Establish an In Vitro Cell Model to Explore the Impacts of UVA on Human Corneal Endothelial Wound Healing

Evolution of therapeutic strategy based on oxidant-antioxidant balance for fuchs endothelial corneal dystrophy

Fuchs endothelial corneal dystrophy (FECD) stands as the most prevalent primary corneal endothelial dystrophy worldwide, posing a significant risk to corneal homeostasis and clarity. Corneal endothelial cells exhibit susceptibility to oxidative stress, suggesting a nuanced relationship between oxidant-antioxidant imbalance and FECD pathogenesis, irrespective of FECD genotype. Given the constrained availability of corneal transplants, exploration into non-surgical interventions becomes crucial. This encompasses traditional antioxidants, small molecule compounds, biologics, and diverse non-drug therapies, such as gene-related therapy, hydrogen therapy and near infrared light therapy. This review concentrates on elucidating the mechanisms behind oxidant-antioxidant imbalance and the evolution of strategies to restore oxidant-antioxidant balance in FECD. It provides a comprehensive overview of both conventional and emerging therapeutic approaches, offering valuable insights for the advancement of non-surgical treatment modalities. The findings herein might establish a robust foundation for future research and the therapeutic strategy of FECD.

Ultraviolet B irradiation induces senescence of human corneal endothelial cells in vitro by DNA damage response and oxidative stress

The human corneal endothelial cells (HCEnCs) play a vital role in the maintenance of corneal transparency and visual acuity. In our daily life, HCEnCs are inevitably exposed to ultraviolet B (UVB) radiation leading to decreases of visual acuity and corneal transparency resulting in visual loss eventually. Therefore, understanding the UVB-induced cytotoxicity in HCEnCs is of importance for making efficient strategies to protect our vision from UVB-damage. However, in-depth knowledge about UVB-induced cytotoxicity in HCEnCs is missing. Herein, we pulse-irradiated the HCEnCs in vitro with 150 mJ/cm² UVB (the environmental dose) at each subculture for 4 passages to explore the insights into UVB-induced phototoxicity. The results showed that the UVB-treated HCEnCs exhibit typical senescent characteristics, including significantly enlarged relative cell area, increased senescence-associated β-galactosidase positive staining, and upregulated p16^INK4A and senescence associated secretory phenotypes (SASPs) such as CCL-27, IL-1α/6/8/10, TGF-β1 and TNF-α, as well as decreased cell proliferation and Lamin B1 expression, and translocation of Lamin B1. Furthermore, we explored the causative mechanisms of senescence and found that 150 mJ/cm² UVB pulse-irradiation impairs DNA to activate DNA damage response (DDR) pathway of ATM-p53-p21^WAF1/CIP1 with downregulated DNA repair enzyme PARP1, leading to cell cycle arrest resulting in DDR-mediated senescence. Meanwhile, UVB pulse-irradiation also elicits a consistent increase of ROS production to aggravate DNA damage and impose oxidative stress on energy metabolism leading to metabolic disturbance resulting in metabolic disturbance-mediated senescence. Altogether, the repeated pulse-irradiation of 150 mJ/cm² UVB induces HCEnC senescence via both DDR pathway and energy metabolism disturbance.

Analysis of aqueous humor total antioxidant capacity and its correlation with corneal endothelial health

Corneal endothelial decompensation is a serious condition that frequently requires treatment via corneal transplantation which contributes to a global shortage in donor corneas. Therefore, the purpose of this study was to analyze the influence of aqueous humor total antioxidant capacity (TAC) on corneal endothelial health. There is an urgent need for discovering protective factors to combat corneal endothelial cell (CEC) loss. For methods, we developed a cupric ion-based TAC (CuTAC) assay to analyze TAC level in a small volume of aqueous humor, that is, 10 μL per test, and examined the influences of ascorbic acid (AA) and antioxidant proteins on aqueous humor TAC. To broaden the investigation, we conducted a case-control study with patients classified into two groups, an insufficient endothelial cell density (ECD < 2100 cells/mm2) group, and a control group. These groups were formed based on baseline ECD values and were used to evaluate the influence of aqueous humor TAC and AA on overall corneal endothelial health. A CuTAC assay was used to accurately measure aqueous humor TAC without the need for sample dilution. After analyzing a total of 164 human aqueous humor samples, we found that AA was the major contributor to aqueous humor TAC (73.2%). In addition, TAC and AA levels in the IECD and control groups were both found to be significantly different (1.168 vs. 1.592 mM, p = 0.009 and 0.856 vs. 1.178 mM, p = 0.016). TAC and AA were considered independent protective factors against IECD with adjusted odds ratios of 0.02 (p = 0.017) and 0.023 (p = 0.033), respectively. In conclusion, aqueous humor TAC and AA contribute to the maintenance of sufficient corneal ECD, and our CuTAC assay can be a useful tool for analyzing TAC using only a small aqueous humor sample volume.