The relationship between cataract, cell swelling and volume regulation

The Synergistic Effects of Polyol Pathway-Induced Oxidative and Osmotic Stress in the Aetiology of Diabetic Cataracts

Cataracts are the world's leading cause of blindness, and diabetes is the second leading risk factor for cataracts after old age. Despite this, no preventative treatment exists for cataracts. The altered metabolism of excess glucose during hyperglycaemia is known to be the underlying cause of diabetic cataractogenesis, resulting in localised disruptions to fibre cell morphology and cell swelling in the outer cortex of the lens. In rat models of diabetic cataracts, this damage has been shown to result from osmotic stress and oxidative stress due to the accumulation of intracellular sorbitol, the depletion of NADPH which is used to regenerate glutathione, and the generation of fructose metabolites via the polyol pathway. However, differences in lens physiology and the metabolism of glucose in the lenses of different species have prevented the translation of successful treatments in animal models into effective treatments in humans. Here, we review the stresses that arise from hyperglycaemic glucose metabolism and link these to the regionally distinct metabolic and physiological adaptations in the lens that are vulnerable to these stressors, highlighting the evidence that chronic oxidative stress together with osmotic stress underlies the aetiology of human diabetic cortical cataracts. With this information, we also highlight fundamental gaps in the knowledge that could help to inform new avenues of research if effective anti-diabetic cataract therapies are to be developed in the future.

The lens epithelium as a major determinant in the development, maintenance, and regeneration of the crystalline lens

The crystalline lens is a transparent and refractive biconvex structure formed by lens epithelial cells (LECs) and lens fibers. Lens opacity, also known as cataracts, is the leading cause of blindness in the world. LECs are the principal cells of lens throughout human life, exhibiting different physiological properties and functions. During the embryonic stage, LECs proliferate and differentiate into lens fibers, which form the crystalline lens. Genetics and environment are vital factors that influence normal lens development. During maturation, LECs help maintain lens homeostasis through material transport, synthesis and metabolism as well as mitosis and proliferation. If disturbed, this will result in loss of lens transparency. After cataract surgery, the repair potential of LECs is activated and the structure and transparency of the regenerative tissue depends on postoperative microenvironment. This review summarizes recent research advances on the role of LECs in lens development, homeostasis, and regeneration, with a particular focus on the role of cholesterol synthesis (eg., lanosterol synthase) in lens development and homeostasis maintenance, and how the regenerative potential of LECs can be harnessed to develop surgical strategies and improve the outcomes of cataract surgery (Fig. 1). These new insights suggest that LECs are a major determinant of the physiological and pathological state of the lens. Further studies on their molecular biology will offer possibility to explore new approaches for cataract prevention and treatment.

Recent progress and research trend of anti-cataract pharmacology therapy: A bibliometric analysis and literature review

Cataract is the leading cause of blindness worldwide. Cataract phacoemulsification combined with intraocular lens implantation causes great burden to global healthcare, especially for low- and middle-income countries. Such burden would be significantly relieved if cataracts can effectively be treated or delayed by non-surgical means. Excitingly, novel drugs have been developed to treat cataracts in recent decades. For example, oxysterols are found to be able to innovatively reverse lens clouding, novel nanotechnology-loaded drugs improve anti-cataract pharmacological effect, and traditional Chinese medicine demonstrates promising therapeutic effects against cataracts. In the present review, we performed bibliometric analysis to provide an overview perspective regarding the research status, hot topics, and academic trends in the field of anti-cataract pharmacology therapy. We further reviewed the curative effects and molecular mechanisms of anti-cataract drugs such as lanosterol, metformin, resveratrol and curcumin, and prospected the possibility of their clinical application in future.

-Intracellular hydrostatic pressure regulation in the bovine lens: a role in the regulation of lens optics?

The optical properties of the bovine lens have been shown to be actively maintained by an internal microcirculation system. In the mouse lens, this water transport through gap junction channels generates an intracellular hydrostatic pressure gradient, which is subjected to a dual feedback regulation that is mediated by the reciprocal modulation of the transient receptor potential vanilloid channels, TRPV1 and TRPV4. Here we test whether a similar feedback regulation of pressure exists in the bovine lens, and whether it regulates overall lens optics. Lens pressure was measured using a microelectrode/pico-injector-based pressure measurement system, and lens optics were monitored in organ cultured lenses using a laser ray tracing system. Like the mouse, the bovine lenses exhibited a similar pressure gradient (0 to 340 mmHg). Activation of TRPV1 with capsaicin caused a biphasic increase in surface pressure, while activation of TRPV4 with GSK1016790A caused a biphasic decrease in pressure. These biphasic responses were abolished if lenses were pre-incubated with either the TRPV1 inhibitor A-889425, or the TRPV4 inhibitor HC-067047. While modulation of lens pressure by TRPV1 and TRPV4 had minimal effects on lens power and overall vision quality, the changes in lens pressure did induce opposing changes to lens geometry and GRIN that effectively kept lens power constant. Hence, our results suggest that the TRPV1/4 mediated feedback control of lens hydrostatic pressure operates to ensure that any fluctuations in lens water transport, and consequently water content, do not result in changes in lens power and therefore overall vision quality.

Racemization in cataractous lens from diabetic and aging individuals: analysis of Asp 58 residue in αA-crystallin

Cataract is the leading cause of visual impairment globally. Racemization of lens proteins may contribute to cataract formation in aging individuals. As a special type of age-related cataract (ARC), diabetic cataract (DC) is characterized by the early onset of cortical opacification and finally developed into a mixed type of cortical and nuclear opacification. We compared racemization of Asp 58 residue, a hotspot position in αA-crystallin, from the cortex and nucleus of diabetic and age-matched senile cataractous lenses, by identifying L-Asp/L-isoAsp/D-Asp/D-isoAsp by mass spectrometry. Compared to nondiabetic cataractous lenses, DC lenses showed a significantly increased cortex/nucleus ratio of D-Asp 58, which originated primarily from an increased percentage of D-Asp 58 in the lens cortex of DC. Moreover, patients diagnosed with diabetes for over 10 years showed a lower cortex/nucleus ratio of D-isoAsp 58 in the lens compared with those who had a shorter duration of diabetes, which originated mainly from an increased percentage of D-isoAsp 58 in the lens nucleus of DC with increasing time of hyperglycemia. Further analysis confirmed decreased protein solubility in diabetic cataractous lenses. The different racemization pattern in DC may be distinguished from ARC and influence its phenotype over the protracted duration of diabetes.

Evaluation of factors related to Anaesthesia-induced Lens opacity in experimental mice

To investigate conditions that cause temporal lens opacity, we tested chemical and physical factors, such as anaesthesia dose, ocular surface dryness, and infrared (IR) light exposure in anaesthetised C57BL/6 N mice. Mice were anaesthetised with a low (80%; tiletamine/zolazepam 32 mg/kg and xylazine 8 mg/kg, intraperitoneal injection) or high (120%; 48 mg/kg and 12 mg/kg) dose of anaesthetic and examined every 5 min from 10 to 30 min after anaesthesia was induced. Lens opacity levels were assessed and graded (1-6) using the standard classification system. Regardless of the anaesthetic dose, lens opacity grade was 1-2 in moisturised eyes with application of 0.5% carboxymethylcellulose, and 5-6 in dry ocular surface conditions. Lens opacity in mice with high-dose anaesthetic in the dry ocular surface condition was not different from that of mice with low-dose anaesthetic. Lens opacity grade 1-2 was noted in eyes in the wet ocular surface condition, regardless of IR light exposure. During IR light exposure in eyes in the dry ocular surface condition, lens opacity (grade 6) in mice with high-dose anaesthetic was not different from that (grade 6) in mice with low-dose anaesthetic. We demonstrated that ocular surface dryness might be a relevant factor for the formation and progression of lens opacity in anesthetized C57BL/6 N mice. Anaesthesia dose and IR light exposure did not strongly influence lens opacity formation. Furthermore, eyes with corneal dryness-induced lens opacity recovered to normal status without additional intervention.

The modulation of the phosphorylation status of NKCC1 in organ cultured bovine lenses: Implications for the regulation of fiber cell and overall lens volume

In previous work, we have shown the Sodium/Potassium/2 Chloride Cotransporter (NKCC1) to be a key effector of lens fiber cell volume regulation. Since others have shown that the activity of NKCC1 is regulated via its phosphorylation status, the purpose of this study was to investigate whether NKCC1 phosphorylation can be modulated in organ cultured bovine lenses, and to see how this relates to changes in lens wet weight. Western blotting was first used to confirm the expression of NKCC1, phosphorylated NKCC1 (NKCC1-P) and the regulatory kinases WNK/SPAK and phosphatases PP1/PP2A in bovine lenses at the protein level. Changes to NKCC1-P status were then assessed by organ culturing bovine lenses in either isotonic, hypertonic or hypotonic solutions in the presence or absence of the NKCC inhibitor, bumetanide, or phosphatase inhibitors okadaic acid and calyculin A. After 1-22 h of culturing, lenses were weighed, assessed for transparency and the cortical protein fractions analyzed by western blot using antibodies to detect total NKCC1 and NKCC1-P. NKCC1, NKCC1-P, SPAK, PP1 and PP2A were all detected in the membrane fraction of bovine lenses. Under hypertonic conditions, NKCC1 is phosphorylated and activated to mediate a regulatory volume increase. Finally, NKCC1-P signal increased in the presence of phosphatase inhibitors indicating that PP1/PP2A can dephosphorylate NKCC1. These results show that the phosphorylation status and hence activity of NKCC1 is dynamically regulated and that in response to hypertonic stress, NKCC1 activity is increased to effect a regulatory volume increase that limits cell shrinkage. These findings support the view that the lens dynamically regulates ion fluxes to maintain steady state lens volume, and suggest that dysfunction of this regulation maybe an initiating factor in the localized fiber cell swelling that is a characteristic of diabetic lens cataract.

MALDI Imaging Mass Spectrometry Spatially Maps Age-Related Deamidation and Truncation of Human Lens Aquaporin-0

PURPOSE

To spatially map human lens Aquaporin-0 (AQP0) protein modifications, including lipidation, truncation, and deamidation, from birth through middle age using matrix-assisted laser desorption ionization (MALDI) imaging mass spectrometry (IMS).

METHODS

Human lens sections were water-washed to facilitate detection of membrane protein AQP0. We acquired MALDI images from eight human lenses ranging in age from 2 months to 63 years. In situ tryptic digestion was used to generate peptides of AQP0 and peptide images were acquired on a 15T Fourier transform ion cyclotron resonance (FTICR) mass spectrometer. Peptide extracts were analyzed by liquid chromatography-tandem mass spectrometry (LC-MS/MS) and database searched to identify peptides observed in MALDI imaging experiments.

RESULTS

Unmodified, truncated, and fatty acid-acylated forms of AQP0 were detected in protein imaging experiments. Full-length AQP0 was fatty acid acylated in the core and cortex of young (2- and 4-month) lenses. Acylated and unmodified AQP0 were C-terminally truncated in older lens cores. Deamidated tryptic peptides (+0.9847 Da) were mass resolved from unmodified peptides by FTICR MS. Peptide images revealed differential localization of un-, singly-, and doubly-deamidated AQP0 C-terminal peptide (239-263). Deamidation was present at 4 months and increases with age. Liquid chromatography-MS/MS results indicated N246 undergoes deamidation more rapidly than N259.

CONCLUSIONS

Results indicated AQP0 fatty acid acylation and deamidation occur during early development. Progressive age-related AQP0 processing, including deamidation and truncation, was mapped in human lenses as a function of age. The localization of these modified AQP0 forms suggests where AQP0 functions may change throughout lens development and aging.

Topical Use of NaCl Solution with Different Concentration Affects Lens Transparency in Anesthetized Mice

PURPOSE

To study the influence of NaCl solution with different concentration on lens transparency in anesthetized mice.

METHODS

Four kinds of NaCl solution with different concentration were prepared as eye drops to imply graded osmolarity (100, 300, 500 and 1000 mOsmol/kg). Five groups of anesthetized mice were set-up to induce lens opacity, in which four groups were treated with NaCl solution and another group naturally exposed to air. The lens opacity was graded as no opacity, mild, medium and severe opacity at 0, 10, 20, 30, 45 and 60 min after the start of the experiment. A numerical value from 0 to 3 was assigned to each grade for the cataract index (CI) calculation and data analysis. The same procedure was repeated in all groups 48 h later. The reversion process of lens opacity was explored using a hypotonic NaCl solution (100 mOsmol/kg) in another pair of groups, a 500 mOsmol/kg NaCl solution group and natural exposure group. The gross appearance and time course of development and reversion of lens opacity were assessed.

RESULTS

Lens opacity primarily developed in a hypertonic NaCl solution-treated and naturally exposed eyes, and the gross anatomical appearance were similar. The speed of lens opacity development and CI changes were osmolarity-dependent, and the higher NaCl concentration solution used, the faster and more severe the formation of opacification. Both hypertonic NaCl-solution-induced lens opacity and natural exposure induced lens opacity could be resolved by hypotonic NaCl solution prior to anesthesia recovery.

CONCLUSIONS

This study indicates a crucial effect of NaCl concentration on the development and reversion of lens opacity in the anesthetized mice, and support the osmolarity theory in the reversible lens opacification phenomenon. It is also of practical significance to mouse eye studies that require lens transparency.

Identification of the WNK-SPAK/OSR1 signaling pathway in rodent and human lenses

PURPOSE

To identify whether the kinases that regulate the activity of cation chloride cotransporters (CCC) in other tissues are also expressed in rat and human lenses.

METHODS

The expression of with-no-lysine kinase (WNK 1, 3, 4), oxidative stress response kinase 1 (OSR1), and Ste20-like proline alanine rich kinase (SPAK) were determined at either the transcript or protein levels in the rat and human lenses by reverse-transcriptase PCR and/or Western blotting, respectively. Selected kinases were regionally and subcellularly characterized in rat and human lenses. The transparency, wet weight, and tissue morphology of lenses extracted from SPAK knock-out animals was compared with wild-type lenses.

RESULTS

WNK 1, 3, 4, SPAK, and OSR1 were identified at the transcript level in rat lenses and WNK1, 4, SPAK, and OSR1 expression confirmed at the protein level in both rat and human lenses. SPAK and OSR1 were found to associate with membranes as peripheral proteins and exhibited distinct subcellular and region-specific expression profiles throughout the lens. No significant difference in the wet weight of SPAK knock-out lenses was detected relative to wild-type lenses. However, SPAK knock-out lenses showed an increased susceptibility to opacification.

CONCLUSIONS

Our results show that the WNK 1, 3, 4, OSR1, and SPAK signaling system known to play a role in regulating the phosphorylation status, and hence activity of the CCCs in other tissues, is also present in the rat and human lenses. The increased susceptibility of SPAK lenses to opacification suggests that disruption of this signaling pathway may compromise the ability of the lens to control its volume, and its ability to maintain its transparency.

Aquaporins in the eye: expression, function, and roles in ocular disease

BACKGROUND

All thirteen known mammalian aquaporins have been detected in the eye. Moreover, aquaporins have been identified as playing essential roles in ocular functions ranging from maintenance of lens and corneal transparency to production of aqueous humor to maintenance of cellular homeostasis and regulation of signal transduction in the retina.

SCOPE OF REVIEW

This review summarizes the expression and known functions of ocular aquaporins and discusses their known and potential roles in ocular diseases.

MAJOR CONCLUSIONS

Aquaporins play essential roles in all ocular tissues. Remarkably, not all aquaporin function as a water permeable channel and the functions of many aquaporins in ocular tissues remain unknown. Given their vital roles in maintaining ocular function and their roles in disease, aquaporins represent potential targets for future therapeutic development.

GENERAL SIGNIFICANCE

Since aquaporins play key roles in ocular physiology, an understanding of these functions is important to improving ocular health and treating diseases of the eye. It is likely that future therapies for ocular diseases will rely on modulation of aquaporin expression and/or function. This article is part of a Special Issue entitled Aquaporins.

Lenses from Brown-Norway pigmented rats are more tolerant to in vitro ultraviolet irradiation than lenses from Fischer-344 albino rats

PURPOSE

To investigate if the previously shown difference in in vivo-induced ultraviolet B radiation (UVR-B) cataractogenesis between pigmented and albino rats can be seen also with in vitro irradiation. The shielding effect of the iris and UVR absorption in the anterior segment is nullified, and inherent differences in lenticular UVR-B sensitivity between the strains may be revealed.

METHODS

Lenses from albino (Fischer-344) and pigmented (Brown-Norway) rats were irradiated in vitro with 1.8 kJ/m(2) UVR-B. The lenses were cultured in standard environment in a culture incubator. Cataract was quantified daily by measuring the amount of lens forward light scattering over a period of 1 week. All lenses were photographed during the week.

RESULTS

Two days after exposure, both strains developed significant cataract compared to control lenses, and the light scattering increased exponentially to the last day. From day 4, exposed Fischer lenses scattered more light than Brown-Norway lenses. This difference increased towards the end of the week. The type of cataract (anterior subcapsular, equatorial, and posterior cortical cataract) was similar in both strains. No anterior polar or nuclear cataract was observed.

CONCLUSIONS

Lenses from albino Fischer rats are more sensitive to in vitro UVR-B than lenses from pigmented Brown-Norway rats. Ultraviolet B radiation cataract type induced in vitro differs from in vivo cataract in pigmented rats, but not from albino rats. In vitro UVR-B exposure induces more cataract than corresponding lenticular UVR-B in vivo exposures, for both albino and pigmented rat.

Up-regulation of P-glycoprotein expression by osmotic stress in rat sugar cataract

P-glycoprotein (P-gp), a plasma membrane protein, is thought to function in the export of cytotoxic drugs and to act as a modulator of chloride channels that regulate cell volume in many cell types. P-gp has been shown to play a role in lens volume regulation and initiation of osmotic cataract. We investigated the lenticular expression levels of P-gp in galactose-fed rats, an experimental model of sugar cataract. P-gp was overexpressed in lenses from galactose-fed rats with cortical sugar cataract, and in rat lens epithelial cells cultured in high-glucose medium. However, application of aldose reductase (AR) inhibitor was able to reverse the changes in P-gp levels in the lenses of galactose-fed rats, confirming the role of AR and involvement of the polyol pathway in cataract formation. Our findings suggest that P-gp may be induced by AR over-expression and/or osmotic stress, thus playing a regulatory role in maintaining lenticular osmotic balance in sugar cataract.

Emerging roles of chloride channels in human diseases

In the past decade, there has been remarkable progress in understanding of the roles of Cl(-) channels in the development of human diseases. Genetic studies in humans have identified mutations in the genes encoding Cl(-) channels which lead to a loss of Cl(-) channel activity. These mutations are responsible for the development of a variety of deleterious diseases in muscle, kidney, bone and brain including myotonia congenita, dystrophia myotonica, cystic fibrosis, osteopetrosis and epilepsy. Recent studies indicate that some diseases may develop as a result of Cl(-) channel activation. There is growing evidence that the progression of glioma in the brain and the growth of the malaria parasite in red blood cells may be mediated through Cl(-) channel activation. These findings suggest that Cl(-) channels may be novel targets for the pharmacological treatment of a broad spectrum of diseases. This review discusses the proposed roles of abnormal Cl(-) channel activity in the pathogenesis of human diseases.

Effect of membrane potential depolarization on the organization of the actin cytoskeleton of eye epithelia. The role of adherens junctions

We have previously determined that the depolarization of the plasma membrane potential of confluent bovine corneal endothelial cells in culture, provokes a characteristic reorganization of the actin cytoskeleton. The purposes of the present work are to investigate whether similar responses are exhibited by other epithelia, irrespectively of their specific functions and embryonic origin, and to test the hypothesis that the cytoskeletal reorganization induced by membrane depolarization requires of a well-organized circumferential actin disposition in order to take place. For this, we have performed studies on three different cultured epithelia of the eye: bovine corneal endothelium, bovine retinal pigment epithelium and cellular lines of murine lens epithelium. For all of these cells, we explored the effects of plasma membrane depolarization, achieved via the incorporation of gramicidin D to the bathing media or by the replacement of extracellular sodium chloride by potassium gluconate, on the cadherin and actin distribution. The membrane potential changes were monitored by fluorescence microscopy using oxonol V; fluorescent probes were also used for F-actin and cadherin. Detergent extraction and Western blot analysis were employed to reveal the relative amount of cadherin attached to the cytoskeleton. The main findings of this study are that different confluent cultured epithelia exhibiting a well-defined circumferential pattern of actin distribution respond to plasma membrane depolarization by similar modifications in the actin cystoskeleton to those reported for bovine corneal endothelial cells. On the other hand, epithelia that do not exhibit such actin pattern in confluence, as well as non-confluent monolayers, do not display noticeable actin modifications in response to the depolarizing procedures. While in the former cells, cadherin is predominantly located at the lateral membrane domain, the cells that do not respond to membrane depolarization mainly display their cadherin in the intracellular compartment. We suggest that the typical peripheral disposition of actin, associated to well-established epithelial-type adherens junctions (i.e. zonula adherens), is a pre-requisite for the cytoskeletal organizational modifications exhibited by epithelial cells in response to the depolarization of the plasma membrane potential.

Intraocular light scatter as modeled through a stratified medium

Intraocular light scatter is modeled through a stratified medium. It is shown that the eye lens possesses properties of an interference filter. In conditions that may mimic opacification, as found with cataract formation, such a filter may have stop zones with reflectance up to 1 in the band of visible light.