Blood and lens lipid peroxidation and antioxidant status in normal individuals, senile and diabetic cataractous patients

Pre-hyperglycemia immune cell trafficking underlies subclinical diabetic cataractogenesis

BACKGROUND

This work elucidates the first cellular and molecular causes of cataractogenesis. Current paradigm presupposes elevated blood glucose as a prerequisite in diabetic cataractogenesis. Novel evidence in our model of diabetic cataract challenges this notion and introduces immune cell migration to the lens and epithelial-mesenchymal transformation (EMT) of lens epithelial cells (LECs) as underlying causes.

METHODS

Paucity of suitable animal models has hampered mechanistic studies of diabetic cataract, as most studies were traditionally carried out in acutely induced hyperglycemic animals. We introduced diabetic cataract in the Nile grass rat (NGR) that spontaneously develops type 2 diabetes (T2D) and showed its closeness to the human condition. Specialized stereo microscopy with dual bright-field illumination revealed novel hyperreflective dot-like microlesions in the inner cortical regions of the lens. To study immune cell migration to the lens, we developed a unique in situ microscopy technique of the inner eye globe in combination with immunohistochemistry.

RESULTS

Contrary to the existing paradigm, in about half of the animals, the newly introduced hyper reflective dot-like microlesions preceded hyperglycemia. Even though the animals were normoglycemic, we found significant changes in their oral glucose tolerance test (OGTT), indicative of the prediabetic stage. The microlesions were accompanied with significant immune cell migration from the ciliary bodies to the lens, as revealed in our novel in situ microscopy technique. Immune cells adhered to the lens surface, some traversed the lens capsule, and colocalized with apoptotic nuclei of the lens epithelial cells (LECs). Extracellular degradations, amorphous material accumulations, and changes in E-cadherin expressions showed epithelial-mesenchymal transformation (EMT) in LECs. Subsequently, lens fiber disintegration and cataract progression extended into cortical, posterior, and anterior subcapsular cataracts.

CONCLUSIONS

Our results establish a novel role for immune cells in LEC transformation and death. The fact that cataract formation precedes hyperglycemia challenges the prevailing paradigm that glucose initiates or is necessary for initiation of the pathogenesis. Novel evidence shows that molecular and cellular complications of diabetes start during the prediabetic state. These results have foreseeable ramifications for early diagnosis, prevention and development of new treatment strategies in patients with diabetes.

Atm inhibition decreases lens opacity in a rat model of galactose-induced cataract

Cataract causes vision loss and blindness due to formation of opacities of the lens. The regulatory mechanisms of cataract formation and progression remain unclear, and no effective drug treatments are clinically available. In the present study, we tested the effect of ataxia telangiectasia mutated (Atm) inhibitors using an ex vivo model in which rat lenses were cultured in galactose-containing medium to induce opacity formation. After lens opacities were induced by galactose, the lenses were further incubated with the Atm inhibitors AZD0156 or KU55933, which decreased lens opacity. Subsequently, we used microarray analysis to investigate the underlying molecular mechanisms of action, and extracted genes that were upregulated by galactose-induced opacity, but not by inhibitor treatment. Quantitative measurement of mRNA levels and subsequent STRING analysis revealed that a functional network consisting primarily of actin family and actin-binding proteins was upregulated by galactose treatment and downregulated by both Atm inhibitors. In particular, Acta2 is a known marker of epithelial-mesenchymal transition (EMT) in epithelial cells, and other genes connected in this functional network (Actn1, Tagln, Thbs1, and Angptl4) also suggested involvement of EMT. Abnormal differentiation of lens epithelial cells via EMT could contribute to formation of opacities; therefore, suppression of these genes by Atm inhibition is a potential therapeutic target for reducing opacities and alleviating cataract-related visual impairment.

Levels of Trace Elements in the Lens, Aqueous Humour, and Plasma of Cataractous Patients-A Narrative Review

Cataracts are one of the most common causes of effective vision loss. Although most cases of cataracts are related to the ageing process, identifying modifiable risk factors can prevent their onset or progression. Many studies have suggested that micro and macroelement levels, not only in blood serum but also in the lens and aqueous humour, may affect the risk of the occurrence and severity of cataracts. This systematic review aims to summarise existing scientific reports concerning the importance of trace elements in cataractogenesis. Many authors have pointed out elevated or decreased levels of particular elements in distinct ocular compartments. However, it is not known if these alterations directly affect the increased risk of cataract occurrence. Further studies are needed to show whether changes in the levels of these elements are correlated with cataract severity and type. Such information would be useful for determining specific recommendations for micronutrient supplementation in preventing cataractogenesis.

Evaluation of antioxidative enzymes levels and lipid peroxidation products levels in diabetic and non diabetic senile cataract patients

Background

The current study aimed to investigate the Superoxide dismutase, Glutathione Peroxidase activity, Advanced oxidation Protein products levels, Malondialdehyde levels, Baseline Conjugated Diene concentration, and 8-Isoprostaglandin F2α (8-IPG-F2α) quantification in diabetic and non-diabetic senile cataract patients to find out the pathomechanism of early onset of cataract in diabetic patients.

Methods

This case-control study was performed on 184 subjects undergoing cataract surgery. For 8-IPG-F2α quantification, 35 diabetics and non-diabetic lenses and the entire study included 22 patients with diabetic senile cataracts and non-diabetic senile cataracts of aqueous humor age ≥ 40 years. Ninety-two patients with diabetic senile cataract and non-diabetic senile cataract lenses aged ≥ 40 years were incorporated for all other studies. The student's t-test was used for statistical analysis.

Results

From the study population, the mean age was 63.82 ± 0.6, and 75% of them were female. Higher female prevalence in both groups was observed. The results revealed that the superoxide dismutase and glutathione peroxidase activity were significantly reduced in diabetic patients compared to non-diabetic patients (p < 0.001) in both lenses and aqueous humor. Malondialdehyde, conjugated diene, and 8-IPG-F2α levels significantly increased in diabetic patients when compared to non-diabetic (p < 0.01), and advanced oxidation protein products levels also significantly increased in diabetic patients when compared to non-diabetics in both lenses and aqueous humor (p < 0.001).

Conclusion

The current study revealed that oxidative stress and Lipid per-oxidation have an imperative role in the diabetic-related complication, specifically in the lens, may have a responsibility in the pathomechanism of early onset of cataracts coupled with diabetes mellitus.

Relationship between the Structure and Chaperone Activity of Human αA-Crystallin after Its Modification with Diabetes-Associated Oxidative Agents and Protective Role of Antioxidant Compounds

The study was aimed to evaluate the impact of peroxynitrite (PON, oxidative stress agent in diabetes), methylglyoxal (MGO, diabetes-associated reactive carbonyl compound), and their simultaneous application on the structural and functional features of human αA-crystallin (αA-Cry) using various spectroscopy techniques. Additionally, the surface tension and oligomer size distribution of the treated and untreated protein were tested using tensiometric analysis and dynamic light scattering, respectively. Our results indicated that the reaction of PON and MGO with human αA-Cry leads to the formation of new chromophores, alterations in the secondary to quaternary protein structure, reduction in the size of protein oligomers, and significant enhancement in the chaperone activity of αA-Cry. To reverse the effects of the tested compounds, ascorbic acid and glutathione (main components of lens antioxidant defense system) were applied. As expected, the two antioxidant compounds significantly prevented formation of high molecular weight aggregates of αA-Cry (according to SDS-PAGE). Our results suggest that the lens antioxidant defense system, in particular, glutathione, may provide a strong protection against rapid incidence and progression of diabetic cataract by preventing the destructive reactions of highly reactive DM-associated metabolites.

Association of Serum Magnesium with Oxidative Stress in the Pathogenesis of Diabetic Cataract

Magnesium deficiency enhances oxidative stress which contributes to early development of cataract formation, and also the progression in type 2 diabetes mellitus patients remains unclear. The present study was designed to evaluate the serum levels of magnesium, oxidative stress marker and antioxidant status and to find out if there is any association between them in the pathogenesis of diabetic cataract compared with non-diabetic senile cataract, diabetes without cataract and normal healthy subjects. This comparative study includes 90 type 2 diabetes mellitus patients with cataract, 90 non-diabetic senile cataract patients, 90 type 2 diabetes mellitus without cataract and 90 normal healthy individual subjects without cataract in the age group between 40 and 75 years of both genders. Serum magnesium was estimated by using a fully automated analyser. Serum malondialdehyde (MDA), an indicator of oxidative stress biomarker, was determined by spectrophotometry, and the antioxidant status such as serum reduced glutathione (GSH) and glutathione peroxidase-3(GPX-3) levels was estimated by ELISA method. The present study shows significantly decreased levels of magnesium, GSH, GPX-3 and increased level of MDA in type 2 diabetes mellitus patients with cataract when compared with non-diabetic senile cataract patients, type 2 DM without cataract and normal healthy individuals. A significant negative correlation of serum magnesium with MDA and positive correlation with GPX-3 were observed. The present findings indicate that hypomagnesaemia is a significant pathogenic factor which causes increased oxidative stress which may trigger earlier cataractogenesis in patients with type 2 diabetes mellitus.

Diabetic cataract in the Nile grass rat: A longitudinal phenotypic study of pathology formation

Diabetes is a major risk factor for cataract, the leading cause of blindness worldwide. There is an unmet need for a realistic model of diabetic cataract for mechanistic and longitudinal studies, as existing models do not reflect key aspects of the complex human disease. Here, we introduce and characterize diabetic cataract in the Nile grass rat (NGR, Arvicanthis niloticus), an established model of metabolic syndrome and type 2 diabetes (T2D). We conducted a longitudinal study of cataract in over 88 NGRs in their non-diabetic, pre-diabetic, and diabetic stages of metabolism. Oral glucose tolerance test (OGTT) results distinguished the metabolic stages. Diverse cataract types were observed in the course of diabetes, including cortical, posterior subcapsular (PSC), and anterior subcapsular (ASC), all of which succeeded a characteristic dotted ring stage in all animals. The onset ages of diabetes and cataract were 44 ± 3 vs 29 ± 1 (P < .001) and 66 ± 5 vs 58 ± 6 (not significant) weeks in females and males, respectively. Histological analysis revealed fiber disorganization, vacuolar structures, and cellular proliferation and migration in cataractous lenses. The lens epithelial cells (LECs) in non-diabetic young NGRs expressed the stress marker GRP78, as did LECs and migrated cells in the lenses of diabetic animals. Elucidating mechanisms underlying LEC proliferation and migration will be clinically valuable in prevention and treatment of posterior capsule opacification, a dreaded complication of cataract surgery. Marked changes in N-cadherin expression emphasized a role for LEC integrity in cataractogenesis. Apoptotic cells were dispersed in the equatorial areas in early cataractogenesis. Our study reveals diverse cataract types that spontaneously develop in the diabetic NGR, and which uniquely mirror the cataract and its chronic course of development in individuals with diabetes. We provide mechanistic insights into early stages of diabetic cataract. These unique characteristics make NGR highly suited for mechanistic studies, especially in the context of metabolism, diabetes, and aging.

Effects of neutron radiation on Nrf2-regulated antioxidant defense systems in rat lens

Accumulating evidence suggests that ionizing radiation (IR)-induced cataract may be associated with oxidative stress. Nuclear factor erythroid 2-related factor 2 (Nrf2) serves as a master regulator of the antioxidant defense system against oxidative stress. The present study aimed to investigate the effects of different doses of neutron radiation on the Nrf2-reegulated antioxidant defense system in rat lens and assess the status of oxidative stress. A total of 24 SD rats were randomly divided into the following four groups: i) Control group; iis) 0.4 Sv group; iii) 1.2 Sv group; and iv) 3.6 Sv group. The rats were sacrificed 7 days after radiation and lenses were dissected for histological, biochemical (malondialdehyde, glutathione and superoxide dismutase) and western blot (Nrf2, glutamate-cysteine ligase catalytic subunit and heme oxygenase 1) analyses. The morphological features of the lenses remained intact in the 0.4 Sv, 1.2 Sv and control groups, whilst the lenses in the 3.6 Sv group exhibited injuries. Results from the TUNEL assay demonstrated apparent apoptosis in lens epithelial cells following 3.6 Sv neutron radiation whereas sparse apoptosis was observed following 0.4 Sv and 1.2 Sv radiation. Malondialdehyde levels were reduced in the 0.4 Sv and 1.2 Sv groups but increased in the 3.6 Sv group, compared with those in the control group. Conversely, glutathione expression and the activity of superoxide dismutase were higher in the 0.4 Sv and 1.2 Sv groups, but lower in the 3.6 Sv group, compared with those in the control group. In addition, the total and nuclear protein levels of Nrf2 were increased following neutron radiation compared with those in the control group, though the Nrf2 protein levels decreased in the 3.6 Sv group compared with those in the 1.2 Sv group. The levels of glutamate-cysteine ligase catalytic subunit and heme oxygenase 1, downstream antioxidant enzymes of Nrf2, demonstrated the same profile as that in Nrf2. Taken together, the results of the present study suggest that neutron radiation affects Nrf2-regulated antioxidant systems in a two-stage process. Namely, the induction phase for low-dose radiation and regression phase for high-dose radiation. Therefore, it was hypothesized that activation and enhancement of the Nrf2-regulated antioxidant system may be useful in preventing or delaying IR-induced cataract, which may be extended even for other diseases associated with oxidative stress.

Ocular conditions and dry eye due to traditional and new forms of smoking: A review

Addiction to cigarette smoking has high prevalence rates recorded worldwide. Smoking has been linked to several life-threatening systemic conditions such as cancer, heart attack and stroke, in addition to a range of ocular pathologies. In recent years, electronic cigarettes (EC) have emerged as alternatives to smoking. ECs are nicotine delivery devices which produce an aerosol by heating, rather than combusting, a liquid which contains nicotine, flavours and preservatives. This review focuses on the association of traditional and new forms of smoking with dry eye disease, contact lens wear and four other common ocular diseases: cataract, age-related macular degeneration, glaucoma and Graves' ophthalmopathy. It is concluded that smoking and vaping appear as a risk factor for the aforementioned ocular conditions. An evidence-based, clear link between cigarette smoking, or EC vaping and ocular problems is yet to be discovered.

Diabetic Cataract in Spontaneously Diabetic Torii Fatty Rats

Spontaneously Diabetic Torii (SDT) fatty rat is a novel animal model of type 2 diabetes with obesity. SDT fatty rats develop hyperglycemia, dyslipidemia, and other diabetic complications including ocular disorders; however, diabetic cataract formation in SDT fatty rats has not been fully investigated. The aim of the current study was to investigate the characteristics of cataract in the SDT fatty rats. The mean body weight of SDT fatty rats is larger than that of age-matched Sprague-Dawley (SD) rats and control animals until 8 weeks of age, and thereafter the growing speed decreased until the end of observation at 16 weeks of age. Blood glucose levels in SDT fatty rats were significantly higher than those in SD rats throughout the observational period. Slit-lamp examination revealed that no rats showed cataract formation at 5 weeks of age; however, SDT fatty rats gradually developed cortical cataract and posterior subcapsular cataract, both of which are the common types of cataract in patients with type 2 diabetes. The levels of glucose, sorbitol, and fructose were higher in the lens tissues of SDT fatty rats in comparison with that of SD rats. Furthermore, the level of 4-hydroxynonenal (4-HNE) was higher in the lens of SDT fatty rats than in that of SD rats. By contrast, total glutathione (GSH) concentration was lower in the lens of SDT fatty rats than in that of SD rats. The present study demonstrated that the cataractogenesis in SDT fatty rats resembled human diabetic cataract formation, indicating that SDT fatty rats serve as a potential animal model in researches on human cataract associated with type 2 diabetes and obesity.

Association between cataract progression and ischemia-modified albumin in relation to oxidant-antioxidant profiles in the serum, aqueous humor, and lens

PURPOSE

To evaluate the levels of ischemia-modified albumin (IMA) in relation to oxidant-antioxidant profiles in the serum, aqueous, and lens in cataract patients.

SETTING

Department of Ophthalmology, Menoufia University, Shebin El Kom, Menoufia, Egypt.

DESIGN

Prospective case series.

METHODS

Patients were divided into 2 groups. The cataract (study) group comprised patients with senile cataract and the control group, age- and sex-matched healthy persons. Patients with systemic disease or cataract formation secondary to identifiable causes were excluded. In all cases, a complete history was taken and a clinical examination was performed. In the cataract group, the lens was examined, and the cataract type and severity were graded. Blood levels of catalase, malondialdehyde (MDA), superoxide dismutase (SOD), and IMA were measured in all participants and in the aqueous and lens lysate of cataract patients.

RESULTS

Each group comprised 30 participants. Cataract patients had significant higher levels of serum MDA and IMA than the control group but had lower levels of serum catalase and SOD. Patients with cortical cataracts had higher level of serum IMA, aqueous catalase, and SOD levels patients with nuclear cataracts but had a lower level of lens SOD. There was a significant positive correlation between serum MDA and the patient's age and serum catalase levels.

CONCLUSION

Patients with cortical cataract had increased local oxidative stress and diminished antioxidant activity compared with systemic oxidative activity, which was not the same in patients with nuclear cataract.

Oxidative Stress Intensity in Lens and Aqueous Depending on Age-Related Cataract Type and Brunescense

Purpose

Cataract formation represents a serious problem in the elderly, and has a large impact on healthcare budget. The oxidative stress form and intensity might determine the cataract type and pigmentation, making efforts in the cataract prevention challenge more complex.

Methods

This is a retrospective cross-sectional review of 80 samples of aqueous humor and lens corticonuclear blocks. Aqueous samples were analyzed by the method of antioxidant activity estimation (%iMDA), while lipid peroxides (LP) and total sulfhydryl groups (TSH) were determined in lenses.

Results

Mixed and brunescent cataracts have statistically significant lower values of antioxidative %iMDA and TSH (p<0.001 for both parameters) and higher values of lipid peroxidation (p<0.001). No correlation between LP and TSH with maturity of cortical cataract was found, but there was a significant correlation with the %iMDA (p<0.05).

Conclusions

The role of the oxidative stress in cataractogenesis could not be the same for all cataract types. High level of lipid peroxides in pigmented cataracts may point to the different nature of pigment source than proteins solely, whereas lipid peroxidation and SH groups consumption in cortical cataractogenesis might be of less importance.

Comparison of the impact of epigallocatechin gallate and ellagic acid in an experimental cataract model induced by sodium selenite

AIM

To compare the potential protective effects of epi-gallocatechin gallate (EGCG) and ellagic acid (EA) in an experimental cataract model.

METHODS

Twenty-eight Spraque-Dawley rat pups were assigned into four groups. All the rats, except for those in the control group, were injected subcutaneously sodium selenite to induce experimental cataract on the postpartum ninth day, and between 10^th and 14^th days. Rats in the sham, EGCG, and EA groups were intraperitoneally administered 50 mg/(kg·d) saline solution, 50 mg/(kg·d) EGCG and 200 mg/(kg·d) EA, respectively. The reduced glutathione (GSH) and malondialdehyde (MDA) levels, total antioxidant status (TAS) and total oxidant status (TOS) in lens supernatants were measured.

RESULTS

The mean cataract gradings in EGCG and EA groups were found to be significantly lower than that in sham group (P<0.001). The mean GSH levels and TASs in EGCG and EA groups were significantly higher than that in sham group while mean MDA levels and TOSs in EGCG and EA groups were significantly lower than that in the sham group (P<0.001).

CONCLUSION

EGCG and EA have protective effects on cataract development via the inhibition of oxidative stress.

The structural damages of lens crystallins induced by peroxynitrite and methylglyoxal, two causative players in diabetic complications and preventive role of lens antioxidant components

Peroxynitrite (PON) and methylglyoxal (MGO), two diabetes-associated compounds, are believed to be important causative players in development of diabetic cataracts. In the current study, different spectroscopic methods, gel electrophoresis, lens culture and microscopic assessments were applied to examine the impact of individual, subsequent or simultaneous modification of lens crystallins with MGO and PON on their structure, oligomerization and aggregation. The protein modifications were confirmed with detection of the significantly increased quantity of carbonyl groups and decreased levels of sulfhydryl, tyrosine and tryptophan. Also, lens proteins modification with these chemical agents was accompanied with important structural alteration, oligomerization, disulfide/chromophore mediated protein crosslinking and important proteolytic instability. All these structural damages were more pronounced when the lens proteins were modified in the presence of both mentioned chemical agents, either in sequential or simultaneous manner. Ascorbic acid and glutathione, as the main components of lens antioxidant defense mechanism, were also capable to markedly prevent the damaging effects of PON and MGO on lens crystallins, as indicated by gel electrophoresis. The results of this study may highlight the importance of lens antioxidant defense system in protection of crystallins against the structural insults induced by PON and MGO during chronic hyperglycemia in the diabetic patients.

Investigation of dynamic thiol-disulphide homoeostasis in age-related cataract patients with a novel and automated assay

PURPOSE

The aim of this study was to determine plasma thiol-disulphide homoeostasis in patients with age-related cataract (ARC) and compare the results of the patients with healthy subjects. Plasma malondialdehyde (MDA) levels and catalase (CAT) activity were also investigated.

METHODS

The study included 53 cataract patients and 52 healthy volunteers. Native thiol-disulphide exchanges were determined using a novel and automated method. CAT activity was determined using the method described by Aebi, and MDA levels were calculated using the thiobarbituric acid method.

RESULT

Native thiol and total thiol levels were significantly lower in the cataract patients compared with the controls (p < 0.001, p = 0.002, respectively). The disulphide levels of the cataract patients were significantly higher than the controls (p = 0.002). The ratios of disulphide/native thiol and disulphide/total thiol were statistically higher in the cataract patients compared with the control group (p < 0.001, p < 0.001, respectively). Furthermore, CAT activity was significantly lower in the cataract patient group compared with the control group (p < 0.001), and MDA levels were insignificantly higher in the patient group (p = 0.581).

CONCLUSIONS

Our study showed that dynamic thiol-disulphide homoeostasis has shifted towards disulphide formation, as a result of thiol oxidation in ARC patients. The present study is the first to measure thiol-disulphide homoeostasis in ARC patients with a novel automated assay. This study supports the hypothesis that cataract is an oxidative disorder. Further studies are required in order to examine the relationship between oxidative stress and the development of cataract formation.

Oestradiol levels and superoxide dismutase activity in age-related cataract: a case-control study

BACKGROUND

It has been suggested that the higher prevalence of cataract in women is caused by a withdrawal effect of oestrogen at menopause. In vitro studies have demonstrated protection of serum oestradiol (E2) against oxidative stress through upregulation of antioxidant enzymes, including superoxide dismutase (SOD). The purpose of the present study was to investigate E2 levels and SOD erythrocyte activity in patients with age-related cataract.

METHODS

The studied subjects consisted of 103 patients with age-related cataract and 22 controls. Cataracts were classified as nuclear, cortical, or posterior subcapsular. Blood samples were collected and data on smoking, hormonal use, diabetes and age at menarche/menopause was obtained for all individuals. Serum oestradiol analyses were performed with radioimmunoassay (RIA) and SOD activity was measured in erythrocyte lysates.

RESULTS

A negative correlation between age and E2 concentration was seen in a linear regression analysis. No correlation was seen between SOD activity and age or gender and no correlation between E2 levels and SOD activity was found using multiple linear regression. The mean level of E2 for all male subjects was 50.1 ± 16.3 pmol/L, significantly higher compared to 13.8 ± 11.8 pmol/L for postmenopausal women.

CONCLUSION

The present study does not support a role for E2-induced effects on SOD in cataract formation. The findings of higher E2 levels in men than in postmenopausal women may suggest that decreased oestrogen at menopause is partially responsible for the gender-related difference in cataract prevalence. However, the latter can only be verified through prospective randomized trials using hormonal replacement therapy.

Effects of histone acetylation on superoxide dismutase 1 gene expression in the pathogenesis of senile cataract

Histone acetylation plays key roles in gene expression, but its effects on superoxide dismutase 1 (SOD1) expression in senile cataract remains unknown. To address this problem, the study was to investigate the influence of histone acetylation on SOD1 expression and its effects in the pathogenesis of senile cataract. Senile cataract was classified into three types—nuclear cataract (NC), cortical cataract (CC), and posterior subcapsular cataract (SC)—using the Lens Opacities Classification System III. In senile cataracts, SOD1 expression decreased significantly. Both H3 and H4 were deacetylated at −600 bp of the SOD1 promoter of cataract lenses, and hypoacetylated at −1500, −1200, and −900 bp. In hypoacetylated histones, the hypoacetylation pattern differed among the cataracts. In vitro, anacardic acid (AA) significantly reduced H3 and H4 acetylation at the SOD1 promoter, decreased protein expression, and induced cataract formation in rabbits. AA also inhibited HLEC viability and increased cell apoptosis. In contrast, trichostatin A (TSA) was able to efficaciously stop AA’s effects on both rabbit lenses and HLECs. Decreased histone acetylation at the SOD1 promoter is associated with declined SOD1 expression in senile cataracts. Histone acetylation plays an essential role in the regulation of SOD1 expression and in the pathogenesis of senile cataracts.

Nutritional modulation of cataract

Lens opacification or cataract reduces vision in over 80 million people worldwide and blinds 18 million. These numbers will increase dramatically as both the size of the elderly demographic and the number of those with carbohydrate metabolism-related problems increase. Preventative measures for cataract are critical because the availability of cataract surgery in much of the world is insufficient. Epidemiologic literature suggests that the risk of cataract can be diminished by diets that are optimized for vitamin C, lutein/zeaxanthin, B vitamins, omega-3 fatty acids, multivitamins, and carbohydrates: recommended levels of micronutrients are salutary. The limited data from intervention trials provide some support for observational studies with regard to nuclear - but not other types of - cataracts. Presented here are the beneficial levels of nutrients in diets or blood and the total number of participants surveyed in epidemiologic studies since a previous review in 2007.

Xanthine oxidase and lens oxidative stress markers in diabetic and senile cataract patients

Xanthine oxidase (XOD) is a prooxidant enzyme possibly implicated in diabetic lens injury and genesis of senile cataract (SC). We evaluated the impact of diabetes on XOD activity and its relationships with lens oxidative stress markers in patients operated on for SC. Serum and lens XOD activities, lens malondialdehyde (MDA), conjugated dienes, superoxide dismutase (SOD), glutathione peroxidase (GPx) and reduced glutathione (GSH) levels were measured in 62 non-diabetic and 29 diabetic patients operated on for SC. Lens XOD, SOD, GPx and GSH levels were gradually declining, while MDA and serum XOD were increasing with patient's age. Lens XOD activity was positively correlated with conjugated dienes concentration (rho=0.316; p=0.003) while being inversely correlated with age (rho=-0.371; p<0.001), indicating that low ocular expression of XOD could be related to lower intensity of oxidative stress and delayed occurrence of SC. When samples were adjusted for confounding factors, serum XOD (p<0.001), lens XOD (p=0.003) and conjugated dienes (p=0.002) were significantly higher in diabetic than in non-diabetic group. Lens SOD and GPx were moderately increased while MDA and GSH were unchanged in diabetic, compared with non-diabetic SC group. Blood HbA1C concentration was positively correlated with lens XOD (rho=0.346; p<0.001) as well as serum XOD activity (rho=0.485; p<0.001). These results suggest that poor glycemic control may upregulate systemic and ocular XOD activities contributing to lens oxidative stress and possibly to earlier onset of cataract.

Assessment of oxidative stress and antioxidant status in age related cataract in a rural population

Oxidative stress was assesed by estimating lipid peroxidation product (LPO) in the form of thiobarbituric acid reactive substances (TBARS), enzymatic antioxidants in the form of superoxide dismutase (SOD), catalase and nonenzymatic antioxidant vitamins e.g. vitamin C, β carotene and vitamin E in either serum or plasma or erythrocytes in 190 cases of age related cataract in the age group of 50-80 years. 190 cases were grouped into three morphological types namely, 73 cases of cortical, 77 cases of posterior subcapsular and 40 cases of nuclear cataract and values of LPO and antioxidants were compared with 78 cases of age matched healthy control groups. Plasma TBARS levels were cataract cases when compared with control groups. There were no significant differences in the erythrocyte levels of catalase and plasma levels of Vit E between cataract cases and control groups. No significant changes of parameters were seen among three different morphological types of age related cataract. The present study shows that the oxidative stress may play an important role in the age related cataract.

The oxidative stress in cataract patients

BACKGROUND

The recent studies on cataract formation focus on the primary role of the systemic oxidative stress which is generated outside the lens. Our research was directed to assess the oxidative stress by measuring the lipid peroxidation products in the form of the Thiobarbituric Acid Reactive Substances (TBARS) and the antioxidant enzyme levels in the blood. The antioxidant therapy may have a role to play in delaying the onset and the progression of age related cataracts.

MATERIAL AND METHOD

This was a case control study. It comprised of 100 age matched subjects (50 with cataracts and 50 controls) with their ages ranging from 45- 75 years. Oxidative stresses such as the Thiobarbituric Acid Reactive Substances (TBARS) and the antioxidant enzymes, Superoxide Dismutase (SOD) and Glutathione Peroxidase( GPX ) were investigated in all the patients and the controls.

RESULTS

Significantly increased levels of serum lipid peroxide in the form of Malondialdehyde (MDA) (p<0.001) were observed in the cataract patients as compared to the controls. Significantly decreased blood levels of SOD and GPX were observed in all the patients.

CONCLUSION

In the present study, it was concluded that oxidative stress plays an important role in the onset and the progression of cataracts. The pro-oxidant i.e. serum malondialdehyde (MDA) levels were increased in the cataract patients. The blood levels of the enzymatic anti-oxidants, SOD and GPX were decreased. The plasma TBARS can be used as biomarkers of the degeneration in the lens.

Osmotic stress induced oxidative damage: possible mechanism of cataract formation in diabetes

Chronic hyperglycemia causes increased level of reactive oxygen species which is thought to be involved in the pathogenesis of diabetes associated complications including cataract. In diabetic cataractous lens, over production of free radicals and decreased capacity of antioxidant defense system are the major contributors to oxidative damage by polyol pathway and advanced glycation end products. The current study focused on analysis of factors associated with osmotic imbalance and oxidative stress in aging and diabetic human cataractous lenses. We examined activities of polyol pathway enzymes, G6PD and glutathione system in lenses from subjects suffering from cataract due to aging and diabetes. We observed elevated activities of aldose reductase and sorbitol dehydrogenase while G6PD and glutathione system enzyme activities were found to be lower in cataractous subjects suffering from diabetes. The findings from the current study support the premise that osmotic imbalance, AGEs formation and oxidative stress contribute synergistically to the development of lens opacity in hyperglycemia.

The Impact of Senile Cataract Maturity on Blood Oxidative Stress Markers and Glutathione-Dependent Antioxidants: Relations with Lens Variables

Oxidative stress is implicated in senile cataract (SC) genesis, although the impact of SC maturity on blood oxidative stress markers is unclear. Total hydroperoxides, malondialdehyde (MDA), glutathione (GSH), glutathione peroxidase (GPx), glutathione reductase (GR) and glutathione S-transferase (GST) were measured in the blood and lens samples of patients having either immature (n=31) or mature SC (n=50), and in 22 blood samples from noncataract controls. Compared to controls, SC patients had higher plasma MDA and serum GST, and decreased plasma GR and GSH levels. Plasma GPx as well as hydroperoxides differed from control values only in patients with mature SC. The multivariate logistic regression analysis showed that the fall of plasma GR activity (OR 5.14; CI 1.82-14.51;p=0.0020), as well as serum GST activity (OR 3.84; CI 1.36-10.83;p=0.0108) were independently associated with the maturity of SC. Lens hydroperoxides, MDA and GST, showed no correlation with correspondent blood values, in contrast to GPx (r=0.715; p<0.001) and GR (r=0.703; p<0.001). This study showed that the severity of SC is associated with increased systemic oxidative stress, which could be due to the fall of GSH-dependent antioxidant enzymes activities.

Magnesium deficiency: does it have a role to play in cataractogenesis?

Magnesium is one of the most important regulatory cation involved in several biological processes. It is important for maintaining the structural and functional integrity of vital ocular tissues such as lens. Presence of high magnesium content especially in the peripheral part of lens as compared to aqueous and vitreous humor has been observed. Magnesium plays significant role as a cofactor for more than 350 enzymes in the body especially those utilizing ATP. Membrane associated ATPase functions that are crucial in regulating the intracellular ionic environment, are magnesium-dependent. Moreover, the enzymes involved in ATP production and hydrolysis are also magnesium-dependent. Magnesium deficiency by interfering with ATPase functions causes increased intracellular calcium and sodium and decreases intracellular potassium concentration. Furthermore, magnesium deficiency is associated with increased oxidative stress secondary to increased expression of inducible nitric oxide synthase and increased production of nitric oxide. Thus the alterations in lenticular redox status and ionic imbalances form the basis of the association of magnesium deficiency with cataract. In this paper we review the mechanisms involved in magnesium homeostasis and the role of magnesium deficiency in the pathogenesis of cataract.

Antioxidant capacity of lenses with age-related cataract

The immediate cause of the occurrence of cataract is unknown, but oxidative damage and effects of reactive oxygen species are considered important in its etiopathogenesis. Our research was aimed at testing the nonenzyme antioxidant power of corticonuclear lens blocks, with different types and different maturity of age-related cataract. Clinical and biochemical researches were carried out in 101 patients with age-related cataract. In corticonuclear lens blocks of the patient, the concentration of nonprotein and total-SH groups and the concentration of total vitamin C and dehydroascorbic acid (DHA) were determined; the current redox balance of dehydroascorbate/ascorbate and total antioxidant power measured by ferric-reducing ability were examined. In corticonuclear lens blocks with incipient cataract a significantly higher concentration of GSH, total SH groups, concentration of total vitamin C and ascorbic acid (AA), and ferric-reducing ability were measured. The measured concentration of DHA is higher than the concentration of AA in the lenses with the incipient and mature cataract. The concentration ratio of redox couple DHA/AA is higher in lenses with mature cataract, where the measured concentration of AA was lower than in the incipient cataract. Timely removal of DHA from the lens is important because of its potential toxicity as an oxidant. An increase of the current concentration of DHA/AA redox balance can be an indicator of oxidative stress.

Decreased Glucose-6-PhosphateDehydrogenase (G6PD) Activity and Risk of Senile Cataract in Taiwan

G6PD deficiency may render afflicted individuals more susceptible to certain degenerative diseases. To clarify the relationship between G6PD deficiency and cataract, blood G6PD activity was determined in patients with cataract in Taiwan. The cases and hospital-based controls were recruited from the medical outpatient department and from the physical checkup department at Chang Gung Memorial Hospital, respectively. A questionnaire survey was used to determine associations between cataracts and their risk factors. G6PD activity in fresh RBC was quantitatively measured and genomic DNA was extracted from lymphocyte nuclei. The mean blood G6PD activity among cataract patients (278.1 U/10[12] RBC) was similar to that of normals (288.0 U/10[12] RBC). No statistically significant difference in the distribution of G6PD activities as grouped by an increment of 100 U/[10, 12] RBC was observed between cataract patients and normal subjects. The predominant forms of G6PD gene mutation (cDNA 1376 G to T and 95 A to G) were both found in the patients with cataract. The adjusted odds ratio for cataract was 1.21 for every decrement of 100 U/10[12] RBC of G6PD activity in these subjects. These data indicate that G6PD activity is not a potential risk factor for senile cataract in Taiwan.

Glutathione and Lipid Peroxide Changes in Pseudoexfoliation Syndrome

PURPOSE

To investigate the oxidative status of the aqueous humor of patients with pseudoexfoliation (PEX) syndrome.

METHODS

Aqueous humor samples obtained during cataract surgery of patients with PEX syndrome and normal age-matched control subjects were examined for changes in the levels of glutathione (GSH), glutathione disulfide (GSSG), and TBA reactive species (TBARS), products of lipid peroxidation. GSH, GSSG, and TBARS were determined by specific fluorescent assays.

RESULTS

Compared to normal controls, PEX syndrome aqueous humor samples showed a decrease of up to 28% of GSH concentration, and GSSG was increased up to 23%. The ratio of GSH/GSSG was 1.7-fold decreased in PEX syndrome samples. TBARS levels were increased by 100% in the PEX aqueous humor samples as compared to the controls.

CONCLUSIONS

High levels of GSSG and TBARS indicate high oxidative stress, as well as the decrease in the ratio of GSH/GSSG. Our findings suggest a role for oxidation stress in the pathogenesis and the progression of PEX syndrome.

Glutathione-Related Enzymes and the Eye

Glutathione and the related enzymes belong to the defence system protecting the eye against chemical and oxidative stress. This review focuses on GSH and two key enzymes, glutathione reductase and glucose-6-phosphate dehydrogenase in lens, cornea, and retina. Lens contains a high concentration of reduced glutathione, which maintains the thiol groups in the reduced form. These contribute to lens complete transparency as well as to the transparent and refractive properties of the mammalian cornea, which are essential for proper image formation on the retina. In cornea, gluthatione also plays an important role in maintaining normal hydration level, and in protecting cellular membrane integrity. In retina, glutathione is distributed in the different types of retinal cells. Intracellular enzyme, glutathione reductase, involved in reducing the oxidized glutathione has been found at highest activity in human and primate lenses, as compared to other species. Besides the enzymes directly involved in maintaining the normal redox status of the cell, glucose-6-phosphate dehydrogenase which catalyzes the first reaction of the pentose phosphate pathway, plays a key role in protection of the eye against reactive oxygen species. Cornea has a high activity of the pentose phosphate pathway and glucose-6-phosphate dehydrogenase activity. Glycation, the non-enzymic reaction between a free amino group in proteins and a reducing sugar, slowly inactivates gluthathione-related and other enzymes. In addition, glutathione can be also glycated. The presence of glutathione, and of the related enzymes has been also reported in other parts of the eye, such as ciliary body and trabecular meshwork, suggesting that the same enzyme systems are present in all tissues of the eye to generate NADPH and to maintain gluthatione in the reduced form. Changes of glutathione and related enzymes activity in lens, cornea, retina and other eye tissues, occur with ageing, cataract, diabetes, irradiation and administration of some drugs.

The evaluation of the oxidative stress parameters in nondiabetic and diabetic senile cataract patients

The aim of the present study was to evaluate the copper (Cu), zinc (Zn), malondialdehyde (MDA), glutathione (GSH), and advanced oxidation protein products (AOPP) levels and superoxide dismutase (SOD) activities in diabetic senile cataract. Ten patients with diabetic senile cataract and ten patients with nondiabetic senile cataract (control group) were included in this study. AOPP, MDA, and GSH levels and SOD activity were measured by a spectrophotometric method. Serum, lens Cu, and Zn levels were measured by an atomic absorption spectrophotometric method. Both the lens and serum Zn and Cu levels between the two groups were not significantly different (p > 0.05). GSH, AOPP, and MDA levels and the SOD activities in the diabetic senile cataract group were significantly increased as compared to the control group (p < 0.05). Oxidative stress is one of the major factors which may lead to the early cataract formation. Oxidative events are of great importance in diabetic complications and, particularly in the lens, may have a role in the pathogenesis of cataract associated with diabetes mellitus as exhibited in this study.

Expression and activity of paraoxonase 1 in human cataractous lens tissue

Paraoxonase 1 (PON1) is a high-density lipoprotein-associated enzyme that is believed to be involved in the protection against oxidative stress. There is evidence that paraoxonase activity is reduced in patients with diabetes and cataract. In the current study, we analyzed mRNA expression of PON1 as well as other members of the paraoxonase family, PON2 and PON3, in human cataractous lens samples. Our results indicate that only PON1 is expressed at the gene and protein levels in human lens tissues. We quantified MDA levels and measured PON1 (paraoxonase/arylesterase) enzymatic activities in subjects suffering from cataract due to aging and diabetes. Decreased PON1 activity was more pronounced in diabetic patients (p< 0.001) compared to senile subjects, which may be due to glycation and increased oxidative insult. To examine the structural alterations that occur in response to glycation, we constructed a three-dimensional model of PON1 and its glycated variant. Glycation at Lys70 and Lys75 is predicted to cause hindrance in binding of substrate to the active site of the enzyme.

Role of lipid peroxidation in pathogenesis of senile cataract

Background /Aim. Cataract is a structural, biochemical and optical change in the eye lens, which changes transmission and refraction of light rays reducing keenness and clarity of a figure on the retina. Its occurrence is highest in older people, over the age of 65 (45.9%), thus a certain degree of opacification exists practically in all people over the 70. Our research was directed to measuring of lipid peroxidation products in cataract lenses involved in early stages of cataractogenesis through oxidative stress and in the development of mature cataract. Methods. Clinical and biochemical research was carried out in 101 patients with cataract, 46 women and 55 men. The average age of the group was 72.47 (? = 7.98). According to the cataract maturity degree the patients were classified into two groups as follows: cataracta senilis incipiens (n = 41) and cataracta senilis matura (n = 60). Measuring of diene conjugates was carried out by spectrophotometer. Fluorescent lipid peroxidation products were measured by a spectrofluorophotometer, and malondialdehyde (MDA) concentration was measured by colorimeter as a product of a reaction with thiobarbituric acid (TBA). Result. Significantly higher diene conjugated concentration in lenses was measured in the patients with the diagnosis cataracta senilis incipiens (p < 0.001) as well as the intensity of fluorescent iminopropens (p < 0.001). Significantly higher MDA concentration in lens (p < 0.001) was measured in the patients with cataracta senilis matura. Conclusion. The lens structure changes caused by lipid peroxidation can, with other risk factors present, influence the occurrence and development of mature cataract. Some cataract types show different lipid peroxidation intensity with the most distinct changes in cataract which started as corticonuclear.

The effects of taurine, taurine homologs and hypotaurine on cell and membrane antioxidative system alterations caused by type 2 diabetes in rat erythrocytes

This study compared taurine, aminomethanesulfonic acid, homotaurine and hypotaurine for the ability to modify indices of oxidative stress and membrane damage associated with type 2 diabetes. In the study, male Goto-Kakizaki and Wistar-Kyoto rats were allowed free access to a high fat and normal diet, respectively, for 9 weeks. At the end of week 8, half of the animals in each group received a daily intraperitoneal dose of a sulfur compound (0.612 M/kg) for 5 days and, 24 hr after the last treatment, blood samples were withdrawn by cardiac puncture to obtain plasma and erythrocyte fractions for biochemical analyses. Relative to control values, taurine and its congeners reduced membrane damage, the formation of intracellular malondialdehyde and oxidized glutathione, and the decreases in reduced glutathione and antioxidative enzyme activities in diabetic erythrocytes. Except for a few isolated instances, all test compounds were equiprotective.

Could oxidative stress associate with age products in cataractogenesis?

BACKGROUND

Oxidative stress has been reported to contribute to aging and cataract formation in the lens. The aim was to determine the association of oxidative stress with advanced glycation end products (AGEs) in elderly diabetic and non-diabetic patients with cataract.

METHODS

In the present study, malondialdehyde, vitamin E, serum AGEs, and glycemic control were investigated. The study included 156 subjects. Out of them, 30 were normal elderly subjects, 31 were elderly diabetic patients without cataract, 33 were elderly diabetic patients with cataract, 32 were elderly non-diabetic with cataract, and 30 were normal young subjects. The patients were selected on clinical grounds from Eye Ward, Jinnah Postgraduate Medical Centre, Karachi, Pakistan.

RESULTS

Positive significant correlation was observed between s-AGEs and malondialdehyde in elderly diabetic and non-diabetic patients with cataract. Negative significant correlation was observed between s-AGEs and vitamin E in elderly diabetic and non-diabetic patients with cataract. However, the malondialdehyde and serum AGEs were found to be significantly increased (p < 0.001) in elderly diabetic and non-diabetic patients with and without cataract compared with elderly control subjects. In contrast to all four senile groups, the serum AGEs was significantly lower (p < 0.001) in young control subjects. Serum vitamin E was found to be significantly decreased (p < 0.001) in elderly diabetic patients with and without cataract compared with elderly control subjects. Fasting blood glucose, HbA(1C) and serum fructosamine levels were significantly increased (p < 0.001) in elderly diabetic patients with and without cataract compared with non-diabetic elderly patients with cataract and elderly control subjects.

CONCLUSIONS

This study revealed that increased AGEs were associated with oxidative stress in the elderly groups. AGE, as a result of oxidative stress, might have a role in cataract formation, which, in diabetic patients, occurs vigorously as compared with non-diabetic cataract patients.

The central role of glutathione in the pathophysiology of human diseases

Reduced glutathione (L-gamma-glutamyl-L-cysteinyl-glycine, GSH) is the prevalent low-molecular-weight thiol in mammalian cells. It is formed in a two-step enzymatic process including, first, the formation of gamma-glutamylcysteine from glutamate and cysteine, by the activity of the gamma-glutamylcysteine synthetase; and second, the formation of GSH by the activity of GSH synthetase which uses gamma-glutamylcysteine and glycine as substrates. While its synthesis and metabolism occur intracellularly, its catabolism occurs extracellularly by a series of enzymatic and plasma membrane transport steps. Glutathione metabolism and transport participates in many cellular reactions including: antioxidant defense of the cell, drug detoxification and cell signaling (involved in the regulation of gene expression, apoptosis and cell proliferation). Alterations in its concentration have also been demonstrated to be a common feature of many pathological conditions including diabetes, cancer, AIDS, neurodegenerative and liver diseases. Additionally, GSH catabolism has been recently reported to modulate redox-sensitive components of signal transduction cascades. In this manuscript, we review the current state of knowledge on the role of GSH in the pathogenesis of human diseases with the aim to underscore its relevance in translational research for future therapeutic treatment design.

Assessment of paraoxonase activity and lipid peroxidation levels in diabetic and senile subjects suffering from cataract

OBJECTIVES

The purpose of this study was to evaluate antioxidant effect of paraoxonase 1 activity and malondialdehyde (MDA) levels as a marker of oxidative stress in patients suffering from cataract due to diabetes and aging.

DESIGN AND METHODS

One hundred cataract patients (senile and diabetic) and age- and sex-matched controls were studied. Paraoxonase 1 and arylesterase activities in plasma samples were measured using paraoxon and phenylacetate as substrates, respectively. The magnitude of lipid peroxidation was established by measuring plasma MDA and oxidized low-density lipoprotein (ox LDL) levels. One-way ANOVA was employed for analysis of results.

RESULTS

We observed significantly lower plasma paraoxonase and arylesterase activities in senile and diabetic cataractous patients as compared to respective controls (p<0.001). Plasma MDA and ox LDL levels were found to be higher in patients suffering from cataract (p<0.001).

CONCLUSIONS

The results of present study suggest that the observed decrease in PON1 activity may be due to increase in oxidative stress. It can be concluded that lower paraoxonase activity could contribute to the higher risk of cataract formation.

Pseudoexfoliation syndrome and its antioxidative protection deficiency as risk factors for age-related cataract

PURPOSE

Pseudoexfoliation syndrome (PES) seems to be a systemic condition. However, to an ophthalmologist it represents a continual challenge, due to unclear etiology and patho-genesis, and because of a potential for development of an aggressive glaucoma, and cataract surgery complications. According to some findings, PES could be a factor of hastened aging, which means that it could be considered as a secondary aging factor.

METHODS

Frequencies of secondary aging diseases (non-insulin dependent diabetes mellitus, atherosclerotic myocardiopathy, chronic obstructive lung diseases, arterial hypertension, and PES) were investigated in 162 patients with age-related cataract and 55 age- and sex-matched control subjects, and analyzed by a logistic regression. The authors also determined elements of antioxidative protection in a group of sera from patients with cataract and PES, and compared them to those obtained from patients with cataract without PES (activity of catalase and peroxidase, glutathione, vitamins C and E), and total antioxidative protection (%iMDA). Antioxidant defense of aqueous humors, expressed as a rate of induced malondialdehyde (%iMDA), and total thiol groups in the lens corticonuclear blocks (TSH) were estimated in samples of 17 patients with PES and cataract and 55 patients with cataract only.

RESULTS

Logistic regression showed the highest odds ratio for PES (OR=4.516; p<0.05). Catalytic activity of serum catalase had significantly lower values in patients with PES (p<0.05). Anti oxidative defense of aqueous humor and lens had lower values in patients with PES.

CONCLUSIONS

The results indicate that PES might be a significant factor for cataractogenesis. At least a part of pathogenesis alterations in an eye with PES could be the result of higher intensity of oxidative stress.

Superoxide dismutase activity in the lens capsule of patients with pseudoexfoliation syndrome and cataract

PURPOSE

To evaluate the activity of the antioxidative enzyme superoxide dismutase (SOD) in the anterior lens capsule of patients with cataract complicating pseudoexfoliation syndrome (PEX) in an attempt to determine the role of the oxidative mechanisms in the etiopathogenesis of this disorder.

SETTING

Departments of Ophthalmology and Biochemistry, Ankara University School of Medicine, Ankara, Turkey.

METHODS

At the beginning of phacoemulsification surgery, the anterior lens capsules in 21 eyes with PEX and cataract (group A) and those in 24 eyes with cataract alone (group B) were collected with continuous curvilinear capsulorhexis and were frozen at -20 degrees C. At the time of analysis, the specimens were thawed and centrifuged and the supernatants of the homogenate obtained from the samples were analyzed for the activity of the enzyme SOD.

RESULTS

The mean age of patients was 74.8 years +/- 5.5 (SD) in group A and 71.7 +/- 5.6 years in group B. The specific activity of SOD was 17.6 +/- 10.8 IU/mg and 4.36 +/- 1.80 IU/mL in group A and 9.9 +/- 12.9 IU/mg and 2.71 +/- 2.61 IU/mL in group B. Superoxide dismutase activity was significantly higher in group A patients than in group B patients (P = .022 and P = .011, respectively).

CONCLUSIONS

The increase in SOD activity in the lens capsule of patients with PEX and cataract suggests that oxidative mechanisms play a role in the etiopathogenesis of cataract in PEX. This suggests that SOD activity may be increased as a compensatory mechanism to eliminate this oxidative stress.

Influence of glutathione fructosylation on its properties

Incubation of fructose and glutathione leads to the formation of N-2-deoxy-glucos-2-yl glutathione as the major glycation product, with characteristic positive ion at 470 Th in LC-MS spectra. Glutathione disulfide and fructose generate two compounds: N-2-deoxy-glucos-2-yl glutathione disulfide (m/z=775 Th) and bis di-N,N'-2-deoxy-glucos-2-yl glutathione disulfide (m/z=937 Th). N-2-deoxy-glucos-2-yl glutathione is 2.5-fold less effective than glutathione in reducing dehydroascorbic acid. Glutathione peroxidase and glutahione-S-transferase exhibit marginal activity toward N-2-deoxy-glucos-2-yl glutathione, while glyoxalase I shows 44.9% of the enzyme's specific activity. Glutathione reductase demonstrates 6.9% of the enzyme's specific activity with bis di-N,N'-2-deoxy-glucos-2-yl glutathione, while with mono-N-glucosyl glutathione disulfide retained 5 6.1% of the original activity. Glutathione reductase could not reduce N-2-deoxy-glucos-2-yl glutathione in mixed disulfide with gammaS-crystallin, but reduced glutathione in mixed disulfide with gammaS-crystallin by 90%. The presence of N-2-deoxy-glucos-2-yl glutathione in mixed disulfide with gammaS-crystallin makes this molecule more susceptible to unfolding than native gammaS-crystallin.

Changes in the lens epithelium with respect to cataractogenesis—light microscopic and Scheimpflug densitometric analysis of the cataractous and the clear lens of diabetics and non-diabetics

BACKGROUND

We compared the human lens documented, using the Scheimpflug densitometry, with the light microscopic changes in the epithelium of the anterior central lens in patients with age-related cataract and diabetes mellitus type II and verified the findings on the control tissue of the clear eye lens. We wanted to determine the relevance of the lens epithelium in cataract formation in type II diabetics compared to non-diabetics.

MATERIALS AND METHODS

One hundred fifty central lens capsules (138 cataract and 12 clear lenses) of type II diabetics (n=77, 45 female, 32 male) and non-diabetics (n=73, 41 female, 32 male) were examined by light microscope, regarding defined histomorphological parameters. Further criteria were duration of diabetes, diabetic retinopathy, cataract (PENTACAM, scheimpflug densitometric definition), protein content in the aqueous humour (laser flare meter 500 KOWA, tyndallometry), different blood parameters and glucose content in the aqueous humour.

RESULTS

The mean cell density in the cataractous lens in type II diabetics was 3,951+/-528 cells/mm(2) and in non-diabetics 4,329+/-580 cells/mm(2) (P<0.001); in the clear lens it corresponded to 4,593+/-409 cells/mm(2) (type II diabetics) and 4,894+/-333 cells/mm(2) (non-diabetics, P=0.207). The cell density of the cataractous lens in type II diabetics (P=0.005) and in non-diabetics (P=0.035) is smaller than that of the clear lens. The cell area of the lens epithelium in the cataractous diabetic lens is larger (P<0.001) and the nucleus-plasma ratio is lower (P<0.001) than those of the clear non-diabetic lens. The increase in damage of the lens epithelium correlates with the decrease of cell density (P< 0.001), the increase of nucleus area and volume (P< 0.001), and the decrease of nucleus-plasma ratio (P< 0.001). Risk factors for the decrease of cell density are advanced age (P=0.015), type II diabetes (P=0.01), increase in glucose content in the aqueous humour (P=0.014), increase in blood sugar (P=0.003) and increase in glycosylated haemoglobin (P=0.039).

CONCLUSIONS

The lens epithelium is primarily damaged in type II diabetics who develop age-related cataract. This might play an important role in cataract formation.

Effects of metabolic control and vascular complications on indices of oxidative stress in type 2 diabetic patients

The direct effect and the interaction of diabetic angiopathy and metabolic control on free radical and antioxidant activity indices was investigated in 48 patients with type 2 diabetes mellitus. Conjugated dienes (CD) and thiobarbituric acid-reacting substances (TBARS) levels were 34 and 178% of control values, respectively. An approximate two-fold decrease in plasma thiols (PSH) and erythrocyte lysate thiols (LSH) concentrations, parameters reflecting protein oxidative damage, was found. Impairment of blood antioxidant potential in diabetic patients was reflected by an 81% increase in superoxide dismutase (SOD) activity, a 30% decrease in catalase (CT), 20% decrease in glutathione peroxidase (GPx) and glutathione reductase (GR) activities as well as by lowered total antioxidant status (TAS). CD, TBARS and SOD values were positively correlated with plasma glucose concentration and glycated hemoglobin level. A negative correlation existed between levels of LSH, PSH, CT, GPx or TAS and both glucose and HbA(1c). Blood glucose control and vascular complications had strong independent effects on prooxidant-antioxidant status, apart from blood glucose and GR activity. In addition, glycemic control and diabetic vasculopathy interact in their influence on most of the free radical and antioxidant indices, except for CD, LSH levels and CT activity. Thus, we observed different mechanisms by which vascular complications and glucose control affect blood free radical indices and antioxidant status parameters in type 2 diabetic patients.

Community-based study of cataracts among type 2 diabetics in Kinmen

The purpose of this study was to assess the prevalence and risk factors of each type of cataract among type 2 diabetics in Kinmen, Taiwan. There were 971 type 2 diabetics ascertained from a community-based mass screening between 1991 and 1993. In 1999, a total of 578 (59.5%) patients with type 2 diabetes were examined with an eye screening performed by two senior ophthalmologists using a 45-degree thin slit-lamp biomicroscopy and ophthalmoscopy to examine the lens after dilating the pupils. The overall prevalence, including subjects with or without surgery, was 31.0% (179/578, 95% CI: 27.3-34.7%), and had a statistically significant difference for gender (chi2 = 8.78, p = 0.003) and age (chi2-trend = 11.89, p < 0.0001). Based on multiple logistic regression, the significant risk factors of all types of cataracts were age (OR = 1.16, 95% CI: 1.12-1.20), lower diastolic blood pressure (DBP) at baseline (OR = 0.47, 95% CI: 0.25-0.88), and higher triglyceride at baseline (OR = 2.19, 95% CI: 1.07-4.45). In conclusion, our results found that in addition to age, lower DBP and higher triglyceride at baseline may increase the risk of prevalent cataracts in type 2 diabetics.