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da Silva RA, Roda VMDP, Akamine PS, da Silva DS, Siqueira PV, Matsuda M, Hamassaki DE. Blockade of the TGF-β pathway by galunisertib inhibits the glial-mesenchymal transition in Müller glial cells. Exp Eye Res 2023; 226:109336. [PMID: 36455675 DOI: 10.1016/j.exer.2022.109336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 11/09/2022] [Accepted: 11/19/2022] [Indexed: 11/30/2022]
Abstract
Aging increases the risks for developing fibrocontractile membranes on the retina, which causes significant macular distortion, as in the idiopathic epiretinal membrane (iERM). Retinal Müller glial cells are components of these membranes and may play a key role in the iERM pathogenesis. The transforming growth factor-β (TGF-β) induces Müller cell transdifferentiation into myofibroblast, reducing glial cell markers (glutamine synthetase, GS, and glial fibrillary acidic protein, GFAP) and increasing α-smooth muscle actin (α-SMA). Our aim was to investigate the effect of the TGF-β inhibitor galunisertib (LY2157299) on the glial-mesenchymal transition and contraction of Müller cells. MIO-M1 human Müller cells were treated with TGF-β1 (10 ng/mL), galunisertib (5, 10 and 20 μM) and TGF-β1+galunisertib for 24h and 48h. Galunisertib cytotoxicity was analyzed by MTT and trypan blue, and TGF-β1 blockade by phospho-SMAD3 immunofluorescence. Caspase-3 (cell death indicator), GS, GFAP and α-SMA expression was examined by immunofluorescence, Western blotting, and qPCR analysis. Cell contractility was determined by collagen gel contraction assay with Müller cells incorporated. Galunisertib did not show cytotoxicity at the concentrations evaluated and maintained the Müller cells phenotype, ensuring the GS expression. Galunisertib inhibited the TGF-β1 pathway by decreasing phospho-SMAD3 immunoreactivity, attenuated the α-SMA expression, and prevented the contraction of Müller cells in collagen gel. Although more studies are needed, in vitro assays suggest that galunisertib may be a potential candidate to attenuate the formation of fibrocontractile membranes and prevent retinal detachment and consequent loss of vision.
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Affiliation(s)
- Rafael André da Silva
- Department of Cell & Developmental Biology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil
| | - Vinicius Moraes de Paiva Roda
- Department of Cell & Developmental Biology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil
| | - Priscilla Sayami Akamine
- Department of Cell & Developmental Biology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil
| | - Daniela Simões da Silva
- Department of Cell & Developmental Biology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil
| | - Paula Veloso Siqueira
- Department of Cell & Developmental Biology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil
| | - Monique Matsuda
- Department of Cell & Developmental Biology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil; Laboratory of Investigation in Ophthalmology (LIM-33), Division of Ophthalmology, University of São Paulo Faculty of Medicine, São Paulo, SP, Brazil
| | - Dânia Emi Hamassaki
- Department of Cell & Developmental Biology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil.
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Short-Term In Vitro ROS Detection and Oxidative Stress Regulators in Epiretinal Membranes and Vitreous from Idiopathic Vitreoretinal Diseases. BIOMED RESEARCH INTERNATIONAL 2022; 2022:7497816. [PMID: 36567907 PMCID: PMC9788888 DOI: 10.1155/2022/7497816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/27/2022] [Accepted: 11/03/2022] [Indexed: 12/23/2022]
Abstract
Background A plethora of inflammatory, angiogenic, and tissue remodeling factors has been reported in idiopathic epiretinal membranes (ERMs). Herein we focused on the expression of a few mediators (oxidative, inflammatory, and angiogenic/vascular factors) by means of short-term vitreal cell cultures and biomolecular analysis. Methods Thirty-nine (39) ERMs and vitreal samples were collected at the time of vitreoretinal surgery and biomolecular analyses were performed in clear vitreous, vitreal cell pellets, and ERMs. ROS products and iNOS were investigated in adherent vitreal cells and/or ERMs, and iNOS, VEGF, Ang-2, IFNγ, IL18, and IL22 were quantified in vitreous (ELISA/Ella, IF/WB); transcripts specific for iNOS, p65NFkB, KEAP1, NRF2, and NOX1/NOX4 were detected in ERMs (PCR). Biomolecular changes were analyzed and correlated with disease severity. Results The higher ROS production was observed in vitreal cells at stage 4, and iNOS was found in ERMs and increased in the vitreous as early as at stage 3. Both iNOS and NOX4 were upregulated at all stages, while p65NFkB was increased at stage 3. iNOS and NOX1 were positively and inversely related with p65NFkB. While NOX4 transcripts were always upregulated, NRF2 was upregulated at stage 3 and inverted at stage 4. No significant changes occurred in the release of angiogenic (VEGF, Ang-2) and proinflammatory (IL18, IL22 and IFNγ) mediators between all stages investigated. Conclusions ROS production was strictly associated with iNOS and NOX4 overexpression and increased depending on ERM stadiation. The higher iNOS expression occurred as early as stage 3, with respect to p65NFkB and NRF2. These last mediators might have potential prognostic values in ERMs as representative of an underneath retinal damage.
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Bianchi L, Altera A, Barone V, Bonente D, Bacci T, De Benedetto E, Bini L, Tosi GM, Galvagni F, Bertelli E. Untangling the Extracellular Matrix of Idiopathic Epiretinal Membrane: A Path Winding among Structure, Interactomics and Translational Medicine. Cells 2022; 11:cells11162531. [PMID: 36010606 PMCID: PMC9406781 DOI: 10.3390/cells11162531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/10/2022] [Accepted: 08/12/2022] [Indexed: 12/16/2022] Open
Abstract
Idiopathic epiretinal membranes (iERMs) are fibrocellular sheets of tissue that develop at the vitreoretinal interface. The iERMs consist of cells and an extracellular matrix (ECM) formed by a complex array of structural proteins and a large number of proteins that regulate cell–matrix interaction, matrix deposition and remodelling. Many components of the ECM tend to produce a layered pattern that can influence the tractional properties of the membranes. We applied a bioinformatics approach on a list of proteins previously identified with an MS-based proteomic analysis on samples of iERM to report the interactome of some key proteins. The performed pathway analysis highlights interactions occurring among ECM molecules, their cell receptors and intra- or extracellular proteins that may play a role in matrix biology in this special context. In particular, integrin β1, cathepsin B, epidermal growth factor receptor, protein-glutamine gamma-glutamyltransferase 2 and prolow-density lipoprotein receptor-related protein 1 are key hubs in the outlined protein–protein cross-talks. A section on the biomarkers that can be found in the vitreous humor of patients affected by iERM and that can modulate matrix deposition is also presented. Finally, translational medicine in iERM treatment has been summed up taking stock of the techniques that have been proposed for pharmacologic vitreolysis.
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Affiliation(s)
- Laura Bianchi
- Department of Life Sciences, University of Siena, 53100 Siena, Italy
| | - Annalisa Altera
- Department of Life Sciences, University of Siena, 53100 Siena, Italy
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy
| | - Virginia Barone
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy
| | - Denise Bonente
- Department of Life Sciences, University of Siena, 53100 Siena, Italy
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy
| | - Tommaso Bacci
- Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy
| | - Elena De Benedetto
- Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy
| | - Luca Bini
- Department of Life Sciences, University of Siena, 53100 Siena, Italy
| | - Gian Marco Tosi
- Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy
| | - Federico Galvagni
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, 53100 Siena, Italy
| | - Eugenio Bertelli
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy
- Correspondence:
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van Overdam KA, van den Bosch TPP, van Etten PG, Uppal GS, Veckeneer M, Verdijk RM. Novel insights into the pathophysiology of proliferative vitreoretinopathy: The role of vitreoschisis-induced vitreous cortex remnants. Acta Ophthalmol 2022; 100:e1749-e1759. [PMID: 35673878 DOI: 10.1111/aos.15197] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 05/22/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE We previously hypothesized a causal relationship between vitreoschisis-induced vitreous cortex remnants (VCR) and the development of proliferative vitreoretinopathy (PVR). This study aims to substantiate this association through histopathological analysis of surgical specimens in support of strategies to improve therapeutic outcomes. METHODS A descriptive, prospective, non-consecutive case series. Histopathological and immunohistochemical analyses were performed on membranes removed from the peripheral retinal surface during initial vitrectomy for primary rhegmatogenous retinal detachment (RRD) (n = 11) or recurrent retinal detachment (n = 12). The clinical aspect of the membranes ranged from loose-meshed membranes visualized with triamcinolone to more fibrotic membranes stained with trypan blue. RESULTS Consistent with the clinical presentation, histopathological analysis revealed membranes with different area characteristics. Paucicellular lamellar collagen-rich areas, suggestive of VCR, appeared to transition to areas of increased cellularity and eventually more fibrotic areas of low cellularity. Five different area characteristics could be identified that seemed to correspond to five histopathological stages in PVR formation, with lamellar VCR collagen acting as an essential precondition: 1. Lamellar collagen, low cellularity (hyalocytes). 2. Lamellar collagen, increased cellularity (hyalocytes, glial cells). 3. Lamellar collagen, high cellularity (macrophages, glial cells, RPE-cells). 4. Early fibrosis, decreased cellularity (myofibroblasts). 5. Fibrosis, low cellularity (myofibroblasts). CONCLUSION These findings confirm the role of VCR in preretinal PVR formation posterior to the vitreous base. We propose that the presence of VCR over the retinal surface should be qualified as a risk factor for PVR formation. Detection and adequate removal of VCR may improve the success rate of vitreoretinal surgeries.
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Affiliation(s)
- Koen A van Overdam
- Department of Vitreoretinal Surgery, the Rotterdam Eye Hospital, Rotterdam, The Netherlands
| | - Thierry P P van den Bosch
- Department of Pathology, Section Ophthalmic Pathology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Peter G van Etten
- Department of Vitreoretinal Surgery, the Rotterdam Eye Hospital, Rotterdam, The Netherlands
| | - Gurmit S Uppal
- Department of Vitreoretinal Surgery, Moreton Eye Group, Brisbane, Queensland, Australia
| | - Marc Veckeneer
- Department of Vitreoretinal Surgery, ZNA Middelheim, Antwerp, Belgium
| | - Robert M Verdijk
- Department of Vitreoretinal Surgery, the Rotterdam Eye Hospital, Rotterdam, The Netherlands.,Department of Pathology, Section Ophthalmic Pathology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
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da Silva RA, Roda VMDP, Matsuda M, Siqueira PV, Lustoza-Costa GJ, Wu DC, Hamassaki DE. Cellular components of the idiopathic epiretinal membrane. Graefes Arch Clin Exp Ophthalmol 2021; 260:1435-1444. [PMID: 34842983 DOI: 10.1007/s00417-021-05492-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 10/24/2021] [Accepted: 11/04/2021] [Indexed: 01/19/2023] Open
Abstract
Idiopathic epiretinal membrane (iERM) is a fibrocellular proliferation on the inner surface of the retina, which leads to decreased visual acuity and even central visual loss. As iERM is associated to advanced age and posterior vitreous detachment, a higher prevalence is expected with increasing life expectancy and aging of the global population. Although various cell types of retinal and extra-retinal origin have been described in iERMs (Müller glial cells, astrocytes, hyalocytes, retinal pigment epithelium cells, myofibroblasts, and fibroblasts), myofibroblasts have a central role in collagen production and contractile activity. Thus, myofibroblast differentiation is considered a key event for the iERM formation and progression, and fibroblasts, Müller glial cells, hyalocytes, and retinal pigment epithelium have been identified as myofibroblast precursors. On the other side, the different cell types synthesize growth factors, cytokines, and extracellular matrix, which have a crucial role in ERM pathogenesis. In the present review, the major cellular components and their functions are summarized, and their possible roles in the iERM formation are discussed. By exploring in detail the cellular and molecular aspects of iERM, we seek to contribute for better understanding of this fibrotic disease and the origin of myofibroblasts, which may eventually drive to more targeted therapeutic approaches.
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Affiliation(s)
- Rafael André da Silva
- Department of Cell & Developmental Biology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, 05508-000, Brazil
| | - Vinicius Moraes de Paiva Roda
- Department of Cell & Developmental Biology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, 05508-000, Brazil
| | - Monique Matsuda
- Laboratory of Investigation in Ophthalmology (LIM-33), Division of Ophthalmology, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - Paula Veloso Siqueira
- Department of Cell & Developmental Biology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, 05508-000, Brazil
| | - Gabriela Jesus Lustoza-Costa
- Department of Cell & Developmental Biology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, 05508-000, Brazil
| | - Davi Chen Wu
- Department of Cell & Developmental Biology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, 05508-000, Brazil.,Department of Ophthalmology, Irmandade de Misericórdia da Santa Casa de São Paulo, São Paulo, SP, Brazil
| | - Dânia Emi Hamassaki
- Department of Cell & Developmental Biology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, 05508-000, Brazil.
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van Overdam KA, Busch EM, Verdijk RM, Pennekamp CWA. The role of vitreous cortex remnants in proliferative vitreoretinopathy formation demonstrated by histopathology: A case report. Am J Ophthalmol Case Rep 2021; 24:101219. [PMID: 34646961 PMCID: PMC8501493 DOI: 10.1016/j.ajoc.2021.101219] [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: 10/13/2020] [Revised: 06/30/2021] [Accepted: 10/04/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose The pathogenesis of proliferative vitreoretinopathy (PVR), the most important cause of retinal detachment surgery failure, is still not fully understood. We previously hypothesized a causal link between vitreoschisis-induced vitreous cortex remnants (VCR) and PVR formation. The purpose of this case report is to demonstrate this association by showing the clinical occurrence of PVR in the presence of VCR across the retinal surface, illustrated by histopathological analysis. Observations A 69-year-old male was referred because of widespread epiretinal membrane formation after treatment of recurrent retinal detachments. During surgery with extensive membrane peeling, a large continuous membrane was peeled from the superior arcade towards the inferior temporal mid-periphery. Histopathological analysis of this membrane revealed areas with different characteristics: paucicellular laminar collagen-rich areas, suggestive for VCR, areas with increased cellularity, and more fibrotic areas with low cellularity. The immunohistochemical analysis identified cell type variety in these areas: collagen-rich areas showed glial cells and hyalocytes, while in areas with high cellularity fibroblasts, macrophages and retinal pigment epithelial cells were found, which have previously been shown to play an important role in the development of PVR as they can transdifferentiate into myofibroblasts, which were seen in the more fibrotic areas. Conclusions and importance These findings support the theory that VCR have a role in PVR development, where VCR can act as a scaffold for fibrocellular proliferation. We suggest that the presence of VCR over the retinal surface should be qualified as a risk factor for PVR formation. Detection and adequate removal of VCR may improve the success rate of retinal detachment surgery.
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Affiliation(s)
- Koen A van Overdam
- Department of Vitreoretinal Surgery, The Rotterdam Eye Hospital, Rotterdam, the Netherlands
| | - Eelco M Busch
- Department of Ophthalmology, Noordwest Ziekenhuisgroep, Alkmaar, the Netherlands
| | - Robert M Verdijk
- Department of Pathology, Section Ophthalmic Pathology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Claire W A Pennekamp
- Department of Vitreoretinal Surgery, The Rotterdam Eye Hospital, Rotterdam, the Netherlands
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Adıyeke SK, Kutlu N, Özen K, Doran MA, Demirbaş K, Ture G, Talay E. Is pseudoexfoliation syndrome associated with vitreoretinal interface abnormalities? Graefes Arch Clin Exp Ophthalmol 2021; 260:431-437. [PMID: 34406503 DOI: 10.1007/s00417-021-05373-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 07/31/2021] [Accepted: 08/06/2021] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND To evaluate vitreoretinal interface abnormalities in patients with pseudoexfoliation (PEX) syndrome. METHODS This case-control study was performed in 136 patients diagnosed with unilateral PEX (PEX group) and 139 age- and sex-matched healthy volunteers (Control group). Both the affected and contralateral eyes were evaluated in the PEX group and the right eye was evaluated in the Control group. Vitreoretinal interface abnormalities and posterior vitreous detachment (PVD) were evaluated on optical coherence tomography (OCT) examination. RESULTS The incidences of incomplete and complete PVD were significantly higher in the affected than contralateral eye in the PEX group and in the right eye in the Control group (P = 0.009, P = 0.012 and P = 0.004, P = 0.017, respectively). The rates of 'no PVD' were significantly higher in the contralateral eye in the PEX group and the Control group compared to the affected eye in the PEX group (P = 0.003 and P = 0.001, respectively). The odds ratio for incomplete PVD was 3.1 in PEX eyes compared to the contralateral eye in the PEX group and 3.9 compared to the Control group. The rate of epiretinal membranes (ERMs) in the affected eye was significantly different from the contralateral eye in the PEX and Control groups (P < 0.001 and P < 0.001, respectively). The odds ratio for ERM in PEX eyes was 3.51 compared to the contralateral eye in the PEX group and 4.23 compared to the Control group. In the presence of incomplete PVD, the odds ratio for ERM development was 3.81 in PEX eyes. CONCLUSIONS We detected high rates of ERMs and incomplete PVD in patients with PEX. It is important to evaluate and follow up PEX cases in terms of vitreoretinal interface abnormalities.
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Affiliation(s)
- Seda Karaca Adıyeke
- Tepecik Research and Training Hospital Ophthalmology Department, Izmir, Turkey.
| | - Neslisah Kutlu
- Tepecik Research and Training Hospital Ophthalmology Department, Izmir, Turkey
| | - Kıvanç Özen
- Tepecik Research and Training Hospital Ophthalmology Department, Izmir, Turkey
| | - Mehmet Ali Doran
- Tepecik Research and Training Hospital Ophthalmology Department, Izmir, Turkey
| | - Kemal Demirbaş
- Tepecik Research and Training Hospital Ophthalmology Department, Izmir, Turkey
| | - Gamze Ture
- Tepecik Research and Training Hospital Ophthalmology Department, Izmir, Turkey
| | - Ekrem Talay
- Tepecik Research and Training Hospital Ophthalmology Department, Izmir, Turkey
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Ikegami Y, Numaga J, Ue S, Sano T. Morphological alternation and influence of aqueous flare in idiopathic epiretinal membrane. Int J Retina Vitreous 2021; 7:40. [PMID: 34001276 PMCID: PMC8127242 DOI: 10.1186/s40942-021-00294-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 03/09/2021] [Indexed: 11/12/2022] Open
Abstract
Background Idiopathic epiretinal membrane (iERM) is a common retinal disease in the elderly population. The exact pathogenesis of iERM is unknown. The present study aimed to evaluate the relationship between aqueous flare and morphology of iERM using swept-source optical coherence tomography (OCT). Methods A consecutive series of 36 eyes of 33 patients with iERM and 109 control eyes of 109 patients were retrospectively examined. Aqueous flare measurements and OCT images were obtained on the same day. The average total retinal, inner retinal, outer retinal, and choroidal thicknesses were calculated using the thickness map mode with an Early Treatment Diabetic Retinopathy Study nine-zone grid that was divided into three zones. The maximum depth of the retinal folds in iERMs was manually measured. The correlation among flare value, maximum depth of folds, and retinal and choroidal thicknesses was evaluated. The morphological changes between the control eyes and the eyes with iERM in different stages were examined. Results The result demonstrated a significant positive correlation between the aqueous flare value and total and inner retinal thicknesses in the early stage of iERM. There was a significant positive correlation between the maximum depth of folds and total and inner retinal thicknesses in the early stage of iERM, and the maximum depth of folds significantly increased in the advanced stage. The total and inner retinal thicknesses and proportion of inner retinal thickness significantly increased as the stage of iERM progressed. Conclusions The aqueous flare value was associated with retinal thickness in the early stage of iERM, which supports the idea that inflammation or breakdown of blood–ocular barrier is involved in the process of iERM formation. The maximum retinal folds increased as the stage of iERM progressed and retinal thickness increased, which indicates that the tangential force increases as the iERM stage progresses.
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Affiliation(s)
- Yasuko Ikegami
- Department of Ophthalmology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakae-cho, Itabashi district, Tokyo, 173-0015, Japan. .,Department of Ophthalmology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
| | - Jiro Numaga
- Department of Ophthalmology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakae-cho, Itabashi district, Tokyo, 173-0015, Japan
| | - Saori Ue
- Department of Ophthalmology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakae-cho, Itabashi district, Tokyo, 173-0015, Japan
| | - Tomohiro Sano
- Department of Ophthalmology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakae-cho, Itabashi district, Tokyo, 173-0015, Japan
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Abstract
Clear vision is dependent on features that protect the anatomical integrity of the eye (cornea and sclera) and those that contribute to internal ocular homeostasis by conferring hemangiogenic (avascular tissues and antiangiogenic factors), lymphangiogenic (lack of draining lymphatics), and immunologic (tight junctions that form blood-ocular barriers, immunosuppressive cells, and modulators) privileges. The later examples are necessary components that enable the eye to maintain an immunosuppressive environment that responds to foreign invaders in a deviated manner, minimizing destructive inflammation that would impair vision. These conditions allowed for the observations made by Medawar, in 1948, of delayed rejection of allogenic tissue grafts in the anterior chamber of mouse eye and permit the sequestration of foreign invaders (eg, Toxoplasma gondii) within the retina of healthy individuals. Yet successful development of intraocular drugs (biologics and delivery devices) has been stymied by adverse ocular pathology, much of which is driven by immune pathways. The eye can be intolerant of foreign protein irrespective of delivery route, and endogenous ocular cells have remarkable plasticity when recruited to preserve visual function. This article provides a review of current understanding of ocular immunology and the potential role of immune mechanisms in pathology observed with intraocular drug delivery.
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Affiliation(s)
| | | | - Sharmila Masli
- 12259Boston University School of Medicine, Boston, MA, USA
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Tosi GM, Regoli M, Altera A, Galvagni F, Arcuri C, Bacci T, Elia I, Realini G, Orlandini M, Bertelli E. Heat Shock Protein 90 Involvement in the Development of Idiopathic Epiretinal Membranes. Invest Ophthalmol Vis Sci 2021; 61:34. [PMID: 32716502 PMCID: PMC7425702 DOI: 10.1167/iovs.61.8.34] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Purpose This work was aimed to further characterize cells of idiopathic epiretinal membranes (iERMs). We wanted to determine the contribution of 90-kDa heat shock protein (HSP90) to sustain the transforming growth factor-β (TGF-β)-mediated signal transduction pathway in iERM. Methods Immunofluorescence and confocal microscopy were carried out on deplasticized sections from 36 epiretinal membranes processed for electron microscopy and on frozen sections from five additional samples with antibodies against α-smooth muscle actin (αSMA), vimentin, glial fibrillary acidic protein (GFAP), SMAD2, HSP90α, type-II TGF-β1 receptor (TβRII), type-I collagen, and type-IV collagen. In addition, Müller MIO-M1 cells were transfected with HSP90 and challenged with TGF-β1. Results Double and triple labeling experiments showed that a variable number of TβRII+ cells were present in 94.1% of tested iERMs and they were mostly GFAP-/αSMA+/vimentin+/HSP90α+. In almost half of the cases these cells contained type-I collagen, suggesting their involvement in matrix deposition. HSP90 overexpressing MIO-M1 cells challenged with TGF-β1 showed increased levels of TβRII, SMAD2, SMAD3, and phosphor-SMAD2. Nuclear SMAD2 staining could be observed in HSP90α+ cells on frozen sections of iERMs. Conclusions Cells in iERMs that express TβRII are also HSP90α+ and show the antigenic profile of myofibroblast-like cells as they are GFAP-/αSMA+/vimentin+. HSP90α-overexpressing MIO-M1 cells challenged with TGF-β1 showed an increased activation of the SMAD pathway implying that HSP90α might play a role in sustaining the TGF-β1-induced fibrotic response of iERM cells.
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Uzlu D, Erdöl H, Somuncu AM, Özbay AD, Kola M, Köse B. The role of simple inflammatory blood parameters in idiopathic epiretinal membrane patients. Int Ophthalmol 2020; 41:107-112. [PMID: 32851557 DOI: 10.1007/s10792-020-01557-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 08/16/2020] [Indexed: 10/23/2022]
Abstract
AIM To evaluate the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in idiopathic epiretinal membrane (IERM) patients, and their relations with visual acuity. METHOD Fifty-seven IERM and 51 control patients were included. All patients underwent comprehensive ophthalmological examination and complete blood count tests, and NLR and PLR values were calculated. Patients with IERM were compared with the control group, and associations with visual prognosis were evaluated. These ratios' cut-off values for IERM were also calculated RESULTS: NLR values were statistically significantly higher in the IERM group than in the control group (p = 0.001). No significant difference was observed between the IERM and control groups in terms of PLR (p = 0.43). No significant correlation was determined between visual acuity and NLR or PLR (r = 0.05, p = 0.66; and r = 0.18, p = 0.16, respectively). The cut-off value for NLR was 1.91. CONCLUSION Patients with IERM showed significantly increased NLR compared to control subjects suggesting that IERM patients may be prone to have high NLR values.
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Affiliation(s)
- Dilek Uzlu
- Department of Ophthalmology, Medical Faculty, Karadeniz Technical University, Trabzon, Turkey.
| | - Hidayet Erdöl
- Department of Ophthalmology, Medical Faculty, Karadeniz Technical University, Trabzon, Turkey
| | - Ahmet Mehmet Somuncu
- Department of Ophthalmology, Medical Faculty, Karadeniz Technical University, Trabzon, Turkey
| | - Ahmet Duhan Özbay
- Department of Ophthalmology, Medical Faculty, Karadeniz Technical University, Trabzon, Turkey
| | - Mehmet Kola
- Department of Ophthalmology, Medical Faculty, Karadeniz Technical University, Trabzon, Turkey
| | - Büşra Köse
- The State Hospital of Bayburt, Bayburt, Turkey
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Coltrini D, Belleri M, Gambicorti E, Romano D, Morescalchi F, Krishna Chandran AM, Calza S, Semeraro F, Presta M. Gene expression analysis identifies two distinct molecular clusters of idiopatic epiretinal membranes. Biochim Biophys Acta Mol Basis Dis 2020; 1866:165938. [PMID: 32827649 DOI: 10.1016/j.bbadis.2020.165938] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 07/30/2020] [Accepted: 08/17/2020] [Indexed: 12/18/2022]
Abstract
Idiopathic epiretinal membranes (ERMs) are fibrocellular membranes containing extracellular matrix proteins and epiretinal cells of retinal and extraretinal origin. iERMs lead to decreased visual acuity and their pathogenesis has not been completely defined. Aim of this study was to provide a molecular characterization of iERMs by gene expression analysis. To this purpose, 56 iERMs obtained by pars plana vitrectomy were analyzed for the expression levels of genes encoding biomarkers of the cellular and molecular events occurring in iERMs. RT-qPCR analysis showed significant differences in the levels of cell population, extracellular matrix and cytokine/growth factor biomarkers among the iERMs investigated. Hierarchical clustering of RT-qPCR data identified two distinct iERM clusters, Cluster B samples representing transcriptionally "activated" iERMs when compared to transcriptionally "quiescent" Cluster A specimens. Further, Cluster B could be subdivided in two subgroups, Cluster B1 iERMs, characterized by a marked glial cell activation, and Cluster B2 samples characterized by a more pro-fibrotic phenotype. Preoperative decimal best-corrected visual acuity and post-surgery inner segment/outer grading values were higher in Cluster A patients, that showed a prevalence of fovea-attached type iERMs with near-normal inner retina, than in Cluster B patients, that presented more severe clinical and spectral domain optical coherence tomography (SD-OCT) features. In conclusion, this molecular characterization has identified two major clusters of iERM specimens with distinct transcriptional activities that reflect different clinical and SD-OCT features of iERM patients. This retrospective work paves the way to prospective whole-genome transcriptomic studies to allow a molecular classification of iERMs and for the identification of molecular signature(s) of prognostic and therapeutic significance.
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Affiliation(s)
- Daniela Coltrini
- Department of Molecular and Translational Medicine, University of Brescia, Viale Europa 11, 25123 Brescia, Italy
| | - Mirella Belleri
- Department of Molecular and Translational Medicine, University of Brescia, Viale Europa 11, 25123 Brescia, Italy
| | - Elena Gambicorti
- Eye Clinic, Department of Neurological and Vision Sciences, University of Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy
| | - Davide Romano
- Eye Clinic, Department of Neurological and Vision Sciences, University of Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy
| | - Francesco Morescalchi
- Eye Clinic, Department of Neurological and Vision Sciences, University of Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy
| | - Adwaid Manu Krishna Chandran
- Department of Molecular and Translational Medicine, University of Brescia, Viale Europa 11, 25123 Brescia, Italy
| | - Stefano Calza
- Department of Molecular and Translational Medicine, University of Brescia, Viale Europa 11, 25123 Brescia, Italy
| | - Francesco Semeraro
- Eye Clinic, Department of Neurological and Vision Sciences, University of Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy.
| | - Marco Presta
- Department of Molecular and Translational Medicine, University of Brescia, Viale Europa 11, 25123 Brescia, Italy.
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Momota A, Iwase T, Akahori T, Goto K, Yamamoto K, Ra E, Terasaki H. Association between displacement and thickness of macula after vitrectomy in eyes with epiretinal membrane. Sci Rep 2020; 10:13227. [PMID: 32764657 PMCID: PMC7414027 DOI: 10.1038/s41598-020-70197-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 07/23/2020] [Indexed: 12/12/2022] Open
Abstract
The purpose of this cross-sectional retrospective study was to determine the relationship between the retinal displacements and the retinal thickness in eyes with epiretinal membrane (ERM) after vitrectomy with internal limiting membrane (ILM) peeling. To accomplish this, we measured the retinal thickness using optical coherence tomography (OCT) and the retinal displacement using OCT angiography to obtain 3 mm × 3 mm en face images before, and 2, 4, and 8 weeks following the surgery from 20 eyes of 20 patients. The distance between the retinal vessel bifurcations and the fovea was significantly displaced centrifugally and asymmetrically in the 4 quadrants postoperatively (P < 0.001). The foveal avascular zone (FAZ) was significantly enlarged, and the central foveal thickness (CFT) and the inner nuclear layer (INL) thickness were significantly thinner postoperatively. The displacements were significantly correlated with the changes in the FAZ area (r = 0.717, P < 0.001), the CFT (r = − 0.702, P < 0.001), and the INL thickness (r = − 0.702, P < 0.001). In conclusion, the distance between the retinal bifurcations and the fovea was asymmetrically expanded after the surgery and was significantly correlated with the morphological changes. These results indicate that a horizontal macular contraction is correlated with vertical retinal contraction in the eyes with an ERM.
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Affiliation(s)
- Ayana Momota
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8560, Japan
| | - Takeshi Iwase
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8560, Japan. .,Department of Ophthalmology, Akita University Graduate School of Medicine, 1-1-1 Hondou, Akita, 010-0041, Japan.
| | - Tomohiko Akahori
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8560, Japan
| | - Kensuke Goto
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8560, Japan
| | - Kentaro Yamamoto
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8560, Japan
| | - Eimei Ra
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8560, Japan
| | - Hiroko Terasaki
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8560, Japan
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Dinice L, Cacciamani A, Esposito G, Taurone S, Carletti R, Ripandelli G, Artico M, Micera A. Osteopontin in vitreous and idiopathic epiretinal membranes. Graefes Arch Clin Exp Ophthalmol 2020; 258:1503-1513. [PMID: 32277255 DOI: 10.1007/s00417-020-04685-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 03/20/2020] [Accepted: 04/03/2020] [Indexed: 01/10/2023] Open
Abstract
PURPOSE To investigate osteopontin (OPN) expression in vitreous and in related idiopathic epiretinal membranes (ERMs), with respect to VEGF-A, IL8, MIP1α, IL6, and IL33, and correlate OPN expression with disease staging. METHODS Fifteen (15) vitreous and allied ERMs were collected at the time of therapeutic vitreoretinal surgery. Additional 5 vitreous and 10 ERMs (historical collection) were used. Biochemical and molecular analysis of OPN was performed in clear vitreous, vitreal pelleted cells, and ERMs. Double-immunofluorescence analysis (OPN - GFAP and OPN - αSMA) was performed on paraffin and whole-mounted ERMs. Vitreal OPN levels were correlated to those of VEGF-A, IL8, MIP1α, IL6, and IL33. RESULTS High OPN levels were observed in vitreal samples, and OPN transcripts were amplified in vitreal cells and related ERMs. OPN immunoreactivity was found in ERMs, mainly in GFAP-bearing (Muller cells) and to a less extend in αSMA-expressing (myofibroblasts) cells. OPN levels were highest at early stages of ERM formation and positively correlated to VEGF-A and MIP1α. CONCLUSIONS High OPN levels in vitreous, OPN transcripts in vitreal cells/ERMs, OPN immunoreactivity in activated Müller cells and contractile myofibroblasts, as well as the correlation with VEGF-A and MIP1α fulfill the potential involvement of OPN in both inflammation and tissue remodeling that takes part in vitreoretinal interface disorders. The highest OPN levels at early stages of ERM formation would prospect OPN as a potential biomarker for disease severity.
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Affiliation(s)
- Lucia Dinice
- Research Laboratories in Ophthalmology, IRCCS-Fondazione Bietti, Via Santo Stefano Rotondo, 6, 00184, Rome, Italy
| | | | - Graziana Esposito
- Research Laboratories in Ophthalmology, IRCCS-Fondazione Bietti, Via Santo Stefano Rotondo, 6, 00184, Rome, Italy
| | - Samanta Taurone
- Research Laboratories in Ophthalmology, IRCCS-Fondazione Bietti, Via Santo Stefano Rotondo, 6, 00184, Rome, Italy
| | - Raffaella Carletti
- Department of Radiology, Oncology and Pathology, Sapienza University of Rome, Rome, Italy
| | | | - Marco Artico
- Department of Sensory Organs, Sapienza University of Rome, Rome, Italy
| | - Alessandra Micera
- Research Laboratories in Ophthalmology, IRCCS-Fondazione Bietti, Via Santo Stefano Rotondo, 6, 00184, Rome, Italy.
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Roybal CN, Velez G, Toral MA, Tsang SH, Bassuk AG, Mahajan VB. Personalized Proteomics in Proliferative Vitreoretinopathy Implicate Hematopoietic Cell Recruitment and mTOR as a Therapeutic Target. Am J Ophthalmol 2018; 186:152-163. [PMID: 29246578 PMCID: PMC5805631 DOI: 10.1016/j.ajo.2017.11.025] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 11/29/2017] [Accepted: 11/30/2017] [Indexed: 12/25/2022]
Abstract
PURPOSE To profile vitreous cytokine expression of proliferative vitreoretinopathy (PVR) patients. DESIGN Case-control study. METHODS Liquid biopsies were collected from 2 groups: control subjects (n = 3) undergoing pars plana vitrectomy to remove an epiretinal membrane (ERM), and test subjects (n = 7) with varying degrees of PVR. A high-throughput cytokine screen measured expression of 200 cytokines. Cytokine expression patterns were prospectively validated in separate cohorts of control patients and those with PVR-A, PVR-B, and PVR-C (n = 10 for each group). Expression changes were evaluated by analysis of variance (significant P value < .05), hierarchical cluster algorithm, and pathway analysis, to identify candidate pathways for prospective studies. RESULTS In PVR vitreous, 29 cytokines were upregulated compared to controls. Early PVR vitreous showed upregulation of T-cell markers, profibrotic cytokines, and cytokines downstream of mTOR activation (IL-2, IL-6, and IL-13), whereas in late PVR vitreous, cytokines driving monocyte responses and stem-cell recruitment (SDF-1) prevailed. Prospective validation confirmed the differential expression of specific cytokines from PVR-A to C. CONCLUSIONS Early PVR is characterized by activation of T cells and mTOR signaling, whereas advanced PVR is characterized by a chronic monocyte response. PVR might be treated by rational repositioning of existing drugs that target mTOR and IL-6. Our analysis demonstrates that successful therapeutic intervention will be highly dependent on the specific therapeutic target and the stage of PVR. This study provides insights into cytokines that will serve as biomarkers and therapeutic targets. These biomarkers will help design clinical trials that intervene at appropriate times.
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Affiliation(s)
- C Nathaniel Roybal
- Eye Associates of New Mexico, Albuquerque, New Mexico; Department of Surgery, University of New Mexico, Albuquerque, New Mexico; Omics Laboratory, Stanford University, Palo Alto, California
| | - Gabriel Velez
- Omics Laboratory, Stanford University, Palo Alto, California; Medical Scientist Training Program, University of Iowa, Iowa City, Iowa
| | - Marcus A Toral
- Omics Laboratory, Stanford University, Palo Alto, California; Medical Scientist Training Program, University of Iowa, Iowa City, Iowa
| | - Stephen H Tsang
- Barbara and Donald Jonas Laboratory of Stem Cells and Regenerative Medicine and Bernard & Shirlee Brown Glaucoma Laboratory, Edward S. Harkness Eye Institute, Columbia University, New York, New York; Department of Pathology & Cell Biology, College of Physicians & Surgeons, Columbia University, New York, New York
| | | | - Vinit B Mahajan
- Omics Laboratory, Stanford University, Palo Alto, California; Byers Eye Institute, Department of Ophthalmology, Stanford University, Palo Alto, California; Palo Alto Veterans Administration, Palo Alto, California.
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Dikkaya F, Karaman Erdur S, Ozsutcu M, Aydin R, Kocabora MS, Aras C. The significance of neutrophil-to-lymphocyte ratio in idiopathic epiretinal membrane. Int Ophthalmol 2017; 38:1393-1397. [PMID: 28608032 DOI: 10.1007/s10792-017-0597-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 06/05/2017] [Indexed: 11/30/2022]
Abstract
PURPOSE To assess the levels of neutrophil-to-lymphocyte ratio (NLR) in patients with idiopathic epiretinal membrane (iERM) and to compare the NLR results of patients with iERM and healthy controls. METHODS This retrospective study enrolled 43 patients with iERM and 40 healthy subjects. Complete ophthalmologic examination and complete blood count measurements were performed of all subjects. Complete blood counts were performed within 2 h of blood collection. RESULTS There was a significant difference in NLR between iERM and control groups (p < 0.01). The receiver operating characteristics analysis revealed that the value of NLR to distinguish patients with iERM and controls was found to be 0.832. The best cutoff value was 1.90, with a sensitivity of 72% and specificity 70%. CONCLUSIONS Our study for the first time provides evidence that subclinical systemic inflammation may cause or at least accompanies iERM using a novel biomarker NLR.
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Affiliation(s)
- Funda Dikkaya
- Department of Ophthalmology, Istanbul Medipol University, Istanbul, 34214, Turkey
| | - Sevil Karaman Erdur
- Department of Ophthalmology, Istanbul Medipol University, Istanbul, 34214, Turkey.
| | - Mustafa Ozsutcu
- Department of Ophthalmology, Istanbul Medipol University, Istanbul, 34214, Turkey
| | - Rukiye Aydin
- Department of Ophthalmology, Istanbul Medipol University, Istanbul, 34214, Turkey
| | | | - Cengiz Aras
- Department of Ophthalmology, Istanbul Medipol University, Istanbul, 34214, Turkey
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Pathologic Roles of Receptor-Associated Prorenin System in Idiopathic Epiretinal Membrane. Sci Rep 2017; 7:44266. [PMID: 28276504 PMCID: PMC5343583 DOI: 10.1038/srep44266] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 02/07/2017] [Indexed: 11/09/2022] Open
Abstract
Receptor-associated prorenin system (RAPS) refers to the pathogenic mechanism whereby prorenin binding to (pro)renin receptor [(P)RR] dually activates tissue renin-angiotensin system (RAS) and RAS-independent signaling via (P)RR. The aim of this study is to determine the association of RAPS with idiopathic epiretinal membrane (iERM). Reverse transcription-PCR indicated the expression of RAPS components, including (P)RR and Ang II type 1 receptor (AT1R), in iERM tissues and human Müller glial cell line. Double-labeling analyses demonstrated that (P)RR and AT1R were detected in cells positive for glial fibrillary acidic protein, a marker for glial cells, and co-localized with prorenin and angiotensinogen, respectively. Administration of prorenin to Müller glial cells enhanced mRNA expression of fibroblast growth factor 2, while Ang II application stimulated the expression of glial cell line-derived neurotrophic factor, nerve growth factor, and transforming growth factor-β1. These expression levels induced by prorenin or Ang II were reversed by (P)RR or AT1R blockade, respectively. Immunofluorescence revealed tissue co-localization of (P)RR and AT1R with the products of the upregulated genes in vitro. The present findings suggest the involvement of RAPS in the pathogenesis of iERM.
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18
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Soluble form of LR11 is highly increased in the vitreous fluids of patients with idiopathic epiretinal membrane. Graefes Arch Clin Exp Ophthalmol 2017; 255:885-891. [DOI: 10.1007/s00417-017-3585-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 12/24/2016] [Accepted: 01/04/2017] [Indexed: 12/11/2022] Open
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Myojin S, Yoshimura T, Yoshida S, Takeda A, Murakami Y, Kawano Y, Oshima Y, Ishibashi T, Sonoda KH. Gene Expression Analysis of the Irrigation Solution Samples Collected during Vitrectomy for Idiopathic Epiretinal Membrane. PLoS One 2016; 11:e0164355. [PMID: 27736918 PMCID: PMC5063277 DOI: 10.1371/journal.pone.0164355] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 09/24/2016] [Indexed: 02/03/2023] Open
Abstract
Purpose The analysis of gene expression in idiopathic epiretinal membranes (iERMs) may help elucidate ERM formation and its pathology. Here, we conducted a case-control study, in order to determine the expression levels of cytokines and other genes in eyes with macular hole (MH) or iERM. Methods Twenty eyes, obtained from seven male and 13 female patients, were included in the study. The average age of the study subjects was 69.1 ± 7.67 years, and 15 eyes had iERM, while five eyes had MH. Irrigation solution samples were collected during vitrectomy, centrifuged, and the levels of cytokine and other mRNAs in the sediment were assessed using real-time PCR. The expression level of 11 cytokine genes, four transcription factor genes, two cytoskeletal genes, and genes encoding two extracellular matrix proteins in eyes with MH or iERM were determined and compared. Results The expression levels of interleukin 6 (IL6), tumor growth factor B2 (TGFB2), vascular endothelial growth factor A (VEGFA), chemokine C-X-C motif ligand 1 (CXCL1), v-rel avian reticuloendotheliosis viral oncogene homolog A (RELA), glial fibrillary acidic protein (GFAP), and tenascin C (TNC) were significantly higher in eyes with iERM than in eyes with MH. The expression of these genes was not associated with the preoperative visual acuity of the investigated patients. Conclusions The obtained results indicate that real-time PCR analysis of irrigation solution samples collected during vitrectomy can help assess the expression levels of several genes, and that iERM is associated with the expression of pro-inflammatory genes and the genes expressed during angiogenesis and wound healing process (IL6, TGFB2, VEGFA, CXCL1, RELA, GFAP, and TNC).
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Affiliation(s)
- Sayaka Myojin
- Department of Ophthalmology, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Takeru Yoshimura
- Department of Ophthalmology, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
- * E-mail:
| | - Shigeo Yoshida
- Department of Ophthalmology, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Atsunobu Takeda
- Department of Ophthalmology, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Yusuke Murakami
- Department of Ophthalmology, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Yoichi Kawano
- Section of Ophthalmology, Department of Medicine, Fukuoka Dental College, 2-15-1 Tamura, Sawara-ku, Fukuoka 814-0193, Japan
| | - Yuji Oshima
- Department of Ophthalmology, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Tatsuro Ishibashi
- Department of Ophthalmology, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Koh-Hei Sonoda
- Department of Ophthalmology, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
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Tuuminen R, Loukovaara S. Statin medication in patients with epiretinal membrane is associated with low intravitreal EPO, TGF-beta-1, and VEGF levels. Clin Ophthalmol 2016; 10:921-8. [PMID: 27284236 PMCID: PMC4883812 DOI: 10.2147/opth.s105686] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background In eyes with idiopathic epiretinal membrane (iERM), the intravitreal growth factor and cytokine levels may associate with postvitrectomy outcomes. Here, we have analyzed the perioperative intravitreal protein levels of potent vasoactive, proinflammatory, and extracellular matrix-remodeling factors in iERM eyes and evaluated the postvitrectomy outcomes. Methods This was an institutional, observational study. Eyes operated on for iERM (n=26) were analyzed according to the use of statin medication. Vitreous samples were subjected to protein measurements of angiopoietin-1 and -2, erythropoietin, transforming growth factor-β1, and vascular endothelial growth factor by enzyme-linked immunosorbent assay, and of matrix metalloproteinase-2 and -9 by gelatin zymography. One-month visual outcomes and 1-year revitrectomy rates were recorded. Results In iERM eyes of patients taking statins, intravitreal levels of erythropoietin (mean ± standard deviation, 10.8±4.9 vs 82.9±119.5 mIU/mg, P=0.003), transforming growth factor-β1 (2.3±4.7 vs 15.8±16.3 pg/mg, P=0.035), and vascular endothelial growth factor (5.5±9.9 vs 236.6±491.6 pg/mg, P=0.006) were lower than in nonstatin-treated patients. At 1-month, visual gain did not significantly differ between iERM eyes of patients with statins and those without (improvement 0.27±0.20 vs 0.16±0.38 logarithm of the minimum angle of resolution units, P=0.118). Conclusion Systemic statin therapy might have a favorable effect on intravitreal factors involved in vascular permeability, inflammation, and fibroproliferation in aging human iERM eyes.
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Affiliation(s)
- Raimo Tuuminen
- Department of Ophthalmology, Kymenlaakso Central Hospital, Kotka, Finland
| | - Sirpa Loukovaara
- Unit of Vitreoretinal Surgery, Department of Ophthalmology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
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Campagnoli TR, Smiddy WE. Idiopathic epiretinal membrane management and prognosis: a review. EXPERT REVIEW OF OPHTHALMOLOGY 2015. [DOI: 10.1586/17469899.2015.1094378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Romano MR, Comune C, Ferrara M, Cennamo G, De Cillà S, Toto L, Cennamo G. Retinal Changes Induced by Epiretinal Tangential Forces. J Ophthalmol 2015; 2015:372564. [PMID: 26421183 PMCID: PMC4573429 DOI: 10.1155/2015/372564] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 06/11/2015] [Accepted: 06/22/2015] [Indexed: 12/05/2022] Open
Abstract
Two kinds of forces are active in vitreoretinal traction diseases: tangential and anterior-posterior forces. However, tangential forces are less characterized and classified in literature compared to the anterior-posterior ones. Tangential epiretinal forces are mainly due to anomalous posterior vitreous detachment (PVD), vitreoschisis, vitreopapillary adhesion (VPA), and epiretinal membranes (ERMs). Anomalous PVD plays a key role in the formation of the tangential vectorial forces on the retinal surface as consequence of gel liquefaction (synchysis) without sufficient and fast vitreous dehiscence at the vitreoretinal interface. The anomalous and persistent adherence of the posterior hyaloid to the retina can lead to vitreomacular/vitreopapillary adhesion or to a formation of avascular fibrocellular tissue (ERM) resulting from the proliferation and transdifferentiation of hyalocytes resident in the cortical vitreous remnants after vitreoschisis. The right interpretation of the forces involved in the epiretinal tangential tractions helps in a better definition of diagnosis, progression, prognosis, and surgical outcomes of vitreomacular interfaces.
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Affiliation(s)
- Mario R. Romano
- Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, University Federico II, Napoli, Italy
| | - Chiara Comune
- Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, University Federico II, Napoli, Italy
| | - Mariantonia Ferrara
- Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, University Federico II, Napoli, Italy
| | - Gilda Cennamo
- Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, University Federico II, Napoli, Italy
| | - Stefano De Cillà
- Azienda Ospedaliero-Universitaria “Maggiore della Carità” di Novara, 28100 Novara, Italy
| | - Lisa Toto
- Ophthalmology Clinic, University G. d'Annunzio of Chieti-Pescara, 66100 Chieti, Italy
| | - Giovanni Cennamo
- Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, University Federico II, Napoli, Italy
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Abstract
BACKGROUND Idiopathic epiretinal membrane (iERM) is a fibrocellular membrane that proliferates on the inner surface of the retina at the macular area. Membrane contraction is an important sight-threatening event and is due to fibrotic remodeling. METHODS Analysis of the current literature regarding the epidemiology, clinical features, and pathogenesis of iERM and fibrotic tissue contraction. RESULTS Epidemiologic studies report a relationship between iERM prevalence, increasing age, and posterior vitreous detachment. Clinically, iERM progresses through different stages characterized by an increased thickness and wrinkling of the membrane. Pathophysiologically, iERM formation is a fibrotic process in which myofibroblast formation and the deposition of newly formed collagens play key roles. Anomalous posterior vitreous detachment may be a key event initiating the formation of iERM. The age-related accumulation of advanced glycation end products may contribute to anomalous posterior vitreous detachment formation and may also influence the mechanical properties of the iERM. CONCLUSION Remodeling of the extracellular matrix at the vitreoretinal interface by aging and fibrotic changes, plays a significant role in the pathogenesis of iERM. A better understanding of molecular mechanisms underlying this process may eventually lead to the development of effective and nonsurgical approaches to treat and prevent vitreoretinal fibrotic diseases.
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Inflammatory mechanisms of idiopathic epiretinal membrane formation. Mediators Inflamm 2013; 2013:192582. [PMID: 24324293 PMCID: PMC3844245 DOI: 10.1155/2013/192582] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Accepted: 10/11/2013] [Indexed: 02/01/2023] Open
Abstract
The pathogenesis of idiopathic epiretinal membranes (iERMs), a common pathology found in retina clinics, still eludes researchers to date. Ultrastructural studies of iERMs in the past have failed to identify the cells of origin due to the striking morphologic changes of cells involved via transdifferentiation. Thus, immunohistochemical techniques that stain for the cytostructural components of cells have confirmed the importance of glial cells and hyalocytes in iERM formation. The cellular constituents of iERMs are thought to consist of glial cells, fibroblasts, hyalocytes, etc. that, in concert with cytokines and growth factors present in the vitreous, lead to iERM formation. Recently, research has focused on the role of the posterior hyaloid in iERM formation and contraction, particularly the process of anomalous PVD as it relates to iERM formation. Recent advances in proteomics techniques have also elucidated the growth factors and cytokines involved in iERM formation, most notably nerve growth factor, glial cell line-derived growth factor, and transforming growth factor β1.
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Quantitative proteomics of aqueous and vitreous fluid from patients with idiopathic epiretinal membranes. Exp Eye Res 2013. [DOI: 10.1016/j.exer.2012.11.010] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Improvement of horizontal macular contraction after surgical removal of epiretinal membranes. Eye (Lond) 2011; 25:754-61. [PMID: 21455247 DOI: 10.1038/eye.2011.48] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
PURPOSE To determine whether horizontal macular contraction caused by epiretinal membranes (ERMs) improves after surgical removal. METHODS In this prospective, single-center, observational study, 63 consecutive patients with unilateral idiopathic ERM in one eye and no retinal disease in the fellow eye underwent pars plana vitrectomy. Fundus photography and optical coherence tomography (OCT) were performed preoperatively and at 3 months postoperatively. The area enclosed by superior and inferior major vessels from the optic disc to the fovea (area under major vessel (AUV)) and the macroscopic diverging angle (MDA) between superior and inferior major vessels were calculated using digital image analysis of fundus photographs and compared pre- and postoperatively. RESULTS AUV was significantly smaller in the eyes with ERM compared with the normal fellow eyes (P<0.001). Significant postoperative change in AUV and MDA was demonstrated after ERM removal (P<0.001). However, postoperative AUV of grade 2 and 3 ERM eyes was still significantly smaller than that of normal fellow eyes. Macular thickness differences measured with stratus OCT were positively correlated with AUV differences. CONCLUSIONS Retinal topographic changes caused by ERM improved in part after ERM removal. The improvement of topographic changes were correlated with tomographic changes detected with OCT.
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George B, Chen S, Chaudhary V, Gonder J, Chakrabarti S. Extracellular Matrix Proteins in Epiretinal Membranes and in Diabetic Retinopathy. Curr Eye Res 2009; 34:134-44. [DOI: 10.1080/02713680802585946] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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