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Krilis M, Fry L, Ngo P, Goldberg I. The gut microbiome and primary open angle glaucoma: Evidence for a 'gut-glaucoma' axis? Eur J Ophthalmol 2024; 34:924-930. [PMID: 38086752 DOI: 10.1177/11206721231219147] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2024]
Abstract
Glaucoma presents an epidemiological burden as the leading cause of irreversible blindness globally and the most common cause of preventable blindness. While elevated intraocular pressure is the strongest modifiable risk factor, the exact mechanisms of retinal ganglion cell damage leading to progressive vision loss are not entirely understood. Studies of other neurodegenerative diseases show a potential for human gut microbiome dysbiosis to play a pathogenic role. An investigation into whether the microbiome, a potential modifiable risk factor, has significance in glaucoma enables exploration of prophylactic or additive treatments. Elevated population levels of specific bacterial species have been noted in glaucoma patients, particularly Prevotellaceae, Enterobacteriaceae and Escherichia coli, while Megomonas is speculated to be protective. Evidence also points to systemic neuro-inflammation and disruption of autoimmune processes as a result of imbalances in both human and animal models, where heat shock proteins may contribute to pathogenesis. Further research into the influence of gut microbiome on pathogenesis offers a chance to minimise irreversible vision loss in glaucoma.
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Affiliation(s)
- Matthew Krilis
- Oxford Eye Hospital, Oxford, UK
- Save Sight Institute, Sydney, Australia
| | - Lewis Fry
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Patrick Ngo
- School of Medicine, University of Sydney, Camperdown, Australia
| | - Ivan Goldberg
- Discipline of Ophthalmology, University of Sydney, Sydney, Australia
- Glaucoma Unit, Sydney Eye Hospital, Sydney, Australia
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2
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He C, Peng K, Zhu X, Wang Z, Xiu W, Zhang G, Chen Y, Sun C, Xiao X, Liu D, Li A, Gao Y, Wang J, Shuai P, Chen Y, Yu L, Lu F. Th1 cells contribute to retinal ganglion cell loss in glaucoma in a VCAM-1-dependent manner. J Neuroinflammation 2024; 21:43. [PMID: 38317227 PMCID: PMC10840227 DOI: 10.1186/s12974-024-03035-5] [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: 09/14/2023] [Accepted: 01/31/2024] [Indexed: 02/07/2024] Open
Abstract
Glaucoma is a complex neurodegenerative disorder characterized by the progressive loss of retinal ganglion cells (RGC) and optic nerve axons, leading to irreversible visual impairment. Despite its clinical significance, the underlying mechanisms of glaucoma pathogenesis remain poorly understood. In this study, we aimed to unravel the multifaceted nature of glaucoma by investigating the interaction between T cells and retinas. By utilizing clinical samples, murine glaucoma models, and T cell transfer models, we made several key findings. Firstly, we observed that CD4+ T cells from glaucoma patients displayed enhanced activation and a bias towards T helper (Th) 1 responses, which correlated with visual impairment. Secondly, we identified the infiltration of Th1 cells into the retina, where they targeted RGC and integrated into the pro-inflammatory glial network, contributing to progressive RGC loss. Thirdly, we discovered that circulating Th1 cells upregulated vascular cell adhesion protein 1 (VCAM-1) on retinal microvessels, facilitating their entry into the neural retina. Lastly, we found that Th1 cells underwent functional reprogramming before reaching the retina, acquiring a phenotype associated with lymphocyte migration and neurodegenerative diseases. Our study provides novel insights into the role of peripheral CD4+ T cells in glaucoma pathogenesis, shedding light on the mechanisms underlying their infiltration into the retina and offering potential avenues for innovative therapeutic interventions in this sight-threatening disease.
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Affiliation(s)
- Chong He
- Clinical Immunology Translational Medicine Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Kun Peng
- Health Management Center, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Xiong Zhu
- Clinical Immunology Translational Medicine Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Department of Prenatal Diagnosis, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Zuo Wang
- Clinical Immunology Translational Medicine Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Department of Clinical Laboratory, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Wenbo Xiu
- Clinical Immunology Translational Medicine Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Gao Zhang
- Clinical Immunology Translational Medicine Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Yang Chen
- Clinical Immunology Translational Medicine Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Chaonan Sun
- Clinical Immunology Translational Medicine Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Xiao Xiao
- Clinical Immunology Translational Medicine Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Donghua Liu
- Health Management Center, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - An Li
- Clinical Immunology Translational Medicine Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Yanping Gao
- Clinical Immunology Translational Medicine Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Jinxia Wang
- Clinical Immunology Translational Medicine Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Ping Shuai
- Health Management Center, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Yilian Chen
- Department of Ophthalmology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Ling Yu
- Department of Ophthalmology, Daping Hospital, Army Medical Center, Army Medical University, Chongqing, China
| | - Fang Lu
- Clinical Immunology Translational Medicine Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
- Yangtze Delta Region Institute (Quzhou), University of Electronic Science and Technology of China, Quzhou, China.
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Yang Y, Wang N, Xu L, Liu Y, Huang L, Gu M, Wu Y, Guo W, Sun H. Aryl hydrocarbon receptor dependent anti-inflammation and neuroprotective effects of tryptophan metabolites on retinal ischemia/reperfusion injury. Cell Death Dis 2023; 14:92. [PMID: 36754954 PMCID: PMC9908897 DOI: 10.1038/s41419-023-05616-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 01/20/2023] [Accepted: 01/23/2023] [Indexed: 02/10/2023]
Abstract
Glaucoma is the major cause of irreversible blindness in the world characterized by progressive retinal neurodegeneration, in which local inflammation in retina is involved in persistent loss of retinal ganglion cells (RGCs). In order to explore whether aryl hydrocarbon receptor (AhR) and its agonists tryptophan metabolites are involved in the development of glaucoma, we collected serum and retinas from non-glaucoma controls and patients with glaucoma. Results showed altered serum tryptophan metabolism and reduced retinal AhR expression in glaucoma patients. We also showed intraperitoneally injection of tryptophan metabolite 2-(1'H-indole-3'-carbonyl)-thiazole-4-carboxylic acid methyl ester (ITE) down-regulated retinal local inflammation and protected RGC apoptosis from retinal ischemia/reperfusion (IR) injury via AhR activation. We further revealed that ITE could inhibit inflammation in BV2 microglia and alleviate the neurotoxicity of microglial conditioned medium to RGCs under IR. Finally, we illustrated the possible mechanism that ITE limited ERK and NFκB dependent microglial inflammation. In summary, these findings suggest the critical role of tryptophan metabolism and retinal AhR signaling in modulating local inflammation mediated by microglia in glaucoma, and provide a novel avenue to targeting the intrinsically altered AhR signaling resulted from disturbed tryptophan metabolism for glaucoma treatment.
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Affiliation(s)
- Yijie Yang
- Department of Ophthalmology, Shanghai 9th People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Ning Wang
- Department of Ophthalmology, Shanghai 9th People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Li Xu
- Department of Ophthalmology, Shanghai 9th People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Yixin Liu
- Department of Ophthalmology, Shanghai 9th People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Lulu Huang
- Department of Ophthalmology, Shanghai 9th People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Mengyang Gu
- Department of Ophthalmology, Shanghai 9th People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Yue Wu
- Department of Ophthalmology, Shanghai 9th People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Wenyi Guo
- Department of Ophthalmology, Shanghai 9th People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China.
| | - Hao Sun
- Department of Ophthalmology, Shanghai 9th People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China.
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Lee J, Lim S, Shin JH, Lee Y, Seo JH. Differences in the eyelid and buccal microbiome between open-angle glaucoma and uveitic glaucoma. Acta Ophthalmol 2022; 100:e770-e778. [PMID: 34233092 DOI: 10.1111/aos.14967] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 06/17/2021] [Indexed: 12/21/2022]
Abstract
PURPOSE Microbiomes have immunoregulatory functions and may be involved in the pathophysiology of eye diseases. However, the effects of microbiomes on uveitic glaucoma (UG) and open-angle glaucoma (OAG) have not been sufficiently investigated. This study analysed differences in eyelid and buccal microbiomes between UG and OAG using metagenomic technology. METHODS Eyelid and buccal specimens were collected from 34 UG and 62 OAG patients. The taxonomic composition of the microbiome was determined via 16S rRNA gene sequencing, operational taxonomic unit analysis and diversity analysis. Differential gene expression analysis (DEG) and principal component analyses (PCoA) determined taxon differences between the microbiomes of the UG and OAG patients. Subgroup analysis according to age and baseline IOP was performed. RESULTS There was no significant difference in alpha-diversity between the microbiomes of UG and OAG patients. Further, PCoA revealed no differences in eyelid microbiome between the UG and OAG groups, but significant differences were found in buccal microbiome between the groups, especially in a subgroup of OAG patients with normal IOP. DEG analysis of the eyelid microbiome revealed various taxa differences, including the enrichment of Rhodococcus in UG samples over OAG samples. Taxa such as Lactobacillus and Proteus were significantly depleted (q-value = 9.98e-6 and q-value = 1.38 × 10-4 , respectively) in the buccal microbiome of UG patients, whereas Enterococcus was enriched (q-value = 5.26e-5 ). CONCLUSIONS This study showed that the buccal microbiome in UG differs from that in OAG; reduced Lactobacillus was observed in UG. These results suggest that apart than OAG, microbiome composition may be a factor in the pathogenesis of UG.
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Affiliation(s)
- Ji‐Woong Lee
- Department of Ophthalmology Pusan National University Hospital Busan Korea
| | - Su‐Ho Lim
- Department of Ophthalmology Daegu Veterans Health Service Medical Center Daegu Korea
| | - Jong Hoon Shin
- Department of Ophthalmology Pusan National University Yangsan Hospital Yangsan Korea
| | - Young Lee
- Veterans Medical Research Institute Veterans Health Service Medical Center Seoul Korea
| | - Je Hyun Seo
- Veterans Medical Research Institute Veterans Health Service Medical Center Seoul Korea
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Kim SH, Jeong SH, Kim H, Park EC, Jang SY. Development of Open-Angle Glaucoma in Adults With Seropositive Rheumatoid Arthritis in Korea. JAMA Netw Open 2022; 5:e223345. [PMID: 35311960 PMCID: PMC8938713 DOI: 10.1001/jamanetworkopen.2022.3345] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
IMPORTANCE Although evidence is emerging that autoimmunity may be associated with neurodegeneration in glaucoma (beyond intraocular pressure-mediated damage), there is limited evidence connecting rheumatoid arthritis (RA), the most common autoimmune disease, with the risk of developing primary open-angle glaucoma (POAG). OBJECTIVE To investigate whether RA is associated with increased risk of POAG among Korean older adults. DESIGN, SETTING, AND PARTICIPANTS A nationwide propensity-matched cohort study was conducted using data from the Korean National Health Insurance Service-Senior cohort from 2002 to 2013. Data analysis was performed from November 2020 to July 2021. EXPOSURES New onset RA. MAIN OUTCOMES AND MEASURES The main outcome was development of POAG. The Kaplan-Meier method was used to calculate the cumulative incidence of POAG, and the incidence rate of POAG was estimated using a Poisson regression. A Cox proportional hazards regression model was used to investigate associations between RA and risk of POAG. RESULTS Among 10 245 participants, 7490 (73.1%) were women, and the mean (SD) age was 67.70 (4.84) years. A total of 2049 patients with incident seropositive RA and 8196 time-dependent, propensity score-matched, risk-set controls were included. POAG developed in 86 of 2049 patients with RA and 254 of 8196 matched controls. The cumulative incidence of POAG was higher in the RA cohort than in the matched controls. In the RA cohort, the incidence rate of POAG was 981.8 cases per 100 000 person years (95% CI, 794.3-1213.7 cases per 100 000 person years), whereas in the matched controls, the incidence rate was 679.5 cases per 100 000 person years (95% CI, 600.8-768.3 cases per 100 000 person years). Patients with RA were more likely to develop POAG than the matched controls (hazard ratio [HR], 1.44; 95% CI, 1.13-1.84). Increased POAG risk in the RA cohort was predominantly observed 2 years into the follow-up period (HR, 1.83; 95% CI, 1.28-2.61) and in those aged 75 years or older (HR, 2.12; 95% CI, 1.34-3.35). CONCLUSIONS AND RELEVANCE These findings suggest that RA is associated with a higher risk of developing POAG, especially within 2 years after diagnosis or among patients aged 75 years or older. There may be a common pathophysiological pathway between RA and POAG that is possibly immune mediated, and the nature of this association warrants further investigation.
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Affiliation(s)
- Seung Hoon Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- Department of Public Health, Yonsei University Graduate School, Seoul, Republic of Korea
| | - Sung Hoon Jeong
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Hyunkyu Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eun-Cheol Park
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Suk-Yong Jang
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- Department of Healthcare Management, Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea
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6
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Xu J, Li R, Xu H, Yang Y, Zhang S, Ren T. Recent progress of continuous intraocular pressure monitoring. NANO SELECT 2021. [DOI: 10.1002/nano.202100137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Jiandong Xu
- Institute of Microelectronics Tsinghua University Beijing 100084 China
- Beijing National Research Center for Information Science and Technology (BNRist) Tsinghua University Beijing 100084 China
| | - Ruisong Li
- Department of Electrical Engineering and Computer Science and Department of Bioengineering College of Engineering University of California Berkeley California 94720 USA
| | - Haokai Xu
- Institute of Microelectronics Tsinghua University Beijing 100084 China
- Beijing National Research Center for Information Science and Technology (BNRist) Tsinghua University Beijing 100084 China
| | - Yi Yang
- Institute of Microelectronics Tsinghua University Beijing 100084 China
- Beijing National Research Center for Information Science and Technology (BNRist) Tsinghua University Beijing 100084 China
| | - Sheng Zhang
- Shenzhen International Graduate School Tsinghua University Shenzhen 518055 China
| | - Tian‐Ling Ren
- Institute of Microelectronics Tsinghua University Beijing 100084 China
- Beijing National Research Center for Information Science and Technology (BNRist) Tsinghua University Beijing 100084 China
- Center for Flexible Electronics Technology Tsinghua University Beijing 100084 China
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Abstract
Glaucoma is characterized by retinal ganglion cell (RGC) neurodegeneration. Elevated intraocular pressure (IOP) is a major risk factor however, mechanisms independent of IOP play a role in RGC pathology. Both antibodies and CD4 T-cells as well as microbiota take part in the pathogenesis of both glaucoma and rheumatoid arteritis (RA).Heat shock proteins (HSPs) which originate in bacteria cross-react with RCG epitopes and were involved in rat model of retinal injury. Enhanced expression of HSPs in the retina was associated with glaucoma-like neuropathology and previous studies have also suggested a pathogenic role for HSPs in RA. In view of these data we suggest that glaucoma should be included in the spectrum of autoimmune diseases and that proven medications for RA should be adopted as an innovative IOP -independent therapeutic strategy for glaucoma.
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Wang H, Song X, Li M, Wang X, Tao Y, Xiya X, Liu H, Zhao Y, Chang D, Sha Q. The role of TLR4/NF-κB signaling pathway in activated microglia of rats with chronic high intraocular pressure and vitro scratch injury-induced microglia. Int Immunopharmacol 2020; 83:106395. [PMID: 32199351 DOI: 10.1016/j.intimp.2020.106395] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 02/12/2020] [Accepted: 03/09/2020] [Indexed: 12/15/2022]
Abstract
Glaucoma is a kind of blind-causing disease with structural damages of optic nerve and defection of visual field. It is believed that the death of retinal ganglion cell (RGC) is a consequential event of over-reactive immune orchestral cells such as microglia. Previous evidences in animal and clinical studies show the innate immunity plays a pivotal role in neuro-inflammation of glaucoma. Toll-like receptor 4 (TLR4) is expressed on microglia and mediates many neuroinflammatory diseases. We aimed to explore the impacts of high intraocular pressure (IOP) on rat microglia in retina and the regulation of TLR4/NF-κB signaling pathway in scratched microglia cells. In our study, we successfully established chronic high IOP rat model by episcleral vein cauterization (EVC) which behaved like the chronic glaucoma. Besides, we set up an in vitro scratch-induced injury model in rat microglia cells. We found the level of activated microglia cells were significantly increased in the retina of chronic high IOP groups. Moreover, the inhibition of TLR4/NF-κB signaling pathway suppressed the expression of TLR4 protein and mRNA levels of P50, IL-6 and TNF-α. Our original study provided a theoretical basis on targeting TLR4/NF-κB to suppress pro-inflammatory factors releasing in activated microglia and it might be a good treatment target to prevent glaucoma from progressing.
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Affiliation(s)
- Hongjun Wang
- Department of Medical, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China
| | - Xiangyuan Song
- Department of Ophthalmology, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China
| | - Mingzhe Li
- Department of Ophthalmology, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China
| | - Xuefei Wang
- Department of Ophthalmology, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China
| | - Yi Tao
- Department of Ophthalmology, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China
| | - Xiamu Xiya
- Department of Ophthalmology, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China
| | - Hui Liu
- Department of Ophthalmology, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China
| | - Yini Zhao
- Department of Ophthalmology, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China
| | - Dong Chang
- Department of Clinical Laboratory, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China
| | - Qian Sha
- Department of Ophthalmology, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China.
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Zhang JL, Song XY, Chen YY, Nguyen THA, Zhang JY, Bao SS, Zhang YY. Novel inflammatory cytokines (IL-36, 37, 38) in the aqueous humor from patients with chronic primary angle closure glaucoma. Int Immunopharmacol 2019; 71:164-168. [DOI: 10.1016/j.intimp.2019.03.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 02/26/2019] [Accepted: 03/06/2019] [Indexed: 12/21/2022]
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Commensal microflora-induced T cell responses mediate progressive neurodegeneration in glaucoma. Nat Commun 2018; 9:3209. [PMID: 30097565 PMCID: PMC6086830 DOI: 10.1038/s41467-018-05681-9] [Citation(s) in RCA: 174] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 07/18/2018] [Indexed: 01/18/2023] Open
Abstract
Glaucoma is the most prevalent neurodegenerative disease and a leading cause of blindness worldwide. The mechanisms causing glaucomatous neurodegeneration are not fully understood. Here we show, using mice deficient in T and/or B cells and adoptive cell transfer, that transient elevation of intraocular pressure (IOP) is sufficient to induce T-cell infiltration into the retina. This T-cell infiltration leads to a prolonged phase of retinal ganglion cell degeneration that persists after IOP returns to a normal level. Heat shock proteins (HSP) are identified as target antigens of T-cell responses in glaucomatous mice and human glaucoma patients. Furthermore, retina-infiltrating T cells cross-react with human and bacterial HSPs; mice raised in the absence of commensal microflora do not develop glaucomatous T-cell responses or the associated neurodegeneration. These results provide compelling evidence that glaucomatous neurodegeneration is mediated in part by T cells that are pre-sensitized by exposure to commensal microflora.
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Mariacher S, Ebner M, Hurst J, Szurman P, Januschowski K. Implantation and testing of a novel episcleral pressure transducer: A new approach to telemetric intraocular pressure monitoring. Exp Eye Res 2017; 166:84-90. [PMID: 29066280 DOI: 10.1016/j.exer.2017.10.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 09/08/2017] [Accepted: 10/18/2017] [Indexed: 11/29/2022]
Abstract
Measurement of intraocular pressure (IOP) is an essential tool in monitoring glaucoma. Single IOP assessments during clinical routine examinations represent punctual values and are not able to identify IOP fluctuations and spikes. Telemetric IOP measurements are able to monitor IOP during the day and night, and are location-independent. Six telemetric episcleral IOP sensors were investigated after minimally invasive subconjunctival implantation in 6 eyes of 6 New-Zealand-White rabbits. Three of the 4 edges of the implant were fixated intrasclerally with non-absorbable sutures. The sutures were stitched into the edges of the implants' silicone rubber encasements. Telemetric IOP measurements were validated 1 week, 4 weeks, 8 weeks, 12 weeks and 30 weeks after implantation. For each validation the anterior chamber was cannulated and connected to a height-adjustable water column. Different intracameral pressure levels (10-45 mmHg) were generated by height adjustment of the water column. Measurement reliability and concordance between telemetric and intracameral IOP was validated using Bland-Altman analysis. Overall comparison (10-45 mmHg) between telemetric and intracameral pressure revealed a standard deviation of ±1.0 mmHg. A comparison of pressure values in the range between 10 and 30 mmHg revealed a standard deviation of ±0.8 mmHg. Device deficiency was related to follow-up length: 4 weeks after implantation, 3 of the 6 sensors showed malfunction, with all sensors having failed 30 weeks after implantation. The most likely reason for the sensor malfunction is the loss of hermeticity as a result of penetration of the encasement during the episcleral fixation, resulting from the lack of preformed suture holes at the implants encasement. However, no clinical signs of injury or inflammation of the conjunctiva, sclera, implantation site or any other involved structures were observed, except for an expected mild short-term irritation postoperatively. The episcleral pressure transducer for telemetric IOP monitoring is able to assess IOP without the need for invasive intraocular surgery. Episcleral implantation is an easy and safe procedure and can be undone very easily, so even temporary implantation and IOP measurements could be possible in the future. Sensor malfunction over time is a problem that needs to be addressed. Improvements in sensor encapsulation and especially preformed suture holes could significantly decrease the failure rate and increase durability.
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Affiliation(s)
- Siegfried Mariacher
- Knappschaft Eye Clinic Sulzbach, Knappschaft Hospital Saar, An der Klinik 10, 66280 Sulzbach, Germany.
| | - Martina Ebner
- Knappschaft Eye Clinic Sulzbach, Knappschaft Hospital Saar, An der Klinik 10, 66280 Sulzbach, Germany
| | - José Hurst
- Centre for Ophthalmology, University Eye Hospital Tuebingen, Schleichstr. 12, 72076 Tuebingen, Germany
| | - Peter Szurman
- Knappschaft Eye Clinic Sulzbach, Knappschaft Hospital Saar, An der Klinik 10, 66280 Sulzbach, Germany; Centre for Ophthalmology, University Eye Hospital Tuebingen, Schleichstr. 12, 72076 Tuebingen, Germany
| | - Kai Januschowski
- Knappschaft Eye Clinic Sulzbach, Knappschaft Hospital Saar, An der Klinik 10, 66280 Sulzbach, Germany; Centre for Ophthalmology, University Eye Hospital Tuebingen, Schleichstr. 12, 72076 Tuebingen, Germany
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12
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Lee JA, Han K, Min JA, Choi JA. Associations of sleep duration with open angle glaucoma in the Korea national health and nutrition examination survey. Medicine (Baltimore) 2016; 95:e5704. [PMID: 28033268 PMCID: PMC5207564 DOI: 10.1097/md.0000000000005704] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 11/27/2016] [Accepted: 11/30/2016] [Indexed: 11/29/2022] Open
Abstract
The aim of this study is to investigate the relationship between sleep duration and glaucoma, stratified by obesity status.This study was conducted using data from the Korean National Health and Nutrition Examination Survey V 2010 to 2012. Open-angle glaucoma was diagnosed according to the International Society of Geographical and Epidemiological Ophthalmology criteria. Subjects were divided into subgroups based on those who were overweight (body mass index ≥25 kg/m or <25 kg/m) or with abdominal obesity (based on waist circumference). Multiple logistic regression analysis was done to estimate the magnitude of the association between sleep duration (<7 h, 7-<9, or ≥9 hours) and prevalence of glaucoma in the total population and in the subgroups.Individuals who slept <5 hours per night had the highest prevalence of glaucoma (5.55 ± 1.09%), followed by those who slept ≥9 hours per night (4.56 ± 0.10%), and then by those who slept 5 to <6 hours per night (4.15 ± 0.68%), which revealed a U-shaped pattern (P for trend = 0.072). Among overweight individuals, subjects who slept <7 hours and those who slept ≥9 hours were significantly more likely to have glaucoma compared with subjects who slept 7 to <9 hours after adjusting for survey year, age, sex, smoking, drinking, exercise, education level, household income, hypertension, intraocular pressure, stress, and depression (odds ratio, 2.41; 95% confidence interval, 1.14-5.03). Unlike for overweight individuals, sleep duration in nonoverweight individuals was not statistically significantly associated with glaucoma.Our results reveal a U-shaped association between sleep duration and the prevalence of glaucoma. An effect of sleep duration on glaucoma was present in the subgroup of overweight patients.
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Affiliation(s)
- Jin-Ah Lee
- Department of Ophthalmology, St. Vincent's Hospital
| | | | - Jung Ah Min
- Department of Psychiatry, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Kyunggi-do, Korea
| | - Jin A Choi
- Department of Ophthalmology, St. Vincent's Hospital
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Wu N, Wang Y, Yang L, Cho KS. Signaling Networks of Retinal Ganglion Cell Formation and the Potential Application of Stem Cell–Based Therapy in Retinal Degenerative Diseases. Hum Gene Ther 2016; 27:609-20. [PMID: 27466076 DOI: 10.1089/hum.2016.083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Affiliation(s)
- Nan Wu
- 1 Department of Ophthalmology, Southwest Eye Hospital, Southwest Hospital, Third Military Medical University , Chongqing, China
| | - Yi Wang
- 1 Department of Ophthalmology, Southwest Eye Hospital, Southwest Hospital, Third Military Medical University , Chongqing, China
| | - Lanbo Yang
- 2 Schepens Eye Research Institute, Massachusetts Eye and Ear Infirmary, Harvard Medical School , Boston, Massachusetts
| | - Kin-Sang Cho
- 2 Schepens Eye Research Institute, Massachusetts Eye and Ear Infirmary, Harvard Medical School , Boston, Massachusetts
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14
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Johnson TV, Bull ND, Martin KR. Stem cell therapy for glaucoma: possibilities and practicalities. EXPERT REVIEW OF OPHTHALMOLOGY 2014; 6:165-174. [PMID: 21686079 DOI: 10.1586/eop.11.3] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Glaucoma is a progressive, neurodegenerative, optic neuropathy in which currently available therapies cannot always prevent, and do not reverse, vision loss. Stem cell transplantation may provide a promising new avenue for treating many presently incurable degenerative conditions, including glaucoma. This article will explore the various ways in which transplantation of stem or progenitor cells may be applied for the treatment of glaucoma. We will critically discuss the translational prospects of two cell transplantation-based treatment modalities: neuroprotection and retinal ganglion cell replacement. In addition, we will identify specific questions that need to be addressed and obstacles to overcome on the path to clinical translation, and offer insight into potential strategies for approaching this goal.
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Affiliation(s)
- Thomas V Johnson
- Cambridge Centre for Brain Repair, University of Cambridge ED Adrian Building Forvie Site, Robinson Way, Cambridge, CB2 OPY, UK
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Bagnis A, Papadia M, Scotto R, Traverso CE. Current and emerging medical therapies in the treatment of glaucoma. Expert Opin Emerg Drugs 2011; 16:293-307. [PMID: 21406029 DOI: 10.1517/14728214.2011.563733] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
INTRODUCTION Glaucoma is a disease of the eye in which the optic nerve and retinal ganglion cells (RGCs) are injured, leading to the loss of the peripheral visual field and eventually to profound vision loss and blindness. Glaucoma is usually characterized by an increase in intraocular pressure (IOP), which is treated with ocular hypotensive drugs. However, both RGC apoptosis and optic nerve atrophy, due to glaucoma, can occur independently of IOP. AREAS COVERED This review discusses several current and emerging treatments for glaucoma. Current research is updating the known properties of a number of drugs now used to treat glaucoma. Some drugs may offer neuroprotection, not only reducing vision loss, but restoring injured or compromised RGCs and optic nerve cells. Several molecules now under development aim to lower IOP primarily by enhancing aqueous drainage through conventional pathways of the trabecular meshwork and Schlemm's canal. Gene transfer models are being investigated, and a murine-derived neurotrophic growth factor (NGF) seems to offer the promise of actually restoring visual function in some patients. Drugs that are already widely used are being re-branded in preservative-free formulations. EXPERT OPINION The ultimate goal in glaucoma research is to find new compounds that will not only normalize IOP, but also arrest or even reverse apoptotic damage to the optic nerve and RGCs to slow the rate of progression of the disease so that it will not interfere with the patient's ability to see and his/her quality of life. This should be obtained with affordable costs, minimal side effects and a reasonable schedule.
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Affiliation(s)
- Alessandro Bagnis
- University of Genova, Eye Clinic, Department of Neurosciences, Ophthalmology and Genetics, Viale Benedetto XV, 5, 16148 Genova, Italy
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Agorastos A, Huber CG. The role of melatonin in glaucoma: implications concerning pathophysiological relevance and therapeutic potential. J Pineal Res 2011; 50:1-7. [PMID: 21073517 DOI: 10.1111/j.1600-079x.2010.00816.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Glaucoma is a frequent ophthalmologic condition leading to chronic progressive optic neuropathy, which can result in visual impairment and blindness. In addition, glaucoma is associated with a dysregulation of circadian rhythms, as well as with a high incidence of sleep disorders, depression, and anxiety. However, because of their high comorbidity in older age, these conditions have not received much scientific attention and are often undertreated. In the current paper, we review the available literature on the role of melatonergic mechanisms in glaucoma, regulation of circadian rhythms, and depression. The literature is presented as a narrative review, providing an overview on the most important and clinically relevant publications. Recently, there has been evidence for a progressive loss of intrinsically photosensitive retinal ganglion cells (ipRGC) because of oxidative stress in glaucoma. As ipRGC are responsible for the photic transduction to the circadian system and subsequent melatonin secretion, and melatonin is involved in the pathophysiology of circadian desynchronization, sleep disorder, and depression, an impairment of photo-dependent melatonergic signaling may be a common pathway connecting glaucoma with these comorbidities. This fact, as well as the proven retinal neuroprotective role of melatonin, suggests that melatonergic drugs provide a potentially promising treatment strategy supplementing the management of intraocular pressure by pharmacological and surgical measures. Additionally, multidisciplinary treatment focusing on depression and normalization of circadian rhythms might be beneficial for glaucoma patients. Furthermore, glaucoma might be a useful model for studying the pathophysiological interactions between the melatonergic, circadian, and mood systems.
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Affiliation(s)
- Agorastos Agorastos
- Department of Psychiatry and Psychotherapy, Centre for Psychosocial Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
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