Decline of electrogenic Na+/K+ pump activity in rod photoreceptors during maintained illumination

Metabolic responses to light in monkey photoreceptors

PURPOSE

Transient changes in intraretinal oxygen tension (PO(2)) in response to light stimuli were studied in order to understand the dynamics of light-evoked changes in photoreceptor oxidative metabolism.

METHODS

PO(2) changes during illumination were recorded by double-barreled microelectrodes in the outer part of the perifoveal retina in five macaques (Rhesus and Cynomolgus) and were fitted to a single exponential equation to obtain the time constant (tau) and maximum PO(2) change.

RESULTS

At the onset of light, PO(2) increased at all illuminations in all animals. The magnitude of the light-evoked PO(2) change increased with increasing illumination over 3-4 log units but decreased in all animals at the maximum illumination. The median time constant of the PO(2) change (tau) was 26 sec and was not correlated with illumination. The time constant for the return to darkness was similar for illuminations below rod saturation. Since O(2) diffusion is fast over the short distance from the choroid to the inner segments, tau reflects the time course of the underlying change in oxidative metabolism.

CONCLUSIONS

Previous results suggested that two competing processes influence the change in photoreceptor oxidative metabolism with light, Na(+)/K(+) pumping and cyclic guanosine monophosphate (cGMP) turnover. Because a single exponential fitted the PO(2) data, it appears that these processes have time constants that differ by no more than a few seconds in primate. In monkeys, tau is longer than previously reported values for cat and rat. Longer time constants are related to larger photoreceptor volume, possibly because metabolic rate is controlled by intracellular Na(+), and a change in intracellular Na(+) after the onset of illumination occurs more slowly in larger photoreceptors. The "metabolic threshold" illumination that reduced oxygen consumption by about 10% is approximately the same as the illumination that closes 10% of the light-dependent cation channels that are open in the dark.

Potassium channel and NKCC cotransporter involvement in ocular refractive control mechanisms

Myopia affects well over 30% of adult humans globally. However, the underlying physiological mechanism is little understood. This study tested the hypothesis that ocular growth and refractive compensation to optical defocus can be controlled by manipulation of potassium and chloride ion-driven transretinal fluid movements to the choroid. Chicks were raised with +/-10D or zero power optical defocus rendering the focal plane of the eye in front of, behind, or at the level of the retinal photoreceptors respectively. Intravitreal injections of barium chloride, a non-specific inhibitor of potassium channels in the retina and RPE or bumetanide, a selective inhibitor of the sodium-potassium-chloride cotransporter were made, targeting fluid control mechanisms. Comparison of refractive compensation to 5 mM Ba(2+) and 10(-5) M bumetanide compared with control saline injected eyes shows significant change for both positive and negative lens defocus for Ba(2+) but significant change only for negative lens defocus with bumetanide (Rx(SAL)(-10D) = -8.6 +/- .9 D; Rx(Ba2+)(-10D) = -2.9 +/- .9 D; Rx(Bum)(-10D) = -2.9 +/- .9 D; Rx(SAL)(+10D) = +8.2 +/- .9 D; Rx(Ba2+)(+10D) = +2.8 +/- 1.3 D; Rx(Bum)(+10D) = +8.0 +/- .7 D). Vitreous chamber depths showed a main effect for drug conditions with less depth change in response to defocus shown for Ba(2+) relative to Saline, while bumetanide injected eyes showed a trend to increased depth without a significant interaction with applied defocus. The results indicate that both K channels and the NKCC cotransporter play a role in refractive compensation with NKCC blockade showing far more specificity for negative, compared with positive, lens defocus. Probable sites of action relevant to refractive control include the apical retinal pigment epithelium membrane and the photoreceptor/ON bipolar synapse. The similarities between the biometric effects of NKCC inhibition and biometric reports of the blockade of the retinal ON response, suggest a possible common mechanism. The selective inhibition of refractive compensation to negative lens in chick by loop diuretics such as bumetanide suggests that these drugs may be effective in the therapeutic management of human myopia.

Slowing the degenerative process, long lasting effect of hyperbaric oxygen therapy in retinitis pigmentosa

BACKGROUND

Retinitis pigmentosa (RP) therapy is still an unsolved challenge. Recent reports have underlined that hyperbaric oxygen (HBO) therapy could play a role in slowing the retinal degenerative process. The aim of this study was to assess the efficacy of HBO therapy on visual function in RP patients.

METHODS

We performed a single-center, comparative, longitudinal case-controlled randomized clinical trial, which lasted 10 years. We randomly divided RP patients into two groups. Group 1, the control group, consisted of 44 RP patients (21 males and 23 females; mean age 35.5) who took Vitamin A. Group 2, with 44 RP patients (21 males and 23 females; mean age 35,02), underwent HBO therapy. No statistically significant difference was found at the beginning of the study between the two groups. We compared the results concerning visual acuity, Goldmann perimetry, static perimetry Humphrey field analyzer (HFA), and electroretinogram (ERG) obtained in the two groups at 5 and 10 years follow-up. Statistical analysis was performed with Kaplan-Meier life-table with the evaluation of log-rank coefficient.

RESULTS

At 5 year follow-up, 87.5% of group 2 patients preserved 80% of the initial visual acuity, while the same result was achieved in only 70.4% of group 1 patients (X(2) = 8.2; p < 0.01); at 10 year follow-up, 63.33% of group 2 patients preserved 80% of the initial visual acuity, while the same percentage of residual visual acuity was maintained in 40% of group 1 patients (X(2) = 3.22; p = 0.05). At 10 year follow-up, Goldmann perimetry (target I4e) did not change in 31.6% of group 2 and in 10.5% of group 1; evaluation of mean defect (MD) with static perimetry HFA showed that 53% of HBO patients had 80% of residual mean sensitivity compared to 23.5% of the control group patients (X(2) = 4.72; p = 0.035). ERG b-wave mean values at the end of the protocol were significantly higher in the HBO treated group (X(2) = 4.53; p = 0.013).

CONCLUSION

Our study underlines that HBO therapy can be a safe alternative approach to RP patients, contributing to the stabilization of their visual function concerning visual acuity, visual field, and ERG responses while waiting for a definite cure.

Endogenous adenosine reduces glutamatergic output from rods through activation of A2-like adenosine receptors

Adenosine is released from retina in darkness; photoreceptors possess A2 adenosine receptors, and A2 agonists inhibit L-type Ca2+ currents (ICa) in rods. We therefore investigated whether A2 agonists inhibit rod inputs into second-order neurons and whether selective antagonists to A1, A2A, or A3 receptors prevent Ca2+ influx through rod ICa. [Ca2+]i changes in rods were assessed with fura-2. ICa in rods and light responses of rods and second-order neurons were recorded using perforated patch-clamp techniques in the aquatic tiger salamander retinal slice preparation. Consistent with earlier results using the A2 agonist N6-[2-(3,5-dimethoxyphenyl)-2-(2-methylphenyl)-ethyl]adenosine (DPMA), the A2A agonist CGS-21680 significantly inhibited ICa and depolarization-evoked [Ca2+]i increases in rods. The A1 antagonist, 8-cyclopentyl-1,3-dipropylxanthine (DPCPX), and A2A antagonist, ZM-241385, but not the A3 antagonist, VUF-5574, inhibited effects of adenosine on Ca2+ influx in rods. DPCPX and ZM-241385 also inhibited effects of CGS-21680, suggesting they both act at A2A receptors. Both A2 agonists, CGS-21680 and DPMA, reduced light-evoked currents in second-order neurons but not light-evoked voltage responses of rods, suggesting that activation of A2 receptors inhibits transmitter release from rods. The inhibitory effects of CGS-21680 on both depolarization-evoked Ca2+ influx and light-evoked currents in second-order neurons were antagonized by ZM-241385. By itself, ZM-241385 enhanced the light-evoked currents in second-order neurons, suggesting that endogenous levels of adenosine inhibit transmitter release from rods. The effects of these drugs suggest that endogenous adenosine activates an A2-like adenosine receptor on rods leading to inhibition of ICa, which in turn inhibits l-glutamate release from rod photoreceptors.

A2 adenosine receptors inhibit calcium influx through L-type calcium channels in rod photoreceptors of the salamander retina

Presynaptic inhibition is a major mechanism for regulating synaptic transmission in the CNS and adenosine inhibits Ca(2+) currents (I(Ca)) to reduce transmitter release at several synapses. Rod photoreceptors possess L-type Ca(2+) channels that regulate the release of L-glutamate. In the retina, adenosine is released in the dark when L-glutamate release is maximal. We tested whether adenosine inhibits I(Ca) and intracellular Ca(2+) increases in rod photoreceptors in retinal slice and isolated cell preparations. Adenosine inhibited both I(Ca) and the [Ca(2+)]i increase evoked by depolarization in a dose-dependent manner with approximately 25% inhibition at 50 microM. An A2-selective agonist, (N(6)-[2-(3,5-dimethoxyphenyl)-2-(2-methylphenyl)-ethyl]adenosine) (DPMA), but not the A1- or A3-selective agonists, (R)-N(6)-(1-methyl-2-phenylethyl)adenosine and N(6)-2-(4-aminophenyl)ethyladenosine, also inhibited I(Ca) and depolarization-induced [Ca(2+)]i increases. An inhibitor of protein kinase A (PKA), Rp-cAMPS, blocked the effects of DPMA on both I(Ca) and the depolarization-evoked [Ca(2+)]i increase in rods. The results suggest that activation of A2 receptors stimulates PKA to inhibit L-type Ca(2+) channels in rods resulting in a decreased Ca(2+) influx that should suppress glutamate release.

Does hyperbaric oxygen (HBO) delivery rescue retinal photoreceptors in retinitis pigmentosa?

As previously reported in the literature, hyperbaric oxygen delivery seems to modify the natural course of retinitis pigmentosa. In order to evaluate these first encouraging data, 48 affected subjects were separately studied in two subgroups (cases and controls). All patients underwent yearly an ophthalmological examination completed by a maximum amplitude electroretinogram, conducted according to our 'differential derivation' system, a new recording technique specifically designed to enhance the signal-to-noise ratio. Oxygen delivery was provided regularly for 90 min daily (2.2 Absolute Atmosphere) in three cycles according to a standard protocol. In the cases, electroretinographic mean values were as follows: at T0 (basal) 4.68 +/- 3.81 microV; after one year (T1) 8.46 +/- 5.71 microV; at two years (T2) 10.7 +/- 7.6 microV; at the end of the study (T3) 14.4 +/- 11.7 microV. In the controls, electroretinographic mean values were as follows: at T0 4.92 +/- 3.05 microV; at T1 5.04 +/- 3.07 microV; at T2 3.46 +/- 2.77 microV: at T3 2.97 +/- 3.61 microV. Amplitudes showed a remarkable (p<0.001) increase in the cases, while a slightly significant (p<0.02) decrease was evident at the end of the study in the controls. In our opinion, retinal oxygen availability may be critical in retinal degeneration and hyperbaric oxygen delivery, inducing hyperoxia, seems to be able to bring about the rescue of the retinal photoreceptors helping them in their metabolic requirements. Unfortunately, our study demonstrates an increase in electroretinographic responses only, which may not necessarily also mean an evident change in visual acuity.

Oxygen consumption in the rat outer and inner retina: light- and pharmacologically-induced inhibition

Biochemical, physiological and histological data have established that 55-65% of retinal mitochondria are located in the photoreceptor inner segments and suggested that photoreceptors have at least a two-fold greater oxygen consumption (QO2) than the remaining inner retina. QO2 in isolated whole rat retina (QWR), outer retina (QOR) and inner retina (QIR) was measured during dark and rod-saturating light adaptation. The effects of function-specific chemical agents on QWR, QOR and QIR during dark and light adaptation were determined. In addition, the oxidation-reduction (redox) potential of cytochrome a3 of whole, outer and inner retina was measured during dark and light adaptation. During dark adaptation, the mean QWR was 1.62 mumol O2 (mg dry wt)-1 hr-1 and whole retinal level of reduced cytochrome a3 was 19%. They decreased by 24% and 37% during light adaptation, respectively. To determine QOR and QIR during dark and light adaptation, the outer retina was pharmacologically-isolated from inner retina using L-2-amino-4-phosphonobutyric acid plus kynurenic acid (APB/Kyn). Experiments in the presence or absence of APB/Kyn revealed that: (i) QOR, but not QIR, of the dark-adapted retina was decreased 37% during light adaptation, (ii) the outer and inner retina consumed 65% and 35% of the QWR during dark adaptation, respectively, and 54% and 46% of the QWR during light adaptation, respectively, (iii) the level of reduced retinal cytochrome a3 in the outer, but not inner, retina was decreased 34% during light adaptation, (iv) during light adaptation, the rate of QO2 was equal in the outer and inner retina, and (v) the effects of APB/Kyn were reversible. These results establish that the mean rate of QIR and retinal cytochrome a3 are unchanged during dark or light adaptation. In addition, they suggest that QOR:QIR in the rat may be modeled using a 65%:35% model during DA and a 55%:45% model during LA. All the function-specific agents--IBMX, lead, diltiazem, ouabain, CO2+ plus Mg2+ and verapamil--significantly decreased QWR during dark and light adaptation. A more detailed analysis revealed that IBMX and lead each selectively reduced (> or = 90%) QOR during dark adaptation whereas CO2+ plus Mg2+ and verapamil each selectively reduced (> or = 93%) QIR during dark and light adaptation. These results are consistent with the known pharmacological sites and mechanisms of these agents. Additional experiments determined that the IBMX- and lead-induced inhibition of QOR during dark adaptation resulted, either wholly or partially, from the influx of extracellular Ca2+. During dark adaptation in Ca(2+)-free medium: (i) QWR and QOR increased while QIR was unchanged, (ii) QOR was not decreased in the presence of IBMX and (iii) QOR was only partially decreased in the presence of lead.(ABSTRACT TRUNCATED AT 400 WORDS)

Oxygen consumption in the isolated toad retina

Retinal O2 utilization was studied to identify the O2 consuming processes in the retina and the spatial distribution of those processes. Neural retina, retinal pigment epithelium and choroid were dissected from the toad eye and superfused with an oxygenated Ringer's solution. Double-barreled microelectrodes were used to measure O2 and local voltage simultaneously within the retina in both light and dark adaptation. The profile of PO2 was measured during a withdrawal of the electrode tip across the retinal pigment epithelium and through the neural retina. The PO2 decreased through the distal retina, reaching a minimum in the inner segment or outer nuclear layer, and then increased steadily through the proximal retina. From fitting PO2 profiles measured in the dark-adapted retina to a three-layer diffusion model, O2 consumption was found to be 1.0 +/- 0.4 and 0.4 +/- 0.3 ml O2 (100 g min)-1 in the outer and inner halves of the retina, respectively. Light decreased consumption in both halves of the retina. In steady illumination (500 nm) that saturated the ERG b- and c-waves, O2 utilization decreased significantly to 48% and 68% of the dark values in the outer and inner retina, respectively. When Na+ was removed from the superfusate to inhibit the photoreceptor Na+/K+ pump, O2 consumption in the outer retina decreased by about the same amount as in light, but O2 consumption in the inner retina was not significantly affected.

Regulation of the retinal interphotoreceptor matrix Na by the retinal pigment epithelium during the light response

We examined the rabbit retinal pigment epithelium (RPE) for Na transport properties which would allow it to buffer undesirable changes in Na concentrations in the interphotoreceptor matrix (IPM) during light and dark cycles. The RPE is selectivity permeable to sodium. Open and short circuit transport studies with RPE indicate a circulating (choroid to retina and back) Na current which does not compromise the electrical integrity of the blood brain barrier but together with the Na permselectivity is of sufficient magnitude to buffer both upwards and downwards movements of IPM [Na] during light or dark responses.

Potassium-evoked responses from the retinal pigment epithelium of the toad Bufo marinus

Changes in the apical and basal membrane potentials and the resultant changes in the transepithelial potential were recorded from the isolated retinal pigment epithelium of the toad Bufo marinus while the potassium concentration superfusing the apical membrane was changed. Lowering apical potassium caused an initial apically-generated hyperpolarization that increased the transepithelial potential which was usually followed by a delayed basally-generated hyperpolarization that decreased the transepithelial potential. Light evoked a similar pattern of apical and basal responses in a preparation of neural retina-retinal pigment epithelium-choroid. The delayed basal hyperpolarization was accompanied by an apparent increase in basal membrane resistance, and was inhibited by adding the anion transport blocker 4,4'-diisothiocyanatostilbene-2,2'-disulfonic acid or the metabolic inhibitor dinitrophenol to the solution superfusing the choroidal side of the retinal pigment epithelium (RPE). The results suggest that a change in the chloride equilibrium potential or chloride conductance of the basal membrane mediates the delayed basal response.

Evidence for Na+/H+ exchange in vertebrate rod photoreceptors

In this paper, we have documented our investigation of pH regulation in the rod photoreceptor of the toad, Bufo marinus. Unlike other neural tissues, the retina depends upon aerobic glycolysis to meet its energy requirements. A consequence of its reliance on glycolysis is a large metabolic production of protons (H+) which must be extruded by pH regulating mechanisms. Based on the work of previous authors, we propose that rods share these same characteristics with whole retina. Our results in rods are consistent with the hypothesis that under nominally bicarbonate-free conditions, an amiloride-sensitive Na+/H+ exchanger contributes to pH regulation in this cell.

Extracellular pH in the isolated retina of the toad in darkness and during illumination

1. Extracellular pH (pHo) was measured in the isolated retina preparation of the toad, Bufo marinus, using H(+)-selective microelectrodes. During superfusion with phosphate-buffered solution (pH 7.8), which had a low buffering capacity, pHo in the inner retina was 7.0-7.2 and there was a pHo gradient throughout the distal retina and into the bathing solution. 2. The retinal acidity appears to be due in part to the combined reactions of glycolysis and ATP hydrolysis, since anoxia greatly increased the pHo gradient, while superfusion with either glucose-free pyruvate solution or strophanthidin decreased this gradient. 3. Maintained illumination evoked both an acidification in the proximal retina and an alkalinization in the distal retina. Blocking synaptic transmission to second-order neurones (1.0 mM-aspartate) decreased the acidification but had little effect on the alkalinization, consistent with the notion that the alkalinization is of receptoral origin, while the acidification is of post-receptoral origin. 4. Retinal neurones extrude a significant amount of acid via Na(+)-H+ exchange, since 2.0 mM-amiloride, a blocker of Na(+)-H+ exchange, caused a sustained alkalinization in darkness and decreased the light-evoked changes in pHo, while 1.0 mM-4-acetamido-4'-isothiocyanatostilbene-2.2'-disulphonic acid (SITS), a blocker of Cl(-)-HCO3- exchange, produced a much smaller alkalinization. 5. Switching to a bicarbonate-buffered solution having a 75 times greater buffering capacity than the phosphate-buffered solution caused retinal pHo to become less acidic and significantly decreased the amplitude of the light-evoked pHo changes. 6. Addition of 2.0 mM-acetazolamide, a carbonic anhydrase inhibitor, to the bicarbonate-buffered solution increased both the pHo gradient and the light-evoked changes in pHo. These data are consistent with the idea that carbonic anhydrase, which is concentrated in Müller (glial) cells and to a lesser extent in horizontal cells, increases the effectiveness of the bicarbonate buffer system. 7. Switching from bicarbonate-buffered to phosphate-buffered solutions attenuated the b-wave of the electroretinogram, most likely by acidifying pHo. Overall, our results emphasize the importance of the bicarbonate buffer system in buffering pHo during periods of variable acid extrusion in light and in darkness.