Immunohistochemical study of rabbit choroidal innervation

The choroidal nervous system: a link between mineralocorticoid receptor and pachychoroid

Central serous chorioretinopathy (CSCR) belongs to the pachychoroid spectrum, a pathological phenotype of the choroidal vasculature, in which blood flow is under the choroidal nervous system (ChNS) regulation. The pathogenesis of CSCR is multifactorial, with the most recognised risk factor being intake of glucocorticoids, which activate both the gluco- and the mineralocorticoid (MR) receptors. As MR over-activation is pathogenic in the retina and choroid, it could mediate the pathogenic effects of glucocorticoids in CSCR. But the role of MR signalling in pachychoroid is unknown and whether it affects the ChNS has not been explored. Using anatomo-neurochemical characterisation of the ChNS in rodents and humans, we discovered that beside innervation of arteries, choroidal veins and choriocapillaris are also innervated, suggesting that the entire choroidal vasculature is under neural control. The numerous synapses together with calcitonin gene-related peptide (CGRP) vesicles juxtaposed to choroidal macrophages indicate a neuro-immune crosstalk. Using ultrastructural approaches, we show that transgenic mice overexpressing human MR, display a pachychoroid-like phenotype, with signs of choroidal neuropathy including myelin abnormalities, accumulation and enlargement of mitochondria and nerves vacuolization. Transcriptomic analysis of the RPE/choroid complex in the transgenic mice reveals regulation of corticoids target genes, known to intervene in nerve pathophysiology, such as Lcn2, rdas1/dexras1, S100a8 and S100a9, rabphilin 3a (Rph3a), secretogranin (Scg2) and Kinesin Family Member 5A (Kif5a). Genes belonging to pathways related to vasculature development, hypoxia, epithelial cell apoptosis, epithelial mesenchymal transition, and inflammation, support the pachychoroid phenotype and highlight downstream molecular targets. Hypotheses on the imaging phenotype of pachychoroid in humans are put forward in the light of these new data. Our results provide evidence that MR overactivation causes a choroidal neuropathy that could explain the pachychoroid phenotype found in transgenic mice overexpressing human MR. In patients with pachychoroid and CSCR in which systemic dysautonomia has been demonstrated, MR-induced choroidal neuropathy could be the missing link between corticoids and pachychoroid.

Neuronal differentiation in the early human retinogenesis

AIM

Our study investigates the differentiation of retinal stem cells towards different neuronal subtypes during the critical period of human eye development.

METHODS

Expression of the neuronal marker neurofilament 200 (NF200), tyrosine hydroxilase (TH) and choline acetyltransferase (ChAT) was seen by immunofluorescence in the 5th-12th - week stage of development in the human eye. Data was analysed by Mann-Whitney, Kruskal-Wallis and Dunn's post hoc tests.

RESULTS

NF200, TH and ChAT cells appeared in the 5th/6th week and gradually increased during further development. The proportion of TH positive areas were distributed similarly to NF200, with a higher proportion in the outer neuroblastic layer. The proportion of a ChAT positive surface was highest in the 5th/6th - week whilst from the 7th week onwards, its proportion became higher in the optic nerve and inner neuroblastic layers than in the outer layer, where a decrease of ChAT positive areas were seen.

CONCLUSIONS

Our study indicates a high differentiation potential of early retinal cells, which decreased with the advancement of development. The observed great variety of retinal phenotypic expressions results from a large scale of influences, taking place at different developmental stages.

Patterns of neural differentiation in melanomas

Background

Melanomas, highly malignant tumors arise from the melanocytes which originate as multipotent neural crest cells during neural tube genesis. The purpose of this study is to assess the pattern of neural differentiation in relation to angiogenesis in VGP melanomas using the tumor as a three dimensional system.

Methods

Tumor-vascular complexes [TVC] are formed at the tumor-stroma interphase, by tumor cells ensheathing angiogenic vessels to proliferate into a mantle of 5 to 6 layers [L1 to L5] forming a perivascular mantle zone [PMZ]. The pattern of neural differentiation is assessed by immunopositivity for HMB45, GFAP, NFP and synaptophysin has been compared in: [a] the general tumor [b] tumor-vascular complexes and [c] perimantle zone [PC] on serial frozen and paraffin sections. Statistical Analysis: ANOVA: Kruskal-Wallis One Way Analysis of Variance; All Pairwise Multiple Comparison Procedures [Tukey Test].

Results

The cells abutting on the basement membrane acquire GFAP positivity and extend processes. New layers of tumor cells show a transition between L2 to L3 followed by NFP and Syn positivity in L4&L5. The level of GFAP+vity in L1&L2 directly proportionate to the percentage of NFP/Syn+vity in L4&L5, on comparing pigmented PMZ with poorly pigmented PMZ. Tumor cells in the perimantle zone show high NFP [65%] and Syn [35.4%] positivity with very low GFAP [6.9%] correlating with the positivity in the outer layers.

Discussion

From this study it is seen that melanoma cells revert to the embryonic pattern of differentiation, with radial glial like cells [GFAP+ve] which further differentiate into neuronal positive cells [NFP&Syn+ve] during angiogenic tumor-vascular interaction, as seen during neurogenesis, to populate the tumor substance.

Autonomic control of the eye and the iris

The vertebrate eye receives innervation from ciliary and pterygopalatine parasympathetic and cervical sympathetic ganglia as well as sensory trigeminal axons. The sympathetic and parasympathetic pathways represent the classical "core" of neural regulation of ocular homeostasis. Sensory trigeminal neurons are also involved in autonomic regulation by both providing the afferent limb of various reflexes and exerting their peptide-mediated local effector function. This arrangement is remarkably conserved throughout vertebrate classes although significant modifications are observed in anamniotes, in particular their irises. In higher primates and birds, intrinsic choroidal neurons emerged as a significant additional innervation component. They most likely mediate local vascular regulation and other local homeostatic tasks in foveate eyes. This review across the vertebrate classes outfolds the complex neuronal regulatory underpinnings across vertebrates that ensure proper visual function.

Intrinsic choroidal neurons in the chicken eye: chemical coding and synaptic input

Intrinsic choroidal neurons (ICNs) exist in some primates and bird species. They may act on both vascular and non-vascular smooth muscle cells, potentially influencing choroidal blood flow. Here, we report on the chemical coding of ICNs and eye-related cranial ganglia in the chicken, an important model in myopia research, and further to determine synaptic input onto ICN. Chicken choroid, ciliary, superior cervical, pterygopalatine, and trigeminal ganglia were prepared for double or triple immunohistochemistry of calcitonin gene-related peptide (CGRP), choline acetyltransferase (ChAT), dopamine-beta-hydroxylase, galanin (GAL), neuronal nitric oxide synthase (nNOS), somatostatin (SOM), tyrosine hydroxylase (TH), vasoactive intestinal polypeptide (VIP), vesicular monoamine-transporter 2 (VMAT2), and alpha-smooth muscle actin. For documentation, light, fluorescence, and confocal laser scanning microscopy were used. Chicken ICNs express nNOS/VIP/GAL and do not express ChAT and SOM. ICNs are approached by TH/VMAT2-, CGRP-, and ChAT-positive nerve fibers. About 50% of the pterygopalatine ganglion neurons and about 9% of the superior cervical ganglion neurons share the same chemical code as ICN. SOM-positive neurons in the ciliary ganglion are GAL/NOS negative. CGRP-positive neurons in the trigeminal ganglion lack GAL/SOM. The neurochemical phenotype and synaptic input of ICNs in chicken resemble that of other bird and primate species. Because ICNs lack cholinergic markers, they cannot be readily incorporated into current concepts of the autonomic nervous system. The data obtained provide the basis for the interpretation of future functional experiments to clarify the role of these cells in achieving ocular homeostasis.

Intrinsic neurons in the duck choroid are contacted by CGRP-immunoreactive nerve fibres: evidence for a local pre-central reflex arc in the eye

Intrinsic choroidal neurons represent peripherally displaced autonomic nerve cells supposed to work as a local integrative network similar to the enteric nervous system, to control choroidal vasculature and stromal smooth muscle. A typical feature of such intramural neuronal networks is the innervation by primary afferent collaterals expressing peptides, e.g. CGRP. The present study was aimed at determining primary afferent contacts on nitrergic intrinsic choroidal neurons (ICN) in the duck eye. In addition, a sympathetic innervation of ICN was assessed. Choroids were immunohistochemically processed for the following markers: neuronal nitric oxide synthase (nNOS), galanin (GAL), calcitonin gene-related peptide (CGRP), and tyrosine hydroxylase (TH). For evaluation, fluorescence as well as confocal laser scanning microscopy were used. For electron microscopy, immunoperoxidase staining for CGRP in combination with NADPH-diaphorase histochemistry was applied. ICN immunoreactive for nNOS or GAL spread over the entire choroid, although they were concentrated in an equatorial zone passing obliquely from naso-cranial to temporo-caudal. About 40% of ICN showed close relationships with CGRP-immunoreactive nerve fibres, originating most likely in the trigeminal ganglion, as seen in the fluorescence and confocal laserscanning microscope. These appositions could be ultrastructurally defined as both synapses and close contacts without synaptic specialization. Some ICN endowed with CGRP-positive fibres also received TH-immunoreactive boutons. CGRP-immunoreactive profiles were also detected in close relationship to choroidal non-vascular smooth muscle cells and collagen fibres connected to them. In many instances, they were intercalated between smooth muscle cells and processes of ICN forming triads. These results suggest that ICN, similar to other intramural autonomic systems integrate signals from trigeminal primary afferent collaterals. The 'sensory' terminals of these primary afferents may be located in the anterior eye segment but also within the smooth muscle stroma of the choroid itself. Thus, ocular homeostasis may be regulated via intraocular pre-central reflexes which are probably subject to sympathetic modulation.