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Gün RD, Yazıcıoğlu T, Oklar M, Gökkaya N. Assessment of Schlemm's canal with swept-source optical coherence tomography in Graves' ophthalmopathy. Graefes Arch Clin Exp Ophthalmol 2024; 262:2219-2226. [PMID: 38400857 PMCID: PMC11222225 DOI: 10.1007/s00417-024-06397-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 12/16/2023] [Accepted: 01/30/2024] [Indexed: 02/26/2024] Open
Abstract
PURPOSE To evaluate the Schlemm's canal (SC) parameters obtained by swept-source optical coherence tomography (OCT) different in Graves' ophthalmopathy (GO) eyes compared to healthy eyes. METHODS This cross-sectional observational study evaluated 64 eyes of 32 GO cases and 56 eyes of 28 healthy controls. The study was conducted between October 2020 and June 2021. SC images were obtained from the temporal limbus of individuals using swept-source OCT. SC length (SCL) and SC area (SCA) were measured. The relationship between SC parameters in the patient group and intraocular pressure (IOP), retinal nerve fiber layer (RNFL) thickness, Graves' disease (GD) duration, and clinical activity score (CAS) was evaluated. RESULTS In the GO group, 64 eyes of 32 patients were evaluated, and in the age and gender-matched healthy control group, 56 eyes of 28 individuals were assessed. SC images from 4 eyes of 4 patients in the patient group and 1 eye of 1 patient in the control group were not clear, preventing SCL and SCA measurements for these eyes. SCL and SCA measurements were found to be lower, and IOP and Hertel values were higher in the GO group compared to the healthy controls. However, no significant correlation was observed between SCL and SCA with IOP, RNFL thickness, GD duration, GO duration, or CAS in the GO group. In the GO group, the mean value of SCA was found to be higher in eyes with glaucoma or OHT compared to those without. CONCLUSION These findings indicate that SC in GO-affected eyes is shorter and has a smaller area than in healthy individuals. Additionally, higher IOP and Hertel values were observed in the GO group compared to healthy controls. This study suggests that assessing SC using anterior segment OCT could provide valuable insights into the regulation of IOP and the development of glaucoma in GO-affected eyes.
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Affiliation(s)
- Raziye Dönmez Gün
- Department of Ophthalmology, Istanbul Kartal Doctor Lütfi Kırdar City Hospital, Semsi Denizer Street, E-5 Kartal, 34890, Istanbul, Turkey.
| | - Titap Yazıcıoğlu
- Department of Ophthalmology, Istanbul Kartal Doctor Lütfi Kırdar City Hospital, Semsi Denizer Street, E-5 Kartal, 34890, Istanbul, Turkey
| | - Murat Oklar
- Department of Ophthalmology, Istanbul Kartal Doctor Lütfi Kırdar City Hospital, Semsi Denizer Street, E-5 Kartal, 34890, Istanbul, Turkey
| | - Naile Gökkaya
- Department of Endocrinology and Metabolism, Istanbul Kartal Doctor Lütfi Kırdar City Hospital, Istanbul, Turkey
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Choi JA, Ju HH, Kim JE, Lee J, Jee D, Park CK, Paik SY. Cytokine profile and cytoskeletal changes after herpes simplex virus type 1 infection in human trabecular meshwork cells. J Cell Mol Med 2021; 25:9295-9305. [PMID: 34469037 PMCID: PMC8500954 DOI: 10.1111/jcmm.16862] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 03/13/2021] [Accepted: 07/22/2021] [Indexed: 01/20/2023] Open
Abstract
Uveitis caused by herpes simplex virus (HSV)‐1 is characterized by increased intraocular pressure (IOP) in the presence of anterior chamber inflammation. Despite their clinical significance, the pathogenic changes associated with HSV‐1 infection in trabecular meshwork (TM) cells, the key cell type regulating IOP, have not been completely elucidated. In this study, cytokine array analyses showed a significant stepwise increase in monocyte chemoattractant protein (MCP)‐1 expression upon HSV‐1 infection in TM cells (p < 0.05). HSV‐1 infection led to downregulation of fibrogenic molecules (fibronectin, α‐smooth muscle actin, connective tissue growth factor and TGF‐β1). Notably, HSV‐1 infection caused a significant increase in actin stress fibres, with a twofold increase in active RhoA, which was enhanced by treatment with TGF‐β1 and inhibited by treatment with the Rho‐kinase inhibitor, Y‐27632. TM cells treated with MCP‐1 exhibited a dose‐dependent increase in actin stress fibres compared to untreated TM cells. Our study suggests that HSV‐1 infection in TM cells increases cell contractile activity rather than fibrotic changes in the extracellular matrix (ECM) components. Taken together, these observations demonstrate the enhanced expression of MCP‐1 and TM cell contractile activity upon HSV‐1 infection and events with potential implications for the pathobiology of abrupt IOP elevation in HSV‐1 anterior uveitis.
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Affiliation(s)
- Jin A Choi
- Department of Ophthalmology, College of Medicine, St. Vincent's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Hyun-Hee Ju
- Department of Ophthalmology, College of Medicine, St. Vincent's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Ju-Eun Kim
- Department of Microbiology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jiyoung Lee
- Department of Ophthalmology, College of Medicine, St. Vincent's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Donghyun Jee
- Department of Ophthalmology, College of Medicine, St. Vincent's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Chan Kee Park
- Department of Ophthalmology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Soon-Young Paik
- Department of Microbiology, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Wang Y, Wang W, Yang X, Chen W, Yang X, Pan X, Xu P, Zhu W, Han Y, Chen X. ITGA8 positive cells in the conventional outflow tissue exhibit Schlemm's canal endothelial cell properties. Life Sci 2021; 278:119564. [PMID: 33961857 DOI: 10.1016/j.lfs.2021.119564] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/19/2021] [Accepted: 04/23/2021] [Indexed: 11/17/2022]
Abstract
AIMS Elevated intraocular pressure is primarily induced by the increased resistance of conventional outflow of aqueous humor. Dysfunction of the juxtacanalicular region of trabecular meshwork (TM) and Schlemm's canal (SC) endothelium, as the main conventional outflow tissue, have been implicated as the major reasons for the increased resistance. Integrins are widespread in these tissues, especially alpha8 integrin (ITGA8). We aim to investigate the properties of cells expressing ITGA8 in the conventional outflow tissue. MAIN METHODS Fluorescence in situ hybridization (FISH) and immunofluorescence (IF) were performed to detect the mRNA and protein levels of ITGA8 in human conventional outflow tissue. ITGA8-positive cells were isolated from the cultured human TM cells through a magnetic bead-based approach. Flow Cytometry was used to determine the purification efficiency. The expressions of TM and SC biomarkers and dexamethasone-induced myocilin secretion capacity of ITGA8-positive cells was assessed by Real-time PCR, IF and Western blot. A gel contraction assay was performed to evaluate contractility of ITGA8-positive cells after endothelin 1 treatment. KEY FINDINGS ITGA8 was found with robust expression near the inner wall of SC endothelium. After purification, the proportion of ITGA8-positive cells were increased by about 10%. ITGA8-positive cells were identified with the properties as SC endothelial cells, such as more robust expressions of SC biomarkers, less dexamethasone-inducible myocilin expression, and stronger contractility. SIGNIFICANCE This study demonstrated that cells expressing ITGA8 in SC region possess more properties as SC endothelial cells. Our data implicate a crucial role of ITGA8 in aqueous humor (AH) outflow resistance regulation.
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Affiliation(s)
- Yanan Wang
- School of Basic Medicine, Qingdao University, Qingdao 266021, China; Department of Pharmacology, School of Pharmacy, Qingdao University, Qingdao 266021, China
| | - Wenyan Wang
- School of Basic Medicine, Qingdao University, Qingdao 266021, China; Department of Pharmacology, School of Pharmacy, Qingdao University, Qingdao 266021, China
| | - Xuejiao Yang
- Affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - Wenshi Chen
- Affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - Xian Yang
- Affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - Xiaojing Pan
- Qingdao Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, Qingdao 266071, China
| | - Peilong Xu
- State Key Laboratory of Bio-Fibers and Eco-Textiles, Qingdao University, Qingdao 266071, China
| | - Wei Zhu
- Department of Pharmacology, School of Pharmacy, Qingdao University, Qingdao 266021, China; Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Beihang, University & Capital Medical University, Beijing 100730, China
| | - Yantao Han
- School of Basic Medicine, Qingdao University, Qingdao 266021, China.
| | - Xuehong Chen
- School of Basic Medicine, Qingdao University, Qingdao 266021, China.
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Xin C, Wang H, Wang N. Minimally Invasive Glaucoma Surgery: What Do We Know? Where Should We Go? Transl Vis Sci Technol 2020; 9:15. [PMID: 32821487 PMCID: PMC7401977 DOI: 10.1167/tvst.9.5.15] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 12/02/2019] [Indexed: 12/17/2022] Open
Abstract
With the arrival of a plethora of new and revolving minimally invasive glaucoma surgery techniques, glaucoma specialists currently are fortunate to have various surgical options that aim to recovery of the function of the aqueous outflow system in different ways. Meanwhile, the aqueous outflow system has become the hot point of researching. In ARVO 2019, a special interest group session was held on new perspectives on minimally invasive glaucoma surgery. Ten surgeons, clinical professors, and experimental scientists were invited to report their latest studies and discussed on five hot topics in this special interest group. This review summarizes the special interest group session and posts the issues of greatest concern, providing insight to the aqueous outflow system and areas that require further study.
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Affiliation(s)
- Chen Xin
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Huangzhou Wang
- Ophthalmology Department, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ningli Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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Liu Y, Allingham RR. Major review: Molecular genetics of primary open-angle glaucoma. Exp Eye Res 2017; 160:62-84. [PMID: 28499933 DOI: 10.1016/j.exer.2017.05.002] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 03/29/2017] [Accepted: 05/07/2017] [Indexed: 12/13/2022]
Abstract
Glaucoma is a leading cause of irreversible blindness worldwide. Primary open-angle glaucoma (POAG), the most common type, is a complex inherited disorder that is characterized by progressive retinal ganglion cell death, optic nerve head excavation, and visual field loss. The discovery of a large, and growing, number of genetic and chromosomal loci has been shown to contribute to POAG risk, which carry implications for disease pathogenesis. Differential gene expression analyses in glaucoma-affected tissues as well as animal models of POAG are enhancing our mechanistic understanding in this common, blinding disorder. In this review we summarize recent developments in POAG genetics and molecular genetics research.
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Affiliation(s)
- Yutao Liu
- Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, Augusta, GA, United States; James & Jean Culver Vision Discovery Institute, Augusta University, Augusta, GA, United States; Center for Biotechnology and Genomic Medicine, Augusta University, Augusta, GA, United States
| | - R Rand Allingham
- Department of Ophthalmology, Duke University Medical Center, Durham, NC, United States; Duke - National University of Singapore (Duke-NUS), Singapore.
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Paula JS, O'Brien C, Stamer WD. Life under pressure: The role of ocular cribriform cells in preventing glaucoma. Exp Eye Res 2016; 151:150-9. [PMID: 27567558 DOI: 10.1016/j.exer.2016.08.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2016] [Revised: 08/22/2016] [Accepted: 08/23/2016] [Indexed: 02/08/2023]
Abstract
Primary open-angle glaucoma is a multifactorial blinding disease often impacting the two pressure-sensitive regions of the eye: the conventional outflow pathway and the optic nerve head (ONH). The connective tissues that span these two openings in the globe are the trabecular meshwork of the conventional outflow pathway and the lamina cribrosa of the ONH. Resident cribiform cells of these two regions are responsible for actively remodeling and maintaining their connective tissues. In glaucoma, aberrant maintenance of the juxtacanalicular tissues (JCT) of the conventional outflow pathway results in ocular hypertension and pathological remodeling of the lamina cribrosa results in ONH cupping, damaging retinal ganglion cell axons. Interestingly, cells cultured from the lamina cribrosa and the JCT of the trabecular meshwork have similarities regarding gene expression, protein production, plus cellular responses to growth factors and mechanical stimuli. This review compares and contrasts the current knowledge of these two cell types, whose health is critical for protecting the eye from glaucomatous changes. In response to pressure gradients across their respective cribiform tissues, the goal is to better understand and differentiate healthy from pathological behavior of these two cell types.
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Affiliation(s)
- Jayter S Paula
- Department of Ophthalmology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil; Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA
| | - Colm O'Brien
- Ophthalmology, UCD School of Medicine, Mater Hospital, Dublin, Ireland
| | - W Daniel Stamer
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA.
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Ge P, Navarro ID, Kessler MM, Bernier SG, Perl NR, Sarno R, Masferrer J, Hannig G, Stamer WD. The Soluble Guanylate Cyclase Stimulator IWP-953 Increases Conventional Outflow Facility in Mouse Eyes. Invest Ophthalmol Vis Sci 2016; 57:1317-26. [PMID: 26998718 PMCID: PMC4811179 DOI: 10.1167/iovs.15-18958] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE The nitric oxide (NO)-cyclic guanosine-3',5'-monophosphate (cGMP) pathway regulates aqueous humor outflow and therefore, intraocular pressure. We investigated the pharmacologic effects of the soluble guanylate cyclase (sGC) stimulator IWP-953 on primary human trabecular meshwork (HTM) cells and conventional outflow facility in mouse eyes. METHODS Cyclic GMP levels were determined in vitro in HEK-293 cells and four HTM cell strains (HTM120/HTM123: predominantly myofibroblast-like phenotype, HTM130/HTM141: predominantly endothelial-like phenotype), and in HTM cell culture supernatants. Conventional outflow facility was measured following intracameral injection of IWP-953 or DETA-NO using a computerized pressure-controlled perfusion system in enucleated mouse eyes ex vivo. RESULTS IWP-953 markedly stimulated cGMP production in HEK-293 cells in the presence and absence of DETA-NO (half maximal effective concentrations: 17 nM, 9.5 μM). Similarly, IWP-953 stimulated cGMP production in myofibroblast-like HTM120 and HTM123 cells, an effect that was greatly amplified by the presence of DETA-NO. In contrast, IWP-953 stimulation of cGMP production in endothelial-like HTM130 and HTM141 cells was observed, but was markedly less prominent than in HTM120 and HTM123 cells. Notably, cGMP was found in all HTM culture supernatants, following IWP-953/DETA-NO stimulation. In paired enucleated mouse eyes, IWP-953 at 10, 30, 60, and 100 μM concentration-dependently increased outflow facility. This effect (89.5%) was maximal at 100 μM (P = 0.002) and in magnitude comparable to DETA-NO at 100 μM (97.5% increase, P = 0.030). CONCLUSIONS These data indicate that IWP-953, via modulation of the sGC-cGMP pathway, increases aqueous outflow facility in mouse eyes, suggesting therapeutic potential for sGC stimulators as novel ocular hypotensive drugs.
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Affiliation(s)
- Pei Ge
- Ironwood Pharmaceuticals Cambridge, Massachusetts, United States
| | - Iris D Navarro
- Ophthalmology Department, Duke University, Durham, North Carolina, United States
| | - Marco M Kessler
- Ironwood Pharmaceuticals Cambridge, Massachusetts, United States
| | - Sylvie G Bernier
- Ironwood Pharmaceuticals Cambridge, Massachusetts, United States
| | - Nicholas R Perl
- formerly of Ironwood Pharmaceuticals, Cambridge, Massachusetts, United States
| | - Renee Sarno
- Ironwood Pharmaceuticals Cambridge, Massachusetts, United States
| | - Jaime Masferrer
- Ironwood Pharmaceuticals Cambridge, Massachusetts, United States
| | - Gerhard Hannig
- Ironwood Pharmaceuticals Cambridge, Massachusetts, United States
| | - W Daniel Stamer
- Ophthalmology Department, Duke University, Durham, North Carolina, United States
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Vranka JA, Kelley MJ, Acott TS, Keller KE. Extracellular matrix in the trabecular meshwork: intraocular pressure regulation and dysregulation in glaucoma. Exp Eye Res 2015; 133:112-25. [PMID: 25819459 DOI: 10.1016/j.exer.2014.07.014] [Citation(s) in RCA: 264] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Revised: 07/14/2014] [Accepted: 07/16/2014] [Indexed: 12/30/2022]
Abstract
The trabecular meshwork (TM) is located in the anterior segment of the eye and is responsible for regulating the outflow of aqueous humor. Increased resistance to aqueous outflow causes intraocular pressure to increase, which is the primary risk factor for glaucoma. TM cells reside on a series of fenestrated beams and sheets through which the aqueous humor flows to exit the anterior chamber via Schlemm's canal. The outer trabecular cells are phagocytic and are thought to function as a pre-filter. However, most of the outflow resistance is thought to be from the extracellular matrix (ECM) of the juxtacanalicular region, the deepest portion of the TM, and from the inner wall basement membrane of Schlemm's canal. It is becoming increasingly evident that the extracellular milieu is important in maintaining the integrity of the TM. In glaucoma, not only have ultrastructural changes been observed in the ECM of the TM, and a significant number of mutations in ECM genes been noted, but the stiffness of glaucomatous TM appears to be greater than that of normal tissue. Additionally, TGFβ2 has been found to be elevated in the aqueous humor of glaucoma patients and is assumed to be involved in ECM changes deep with the juxtacanalicular region of the TM. This review summarizes the current literature on trabecular ECM as well as the development and function of the TM. Animal models and organ culture models targeting specific ECM molecules to investigate the mechanisms of glaucoma are described. Finally, the growing number of mutations that have been identified in ECM genes and genes that modulate ECM in humans with glaucoma are documented.
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Affiliation(s)
- Janice A Vranka
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Mary J Kelley
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Ted S Acott
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Kate E Keller
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA.
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Vranka JA, Bradley JM, Yang YF, Keller KE, Acott TS. Mapping molecular differences and extracellular matrix gene expression in segmental outflow pathways of the human ocular trabecular meshwork. PLoS One 2015; 10:e0122483. [PMID: 25826404 PMCID: PMC4380331 DOI: 10.1371/journal.pone.0122483] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 02/22/2015] [Indexed: 01/09/2023] Open
Abstract
Elevated intraocular pressure (IOP) is the primary risk factor for glaucoma, and lowering IOP remains the only effective treatment for glaucoma. The trabecular meshwork (TM) in the anterior chamber of the eye regulates IOP by generating resistance to aqueous humor outflow. Aqueous humor outflow is segmental, but molecular differences between high and low outflow regions of the TM are poorly understood. In this study, flow regions of the TM were characterized using fluorescent tracers and PCR arrays. Anterior segments from human donor eyes were perfused at physiological pressure in an ex vivo organ culture system. Fluorescently-labeled microspheres of various sizes were perfused into anterior segments to label flow regions. Actively perfused microspheres were segmentally distributed, whereas microspheres soaked passively into anterior segments uniformly labeled the TM and surrounding tissues with no apparent segmentation. Cell-tracker quantum dots (20 nm) were localized to the outer uveal and corneoscleral TM, whereas larger, modified microspheres (200 nm) localized throughout the TM layers and Schlemm’s canal. Distribution of fluorescent tracers demonstrated a variable labeling pattern on both a macro- and micro-scale. Quantitative PCR arrays allowed identification of a variety of extracellular matrix genes differentially expressed in high and low flow regions of the TM. Several collagen genes (COL16A1, COL4A2, COL6A1 and 2) and MMPs (1, 2, 3) were enriched in high, whereas COL15A1, and MMP16 were enriched in low flow regions. Matrix metalloproteinase activity was similar in high and low regions using a quantitative FRET peptide assay, whereas protein levels in tissues showed modest regional differences. These gene and protein differences across regions of the TM provide further evidence for a molecular basis of segmental flow routes within the aqueous outflow pathway. New insight into the molecular mechanisms of segmental aqueous outflow may aid in the design and delivery of improved treatments for glaucoma patients.
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Affiliation(s)
- Janice A. Vranka
- Casey Eye Institute, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, Oregon, United States of America
- * E-mail:
| | - John M. Bradley
- Casey Eye Institute, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, Oregon, United States of America
| | - Yong-Feng Yang
- Casey Eye Institute, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, Oregon, United States of America
| | - Kate E. Keller
- Casey Eye Institute, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, Oregon, United States of America
| | - Ted S. Acott
- Casey Eye Institute, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, Oregon, United States of America
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