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Harvey DH, Sugali CK, Mao W. Glucocorticoid-Induced Ocular Hypertension and Glaucoma. Clin Ophthalmol 2024; 18:481-505. [PMID: 38379915 PMCID: PMC10878139 DOI: 10.2147/opth.s442749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 01/22/2024] [Indexed: 02/22/2024] Open
Abstract
Glucocorticoid (GC) therapy is indicated in many diseases, including ocular diseases. An important side-effect of GC therapy is GC-induced ocular hypertension (GIOHT), which may cause irreversible blindness known as GC-induced glaucoma (GIG). Here, we reviewed the pathological changes that contribute to GIOHT including in the trabecular meshwork and Schlemm's canal at cellular and molecular levels. We also discussed the clinical aspects of GIOHT/GIG including disease prevalence, risk factors, the type of GCs, the route of GC administration, and management strategies.
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Affiliation(s)
- Devon Hori Harvey
- Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, IN, USA
- Eugene and Marilyn Glick Eye Institute, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Chenna Kesavulu Sugali
- Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, IN, USA
- Eugene and Marilyn Glick Eye Institute, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Weiming Mao
- Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, IN, USA
- Eugene and Marilyn Glick Eye Institute, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Biochemistry & Molecular Biology, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Pharmacology and Toxicology, Indiana University School of Medicine, Indianapolis, IN, USA
- Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA
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Kathirvel K, Fan X, Haribalaganesh R, Bharanidharan D, Sharmila R, Krishnadas R, Muthukkaruppan V, Willoughby CE, Senthilkumari S. Small RNA Sequencing Reveals a Distinct MicroRNA Signature between Glucocorticoid Responder and Glucocorticoid Non-Responder Primary Human Trabecular Meshwork Cells after Dexamethasone Treatment. Genes (Basel) 2023; 14:2012. [PMID: 38002955 PMCID: PMC10671261 DOI: 10.3390/genes14112012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 10/22/2023] [Accepted: 10/23/2023] [Indexed: 11/26/2023] Open
Abstract
Glucocorticoids (GCs) are known to regulate several physiological processes and are the mainstay in the management of inflammatory eye diseases. The long-term use of GC causes raised intraocular pressure (IOP) or ocular hypertension (OHT) in about 30-50% of the susceptible individuals depending on the route of administration, and can lead to steroid-induced secondary glaucoma. The present study aims to understand the role of microRNAs (miRNAs) in differential glucocorticoid (GC) responsiveness in human trabecular meshwork (HTM) cells using small RNA sequencing. The human organ-cultured anterior segment (HOCAS) model was used to identify whether donor eyes were from GC-responders (GC-R; n = 4) or GC-non-responders (GC-NR; n = 4) following treatment with either 100 nM dexamethasone (DEX) or ethanol (ETH) for 7 days. The total RNA was extracted from cultured HTM cells with known GC responsiveness, and the differentially expressed miRNAs (DEMIRs) were compared among the following five groups: Group #1: ETH vs. DEX-treated GC-R; #2: ETH vs. DEX-treated GC-NR; #3: overlapping DEGs between Group #1 and #2; #4: Unique DEMIRs of GC-R; #5: Unique DEMIRs of GC-NR; and validated by RT-qPCR. There were 13 and 21 DEMIRs identified in Group #1 and Group #2, respectively. Seven miRNAs were common miRNAs dysregulated in both GC-R and GC-NR (Group #3). This analysis allowed the identification of DEMIRs that were unique to GC-R (6 miRNAs) and GC-NR (14 miRNAs) HTM cells, respectively. Ingenuity Pathway Analysis identified enriched pathways and biological processes associated with differential GC responsiveness in HTM cells. This is the first study to reveal a unique miRNA signature between GC-R and GC-NR HTM cells, which raises the possibility of developing new molecular targets for the management of steroid-OHT/glaucoma.
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Affiliation(s)
- Kandasamy Kathirvel
- Department of Ocular Pharmacology, Aravind Medical Research Foundation #1, Anna Nagar, Madurai 625020, Tamilnadu, India
- Department of Bioinformatics, Aravind Medical Research Foundation, Madurai 625020, Tamilnadu, India;
| | - Xiaochen Fan
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L69 7ZX, UK;
| | - Ravinarayanan Haribalaganesh
- Department of Ocular Pharmacology, Aravind Medical Research Foundation #1, Anna Nagar, Madurai 625020, Tamilnadu, India
| | - Devarajan Bharanidharan
- Department of Bioinformatics, Aravind Medical Research Foundation, Madurai 625020, Tamilnadu, India;
| | | | - Ramasamy Krishnadas
- Glaucoma Clinic, Aravind Eye Hospital, Madurai 625020, Tamilnadu, India (R.K.)
| | | | - Colin E. Willoughby
- Genomic Medicine, Biomedical Sciences Research Institute, Ulster University, BT52 1SA Coleraine, UK
| | - Srinivasan Senthilkumari
- Department of Ocular Pharmacology, Aravind Medical Research Foundation #1, Anna Nagar, Madurai 625020, Tamilnadu, India
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Choi KJ, Na YJ, Jung WH, Park SB, Kang S, Nam HJ, Ahn JH, Kim KY. Protective effect of a novel selective 11β-HSD1 inhibitor on eye ischemia-reperfusion induced glaucoma. Biochem Pharmacol 2019; 169:113632. [PMID: 31494147 DOI: 10.1016/j.bcp.2019.113632] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 09/03/2019] [Indexed: 02/06/2023]
Abstract
Glaucoma is one of the leading causes of preventable blindness, affecting > 2 million people in the United States. Recently, 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) inhibitors were found to exert preventive effects against glaucoma. However, there is no evidence for the role of 11β-HSD1 inhibitors against glaucoma. Here, we developed a novel 11β-HSD1 inhibitor, (1R,2S,3S,5R,6S,7S)-6-(2-(6-(2,6-dichloro-4-(trifluoromethyl)phenyl)-4-methyl-1,1-dioxido-1,2,6-thiadiazinan-2-yl)acetamido)-adamantane-2-carboxamide (KR-67607) and showed its protective effects against ischemia-reperfusion-induced eye injury. We demonstrate that KR-67607 effectively reduced cortisol levels in mouse eyes and maintained the trabecular meshwork (TM) structure in the presence of transient ischemic stress. Furthermore, KR-67607 reversed the elevation of intra-ocular pressure (IOP), suggesting that the TM structure maintained by KR-67607 prevented the excessive rise in IOP that exacerbates glaucoma. KR-67607 was shown to have a higher specificity for 11β-HSD1 than carbenoxolone (CBX) in vitro. Moreover, KR-67607 reduced apoptosis and the structural disruption of TM cells. Antioxidation was the major protective pathway of KR-67607 against chemically-induced ischemia-reperfusion in TM cells and the glucocorticoid receptor (GR) was closely associated with this pathway. When TM cells undergo ischemic stress, GR is activated and then translocates to the cell nucleus where it interferes with Nrf-2-mediated antioxidant gene expression. However, when KR-67607 inhibited GR translocation, Nrf-2 was able to induce antioxidant gene transcription, which consequently, enhanced the antioxidant capacity of the cells. In conclusion, our current work describes a novel selective 11β-HSD1 inhibitor for glaucoma treatment and provides evidence of its physiological role in anti-oxidative pathways in the TM.
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Affiliation(s)
- Kyoung Jin Choi
- Therapeutics & Biotechnology Division, Korea Research Institute of Chemical Technology, P.O. Box 107, Yuseong-gu, Daejeon 34114, Republic of Korea
| | - Yoon-Ju Na
- Therapeutics & Biotechnology Division, Korea Research Institute of Chemical Technology, P.O. Box 107, Yuseong-gu, Daejeon 34114, Republic of Korea; Graduate School of New Drug Discovery and Development, Chungnam National University, 99 Daehak-ro, Yuseong-gu, Daejeon 34134, Republic of Korea
| | - Won Hoon Jung
- Therapeutics & Biotechnology Division, Korea Research Institute of Chemical Technology, P.O. Box 107, Yuseong-gu, Daejeon 34114, Republic of Korea
| | - Sung Bum Park
- Therapeutics & Biotechnology Division, Korea Research Institute of Chemical Technology, P.O. Box 107, Yuseong-gu, Daejeon 34114, Republic of Korea
| | - Sein Kang
- Therapeutics & Biotechnology Division, Korea Research Institute of Chemical Technology, P.O. Box 107, Yuseong-gu, Daejeon 34114, Republic of Korea; Graduate School of New Drug Discovery and Development, Chungnam National University, 99 Daehak-ro, Yuseong-gu, Daejeon 34134, Republic of Korea
| | - Hye Jin Nam
- Therapeutics & Biotechnology Division, Korea Research Institute of Chemical Technology, P.O. Box 107, Yuseong-gu, Daejeon 34114, Republic of Korea
| | - Jin Hee Ahn
- Department of Chemistry, Gwangju Institute of Science and Technology, Gwangju 61005, Republic of Korea
| | - Ki Young Kim
- Therapeutics & Biotechnology Division, Korea Research Institute of Chemical Technology, P.O. Box 107, Yuseong-gu, Daejeon 34114, Republic of Korea; Graduate School of New Drug Discovery and Development, Chungnam National University, 99 Daehak-ro, Yuseong-gu, Daejeon 34134, Republic of Korea.
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Na YJ, Choi KJ, Park SB, Sung HR, Jung WH, Kim HY, Rhee SD, Kim KY. Protective effects of carbenoxolone, an 11β-HSD1 inhibitor, against chemical induced dry eye syndrome. Apoptosis 2017; 22:1441-1453. [DOI: 10.1007/s10495-017-1419-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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