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Jiang H, Chen Y, He Z, Li J, Gao Q, Li W, Wei W, Zhang Y. Targeting non-muscle myosin II inhibits proliferative vitreoretinopathy through regulating epithelial-mesenchymal transition. Biochem Biophys Res Commun 2023; 686:149149. [PMID: 37918204 DOI: 10.1016/j.bbrc.2023.149149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 10/10/2023] [Accepted: 10/23/2023] [Indexed: 11/04/2023]
Abstract
Proliferative vitreoretinopathy (PVR) is a common complication of rhegmatogenous retinal detachment, eventually leading to vision loss. To date, there are no effective drugs for the treatment of this disease. In this study, we investigated the effect of blebbistatin, a non-muscle myosin II inhibitor, on the ARPE-19 cell line and in a rabbit model of proliferative vitreoretinopathy. In vitro, we found that blebbistatin inhibited the epithelial-mesenchymal transition of retinal pigment epithelial (RPE) cells and inhibited the ability of RPE cells to migrate, proliferate, generate extracellular matrix, and affect contractility. In vivo the PVR model showed that blebbistatin significantly delayed PVR progression. It also partially prevents the loss of retinal function caused by PVR. Our results suggest that blebbistatin is a potential drug with clinical applications for the treatment of PVR.
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Affiliation(s)
- Haiping Jiang
- State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, 100101, China; Institute for Stem Cell and Regenerative Medicine, Chinese Academy of Sciences, Beijing, 100101, China; University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Yuning Chen
- Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China
| | - Zhengquan He
- State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, 100101, China; Institute for Stem Cell and Regenerative Medicine, Chinese Academy of Sciences, Beijing, 100101, China; Beijing Institute for Stem Cell and Regenerative Medicine, Beijing, 100101, China; University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Jie Li
- State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, 100101, China; Institute for Stem Cell and Regenerative Medicine, Chinese Academy of Sciences, Beijing, 100101, China; University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Qingqin Gao
- State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, 100101, China; Institute for Stem Cell and Regenerative Medicine, Chinese Academy of Sciences, Beijing, 100101, China; University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Wei Li
- State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, 100101, China; Institute for Stem Cell and Regenerative Medicine, Chinese Academy of Sciences, Beijing, 100101, China; Beijing Institute for Stem Cell and Regenerative Medicine, Beijing, 100101, China; University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Wenbin Wei
- Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China.
| | - Ying Zhang
- State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, 100101, China; Institute for Stem Cell and Regenerative Medicine, Chinese Academy of Sciences, Beijing, 100101, China; Beijing Institute for Stem Cell and Regenerative Medicine, Beijing, 100101, China; University of Chinese Academy of Sciences, Beijing, 100049, China.
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2
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Peterson C, Lu Y, Santiago CP, Price AC, McNally MM, Schubert W, Nassar K, Zollner T, Blackshaw S, Eberhart CG, Singh MS. Transition to Chronic Fibrosis in an Animal Model of Retinal Detachment With Features of Proliferative Vitreoretinopathy. Invest Ophthalmol Vis Sci 2023; 64:39. [PMID: 38153753 PMCID: PMC10756252 DOI: 10.1167/iovs.64.15.39] [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: 01/09/2023] [Accepted: 09/18/2023] [Indexed: 12/29/2023] Open
Abstract
Purpose Proliferative vitreoretinopathy (PVR) is the most common cause of failure of surgically repaired rhegmatogenous retinal detachment (RRD). Chemically induced and cell injection PVR models do not fully simulate the clinical characteristics of PVR in the post-RRD context. There is an unmet need for translational models in which to study mechanisms and treatments specific to RRD-PVR. Methods RRD was induced in adult Dutch Belted rabbits. Posterior segments were fixed or processed for RNA sequencing at 6 hours and 2, 7, 14, and 35 days after induction. Histochemical staining and immunolabeling for glial fibrillary acidic protein, alpha smooth muscle actin, vascular endothelial growth factor receptor 2, CD68, and RPE 65 kDa protein were performed, and labeling intensity was scored. Single cell RNA sequencing was performed. Results Acute histopathological changes included intravitreal and intraretinal hemorrhage, leukocytic vitritis, chorioretinitis, and retinal rarefaction. Chronic lesions showed retinal atrophy, gliosis, fibrotic subretinal membranes, and epiretinal fibrovascular proliferation. Fibrillar collagen was present in the fibrocellular and fibrovascular membranes in chronic lesions. Moderate to strong labeling of glia and vasculature was detected in chronic lesions. At day 14, most cells profiled by single cell sequencing were identified as Mϋller glia and microglia, consistent with immunolabeling. Expression of several fibrillar collagen genes was upregulated in chronic lesions. Conclusions Histological and transcriptional features of this rabbit model simulate important features of human RRD-PVR, including the transition to chronic intraretinal and periretinal fibrosis. This animal model of RRD with features of PVR will enable further research on targeted treatment interventions.
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Affiliation(s)
- Cornelia Peterson
- Department of Molecular and Comparative Pathobiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
- Department of Comparative Pathobiology, Tufts University, Cummings School of Veterinary Medicine, North Grafton, Massachusetts, United States
| | - Yuchen Lu
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Clayton P. Santiago
- Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Antoinette C. Price
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Minda M. McNally
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | | | | | | | - Seth Blackshaw
- Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Charles G. Eberhart
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Mandeep S. Singh
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
- Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
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3
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Carpineto P, Licata AM, Ciancaglini M. Proliferative Vitreoretinopathy: A Reappraisal. J Clin Med 2023; 12:5287. [PMID: 37629329 PMCID: PMC10455099 DOI: 10.3390/jcm12165287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/31/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023] Open
Abstract
Proliferative vitreoretinopathy (PVR) remains the main cause of failure after retinal detachment (RD) surgery. Despite the development of modern technologies and sophisticated techniques for the management of RD, the growth of fibrocellular membranes within the vitreous cavity and on both sides of the retinal surface, as well as intraretinal fibrosis, can compromise surgical outcomes. Since 1983, when the term PVR was coined by the Retina Society, a lot of knowledge has been obtained about the physiopathology and risk factors of PVR, but, despite the proposal of a lot of therapeutic challenges, surgical skills seem to be the only effective way to manage PVR complications.
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Affiliation(s)
- Paolo Carpineto
- Department of Medical, Oral and Biotechnological Sciences, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy;
| | - Arturo Maria Licata
- Department of Medical, Oral and Biotechnological Sciences, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy;
| | - Marco Ciancaglini
- Department of Clinical Medicine, Public Health, Life and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy;
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Deliyanti D, Figgett WA, Gebhardt T, Trapani JA, Mackay F, Wilkinson-Berka JL. CD8 + T Cells Promote Pathological Angiogenesis in Ocular Neovascular Disease. Arterioscler Thromb Vasc Biol 2023; 43:522-536. [PMID: 36794587 DOI: 10.1161/atvbaha.122.318079] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
BACKGROUND CD4+ (cluster of differentation) and CD8+ T cells are increased in the ocular fluids of patients with neovascular retinopathy, yet their role in the disease process is unknown. METHODS We describe how CD8+ T cells migrate into the retina and contribute to pathological angiogenesis by releasing cytokines and cytotoxic factors. RESULTS In oxygen-induced retinopathy, flow cytometry revealed the numbers of CD4+ and CD8+ T cells were increased in blood, lymphoid organs, and retina throughout the development of neovascular retinopathy. Interestingly, the depletion of CD8+ T cells but not CD4+ T cells reduced retinal neovascularization and vascular leakage. Using reporter mice expressing gfp (green fluorescence protein) in CD8+ T cells, these cells were localized near neovascular tufts in the retina, confirming that CD8+ T cells contribute to the disease. Furthermore, the adoptive transfer of CD8+ T cells deficient in TNF (tumor necrosis factor), IFNγ (interferon gamma), Prf (perforin), or GzmA/B (granzymes A/B) into immunocompetent Rag1-/- mice revealed that CD8+ T cells mediate retinal vascular disease via these factors, with TNF influencing all aspects of vascular pathology. The pathway by which CD8+ T cells migrate into the retina was identified as CXCR3 (C-X-C motif chemokine receptor 3) with the CXCR3 blockade reducing the number of CD8+ T cells within the retina and retinal vascular disease. CONCLUSIONS We discovered that CXCR3 is central to the migration of CD8+ T cells into the retina as the CXCR3 blockade reduced the number of CD8+ T cells within the retina and vasculopathy. This research identified an unappreciated role for CD8+ T cells in retinal inflammation and vascular disease. Reducing CD8+ T cells via their inflammatory and recruitment pathways is a potential treatment for neovascular retinopathies.
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Affiliation(s)
- Devy Deliyanti
- Department of Anatomy and Physiology, School of Biomedical Sciences (D.D., J.L.W.-B.), University of Melbourne, Parkville, Victoria, Australia
- Department of Diabetes, Monash University, Melbourne, Victoria, Australia (D.D., J.L.W.-B.)
| | - William A Figgett
- Department of Microbiology and Immunology, School of Biomedical Sciences, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Parkville, Victoria, Australia (W.A.F.)
- Kinghorn Centre for Clinical Genomics, Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia (W.A.F., T.G.)
| | - Thomas Gebhardt
- Kinghorn Centre for Clinical Genomics, Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia (W.A.F., T.G.)
| | - Joseph A Trapani
- Sir Peter MacCallum Department of Oncology (J.A.T.), University of Melbourne, Parkville, Victoria, Australia
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia (J.A.T.)
| | - Fabienne Mackay
- QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia (F.M.)
| | - Jennifer L Wilkinson-Berka
- Department of Anatomy and Physiology, School of Biomedical Sciences (D.D., J.L.W.-B.), University of Melbourne, Parkville, Victoria, Australia
- Department of Diabetes, Monash University, Melbourne, Victoria, Australia (D.D., J.L.W.-B.)
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5
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Bayless KJ. Direct Involvement of CD8 + T Cells in Retinal Angiogenesis. Arterioscler Thromb Vasc Biol 2023; 43:537-539. [PMID: 36947606 DOI: 10.1161/atvbaha.123.319101] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
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Jung WK, Park SB, Yu HY, Kim YH, Kim J. Effect of Esculetin on Tert-Butyl Hydroperoxide-Induced Oxidative Injury in Retinal Pigment Epithelial Cells In Vitro. MOLECULES (BASEL, SWITZERLAND) 2022; 27:molecules27248970. [PMID: 36558102 PMCID: PMC9781126 DOI: 10.3390/molecules27248970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022]
Abstract
Esculetin is a coumarin-derived compound with antioxidant and anti-inflammatory properties. The current study aims to evaluate the therapeutic implications of esculetin on retinal dysfunction and uncover the underlying mechanisms. Tert-butyl hydroperoxide (t-BHP) at a concentration of 300 μM was used to induce oxidative stress in human retinal pigment epithelial cell line (ARPE-19) cells. Esculetin at concentrations below 250 μM did not cause cytotoxicity to ARPE-19 cells. Cell viability analysis confirmed that t-BHP induced oxidative injury of ARPE-19 cells. However, ARPE-19 cells were protected from t-BHP-induced oxidative injury by esculetin in a concentration-dependent manner. As a result of the TUNEL assay to confirm apoptosis, esculetin treatment reduced the number of TUNEL-positive cells. Esculetin down-regulated the expression levels of Bax, Caspase-3, and PARP and up-regulated the expression level of Bcl2. Collectively, this study demonstrates that esculetin exerts potent antioxidant properties in ARPE-19 cells, inhibiting t-BHP-induced apoptosis under the regulation of apoptotic factors.
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Affiliation(s)
| | | | | | | | - Junghyun Kim
- Correspondence: ; Tel.: +82-63-270-4032; Fax: +82-63-270-4025
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Chen SH, Lin YJ, Wang LC, Tsai HY, Yang CH, Teng YT, Hsu SM. Doxycycline Ameliorates the Severity of Experimental Proliferative Vitreoretinopathy in Mice. Int J Mol Sci 2021; 22:11670. [PMID: 34769100 PMCID: PMC8584209 DOI: 10.3390/ijms222111670] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 10/22/2021] [Accepted: 10/25/2021] [Indexed: 12/04/2022] Open
Abstract
After successful surgeries for patients with rhegmatogenous retinal detachment, the most common cause of retinal redetachment is proliferative vitreoretinopathy (PVR), which causes severe vision impairment and even blindness worldwide. Until now, the major treatment for PVR is surgical removal of the epiretinal membrane, while effective treatment to prevent PVR is still unavailable. Therefore, we investigated the potential of doxycycline, an antibiotic in the tetracycline class, to treat PVR using a mouse model. We used the human retinal pigment epithelial cell line, ARPE-19, for in vitro and in vivo studies to test doxycycline for PVR treatment. We found that doxycycline suppressed the migration, proliferation, and contraction of ARPE-19 cells with reduced p38 MAPK activation and total MMP activity. Intravitreal doxycycline and topical tetracycline treatment significantly ameliorated the PVR severity induced by ARPE-19 cells in mice. PVR increased the expression of MMP-9 and IL-4 and p38 MAPK phosphorylation and modestly decreased IL-10. These effects were reversed by doxycycline and tetracycline treatment in the mouse retina. These results suggest that doxycycline will be a potential treatment for PVR in the future.
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Affiliation(s)
- Shun-Hua Chen
- Department of Microbiology and Immunology, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan; (S.-H.C.); (Y.-J.L.)
| | - Yu-Jheng Lin
- Department of Microbiology and Immunology, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan; (S.-H.C.); (Y.-J.L.)
| | - Li-Chiu Wang
- School of Medicine, I-Shou University, Kaohsiung 824, Taiwan;
| | - Hsien-Yang Tsai
- Department of Ophthalmology, Tzu Chi Hospital, Taichung 427, Taiwan;
| | - Chang-Hao Yang
- Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei 100, Taiwan;
| | - Yu-Ti Teng
- Department of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan;
| | - Sheng-Min Hsu
- Department of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan;
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8
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Dan-Brezis I, Zahavi A, Axer-Siegel R, Nisgav Y, Dahbash M, Weinberger D, Ehrlich R, Livnat T. Inflammation, angiogenesis and coagulation interplay in a variety of retinal diseases. Acta Ophthalmol 2020; 98:e559-e562. [PMID: 31833198 DOI: 10.1111/aos.14331] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Accepted: 11/18/2019] [Indexed: 01/14/2023]
Abstract
PURPOSE To evaluate and correlate levels of various proteins involved in coagulation, inflammation and angiogenesis processes in the vitreous of patients with different vitreoretinal pathologies. METHODS Vitreous samples were collected from patients scheduled for pars plana vitrectomy for the treatment of rhegmatogenous retinal detachment (RRD), vitreous haemorrhage or tractional retinal detachment associated with proliferative diabetic retinopathy (PDR). Macular hole and epiretinal membrane served as controls. Levels of vascular endothelial growth factor, thrombin-antithrombin III complex, interleukin-8, tissue factor, thrombomodulin, P-selectin, D-dimer and tissue factor pathway inhibitor were compared among the vitreoretinal pathology groups. RESULTS Compared to controls, patients with PDR had significantly higher levels of thrombin-antithrombin III complex (p < 0.001), vascular endothelial growth factor (p < 0.001), D-dimer (p = 0.038) and interleukin-8 (p = 0.04), and patients with RRD group had significantly higher levels only of thrombin-antithrombin III complex (p < 0.001). There was a significant linear correlation between levels of P-selectin and D-dimer (p = 0.003), P-selectin and interleukin-8 (p < 0.001), and D-dimer and IL-8 (p = 0.007). These correlations were particularly strong in the PDR group compared to the other groups. CONCLUSION Patients with PDR manifest high coagulative and angiogenic activity in the vitreous. These pathways are highly correlated with the inflammatory cascade.
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Affiliation(s)
- Idit Dan-Brezis
- Department of Ophthalmology, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel
| | - Alon Zahavi
- Department of Ophthalmology, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ruth Axer-Siegel
- Department of Ophthalmology, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yael Nisgav
- Laboratory of Eye Research, Felsenstein Medical Research Center, Petach Tikva, Israel
| | - Mor Dahbash
- Laboratory of Eye Research, Felsenstein Medical Research Center, Petach Tikva, Israel
| | - Dov Weinberger
- Department of Ophthalmology, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Laboratory of Eye Research, Felsenstein Medical Research Center, Petach Tikva, Israel
| | - Rita Ehrlich
- Department of Ophthalmology, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tami Livnat
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Laboratory of Eye Research, Felsenstein Medical Research Center, Petach Tikva, Israel.,Israeli National Hemophilia Center, Sheba Medical Center, Tel Hashomer, Israel
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Chaudhary R, Scott RAH, Wallace G, Berry M, Logan A, Blanch RJ. Inflammatory and Fibrogenic Factors in Proliferative Vitreoretinopathy Development. Transl Vis Sci Technol 2020; 9:23. [PMID: 32742753 PMCID: PMC7357815 DOI: 10.1167/tvst.9.3.23] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Purpose Proliferative vitreoretinopathy (PVR) occurs in 5%-10% of rhegmatogenous retinal detachment cases and is the principle cause for failure of retinal reattachment surgery. Although there are a number of surgical adjunctive agents available for preventing the development of PVR, all have limited efficacy. Discovering predictive molecular biomarkers to determine the probability of PVR development after retinal reattachment surgery will allow better patient stratification for more targeted drug evaluations. Methods Narrative literature review. Results We provide a summary of the inflammatory and fibrogenic factors found in ocular fluid samples during the development of retinal detachment and PVR and discuss their possible use as molecular PVR predictive biomarkers. Conclusions Studies monitoring the levels of the above factors have found that few if any have predictive biomarker value, suggesting that widening the phenotype of potential factors and a combinatorial approach are required to determine predictive biomarkers for PVR. Translational Relevance The identification of relevant biomarkers relies on an understanding of disease signaling pathways derived from basic science research. We discuss the extent to which those molecules identified as biomarkers and predictors of PVR relate to disease pathogenesis and could function as useful disease predictors. (http://www.umin.ac.jp/ctr/ number, UMIN000005604).
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Affiliation(s)
- Rishika Chaudhary
- Academic Unit of Ophthalmology, Birmingham and Midland Eye Centre, Birmingham, UK.,Neuroscience and Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.,NIHR Surgical Reconstruction and Microbiology Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | | | - Graham Wallace
- Neuroscience and Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Martin Berry
- Neuroscience and Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Ann Logan
- Neuroscience and Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.,NIHR Surgical Reconstruction and Microbiology Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Richard J Blanch
- Neuroscience and Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.,NIHR Surgical Reconstruction and Microbiology Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.,Department of Ophthalmology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.,Academic Unit of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham, UK
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10
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Murakami Y, Ishikawa K, Nakao S, Sonoda KH. Innate immune response in retinal homeostasis and inflammatory disorders. Prog Retin Eye Res 2019; 74:100778. [PMID: 31505218 DOI: 10.1016/j.preteyeres.2019.100778] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 08/12/2019] [Accepted: 09/02/2019] [Indexed: 01/03/2023]
Abstract
Innate immune cells such as neutrophils, monocyte-macrophages and microglial cells are pivotal for the health and disease of the retina. For the maintenance of retinal homeostasis, these cells and immunosuppressive molecules in the eye actively regulate the induction and the expression of inflammation in order to prevent excessive activation and subsequent tissue damage. In the disease context, these regulatory mechanisms are modulated genetically and/or by environmental stimuli such as damage-associated molecular patterns (DAMPs), and a chronic innate immune response regulates or contributes to the formation of diverse retinal disorders such as uveitis, retinitis pigmentosa, retinal vascular diseases and retinal fibrosis. Here we summarize the recent knowledge regarding the innate immune response in both ocular immune regulation and inflammatory retinal diseases, and we describe the potential of the innate immune response as a biomarker and therapeutic target.
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Affiliation(s)
- Yusuke Murakami
- Department of Ophthalmology, Graduate School of Medical Science, Kyushu University, Fukuoka, 812-8582, Japan
| | - Keijiro Ishikawa
- Department of Ophthalmology, Graduate School of Medical Science, Kyushu University, Fukuoka, 812-8582, Japan
| | - Shintaro Nakao
- Department of Ophthalmology, Graduate School of Medical Science, Kyushu University, Fukuoka, 812-8582, Japan
| | - Koh-Hei Sonoda
- Department of Ophthalmology, Graduate School of Medical Science, Kyushu University, Fukuoka, 812-8582, Japan.
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11
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Utility of Induced Pluripotent Stem Cell-Derived Retinal Pigment Epithelium for an In Vitro Model of Proliferative Vitreoretinopathy. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1186:33-53. [PMID: 31654385 DOI: 10.1007/978-3-030-28471-8_2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The advent of stem cell technology, including the technology to induce pluripotency in somatic cells, and direct differentiation of stem cells into specific somatic cell types, has created an exciting new field of scientific research. Much of the work with pluripotent stem (PS) cells has been focused on the exploration and exploitation of their potential as cells/tissue replacement therapies for personalized medicine. However, PS and stem cell-derived somatic cells are also proving to be valuable tools to study disease pathology and tissue-specific responses to injury. High-throughput drug screening assays using tissue-specific injury models have the potential to identify specific and effective treatments that will promote wound healing. Retinal pigment epithelium (RPE) derived from induced pluripotent stem cells (iPS-RPE) are well characterized cells that exhibit the phenotype and functions of in vivo RPE. In addition to their role as a source of cells to replace damaged or diseased RPE, iPS-RPE provide a robust platform for in vitro drug screening to identify novel therapeutics to promote healing and repair of ocular tissues after injury. Proliferative vitreoretinopathy (PVR) is an abnormal wound healing process that occurs after retinal tears or detachments. In this chapter, the role of iPS-RPE in the development of an in vitro model of PVR is described. Comprehensive analyses of the iPS-RPE response to injury suggests that these cells provide a physiologically relevant tool to investigate the cellular mechanisms of the three phases of PVR pathology: migration, proliferation, and contraction. This in vitro model will provide valuable information regarding cellular wound healing responses specific to RPE and enable the identification of effective therapeutics.
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12
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Abstract
Proliferative vitreoretinopathy (PVR) is the most common cause for failure of rhegmatogenous retinal detachment repair and is characterized by the growth and contraction of cellular membranes within the vitreous cavity and on both sides of the retinal surface as well as intraretinal fibrosis. Currently, PVR is thought to be an abnormal wound healing response that is primarily driven by inflammatory, retinal, and RPE cells. At this time, surgery is the only management option for PVR as there is no proven pharmacologic agent for the treatment or prevention of PVR. Laboratory research to better understand PVR pathophysiology and clinical trials of various agents to prevent PVR formation are ongoing.
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Affiliation(s)
- Sana Idrees
- Flaum Eye Institute, University of Rochester Medical Center, Rochester, NY, USA
| | - Jayanth Sridhar
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA
| | - Ajay E. Kuriyan
- Flaum Eye Institute, University of Rochester Medical Center, Rochester, NY, USA
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13
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Bastiaans J, Mulder VC, van Meurs JC, Smits - te Nijenhuis M, van Holten - Neelen C, van Hagen PM, Dik WA. Dabigatran inhibits intravitreal thrombin activity. Acta Ophthalmol 2018; 96:452-458. [PMID: 29193875 DOI: 10.1111/aos.13630] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Accepted: 09/18/2017] [Indexed: 12/22/2022]
Abstract
PURPOSE Proliferative vitreoretinopathy (PVR) is a vitreoretinal disorder in which retinal pigment epithelial (RPE) cell activation contributes to both formation of fibrotic retinal membranes and inflammation. Vitreous of patients with PVR contains increased thrombin activity which induces profibrotic and proinflammatory programs in RPE cells. Inhibition of intravitreal thrombin activity may thus represent a therapeutic option for PVR. In this study, we examined the capacity of the clinically available direct thrombin inhibitor dabigatran to inhibit thrombin activity in vitreous fluids. METHODS ARPE-19 cells were cultured with the following: (i) thrombin, (ii) vitreous without thrombin activity and (iii) vitreous with elevated thrombin activity (PVR samples and thrombin spiked vitreous) either in the presence or absence of dabigatran (range: 10-5 to 10-7 M). Subsequently, CCL2, CXCL8, GMCSF, IL6 and PDGFB mRNA expression levels were determined by RQ-PCR and protein levels of 27 cytokines, chemokines and growth factors were detected in culture supernatants using a multiplex approach. In addition, the capacity of vitreous fluids obtained from patients after oral dabigatran intake was tested in an in vitro thrombin activity assay. RESULTS Thrombin and vitreous fluids containing thrombin activity induced CCL2, CXCL8, GM-CSF, IL-6 and PDGF-BB expression by ARPE-19 cells, which was inhibited by dabigatran. In addition, dabigatran that reached the vitreous after repeated oral intake did inhibit thrombin activity in the in vitro activity assay. CONCLUSION Proliferative vitreoretinopathy (PVR) is associated with increased intravitreal thrombin activity that activates profibrotic and proinflammatory pathways in RPE cells. Our findings provide evidence that this activation pathway can potentially be inhibited by dabigatran.
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Affiliation(s)
- Jeroen Bastiaans
- Departments of Immunology; Erasmus MC; Rotterdam The Netherlands
| | | | - Jan C. van Meurs
- The Rotterdam Eye Hospital; Rotterdam The Netherlands
- Ophthalmology; Erasmus MC; Rotterdam The Netherlands
| | | | | | - P. Martin van Hagen
- Departments of Immunology; Erasmus MC; Rotterdam The Netherlands
- Internal Medicine; Erasmus MC; Rotterdam The Netherlands
| | - Willem A. Dik
- Departments of Immunology; Erasmus MC; Rotterdam The Netherlands
- Laboratory Medical Immunology; Erasmus MC; Rotterdam The Netherlands
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Ilhan HD, Bilgin AB, Toylu A, Dogan ME, Apaydin KC. The Expression of GDF-15 in the Human Vitreous in the Presence of Retinal Pathologies with an Inflammatory Component. Ocul Immunol Inflamm 2015; 24:178-83. [PMID: 26177355 DOI: 10.3109/09273948.2014.981549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE The presence of growth differentiation factor-15 (GDF-15), a protein implicated in the regulation of the inflammatory response, was investigated in the vitreous of patients with vitreoretinal disorders. METHODS Vitreous and plasma samples were collected from patients with idiopathic epiretinal membrane (IERM), macular hole (MH), rhegmatogenous retinal detachment (RRD), nucleus drop (ND), or proliferative diabetic retinopathy (PDR). GDF-15 concentrations were measured using ELISA. RESULTS The vitreous levels of GDF-15 were higher in ND (5) and PDR (14) patients (1494 ± 243 and 904 ± 138 pg/mL, respectively) than RRD (3), MH (3), and IERM (8) patients (302 ± 160, 288 ± 24, and 254 ± 91 pg/mL, respectively). The vitreous levels of GDF-15 were significantly higher in patients with inflammatory vitreoretinal disorders (p < 0.0001). CONCLUSIONS This is the first report showing that GDF-15 appears to be expressed in the vitreous, and that its expression is significantly higher in the presence of a vitreoretinal disorder in which there is an inflammatory component.
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Affiliation(s)
| | | | - Asli Toylu
- b Akdeniz University , Department of Medical Genetics , Antalya , Turkey , and
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15
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Ikeda T, Nakamura K, Oku H, Morishita S, Fukumoto M, Suzuki H, Kida T, Horie T, Sugiyama T, Takai S. The role of tryptase and anti-type II collagen antibodies in the pathogenesis of idiopathic epiretinal membranes. Clin Ophthalmol 2015; 9:1181-6. [PMID: 26170611 PMCID: PMC4494616 DOI: 10.2147/opth.s82015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Purpose To investigate the pathogenesis of idiopathic epiretinal membrane (ERM) from a biochemical perspective, the relationships between ERM and tryptase activity, a serine protease, and the levels of anti-type II collagen (anti-IIC) antibodies in the serum. Patients and methods Vitreous samples for measurement of tryptase activity were obtained from 54 eyes of 54 patients who underwent a vitrectomy for vitreoretinal disease, ie, 14 eyes of 14 patients with idiopathic macular hole, 14 eyes of 14 patients with proliferative diabetic retinopathy (PDR), 13 eyes of 13 patients with ERM, and 13 eyes of 13 patients with rhegmatogenous retinal detachment (RRD). Tryptase activity was measured by spectrophotometry. Anti-IIC antibodies were measured in the serum obtained from 17 patients with ERM, eight patients who underwent cataract surgery, 12 patients with PDR, and nine patients with RRD. In these 46 patients, the anti-IIC antibodies were measured using a Human/Monkey Anti-Type I and Type II Collagen IgG Assay Kit. Results Vitreal tryptase activity (mean ± standard deviation [SD]) in macular hole, PDR, ERM, and RRD was 0.0146±0.0053, 0.0018±0.0018, 0.0166±0.0046, and 0.0117±0.0029 mU/mg protein, respectively. Vitreal tryptase activity was significantly higher in macular hole and ERM than in PDR and RRD (P<0.05, Fisher’s protected least significant difference). The serum levels of anti-IIC immunoglobulin G (IgG) antibody (mean ± SD) in ERM, cataract surgery, PDR, and RRD were 58.222±30.986, 34.890±18.165, 55.760±26.008, and 35.453±12.769 units/mL, respectively. The serum levels of anti-IIC IgG antibody were significantly higher in ERM and PDR than in cataract surgery and RRD (P<0.05, Fisher’s protected least significant difference, two-sided). Conclusion In the pathogenesis of ERM, increased vitreal tryptase activity may be involved in tissue fibrosis, and elevated serum anti-IIC antibodies may lead to an immune response at the vitreoretinal interface, thus resulting in membrane formation.
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Affiliation(s)
- Tsunehiko Ikeda
- Department of Ophthalmology, Osaka Medical College, Takatsuki City, Osaka, Japan
| | | | - Hidehiro Oku
- Department of Ophthalmology, Osaka Medical College, Takatsuki City, Osaka, Japan
| | - Seita Morishita
- Department of Ophthalmology, Osaka Medical College, Takatsuki City, Osaka, Japan
| | - Masanori Fukumoto
- Department of Ophthalmology, Osaka Medical College, Takatsuki City, Osaka, Japan
| | - Hiroyuki Suzuki
- Department of Ophthalmology, Osaka Medical College, Takatsuki City, Osaka, Japan
| | - Teruyo Kida
- Department of Ophthalmology, Osaka Medical College, Takatsuki City, Osaka, Japan
| | - Taeko Horie
- Department of Ophthalmology, Osaka Medical College, Takatsuki City, Osaka, Japan
| | | | - Shinji Takai
- Department of Pharmacology, Osaka Medical College, Takatsuki City, Osaka, Japan
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Kuo HK, Chen YH, Huang F, Wu YC, Shiea J, Wu PC. The upregulation of zinc finger protein 670 and prostaglandin D2 synthase in proliferative vitreoretinopathy. Graefes Arch Clin Exp Ophthalmol 2015; 254:205-13. [DOI: 10.1007/s00417-015-3022-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Revised: 04/07/2015] [Accepted: 04/09/2015] [Indexed: 01/13/2023] Open
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Tosi GM, Marigliani D, Romeo N, Toti P. Disease pathways in proliferative vitreoretinopathy: an ongoing challenge. J Cell Physiol 2014; 229:1577-83. [PMID: 24604697 DOI: 10.1002/jcp.24606] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Accepted: 01/16/2014] [Indexed: 11/08/2022]
Abstract
Despite remarkable advances in vitreoretinal surgery, proliferative vitreoretinopathy (PVR) remains a common cause of severe visual loss or blindness. One of the critical reasons for PVR-induced blindness is tractional retinal detachment due to the formation of contractile preretinal fibrous membranes. This membrane formation is characterized by the proliferation and migration of cells and the excessive synthesis and deposition of extracellular matrix proteins. Herein we present the disease pathways of PVR, reviewing the role of both systemic and intraocular cells as well as molecular mediators. A chronological sequence of events leading to PVR is also hypothesized. Better understanding of the pathogenesis of PVR is needed in order to improve disease management. Efforts should be oriented towards greater cooperation between basic researchers and clinicians, aimed at matching the different clinical scenarios with the biological markers of the disease.
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Affiliation(s)
- Gian Marco Tosi
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
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Rouberol F, Chiquet C. [Proliferative vitreoretinopathy: pathophysiology and clinical diagnosis]. J Fr Ophtalmol 2014; 37:557-65. [PMID: 24997864 DOI: 10.1016/j.jfo.2014.04.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Revised: 04/22/2014] [Accepted: 04/23/2014] [Indexed: 12/24/2022]
Abstract
Proliferative vitreoretinopathy (PVR) remains one of the most common causes of failed retinal detachment (RD) surgery. Many histological and clinical studies have highlighted the chain of events leading to PVR: cellular migration into the vitreous cavity, cellular differentiation, myofibroblast proliferation and activation, synthesis of extracellular matrix proteins, then contraction of preretinal tissues. The development of PVR can be explained schematically by cellular exposure to growth factors and cytokines (particularly retinal pigment epithelial cells and glial cells), in the context of break-down of the blood-retinal barrier (inflammation, choroidal detachment, iatrogenic effect of cryotherapy and surgery) and of cellular contact with the vitreous. Although the pathophysiology of PVR is now better understood, its severity remains an issue. A systematic search for preoperative PVR risk factors allows the most suitable therapeutic option to be chosen.
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Affiliation(s)
- F Rouberol
- Centre d'ophtalmologie Kléber, 50, cours Franklin-Roosevelt, 69006 Lyon, France
| | - C Chiquet
- Clinique universitaire d'ophtalmologie, université J.-Fourier, CHU de Grenoble, CS 2017, 38043 Grenoble cedex 09, France.
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Kim B, Abdel-Rahman MH, Wang T, Pouly S, Mahmoud AM, Cebulla CM. Retinal MMP-12, MMP-13, TIMP-1, and TIMP-2 expression in murine experimental retinal detachment. Invest Ophthalmol Vis Sci 2014; 55:2031-40. [PMID: 24526442 DOI: 10.1167/iovs.13-13374] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
PURPOSE Matrix metalloproteinases (MMPs) and their inhibitors play a role in the pathobiology of retinal detachment (RD) and proliferative vitreoretinopathy (PVR). Proliferative vitreoretinopathy is facilitated by chronic retinal detachment and involves excessive deposition of extracellular matrix (ECM) proteins. Matrix metalloproteinase-2 and -13 are important modulators of the ECM which have not been evaluated in RD. The purpose of this study was to investigate the retinal expression of select MMPs, including MMP-12, MMP-13, and associated inhibitors in a murine model of retinal detachment. METHODS Transient or chronic retinal detachments (RDs) were induced by subretinal injection of either saline (SA) or hyaluronic acid (HA) in C57BL/6 mice. To confirm that the HA-RD model has features consistent with PVR-like changes, glial activation and subretinal fibrosis were evaluated with immunofluorescence, dilated fundus examination, and spectral-domain optical coherence tomography (SD-OCT). Gene expression was quantified by qRT-PCR. Proteins were assayed by immunoblot and immunohistochemistry. RESULTS Hyaluronic acid RD eyes developed gliosis and subretinal fibrosis on dilated exam, SD-OCT, and immunofluorescence analysis. Gene expression of Mmp-12 and Mmp-13, and Timp-1 was strongly upregulated at all time points in RD compared with controls. Timp-2, Mmp-2, and Mmp-9 expression was modest. Hyaluronic acid RDs exhibited more MMP and TIMP expression than SA-RDs. MMP-12, -13, and TIMP-1 proteins were elevated in RDs compared with controls. Immunohistochemistry revealed moderate to strong MMP-13 levels in subretinal space macrophages. CONCLUSIONS Fibrosis can develop in the HA-RD model. There is an upregulation of select MMPs that may modulate the wound healing process following RD.
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Affiliation(s)
- Bongsu Kim
- Havener Eye Institute, Department of Ophthalmology and Visual Science, The Ohio State University, Columbus, Ohio, United States
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20
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Garweg JG, Tappeiner C, Halberstadt M. Pathophysiology of proliferative vitreoretinopathy in retinal detachment. Surv Ophthalmol 2013; 58:321-9. [PMID: 23642514 DOI: 10.1016/j.survophthal.2012.12.004] [Citation(s) in RCA: 94] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2012] [Revised: 12/02/2012] [Accepted: 12/04/2012] [Indexed: 10/26/2022]
Abstract
Because proliferative vitreoretinopathy cannot be effectively treated, its prevention is indispensable for the success of surgery for retinal detachment. The elaboration of preventive and therapeutic strategies depends upon the identification of patients who are genetically predisposed to develop the disease, as well as upon an understanding of the biological process involved and the role of local factors, such as the status of the uveovascular barrier. Detachment of the retina or vitreous activates glia to release cytokines and ATP, which not only protect the neuroretina but also promote inflammation, retinal ischemia, cell proliferation, and tissue remodeling. The vitreal microenvironment favors cellular de-differentiation and proliferation of cells with nonspecific nutritional requirements. This may render a pharmacological inhibition of their growth difficult without causing damage to the pharmacologically vulnerable neuroretina. Moreover, reattachment of the retina relies upon the local induction of a controlled wound-healing response involving macrophages and proliferating glia. Hence, the functional outcome of proliferative vitreoretinopathy will be determined by the equilibrium established between protective and destructive repair mechanisms, which will be influenced by the location and the degree of damage to the photoreceptor cells that is induced by peri-retinal gliosis.
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Affiliation(s)
- Justus G Garweg
- Swiss Eye Institute and University of Bern, Bern, Switzerland.
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21
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Time course of changes in aqueous flare intensity after vitrectomy for rhegmatogenous retinal detachment. Retina 2013; 32:1862-7. [PMID: 22466487 DOI: 10.1097/iae.0b013e3182456f38] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To investigate the time course of changes in aqueous flare intensity after vitrectomy for rhegmatogenous retinal detachment (RD) and to determine the clinical factors related to an increase in aqueous flare. METHODS The present study included 22 unilateral patients with RD undergoing primary 20-gauge vitrectomy. Aqueous flare intensity was measured preoperatively and at 1 week, 2 weeks, 1 month, and 3, 6, and 12 months postoperatively using the laser flare meter. RESULTS Before vitrectomy, aqueous flare intensity was significantly higher in eyes with RD than in contralateral normal eyes. Vitrectomy increased aqueous flare intensity, and the peak was observed at the first postoperative week. Aqueous flare intensity decreased to a stable level at 3 months postoperatively but remained significantly higher than that of contralateral and preoperative eyes throughout the observation period. Clinical factors that were found to be significantly correlated with an increase in aqueous flare intensity included 1) before the surgical procedure: extent of RD and intraocular pressure, and 2) 3 months postoperatively: size of retinal breaks, number of laser photocoagulation spots, operation time, and performance of combined cataract surgery. Multiple regression analysis revealed that aqueous flare intensity at 3 months postoperatively had significant correlation with the size of retinal breaks (P < 0.005) and the number of laser photocoagulation spots (P < 0.05). CONCLUSION Aqueous flare intensity after vitrectomy for RD decreased to a stable level at 3 months postoperatively but remained significantly higher than the normal level. The size of retinal breaks and the degree of surgical invasion were associated with the increase in aqueous flare.
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22
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Lee SY, Ryan SJ. Pathophysiology of Ocular Trauma. Retina 2013. [DOI: 10.1016/b978-1-4557-0737-9.00098-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Zhang W, Tan J, Liu Y, Li W, Gao Q, Lehmann PV. Assessment of the innate and adaptive immune system in proliferative vitreoretinopathy. Eye (Lond) 2012; 26:872-81. [PMID: 22460468 PMCID: PMC3376296 DOI: 10.1038/eye.2012.52] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
PURPOSE Proliferative vitreoretinopathy (PVR) is the leading cause of failure of surgery for rhegmatogenous retinal detachment. Although indirect evidence suggests that this disease might be autoimmune in nature, direct proof for this hypothesis is lacking. The purpose of this study was to determine in a murine model whether PVR can develop in the absence of T- or B-cell immunity. METHODS Four- to six-week-old Rag-1 gene knockout (KO) and congenic wild-type mice (WT) on the C57.Bl/6 background were studied. PVR was induced by intravitreal injection of 3 μl dispase at the concentration of 0.2 U/μl. PVR development was monitored by electroretinograms, the macroscopic observation of hemorrhage, cataract, retinal folds, and of an uneven iris, as well as the histological detection of epiretinal membranes on haematoxylin-eosin stained tissue. Additionally, immunofluorescence analysis was performed. These manifestations of PVR were assessed 1, 2, 4, 6, and 8 weeks after the intravitreal injection. RESULTS The data showed that the immune-deficient Rag-1 KO mice developed PVR with similar kinetics and severity as did the fully immune competent congenic WT mice. Carboxyfluorescein diacetate succinimidyl ester-labeled T cells that are specific for ovalbumin were detected in the inflamed vitreous and retina showing that T cells that are not specific for autoantigens present in the eye can migrate to PVR lesions. Therefore, the mere presence of T cells in PVR lesions does not imply an autoimmune pathogenesis. CONCLUSION This study suggests that T- and B-cell immunity is not essential for the induction of PVR.
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Affiliation(s)
- W Zhang
- Department of Pathology, Case Western Reserve University, Cleveland, OH, USA
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Zhou Q, Xu G, Zhang X, Cao C, Zhou Z. Proteomics of Post-Traumatic Proliferative Vitreoretinopathy in Rabbit Retina Reveals Alterations to a Variety of Functional Proteins. Curr Eye Res 2012; 37:318-26. [DOI: 10.3109/02713683.2011.635397] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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25
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Delyfer MN, Raffelsberger W, Mercier D, Korobelnik JF, Gaudric A, Charteris DG, Tadayoni R, Metge F, Caputo G, Barale PO, Ripp R, Muller JD, Poch O, Sahel JA, Léveillard T. Transcriptomic analysis of human retinal detachment reveals both inflammatory response and photoreceptor death. PLoS One 2011; 6:e28791. [PMID: 22174898 PMCID: PMC3235162 DOI: 10.1371/journal.pone.0028791] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2011] [Accepted: 11/15/2011] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Retinal detachment often leads to a severe and permanent loss of vision and its therapeutic management remains to this day exclusively surgical. We have used surgical specimens to perform a differential analysis of the transcriptome of human retinal tissues following detachment in order to identify new potential pharmacological targets that could be used in combination with surgery to further improve final outcome. METHODOLOGY/PRINCIPAL FINDINGS Statistical analysis reveals major involvement of the immune response in the disease. Interestingly, using a novel approach relying on coordinated expression, the interindividual variation was monitored to unravel a second crucial aspect of the pathological process: the death of photoreceptor cells. Within the genes identified, the expression of the major histocompatibility complex I gene HLA-C enables diagnosis of the disease, while PKD2L1 and SLCO4A1 -which are both down-regulated- act synergistically to provide an estimate of the duration of the retinal detachment process. Our analysis thus reveals the two complementary cellular and molecular aspects linked to retinal detachment: an immune response and the degeneration of photoreceptor cells. We also reveal that the human specimens have a higher clinical value as compared to artificial models that point to IL6 and oxidative stress, not implicated in the surgical specimens studied here. CONCLUSIONS/SIGNIFICANCE This systematic analysis confirmed the occurrence of both neurodegeneration and inflammation during retinal detachment, and further identifies precisely the modification of expression of the different genes implicated in these two phenomena. Our data henceforth give a new insight into the disease process and provide a rationale for therapeutic strategies aimed at limiting inflammation and photoreceptor damage associated with retinal detachment and, in turn, improving visual prognosis after retinal surgery.
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Affiliation(s)
- Marie-Noëlle Delyfer
- INSERM, U968, Paris, France
- UPMC Univ Paris 06, UMR_S 968, Institut de la Vision, Paris, France
- CNRS, UMR_7210, Paris, France
- Unité Rétine, Uvéite et Neuro-Ophtalmologie, Département d'Ophtalmologie, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Wolfgang Raffelsberger
- Laboratoire de BioInformatique et Génomique Intégratives, CNRS UMR_7104, Institut de Génétique et de Biologie Moléculaire et Cellulaire, Strasbourg, France
| | - David Mercier
- CEA, LIST, Information, Models and Learning Laboratory, Gif-sur-Yvette, France
| | - Jean-François Korobelnik
- Unité Rétine, Uvéite et Neuro-Ophtalmologie, Département d'Ophtalmologie, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Alain Gaudric
- Département d'Ophtalmologie, Hôpital Lariboisière, Paris, France
| | | | - Ramin Tadayoni
- Département d'Ophtalmologie, Hôpital Lariboisière, Paris, France
| | - Florence Metge
- Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
| | - Georges Caputo
- Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
| | | | - Raymond Ripp
- Laboratoire de BioInformatique et Génomique Intégratives, CNRS UMR_7104, Institut de Génétique et de Biologie Moléculaire et Cellulaire, Strasbourg, France
| | - Jean-Denis Muller
- CEA, LIST, Information, Models and Learning Laboratory, Gif-sur-Yvette, France
| | - Olivier Poch
- INSERM, U968, Paris, France
- UPMC Univ Paris 06, UMR_S 968, Institut de la Vision, Paris, France
- CNRS, UMR_7210, Paris, France
- Laboratoire de BioInformatique et Génomique Intégratives, CNRS UMR_7104, Institut de Génétique et de Biologie Moléculaire et Cellulaire, Strasbourg, France
| | - José-Alain Sahel
- INSERM, U968, Paris, France
- UPMC Univ Paris 06, UMR_S 968, Institut de la Vision, Paris, France
- CNRS, UMR_7210, Paris, France
- Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
- Centre Ophtalmologique des Quinze-Vingts, Paris, France
| | - Thierry Léveillard
- INSERM, U968, Paris, France
- UPMC Univ Paris 06, UMR_S 968, Institut de la Vision, Paris, France
- CNRS, UMR_7210, Paris, France
- * E-mail:
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Yang D, Elner SG, Chen X, Field MG, Petty HR, Elner VM. MCP-1-activated monocytes induce apoptosis in human retinal pigment epithelium. Invest Ophthalmol Vis Sci 2011; 52:6026-34. [PMID: 21447688 DOI: 10.1167/iovs.10-7023] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
PURPOSE The inflammatory response in age-related macular degeneration (AMD) is characterized by mononuclear leukocyte infiltration of the outer blood-retina barrier formed by the retinal pigment epithelium (RPE). A key mechanistic element in AMD progression is RPE dysfunction and apoptotic cell loss. The purpose of this study was to evaluate whether monocyte chemoattractant protein (MCP)-1-activated monocytes induce human RPE apoptosis and whether Ca(2+) and reactive oxygen species (ROS) are involved in this process. METHODS A cell-based fluorometric assay was used to measure intracellular Ca(2+) concentrations ([Ca(2+)](i)) in RPE cells loaded with fluorescent Ca(2+) indicator. Intracellular RPE ROS levels were measured by using the 5- and 6-chloromethyl-2',7'-dichlorodihydrofluorescence diacetate acetyl ester (CM-H(2)DCFDA) assay. RPE apoptosis was evaluated by activated caspase-3, Hoechst staining, and apoptosis ELISA. RESULTS MCP-1-activated human monocytes increased [Ca(2+)](i), ROS levels, and apoptosis in RPE cells, all of which were inhibited by 8-bromo-cyclic adenosine diphosphoribosyl ribose (8-Br-cADPR), an antagonist of cADPR. Although the ROS scavengers pyrrolidinedithiocarbamate (PDTC) and N-acetylcysteine (NAC) significantly inhibited ROS production and apoptosis induced by activated monocytes, they did not affect induced Ca(2+) levels. The induced Ca(2+) levels and apoptosis in RPE cells were inhibited by an antibody against cluster of differentiation antigen 14 (CD14), an adhesion molecule expressed by these cells. CONCLUSIONS These results indicate that CD14, Ca(2+), and ROS are involved in activated monocyte-induced RPE apoptosis and that cADPR contributes to these changes. Understanding the complex interactions among CD14, cADPR, Ca(2+), and ROS may provide new insights and treatments of retinal diseases, including AMD.
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Affiliation(s)
- Dongli Yang
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan 48105-0714, USA
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Wickham L, Tranos P, Hiscott P, Charteris D. The use of silicone oil-RMN3 (Oxane HD) as heavier-than-water internal tamponade in complicated inferior retinal detachment surgery. Graefes Arch Clin Exp Ophthalmol 2010; 248:1225-31. [DOI: 10.1007/s00417-010-1358-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2009] [Revised: 02/14/2010] [Accepted: 03/08/2010] [Indexed: 10/19/2022] Open
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Bali E, Feron EJ, Peperkamp E, Veckeneer M, Mulder PG, van Meurs JC. The effect of a preoperative subconjuntival injection of dexamethasone on blood-retinal barrier breakdown following scleral buckling retinal detachment surgery: a prospective randomized placebo-controlled double blind clinical trial. Graefes Arch Clin Exp Ophthalmol 2010; 248:957-62. [PMID: 20182883 PMCID: PMC2877815 DOI: 10.1007/s00417-010-1319-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2009] [Revised: 01/25/2010] [Accepted: 01/31/2010] [Indexed: 11/30/2022] Open
Abstract
Background Blood–retinal barrier breakdown secondary to retinal detachment and retinal detachment repair is a factor in the pathogenesis of proliferative vitreoretinopathy (PVR). We wished to investigate whether an estimated 700 to 1000 ng/ml subretinal dexamethasone concentration at the time of surgery would decrease the blood–retinal barrier breakdown postoperatively. Methods Prospective, placebo-controlled, double blind clinical trial. In 34 patients with rhegmatogenous retinal detachment scheduled for conventional scleral buckling retinal detachment surgery, a subconjunctival injection of 0.5 ml dexamethasone diphosphate (10 mg) or 0.5 ml placebo was given 5–6 hours before surgery. Differences in laser flare photometry (KOWA) measurements taken 1, 3 and 6 weeks after randomisation between dexamethasone and placebo were analysed using mixed model ANOVA, while correcting for the preoperative flare measurement. Results Six patients did not complete the study, one because of recurrent detachment within 1 week, and five because they missed their postoperative laser flare visits. The use of dexamethasone resulted in a statistically significant decrease in laser flare measurements at the 1-week postoperative visit. Conclusion The use of a preoperative subconjunctival injection of dexamethasone decreased 1-week postoperative blood–retina barrier breakdown in patients undergoing conventional scleral buckling retinal detachment surgery. This steroid priming could be useful as a part of a peri-operative regime that would aim at decreasing the incidence of PVR.
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Affiliation(s)
- Ernesto Bali
- The Rotterdam Eye Hospital, Rotterdam, The Netherlands
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Cheng YW, Wang YL, Zhang YH, Peng SX, Chiou GCY. Proliferation of retinal pigment epithelial cells induced by (R,R)-XY-10 and (S,S)-XY-10 and their action mechanisms. Int J Ophthalmol 2010; 3:9-13. [PMID: 22553508 DOI: 10.3980/j.issn.2222-3959.2010.01.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2009] [Accepted: 01/04/2010] [Indexed: 11/02/2022] Open
Abstract
AIM To investigate the mechanism of proliferation effect induced by (R,R)-XY-10 and (S,S)-XY-10 on retinal pigmented epithelial cells (ARPE-19). METHODS Human retinal pigmented epithelial cells (ARPE-19) and human umbilical vein endothelial cells (HUVECs) were used to investigate the effect of (R,R)-XY-10 and (S,S)-XY-10 on cell growth, and their mechanisms of proliferative action by using ERK, AKT, PI3K, Protein kinase C (PKC) and Nitric oxide synthase (NOS) inhibitors. RESULTS (R,R)-XY-10 and (S,S)-XY-10 dose-dependently increased ARPE-19 cell proliferation, but not on HUVECs. When treated with proliferative inhibitors, H-7 (5µmol/L), hypericin (20µmol/L), PD98059 (2µmol/L), LY294002 (50µmol/L), SH-5 (10µmol/L) and L-NAME (100µmol/L), the proliferative effect was reduced by H-7, hypericin, PD98059 and LY294002, but not by SH-5 and L-NAME. CONCLUSION (R,R)-XY-10 and (S,S)-XY-10 can induce cell proliferation through MAPK and PI3K dependent pathway.
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Affiliation(s)
- Yu-Wen Cheng
- Institute of Ocular Pharmacology, College of Medicine, Texas A&M Health Science Center, College Station, TX 77843, USA
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Yoshimura T, Sonoda KH, Sugahara M, Mochizuki Y, Enaida H, Oshima Y, Ueno A, Hata Y, Yoshida H, Ishibashi T. Comprehensive analysis of inflammatory immune mediators in vitreoretinal diseases. PLoS One 2009; 4:e8158. [PMID: 19997642 PMCID: PMC2780733 DOI: 10.1371/journal.pone.0008158] [Citation(s) in RCA: 248] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2009] [Accepted: 11/11/2009] [Indexed: 11/19/2022] Open
Abstract
Inflammation affects the formation and the progression of various vitreoretinal diseases. We performed a comprehensive analysis of inflammatory immune mediators in the vitreous fluids from total of 345 patients with diabetic macular edema (DME, n = 92), proliferative diabetic retinopathy (PDR, n = 147), branch retinal vein occlusion (BRVO, n = 30), central retinal vein occlusion (CRVO, n = 13) and rhegmatogenous retinal detachment (RRD, n = 63). As a control, we selected a total of 83 patients with either idiopathic macular hole (MH) or idiopathic epiretinal membrane (ERM) that were free of major pathogenic intraocular changes, such as ischemic retina and proliferative membranes. The concentrations of 20 soluble factors (nine cytokines, six chemokines, and five growth factors) were measured simultaneously by multiplex bead analysis system. Out of 20 soluble factors, three factors: interleukin-6 (IL-6), interleukin-8 (IL-8), and monocyte chemoattractant protein-1 (MCP-1) were significantly elevated in all groups of vitreoretinal diseases (DME, PDR, BRVO, CRVO, and RRD) compared with control group. According to the correlation analysis in the individual patient's level, these three factors that were simultaneously increased, did not show any independent upregulation in all the examined diseases. Vascular endothelial growth factor (VEGF) was significantly elevated in patients with PDR and CRVO. In PDR patients, the elevation of VEGF was significantly correlated with the three factors: IL-6, IL-8, and MCP-1, while no significant correlation was observed in CRVO patients. In conclusion, multiplex bead system enabled a comprehensive soluble factor analysis in vitreous fluid derived from variety of patients. Major three factors: IL-6, IL-8, and MCP-1 were strongly correlated with each other indicating a common pathway involved in inflammation process in vitreoretinal diseases.
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Affiliation(s)
- Takeru Yoshimura
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Koh-Hei Sonoda
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- * E-mail:
| | - Mika Sugahara
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yasutaka Mochizuki
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroshi Enaida
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yuji Oshima
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Akifumi Ueno
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yasuaki Hata
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroki Yoshida
- Department of Biomolecular Sciences, Faculty of Medicine, Saga University, Nabeshima, Saga, Japan
| | - Tatsuro Ishibashi
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Bian ZM, Elner SG, Elner VM. Dual involvement of caspase-4 in inflammatory and ER stress-induced apoptotic responses in human retinal pigment epithelial cells. Invest Ophthalmol Vis Sci 2009; 50:6006-14. [PMID: 19643964 PMCID: PMC3208232 DOI: 10.1167/iovs.09-3628] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To investigate the functional involvement of caspase-4 in human retinal pigment epithelial (hRPE) cells. METHODS Expression and activation of caspase-4 in hRPE cells were measured after stimulation with proinflammatory agents IL-1beta (2 ng/mL), TNF-alpha (20 ng/mL), lipopolysaccharide (1000 ng/mL), interferon-gamma (500 U/mL), or monocyte coculture in the absence or presence of immunomodulating agent cyclosporine (3 or 30 ng/mL), dexamethasone (10 microM), or IL-10 (100 U/mL) and endoplasmic reticulum (ER) stress inducer thapsigargin (25 nM) or tunicamycin (3 or 10 microM). The onset of ER stress was determined by expression of GRP78. The involvement of caspase-4 in inflammation and apoptosis was further examined by treating the cells with caspase-4 inhibitor Z-LEVD-fmk, caspase-1 and -4 inhibitor Z-YVAD-fmk, and pan-caspase inhibitor Z-VAD-fmk. RESULTS Caspase-4 mRNA expression and protein activation were induced by all the proinflammatory agents and ER stress inducers tested in this study. Caspase-4 activation was blocked or reduced by dexamethasone and IL-10. Elevated ER stress by proinflammatory agents and ER stress inducers was shown by increased expression of the ER stress marker GRP78. The induced caspase-4 and caspase-3 activities by tunicamycin and the stimulated IL-8 protein expression by IL-1beta were markedly reduced by caspase-4 inhibitor Z-LEVD-fmk. Although caspase-4 inhibitor Z-LEVD-fmk and caspase-1 and -4 inhibitor Z-YVAD-fmk reduced tunicamycin-induced hRPE apoptotic cell death by 59% and 86%, respectively, pan-caspase inhibitor Z-VAD-fmk completely abolished the induced apoptosis. CONCLUSIONS Caspase-4 is dually involved in hRPE proinflammatory and proapoptotic responses. Various proinflammatory stimuli and ER stress induce hRPE caspase-4 mRNA synthesis and protein activation. ER stress-induced hRPE cell death is caspase and, in part, caspase-4 dependent.
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Affiliation(s)
- Zong-Mei Bian
- Department of Ophthalmology, University of Michigan, Ann Arbor, Michigan 48105, USA
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Yu J, Liu F, Cui SJ, Liu Y, Song ZY, Cao H, Chen FE, Wang WJ, Sun T, Wang F. Vitreous proteomic analysis of proliferative vitreoretinopathy. Proteomics 2008; 8:3667-78. [PMID: 18752205 DOI: 10.1002/pmic.200700824] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Proliferative vitreoretinopathy (PVR) is the most common cause of anatomic failure in retinal detachment surgery. To understand the molecular mechanisms, vitreous proteomes of patients with PVR were investigated by two-dimensional-nano-liquid chromatography coupled with tandem mass spectrometry. Vitreous samples of moderate PVR (grade B), and severe PVR (grade C or D) were aspirated during pars plana vitrectomy before infusion. In the current study, 129, 97 and 137 proteins were identified in vitreous of normal control, moderate and severe PVR, respectively. In PVR vitreous samples, complement components, serine proteinase inhibitors, and extracellular proteins were up-regulated or appeared, while normal cytoskeleton and metabolism proteins were down-regulated or disappeared. It was noteworthy that the proteins involved in transcription and translation regulation increased in vitreous with PVR. Among 102 PVR-specific proteins, kininogen 1 was specifically detected in both vitreous and the corresponding serum. Therefore, it can be concluded that PVR is a complicated pathology process with great amount of proteins involved in metabolism dysfunction, immune reactions, and cytoskeleton remolding. Kininogen 1 may be a candidate biomarker of PVR. Further investigations of these special proteins will provide additional targets for treatment or prevention of ocular proliferative diseases.
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Affiliation(s)
- Jing Yu
- The First People Hospital affiliated to Shanghai Jiaotong University, Shanghai, P. R. China
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Bian ZM, Elner SG, Elner VM. Regulated expression of caspase-12 gene in human retinal pigment epithelial cells suggests its immunomodulating role. Invest Ophthalmol Vis Sci 2008; 49:5593-601. [PMID: 18791174 DOI: 10.1167/iovs.08-2116] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
PURPOSE To investigate the expression and regulation of the short form of caspase-12, caspase-12S, in human retinal pigment epithelial (hRPE) cells. METHODS hRPE cells were stimulated by the proinflammatory agents IL-1beta (2 ng/mL) and TNF-alpha (20 ng/mL); LPS (1000 ng/mL); coculture with monocytes; the immunomodulating agent cyclosporine (Cys; 30 ng/mL); the anti-inflammatory cytokine IL-10 (100 U/mL); and the endoplasmic reticulum (ER) stress inducers tunicamycin (3 or 10 muM) and thapsigargin (25 or 100 nM) for 6 hours or longer. The total RNAs were isolated and subjected to semiquantitative and quantitative real-time RT-PCR analysis. Effects of tunicamycin and thapsigargin on IL-1beta- and TNF-alpha-stimulated MCP-1 mRNA expression and protein production were further examined by RT-PCR and ELISA, respectively. RESULTS RT-PCR results showed that caspase-12S is the predominant form of caspase-12 in the examined hRPE cells of this study, with expression at levels as high as those in many other human tissues such as pancreas, prostate, small intestine, lung, spleen, and kidney. Treatment with IL-1beta and TNF-alpha, as well as LPS and coculture with monocytes reduced hRPE caspase-12S mRNA expression within 6 hours. In contrast, hRPE exposure to cyclosporine (Cys) and the cytokine IL-10 for 6 hours increased caspase-12S mRNA expression. Compared to Cys and IL-10, the ER stress activators tunicamycin and thapsigargin were even more potent enhancers of hRPE caspase-12S gene expression. They also caused corresponding reductions in IL-1beta- and TNF-alpha-induced MCP-1 mRNA expression and protein production. CONCLUSIONS hRPE cells express a high level of caspase-12S. The regulated expression of caspase-12S suggests that this caspase recruitment domain (CARD)-only protein may be an endogenous dominant negative regulator that modulates inflammatory responses in hRPE cells.
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Affiliation(s)
- Zong-Mei Bian
- Department of Ophthalmology, University of Michigan, Ann Arbor, Michigan 48105, USA
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Wickham LJ, Asaria RH, Alexander R, Luthert P, Charteris DG. Immunopathology of intraocular silicone oil: retina and epiretinal membranes. Br J Ophthalmol 2006; 91:258-62. [PMID: 17005544 PMCID: PMC1857625 DOI: 10.1136/bjo.2006.103549] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIMS To determine the inflammatory response in retina and epiretinal membranes after intraocular silicone oil tamponade. METHODS 14 proliferative vitreoretinopathy (PVR) epiretinal membranes, 33 retro-oil epiretinal membranes, 19 retinectomies, 14 retro-oil retinectomies and 37 idiopathic epiretinal membranes (controls) underwent immunohistochemical analysis using the avidin-biotin complex technique and a panel of monoclonal and polyclonal antibodies. The number of positive cells counted in five 0.5 mm diameter fields of immunohistochemical sections was graded on a score of 1-4. RESULTS Macrophage cell counts were significantly greater in membranes with a history of exposure to silicone oil (p<0.001). An inflammatory response could be observed within 1 month of silicone oil exchange, and the intensity seemed to be unrelated to the duration of exposure. Macrophages were confined to epiretinal membranes on the surface of retinectomy specimens in 10 of 14 cases and intraretinal macrophages were observed only in specimens with gliotic retina. T and B lymphocytes were rarely seen in the specimens examined. Marked glial cell up regulation was observed in 11 of 16 retinectomy specimens and in 8 of 11 retro-oil retinectomies. Glial cell content was variable in the membranes, but there was a trend of increased presence after exposure to silicone oil. CONCLUSION This study has shown that the use of silicone oil is accompanied by an inflammatory reaction, primarily mediated by bloodborne macrophages. This response can be observed within 1 month of silicone oil injection and continues after silicone oil removal. Retinal surgeons should be aware of the potential secondary effects of intraocular silicone oil when they are considering its use (and removal) in vitreoretinal surgery.
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Ryan SJ, Yoon YH. Posterior Segment Trauma: Open Globe. Retina 2006. [DOI: 10.1016/b978-0-323-02598-0.50144-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Bian ZM, Elner SG, Yoshida A, Elner VM. Human RPE-monocyte co-culture induces chemokine gene expression through activation of MAPK and NIK cascade. Exp Eye Res 2003; 76:573-83. [PMID: 12697421 DOI: 10.1016/s0014-4835(03)00029-0] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Cell-cell contact between human retinal pigment epithelium (hRPE) cells and monocytes occurs in many retinal diseases involving blood-retinal barrier breakdown. This study investigates chemokine secretion induced by co-culture of hRPE cells and monocytes and illustrates the roles of p38 kinase, ERK, JNK/SAPK and NF-kappaB-inducing kinase signaling pathways for hRPE IL-8 and MCP-1 secretion induced in hRPE by co-culture with monocytes. Co-culture of hRPE cells with monocytes increased steady-state IL-8 and MCP-1 mRNA and protein secretion. Stimulation of hRPE cells by monocytes resulted in prominent increases in p38, ERK1/2 and JNK/SAPK phosphorolation, IkappaBalpha degradation, and NF-kappaB nuclear translocation. The induced IL-8 and MCP-1 proteins were almost completely supporessed by U0126, a specific mitogen-activated protein kinase kinase (MEK) inhibitor, or by SB203580, a selective p38 inhibitor. Chemokine secretion was completely blocked by simultaneous administration of U0126 and SB203580. Induction of IL-8 and MCP-1 was abrogated by Ro318220, an inhibitor of PKC, as well as by genistein or herbimycin A, inhibitors of PTK. In addition, anti-inflammatory drugs dexamethasone (DEX) and cyclosporin A (CSA) both blocked activation of JNKS/SAPK and the cell-cell contact induced production of hRPE IL-8 and MCP-1, while activation of p38 and ERK was only inhibited by DEX, but not by CSA. These results suggest that activation of DEX-sensitive, CSA-resistant MEK/ERK and p38 pathways, and activation of NF-kappaB, PKC, and PTK are essential for IL-8 and MCP-1 expression by hRPE cells.
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Affiliation(s)
- Zong-Mei Bian
- Department of Ophthalmology, University of Michigan, Ann Arbor, MI 48105, USA
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Hiscott P, Hagan S, Heathcote L, Sheridan CM, Groenewald CP, Grierson I, Wong D, Paraoan L. Pathobiology of epiretinal and subretinal membranes: possible roles for the matricellular proteins thrombospondin 1 and osteonectin (SPARC). Eye (Lond) 2002; 16:393-403. [PMID: 12101446 DOI: 10.1038/sj.eye.6700196] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Epiretinal and subretinal membranes are fibrocellular proliferations which form on the surfaces of the neuroretina as a sequel to a variety of ocular diseases. When these proliferations complicate rhegmatogenous retinal detachment (a condition known as proliferative vitreoretinopathy or PVR), the membranes often contain numerous retinal pigment epithelial (RPE) cells and a variety of extracellular proteins. The extracellular proteins include adhesive proteins like collagen, laminin and fibronectin. In addition, several matricellular proteins with potential counter-adhesive functions are present in the membranes. Two such matricellular proteins, thrombospondin 1 and osteonectin (or SPARC: Secreted Protein Acidic and Rich in Cysteine), tend to be co-distributed with the RPE cells in PVR membranes. By virtue of their counter-adhesive properties, thrombospondin 1 and SPARC may reduce RPE cell-matrix adhesion and so permit key RPE cellular activities (for example, migration or shape change) in periretinal membrane development. Furthermore, within a 'cocktail' containing other proteins such as the metalloproteinases and growth factors like the scatter factor/hepatocyte growth factor family, matricellular proteins may play a role in the RPE cell dissociation from Bruch's membrane, which characterises early PVR.
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Affiliation(s)
- P Hiscott
- Unit of Ophthalmology Department of Medicine University of Liverpool Liverpool, UK.
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Macky TA, Oelkers C, Rix U, Heredia ML, Künzel E, Wimberly M, Rohrer B, Crosson CE, Rohr J. Synthesis, pharmacokinetics, efficacy, and rat retinal toxicity of a novel mitomycin C-triamcinolone acetonide conjugate. J Med Chem 2002; 45:1122-7. [PMID: 11855992 DOI: 10.1021/jm010511b] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
A novel conjugate of mitomycin C (MMC) and triamcinolone acetonide (TA) was synthesized using glutaric acid as a linker molecule. To determine the rate of hydrolysis, the conjugate was dissolved in aqueous solution and the rate of appearance of free MMC and TA was determined by high-performance liquid chromatography analysis. Antiproliferative activity of the MMC-TA conjugate and parent compounds was assessed using an NIH 3T3 fibroblast cell line. Cell growth was quantified using the MTT assay. Kinetic analysis of the hydrolysis rate demonstrated that the conjugate had a half-life of 23.6 h in aqueous solutions. The antiproliferative activities of the MMC-TA conjugate and MMC were both concentration dependent, with similar IC(50) values of 2.4 and 1.7 microM, respectively. However, individual responses at concentrations above 3 microM showed that the conjugate was less active than MMC alone. TA alone showed only limited inhibition of cell growth. Studies evaluating intravitreal injection of the conjugate demonstrate that this agent produced no measurable toxicity. Our data provide evidence that the MMC-TA conjugate could be used as a slow-release drug delivery system. This could in turn be used to modulate a posttreatment wound healing process or to treat various proliferative diseases.
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Affiliation(s)
- Tamer A Macky
- Department of Ophthalmology, Medical University of South Carolina, 280 Calhoun Street, Charleston, South Carolina 29425-2301, USA
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Pastor JC, de la Rúa ER, Martín F. Proliferative vitreoretinopathy: risk factors and pathobiology. Prog Retin Eye Res 2002; 21:127-44. [PMID: 11906814 DOI: 10.1016/s1350-9462(01)00023-4] [Citation(s) in RCA: 254] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Proliferative vitreoretinopathy (PVR) is still a major cause of failure of retinal detachment surgery. Despite a dramatic increase in our pathobiologic knowledge of PVR during the last 10 years, little of this information has been used to modify the surgical management of the disease, and, thus, the anatomic and functional results are still unsatisfactory. Collaborative research involving clinicians and basic researchers must be encouraged. PVR must be considered a multifactorial disease caused by interaction of several cells and intra- and extraocular factors. Therefore, therapeutic options based on the inhibition of one factor or phenomenon may be regarded with scepticism. To prevent PVR, it is necessary to determine the factors involved in its development, and because of its relatively small prevalence, large, prospective, multicenter studies seem necessary. In addition, clinical research must not be underestimated. PVR affects both sides of the retina and the retina itself, a point to which little attention has been paid and that is critical for surgical results. Therefore, a new classification that provides information about clinical relevance, such as the evolutionary stages of the disease (biologic activity) and the degree of surgical difficulty (location of the fibrotic process), seems necessary.
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Affiliation(s)
- J Carlos Pastor
- Instituto Universitario de Oftalmobiología Aplicada (IOBA), University of Valladolid, Retina Group, Ramon y Cajal, 7, 47005, Spain.
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Bian ZM, Elner SG, Yoshida A, Kunkel SL, Su J, Elner VM. Activation of p38, ERK1/2 and NIK pathways is required for IL-1beta and TNF-alpha-induced chemokine expression in human retinal pigment epithelial cells. Exp Eye Res 2001; 73:111-21. [PMID: 11428868 DOI: 10.1006/exer.2001.1019] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Chemokine secretion by human retinal pigment epithelium (hRPE) in response to IL-1beta and TNF-alpha occurs in infectious and noninfectious retinal diseases. In this study, the roles of p38 kinase and extracellular signal-regulated kinase (ERK) signaling pathways were investigated for IL-1beta- or TNF-alpha-induced IL-8 and MCP-1 secretion by hRPE cells. Treatment of hRPE cells with IL-1beta or TNF-alpha caused increased steady-state IL-8 and MCP-1 mRNA levels and protein secretion. Stimulation of hRPE with IL-1beta and TNF-alpha resulted in degradation of IkappaB-alpha, nuclear translocation of NF-kappaB, and prominent increases in p38 and ERK1/2 phosphorylation for as little as 3 min. The induced IL-8 and MCP-1 mRNA and proteins were partially suppressed by U0126, a specific MEK inhibitor, and by SB202190, a selective p38 inhibitor. This induction was completely blocked by simultaneous administration of the two drugs or by incubation with inhibitors for activation of NF-kappaB such as BAY11-7085, CAPE, and parthenolide. These results suggest that co-activation of MEK/ERK and p38 pathways as well as activation of NIK pathway are essential for IL-1beta- and TNF-alpha-stimulation of IL-8 and MCP-1 gene expression in hRPE cells. Furthermore, co-administration of U0126 and SB202190 did not affect the induced degradation of IkappaB-alpha and NF-kappaB nuclear translocation, indicating that NF-kappaB is activated by IL-1beta and TNF-alpha independently of activation of MEK/MAPK and p38 pathways in hRPE cells.
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Affiliation(s)
- Z M Bian
- Department of Ophthalmology, University of Michigan, Ann Arbor, MI 48105, U.S.A
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El-Ghrably IA, Dua HS, Orr GM, Fischer D, Tighe PJ. Intravitreal invading cells contribute to vitreal cytokine milieu in proliferative vitreoretinopathy. Br J Ophthalmol 2001; 85:461-70. [PMID: 11264138 PMCID: PMC1723908 DOI: 10.1136/bjo.85.4.461] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIM To examine the contribution of infiltrating cells in the local production of cytokines within the vitreous of patients with proliferative vitreoretinopathy (PVR). METHODS The presence of mRNA coding for IL-6, IL-8, IL-1beta, IL-1alpha, TNFalpha, IFNgamma, IL-12, and HPRT was investigated in 25 vitreous samples from patients with PVR, 11 vitreous samples from patients with retinal detachment (RD) not complicated by PVR, and 10 vitreous samples from patients with macular hole (MH). A quantitative reverse transcriptase polymerase chain reaction (RT-PCR) using an internal competitor was used to investigate these samples. From these samples, 15 PVR, 8 RD, and 8 MH were analysed for the protein levels of the same cytokines using enzyme linked immunosorbent assay (ELISA). Spearman correlation was used to test any association between mRNA and cytokine protein levels, as an indicator of the contribution these cells make to the intravitreal cytokine milieu. RESULTS A strong correlation was found between mRNA and their respective cytokine levels (protein products) for IL-6, IL-8, IL-1beta, IL-1alpha, TNFalpha, IFNgamma (Spearman r = 0.83, 0.73, 0.67, 0.91, 0.73, and 0.73 respectively), but not for IL-12. The median levels of IL-6, IL-8, IL-1beta, and IFNgamma mRNA and their respective cytokines were significantly higher (p <0.05) in patients with PVR than in those with macular hole. There was no statistically significant difference in the median levels of IL-1alpha mRNA between PVR and MH but the cytokine IL-1alpha was detected at a significantly higher level in PVR compared with MH patients. Between PVR and RD patients, there was no statistically significant difference in mRNA levels for all the investigated cytokines (p >0.05) except for IL-6 where there was a statistical significance (p= 0.038). In contrast, the median levels of IL-6, IL-8, and IL-1beta cytokines were significantly higher (p <0.05) in patients with PVR than in those with RD, whereas for IL-1alpha and IFNgamma no significant statistical difference was detected between PVR and RD patients (p >0.05). When results of RD and MH patients were compared, a statistical difference was only detected in mRNA levels of INFgamma (p = 0.008). However, no difference was detected for INFgamma (protein product) or for any of the other cytokines between RD and MH patients. CONCLUSION Levels of both protein and mRNA encoding IL-6, IL-8, IL-1beta, and IFNgamma is significantly increased in vitreous samples from patients with PVR. The strong correlation between ELISA detectable cytokines (protein products) and their respective mRNA levels suggest that intravitreal, invasive cells are the major source of these cytokines, with the exception of IL-12. Cells invading the vitreous do not appear to locally produce IL-12 mRNA. This would appear to implicate cells peripheral to the vitreal mass as the major source of this cytokine.
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Affiliation(s)
- I A El-Ghrably
- Larry A Donoso Laboratory for Eye Research, Department of Ophthalmology, University of Nottingham, UK
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Hiscott P, Magee RM, Colthurst M, Lois N, Wong D. Clinicopathological correlation of epiretinal membranes and posterior lens opacification following perfluorohexyloctane tamponade. Br J Ophthalmol 2001; 85:179-83. [PMID: 11159482 PMCID: PMC1723852 DOI: 10.1136/bjo.85.2.179] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND/AIMS Epiretinal and retrolental proliferation may occur during prolonged use of the novel tamponade agent perfluorohexyloctane (F(6)H(8)). This study aims to determine whether there is any histological evidence that F(6)H(8) has a role in the formation of these membranes. METHODS Eight epiretinal membranes and three opaque posterior lens capsules were excised from patients in whom F(6)H(8) had been used as a long term retinal tamponade agent. The membranes and capsules were examined employing light microscopic methods, including immunohistochemistry. RESULTS The epiretinal membranes showed histological features typical of proliferative vitreoretinopathy (PVR) epiretinal membranes, but they also exhibited a dense macrophagic infiltration. In addition, three of the membranes contained multinucleated cells. Macrophages represented up to 30% of the cells present and appeared to contain large intracytoplasmic vacuoles. Similar cells were seen on the back of the posterior lens capsule in one specimen and all three capsules had posterior migration of lens epithelium. CONCLUSION The pathological findings are not simply those of PVR. The macrophage infiltration suggests that there may be a biological reaction to F(6)H(8) which could reflect its surmised propensity to emulsify. Further investigations concerning the cellular response to this promising tamponade agent are warranted.
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Affiliation(s)
- P Hiscott
- Unit of Ophthalmology, Department of Medicine, University of Liverpool, Liverpool, UK.
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Hiscott P, Wong D, Grierson I. Challenges in ophthalmic pathology: the vitreoretinal membrane biopsy. Eye (Lond) 2000; 14 ( Pt 4):549-59. [PMID: 11040899 DOI: 10.1038/eye.2000.142] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The introduction of vitreoretinal microsurgery has produced a new type of biopsy; that of the vitreoretinal membrane. This review investigates methods by which these scar-like tissues are handled in the laboratory and explores the implications of the results of such evaluations. The study of vitreoretinal membrane biopsies has provided much information concerning the pathobiology of the various conditions which may give rise to the tissue as well as insights into how membranes themselves develop. Moreover, the application of new laboratory techniques is expected to enhance our understanding of the formation of vitreoretinal membranes, and lead to further advances in their surgical and medical management.
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Affiliation(s)
- P Hiscott
- Department of Medicine, University of Liverpool, UK.
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Chang L, Crowston JG, Cordeiro MF, Akbar AN, Khaw PT. The role of the immune system in conjunctival wound healing after glaucoma surgery. Surv Ophthalmol 2000; 45:49-68. [PMID: 10946081 DOI: 10.1016/s0039-6257(00)00135-1] [Citation(s) in RCA: 85] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The immune system has a fundamental role in the development and regulation of ocular healing, which plays an important role in the pathogenesis of most blinding diseases. This review discusses the mechanisms of normal wound healing, describing the animal and fetal wound healing models used to provide further insight into normal wound repair. In particular, conjunctival wound repair after glaucoma filtration surgery will be used to illustrate the contributions that the different components of the immune system make to the healing process. The potential role of macrophages, the possible regulatory effect of lymphocytes, and the important role of growth factors and cytokines in the wound healing reaction are discussed. The significance of the immune system in the pathogenesis of aggressive conjunctival scarring is addressed, particularly assessing the predisposing factors, including drugs, age, and ethnicity. The rationale behind the pharmacological agents currently used to modulate the wound healing response and the effects these drugs have on the function of the immune system are described. Finally, potential new therapeutic approaches to regulating the wound healing response are reported.
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Affiliation(s)
- L Chang
- Wound Healing Research and Glaucoma Units, Institute of Ophthalmology, London, United Kingdom
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Toker E, Kazokoğlu H, Sahin S. Cell adhesion molecules in subretinal fluid: soluble forms of VCAM-1 (vascular cell adhesion molecule-1) and L-selectin. Int Ophthalmol 1999; 22:71-6. [PMID: 10472764 DOI: 10.1023/a:1006160209657] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
PURPOSE In this study we investigated the presence of soluble VCAM-1 and soluble L-selectin-1 in subretinal fluids (SRF) of patients suffering from rhegmatogenous retinal detachment . METHOD Subretinal fluids were collected from drainage sclerotomies during surgery from 27 patients with rhegmatogenous retinal detachment complicated by proliferative vitreoretinopathy (PVR) or uncomplicated retinal detachment. Levels of sVCAM-1 and sL-selectin-1 were quantified with ELISA. RESULTS The mean +/- SEM values of sVCAM-1 and sL-selectin-1 were 222.2 +/- 81 ng/ml and 171.7 +/- 42.1 ng/ml, respectively. The concentrations of sVCAM-1 in patients with Grade C PVR (498.2 +/- 1703 ng/ml) were significantly different from those with Grade B PVR (45.6 +/- 16.5 ng/ml) and uncomplicated retinal detachments (19.4 +/- 12.3 ng/ml). SVCAM-1 concentration in detachments which had been present for more than 8 weeks was 738.8 +/- 431 ng/ml, significantly higher than the levels in detachments of shorter duration (132.4 +/- 47.7 ng/ml). sL-selectin-1 level in Grade C PVR (291.6 +/- 92.8 ng/ml) was higher than in uncomplicated retinal detachments (72.8 +/- 13.5 ng/ml). Significantly elevated levels of sL-selectin-1 were observed in detachments lasting more than 8 weeks (605 +/- 151.1 ng/ml) compared to those of shorter duration (96.3 +/- 13.1 ng/ml). CONCLUSION The present study supports growing evidence that these cell adhesion molecules are involved in the inflammatory process during the development and progression of PVR.
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Affiliation(s)
- E Toker
- Marmara University Faculty of Medicine, Department of Ophthalmology
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Abstract
Proliferative vitreoretinopathy (PVR) is still the most common cause of failure of surgery for rhegmatogenous retinal detachment, despite the substantial effort that has been devoted to better understanding and managing this condition during the past 25 years. Basic research has indicated that PVR represents scarring, the end stage of the wound-healing process that occurs after retinal detachment surgery. Medical treatment has been directed toward preventing inflammation, the first phase of the wound healing process, and inhibiting cell proliferation, the second phase. The 1983 Retina Society classification was modified in 1989 by the Silicone Study Group, whose classification differentiates between posterior and anterior forms of PVR and recognizes three patterns of proliferation: diffuse, focal, and subretinal. The anterior form has a worse prognosis than the posterior form, and its treatment requires more complex surgical procedures. In this review, risk factors and pathobiology of PVR are discussed, and management of PVR of various degrees of severity are considered.
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Affiliation(s)
- J C Pastor
- Instituto Universitario de Oftalmobiología Aplicada (IOBA), University of Valladolid, Spain.
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