N-acetyltransferase activity and melatonin level in the eyes of glaucomatous chickens

The Therapeutic Trip of Melatonin Eye Drops: From the Ocular Surface to the Retina

Melatonin is a ubiquitous molecule found in living organisms, ranging from bacteria to plants and mammals. It possesses various properties, partly due to its robust antioxidant nature and partly owed to its specific interaction with melatonin receptors present in almost all tissues. Melatonin regulates different physiological functions and contributes to the homeostasis of the entire organism. In the human eye, a small amount of melatonin is also present, produced by cells in the anterior segment and the posterior pole, including the retina. In the eye, melatonin may provide antioxidant protection along with regulating physiological functions of ocular tissues, including intraocular pressure (IOP). Therefore, it is conceivable that the exogenous topical administration of sufficiently high amounts of melatonin to the eye could be beneficial in several instances: for the treatment of eye pathologies like glaucoma, due to the IOP-lowering and neuroprotection effects of melatonin; for the prevention of other dysfunctions, such as dry eye and refractive defects (cataract and myopia) mainly due to its antioxidant properties; for diabetic retinopathy due to its metabolic influence and neuroprotective effects; for macular degeneration due to the antioxidant and neuroprotective properties; and for uveitis, mostly owing to anti-inflammatory and immunomodulatory properties. This paper reviews the scientific evidence supporting the use of melatonin in different ocular districts. Moreover, it provides data suggesting that the topical administration of melatonin as eye drops is a real possibility, utilizing nanotechnological formulations that could improve its solubility and permeation through the eye. This way, its distribution and concentration in different ocular tissues may support its pleiotropic therapeutic effects.

Role of mechanically-sensitive cation channels Piezo1 and TRPV4 in trabecular meshwork cell mechanotransduction

Glaucoma is one of the leading causes of irreversible blindness in developed countries, and intraocular pressure (IOP) is primary and only treatable risk factor, suggesting that to a significant extent, glaucoma is a disease of IOP disorder and pathological mechanotransduction. IOP-lowering ways are limited to decreaseing aqueous humour (AH) production or increasing the uveoscleral outflow pathway. Still, therapeutic approaches have been lacking to control IOP by enhancing the trabecular meshwork (TM) pathway. Trabecular meshwork cells (TMCs) have endothelial and myofibroblast properties and are responsible for the renewal of the extracellular matrix (ECM). Mechanosensitive cation channels, including Piezo1 and TRPV4, are abundantly expressed in primary TMCs and trigger mechanostress-dependent ECM and cytoskeletal remodelling. However, prolonged mechanical stimulation severely affects cellular biosynthesis through TMC mechanotransduction, including signaling, gene expression, ECM remodelling, and cytoskeletal structural changes, involving outflow facilities and elevating IOP. As for the functional coupling relationship between Piezo1 and TRPV4 channels, inspired by VECs and osteoblasts, we hypothesized that Piezo1 may also act upstream of TRPV4 in glaucomatous TM tissue, mediating the activation of TRPV4 via Ca2+ inflow or Ca2+ binding to phospholipase A2(PLA2), and thus be involved in increasing TM outflow resistance and elevated IOP. Therefore, this review aims to help identify new potential targets for IOP stabilization in ocular hypertension and primary open-angle glaucoma by understanding the mechanical transduction mechanisms associated with the development of glaucoma and may provide ideas into novel treatments for preventing the progression of glaucoma by targeting mechanotransduction.

Influence of Circadian Rhythm in the Eye: Significance of Melatonin in Glaucoma

Circadian rhythm and the molecules involved in it, such as melanopsin and melatonin, play an important role in the eye to regulate the homeostasis and even to treat some ocular conditions. As a result, many ocular pathologies like dry eye, corneal wound healing, cataracts, myopia, retinal diseases, and glaucoma are affected by this cycle. This review will summarize the current scientific literature about the influence of circadian patterns on the eye, focusing on its relationship with increased intraocular pressure (IOP) fluctuations and glaucoma. Regarding treatments, two ways should be studied: the first one, to analyze if some treatments could improve their effect on the ocular disease when their posology is established in function of circadian patterns, and the second one, to evaluate new drugs to treat eye pathologies related to the circadian rhythm, as it has been stated with melatonin or its analogs, that not only could be used as the main treatment but as coadjutant, improving the circadian pattern or its antioxidant and antiangiogenic properties.

The role of TRPV4 channels in ocular function and pathologies

Transient potential receptor vanilloid 4 (TRPV4) is an ion channel responsible for sensing osmotic and mechanical signals, which in turn regulates calcium signaling across cell membranes. TRPV4 is widely expressed throughout the body, and plays an important role in normal physiological function, as well as different pathologies, however, its role in the eye is not well known. In the eye, TRPV4 is expressed in various tissues, such as the retina, corneal epithelium, ciliary body, and the lens. In this review, we provide an overview on TRPV4 structure, activation, mutations, and summarize the current knowledge of TRPV4 function and signaling mechanisms in various locations throughout the eye, as well as its role in ocular diseases, such as glaucoma and diabetic retinopathy. Based on the available data, we highlight the therapeutic potential of TRPV4 as well as the shortcomings of current research. Finally, we provide future perspectives on the implications of targeting TRPV4 to treat various ocular pathologies.

Expression of Melatonin and Dopamine D3 Receptor Heteromers in Eye Ciliary Body Epithelial Cells and Negative Correlation with Ocular Hypertension

BACKGROUND

Experiments in the late nineties showed an inverse relationship in the eye levels of melatonin and dopamine, thereby constituting an example of eye parameters that are prone to circadian variations. The underlying mechanisms are not known but these relevant molecules act via specific cell surface dopamine and melatonin receptors. This study investigated whether these receptors formed heteromers whose function impact on eye physiology. We performed biophysical assays to identify interactions in heterologous systems. Particular heteromer functionality was detected using Gi coupling, MAPK activation, and label-free assays. The expression of the heteroreceptor complexes was assessed using proximity ligation assays in cells producing the aqueous humor and human eye samples. Dopamine D₃ receptors (D₃Rs) were identified in eye ciliary body epithelial cells. We discovered heteromers formed by D₃R and either MT₁ (MT₁R) or MT₂ (MT₂R) melatonin receptors. Heteromerization led to the blockade of D₃R-Gi coupling and regulation of signaling to the MAPK pathway. Heteromer expression was negatively correlated with intraocular hypertension.

CONCLUSIONS

Heteromers likely mediate melatonin and dopamine actions in structures regulating intraocular pressure. Significant expression of D₃R-MT₁R and D₃R-MT₁R was associated with normotensive conditions, whereas expression diminished in a cell model of hypertension. A clear trend of expression reduction was observed in samples from glaucoma cases. The trend was marked but no statistical analysis was possible as the number of available eyes was 2.

Yellow Filter Effect on Melatonin Secretion in the Eye: Role in IOP Regulation

Purpose: Melatonin is a neurohormone mainly synthesized in the pineal gland; however, it is also present in the aqueous humor. One of melatonins' functions in the eye is the regulation of intraocular pressure (IOP). Melatonin is known to be sensitive to light. Recently, the photopigment which controls melatonin synthesis, melanopsin, was found in the crystalline lens. Therefore, light conditions are an interesting possible way of regulating melatonin levels in the aqueous humor. The current study used yellow filters, since melanopsin is activated by short wavelength (blue light). Methods: New Zealand white rabbits were used, divided in two groups, one under controlled 12 h light/dark cycles, while the rest had their cages encased with a yellow filter (λ 465-480). IOP measurements were taken every week at the same time before they were anesthetized for aqueous humor extraction. Results: Keeping the rabbits under the yellow filter resulted in a decrease in IOP up to 43.8 ± 7.8% after 3 weeks. This effect was reversed after the topical application of selective and nonselective melatonin receptors antagonists, 4PPDOT and luzindole. Also, blocking melanopsin by its antagonist AA92593 under white light condition decreased IOP. Finally, melatonin levels were found significantly higher in the aqueous humor of rabbits developed under yellow filter compared to controls (37.4 ± 4.2 and 15.3 ± 3.1 ng/ml, respectively). Conclusion: Yellow filters modulate melatonin levels in the aqueous humor due to deactivating melanopsin activity. This effect leads to a decrease in IOP mediated by melatonin receptors.

The Ciliary Body - The Third Organ Found to Synthesize Indoleamines in Humans

Indoleamines are associated with circadian rhythms in pineal gland and retina. Because the ciliary epithelium has an embryonic origin similar to that of pineal gland and retina, and intraocular pressure shows circadian variations, indoleamines were searched for in aqueous humor and ciliary body in humans. In aqueous humor, serotonin, 6-hydroxymelatonin, and melatonin were simultaneously detected and measured using high-performance liquid chromatography with electrochemical detection. The concentration was 48.7±10.9 ng/ml for serotonin, 0.47±0.8 ng/ml for melatonin, and 13.9±7.7 ng/ml for 6 hydroxy melatonin. In ciliary bodies from freshly enucleated human eyes, tryptophan, 5-hydroxytryptophan, serotonin, and 5-hydroxyindoleacetic acid were detected using high-performance liquid chromatography with simultaneous fluorescence- and electrochemical detection. Finally, the enzymatic activities of arylalkylamine N-acetyltransferase (NAT) and hydroxyindole-O-methyltrans-ferase (HIOMT), enzymes indispensable in the synthesis of melatonin, were measured. The NAT activity was 273±25 pmol/mg protein/hour and that of HIOMT, 13520±50 pmol/mg protein/hour in ciliary body. Comparison of these activities (NAT versus HIOMT) permits the suggestion that NAT is a limiting enzyme in serotonin metabolism in this tissue. These findings indicate that a circadian rhythm of indoleamines exists in human aqueous humor and that the human ciliary body is the third organ, after the pineal gland and the retina, found to synthesize indoleamines in humans.

Melatonin synthesis in the human ciliary body triggered by TRPV4 activation: Involvement of AANAT phosphorylation

Melatonin is a substance synthesized in the pineal gland as well as in other organs. This substance is involved in many ocular functions, giving its synthesis in numerous eye structures. Melatonin is synthesized from serotonin through two enzymes, the first limiting step into the synthesis of melatonin being aralkylamine N-acetyltransferase (AANAT). In this current study, AANAT phosphorylation after the activation of TRPV4 was studied using human non-pigmented epithelial ciliary body cells. Firstly, it was necessary to determine the adequate time and dose of the TRPV4 agonist GSK1016790A to reach the maximal phosphorylation of AANAT. An increase of 72% was observed after 5 min incubation with 10 nM GSK (**p < 0.05, n = 6) with a concomitant rise in N-acetyl serotonin and melatonin synthesis. The involvement of a TRPV4 channel in melatonin synthesis was verified by antagonist and siRNA studies as a previous step to studying intracellular signalling. Studies performed on the second messengers involved in GSK induced AANAT phosphorylation were carried out by inhibiting several pathways. In conclusion, the activation of calmodulin and calmodulin-dependent protein kinase II was confirmed, as shown by the cascade seen in AANAT phosphorylation (***p < 0.001, n = 4). This mechanism was also established by measuring N-acetyl serotonin and melatonin levels. In conclusion, the activation of a TRPV4 present in human ciliary body epithelial cells produced an increase in AANAT phosphorylation and a further melatonin increase by a mechanism in which Ca-calmodulin and the calmodulin-dependent protein kinase II are involved.

Melatonin receptors in the eye: location, second messengers and role in ocular physiology

The pineal hormone melatonin, an important regulator of circadian and seasonal rhythms, has a role in ocular pathophysiology. In addition to the pineal gland, melatonin synthesis is carried out in several ocular structures. Moreover, specific melatonin receptors have been located in the retina, cornea, ciliary body, lens, choroid and sclera, which suggests that cells in these tissues may be targets for melatonin action. This review summarizes the current knowledge about melatonin receptor subtypes with the emphasis on those melatonin receptors, which have been identified in ocular tissues and their possible roles in biochemical and physiological processes in the eye.

Retinal oxidative stress induced by high intraocular pressure

Glaucoma is an optic neuropathy in which retinal ganglion cells die probably through an apoptotic process. Apoptosis is known to involve free radicals in several systems including the retina. In this context, the aim of the present work was to analyze retinal oxidative damage in rats with glaucoma induced by the chronic injection of hyaluronic acid in the eye anterior chamber. The results showed a significant decrease in total retinal superoxide dismutase and catalase activities after 6 and 3 weeks of treatment with hyaluronic acid, respectively. Also, although GPX activity increased after 10 weeks of ocular hypertension, GSH levels significantly decreased at 6 weeks of treatment with hyaluronic acid. Moreover, retinal lipid peroxidation significantly increased in a time-of-hypertension-dependent manner. On the other hand, a significant decrease in both diurnal and nocturnal retinal melatonin content was detected at 3, 6, or 10 weeks of treatment with hyaluronic acid. The present results suggest that retinal oxidative stress may be involved in glaucomatous cell death. Thus, manipulation of intracellular redox status using antioxidants may be a new therapeutic tool to prevent glaucomatous neurodegeneration.

Day and night dysfunction in intraretinal melatonin and related indoleamines metabolism, correlated with the development of glaucoma-like disorder in an avian model

As previous studies have suggested that melatonin and serotonin may be involved in the regulation of intraocular pressure, retinal concentrations of melatonin, 5-HT, and related indoleamines measured at day and at night were studied during the development of a glaucoma-like disorder with increased intraocular pressure in the al mutant quail. Indoleamine levels were determined by HPLC with electrochemical detection in 1-month-, 3-month-, and 7-month-old al mutant and control quails. Morphology and numbers of melatonin-synthesizing and 5-HT-containing cells, labelled immunohistochemically with an anti-hydroxyindol-0-methyltransferase (HIOMT) antibody and an anti-5-HT antibody, respectively, were studied. Major findings were that: (1) no significant changes in morphology of melatonin-synthesizing cells or in the morphology and density of 5-HT-containing amacrine cells were observed during the development of glaucoma: (2) 5-HT metabolism was modified during the night at 1 month of age and during the day after 3 months; and (3) melatonin metabolism was modified during the night at 7 months and during the day after 3 months. These results demonstrate a relationship between the temporal evolution of this avian glaucoma and a dysfunction in indoleamine retinal metabolism.

Light exposure decreases IOP in rabbits during the night

Elevated IOP observed in rabbits during the dark phase of the circadian cycle decreased rapidly and reversibly when rabbits were exposed to light during the dark phase. The decrease of IOP does not result from decreased aqueous flow and only part of the decrease requires intact ocular sympathetic innervation.

Melatonin inhibits the proliferation of retinal pigment epithelial (RPE) cells in vitro

The possible antiproliferative effect of melatonin on retinal pigment epithelial (RPE) cells in vitro was investigated. Bovine RPE cells cultured in Ham's F12 medium supplemented with 10% fetal bovine serum had a nuclear density of 73.6 +/- 6.1 nuclei/mm2 at 72 h after seeding. The nuclear density at this time-point was doubled if either 50 or 100 ng/ml human epidermal growth factors (hEGF) was added to the culture medium. When these hEGF-stimulated cells were treated with melatonin from 10 to 500 pg/ml, the proliferation was suppressed with a dose-response relationship. At 250 and 500 pg/ml melatonin, the nuclear densities of the melatonin-treated cells were similar to those of the control cells. Using mitotically active SV-40 transformed human fetal RPE cells cultured in a serum-free medium, melatonin was also shown to be antiproliferative. In the presence of 500 pg/ml melatonin, the proliferation of these cells was inhibited to 77% as compared to the control. These results were further supported by the reduced [H3]thymidine uptake in the melatonin-treated cells. We propose that melatonin, at physiologic concentrations, has an antiproliferative effect, and that cultured RPE cells stimulated to proliferate by either hEGF treatment or SV-40 transfection are responsive to melatonin. Melatonin may either inhibit mitosis in actively dividing cells or modulate hEGF action.

Melatonin does not increase IOP significantly in rabbits

New Zealand white rabbits have a circadian rhythm of intraocular pressure; pressure is higher during the dark than during the light. We explored the possibility that the dark phase increase of serum and/or ocular melatonin plays a role in regulating the rhythm of intraocular pressure. Exogenous melatonin was delivered by four routes: topical application (0.1 and 10 micrograms), intravenous injection (1 microgram), intravitreal injection (9 micrograms) and intra-arterial infusion (50 ng and 1 microgram). Melatonin delivered by these routes did not increase intraocular pressure. We also measured the concentration of melatonin in the aqueous after unilateral intra-arterial infusion to confirm that melatonin delivered by this route reached the eye. The concentration was 419 +/- 99 and 109 +/- 17 pg/ml (n = 8, p < 0.025) in the ipsilateral and contralateral eyes, respectively. The concentration of melatonin in the aqueous after intra-arterial infusion of saline was less than the sensitivity of the assay (< 16 pg/ml, n = 6). The results of these experiments indicate that melatonin does not increase IOP significantly under the experimental conditions employed in this study.

Diurnal rhythms of immunoreactive melatonin in the aqueous humor and serum of male pigmented rabbits

Using specific radioimmunoassays, melatonin was quantified in the aqueous humor and serum of male pigmented rabbits adapted to 12L:12D with lights on at 06.00 h. Melatonin concentrations in the aqueous humor at 08.00 and 16.00 h were similar (mean: 5.23 pg/ml) and significantly lower than those at 22.00 and 01.00 h (mean: 22.06 pg/ml). A parallel rhythm was also demonstrated in the serum with higher melatonin concentrations (daytime mean: 75.26 pg/ml; nighttime mean: 168.94 pg/ml). We propose that the aqueous melatonin rhythm is associated with the rhythmic change in aqueous flow.

Melatonin reduction by lithium and albinism in quail and hamsters

Melatonin was measured by radioimmunoassay in several genetic strains of Japanese quail. Plasma melatonin (PM), measured at the nighttime peak, was highest in wild type quail reared on a diurnal lighting schedule; this PM peak was suppressed in continuous light. Albino quail had low melatonin levels, whether reared under diurnal conditions or in continuous light. Ocular melatonin was also suppressed in albinos and in dilute mutants. At midday sampling, melatonin was only half as high in albinos as in wild types. Intraocular pressure (IOP, daytime readings) was uniformly low in diurnal birds and was elevated in all quail reared under continuous light. Thus in pigmented birds, a high melatonin level was associated with high IOP, but in albinos displaying high IOP, ocular melatonin was not elevated. Lithium chloride, mixed in the feed, brought about a pronounced reduction in plasma, pineal, and ocular melatonin, in wild-type quail reared on a diurnal schedule. This confirms earlier findings in lithium-fed rats. Golden hamsters displayed a characteristic diurnal cycle of pineal melatonin, with a sharp middark peak; in albino hamsters, also kept on a diurnal schedule, this peak occurred at the same time, but albinos had melatonin levels only about one-third as high as those of pigmented animals.

Serotonin in human aqueous humor

Circadian rhythms in serotonin metabolism have been observed in the pineal gland and retina, and there is evidence that the levels of serotonin and melatonin in these tissues may mediate events in the brain's sleep-wake cycle and the retina's cycle of disc shedding. Because the ciliary epithelium, which produces aqueous humor, has an embryonic origin similar to that of the retina and the pineal gland, the authors believe that serotonin metabolism might play an analogous role in the regulation of the diurnal cycle of aqueous secretion. As a first step in investigating this hypothesis, they measured serotonin concentrations in the aqueous humor of 34 cataract patients. Using high-performance liquid chromatography (HPLC) with electrochemical detection, a mean serotonin concentration of 52 +/- 11 ng/ml was found. This high concentration implies that serotonin has one or more functions: (1) perhaps it acts as a neurotransmitter and precursor of melatonin; (2) conceivably it is related to aqueous humor dynamics; and (3) in particular, perhaps it affects the circadian rhythm of intraocular pressure.

Plasma melatonin rhythm lost in preglaucomatous chicks

Domestic chicks (Gallus domesticus) reared under continuous light, and thus developing light-induced avian glaucoma (LIAG), were tested at 4-hourly intervals around the clock, for evidence of hormonal or other rhythms which might be related to the eye effects of LIAG. Plasma melatonin, corticosterone and thyroxine (T4) all displayed daily rhythms in the young chick reared under control (diurnal) lighting conditions. These daily hormone cycles were somewhat damped under either continuous light or constant darkness, though there were hints of a surviving rhythm, albeit phase-shifted or free-running, in plasma corticosterone and T4. In the eye, mitotic rate in the corneal epithelium displayed a prominent rhythm, high in the dark and low in the light. This rhythm was suppressed by constant darkness, and also in continuous light, the latter apparently related to the impaired corneal growth of LIAG. The daily pattern of corneal mitotic activity and the diurnal curve for plasma melatonin showed remarkable similarities, suggesting the possibility of a causal relationship between the two phenomena.

Existence and role of endogenous ocular melatonin

The proposed role of melatonin as an endogenously synthesized modulator of intraocular pressure in the eye was investigated. Melatonin levels were determined by radioimmunoassay in the iris, ciliary body and retina-choroid of pinealectomized or sham-operated chickens by day and by night. Pinealectomy had no effect on melatonin levels in the ciliary body or retina of chicken eyes; a diurnal rhythm continued to be observed in these tissues, with values higher by night than by day. Chloroform-extracted melatonin levels in the rabbit ciliary body showed a diurnal rhythm but melatonin levels in rabbit retina did not. Intracameral infusion of melatonin into cat eyes caused aqueous humor synthesis to decrease but caused a greater decrease in aqueous humor outflow facility, leading to a significant increase in intraocular pressure. The results suggest that melatonergic mechanisms in the eye could be responsible for the diurnal rhythm in IOP, and the synthesis and diurnal rhythm of this melatonin are independent of the pineal gland.