. RESULTS Of 86 identified studies, 5 were eligible included in our analysis. The 5 studies included a total of 315 participants, of whom 187 had CSC. Statistically significant association was observed between serum cortisol level (summary SMD=0.77, 95%CI=0.55-0.99), 24-hour urine 17-hydroxysteroids level (summary SMD=0.95, 95%CI=0.61-1.30), and the risk of CSC. CONCLUSION Endogenous cortisol level is associated with an increased risk of CSC. Combined treatment targeting the serum cortisol level at 8 a.m. and 24-hour urine 17-hydroxysteroids level can be a potential preventive strategy for individuals who are at risk of CSC and therapeutic strategy for patients with CSC.
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Affiliation(s)
- Zhi-Qiao Liang
- Department of Ophthalmology, Peking University People's Hospital, Beijing 100044, China.,Eye Diseases and Optometry Institute, Beijing 100044, China.,Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing 100044, China.,College of Optometry, Peking University Health Science Center, Beijing 100044, China
| | - Lyu-Zhen Huang
- Department of Ophthalmology, Peking University People's Hospital, Beijing 100044, China.,Eye Diseases and Optometry Institute, Beijing 100044, China.,Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing 100044, China.,College of Optometry, Peking University Health Science Center, Beijing 100044, China
| | - Jin-Feng Qu
- Department of Ophthalmology, Peking University People's Hospital, Beijing 100044, China.,Eye Diseases and Optometry Institute, Beijing 100044, China.,Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing 100044, China.,College of Optometry, Peking University Health Science Center, Beijing 100044, China
| | - Ming-Wei Zhao
- Department of Ophthalmology, Peking University People's Hospital, Beijing 100044, China.,Eye Diseases and Optometry Institute, Beijing 100044, China.,Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing 100044, China.,College of Optometry, Peking University Health Science Center, Beijing 100044, China
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