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Mullany S, Marshall H, Zhou T, Thomson D, Schmidt JM, Qassim A, Knight LSW, Hollitt G, Berry EC, Nguyen T, To MS, Dimasi D, Kuot A, Dubowsky J, Fogarty R, Sun M, Chehade L, Kuruvilla S, Supramaniam D, Breen J, Sharma S, Landers J, Lake S, Mills RA, Hassall MM, Chan WO, Klebe S, Souzeau E, Siggs OM, Craig JE. RNA Sequencing of Lens Capsular Epithelium Implicates Novel Pathways in Pseudoexfoliation Syndrome. Invest Ophthalmol Vis Sci 2022; 63:26. [PMID: 35348588 PMCID: PMC8982629 DOI: 10.1167/iovs.63.3.26] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Purpose Pseudoexfoliation syndrome (PEX) is a common systemic disease that results in severe and often irreversible vision loss. Despite considerable research effort, PEX remains incompletely understood. This study sought to perform the first RNAseq study in elucidate the pathophysiology of PEX, and contribute a publicly available transcriptomic data resource for future research. Methods Human ocular lens capsular epithelium samples were collected from 25 patients with PEX and 39 non-PEX controls undergoing cataract surgery. RNA extracted from these specimens was subjected to polyadenylated (mRNA) selection and deep bulk RNA sequencing. Differential expression analysis investigated protein-coding gene transcripts. Exploratory analyses used pathway analysis tools, and curated class- and disease-specific gene sets. Results Differential expression analysis demonstrated that 2882 genes were differentially expressed according to PEX status. Genes associated with viral gene expression pathways were among the most upregulated, alongside genes encoding ribosomal and mitochondrial respiratory transport chain proteins. Cell adhesion protein transcripts including type 4 collagen subunits were downregulated. Conclusions This comparative transcriptomic dataset highlights novel and previously recognized pathogenic pathways in PEX and provides the first comprehensive transcriptomic resource, adding an additional layer to build further understanding of PEX pathophysiology.
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Affiliation(s)
- Sean Mullany
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - Henry Marshall
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - Tiger Zhou
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - Daniel Thomson
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - Joshua M Schmidt
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - Ayub Qassim
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - Lachlan S W Knight
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - Georgina Hollitt
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - Ella C Berry
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - Thi Nguyen
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - Minh-Son To
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - David Dimasi
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - Abraham Kuot
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - Joshua Dubowsky
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - Rhys Fogarty
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - Michelle Sun
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - Luke Chehade
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - Shilpa Kuruvilla
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - Devaraj Supramaniam
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - James Breen
- SAHMRI Bioinformatics Core, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Shiwani Sharma
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - John Landers
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - Stewart Lake
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - Richard A Mills
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - Mark M Hassall
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - Weng O Chan
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - Sonja Klebe
- Flinders Department of Pathology, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - Emmanuelle Souzeau
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - Owen M Siggs
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia.,Garvan Institute of Medical Research Institute, Darlinghurst, Sydney, Australia
| | - Jamie E Craig
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
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Todorova MG, Grieshaber MC, Cámara RJA, Miny P, Palmowski-Wolfe AM. Anterior segment dysgenesis associated with Williams-Beuren syndrome: a case report and review of the literature. BMC Ophthalmol 2014; 14:70. [PMID: 24885071 PMCID: PMC4031488 DOI: 10.1186/1471-2415-14-70] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Accepted: 05/12/2014] [Indexed: 11/10/2022] Open
Abstract
Background Williams-Beuren syndrome is characterized by mild mental retardation, specific neurocognitive profile, hypercalcemia during infancy, distinctive facial features and cardiovascular diseases. We report on complete ophthalmologic, sonographic and genetic evaluation of a girl with a clinical phenotype of Williams-Beuren syndrome, associated with unilateral anterior segment dysgenesis and bilateral cleft of the soft and hard palate. These phenotypic features have not been linked to the haploinsufficiency of genes involved in the microdeletion. Case presentation A term born girl presented at the initial examination with clouding of the right cornea. On ultrasound biomicroscopy the anterior chamber structures were difficult to differentiate, showing severe adhesions from the opacified cornea to the iris with a kerato-irido-lenticular contact to the remnant lens, a finding consistent with Peters' anomaly. Genetic analyses including FISH confirmed a loss of the critical region 7q11.23, usually associated with the typical Williams-Beuren syndrome. Microsatellite analysis showed a loss of about 2.36 Mb. Conclusions A diagnosis of Williams-Beuren syndrome was made based on the microdeletion of 7q11.23. The unique features, including unilateral microphthalmia and anterior segment dysgenesis, were unlikely to be caused by the microdeletion. Arguments in favor of the latter are unilateral manifestation, as well as the fact that numerous patients with deletions of comparable or microscopically visible size have not shown similar manifestations.
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Affiliation(s)
- Margarita G Todorova
- Department of Ophthalmology, University of Basel, Mittlere Strasse 91, Basel CH-4031, Switzerland.
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Abstract
Exfoliation syndrome (XFS) is an age-related disease in which abnormal fibrillar extracellular material is produced and accumulates in many ocular tissues. Its ocular manifestations involve all of the structures of the anterior segment, as well as conjunctiva and orbital structures. Glaucoma occurs more commonly in eyes with XFS than in those without it; in fact, XFS has recently been recognized as the most common identifiable cause of glaucoma. Patients with XFS are also predisposed to develop angle-closure glaucoma, and glaucoma in XFS has a more serious clinical course and worse prognosis than primary open-angle glaucoma. There is increasing evidence for an etiological association of XFS with cataract formation, and possibly with retinal vein occlusion. XFS is now suspected to be a systemic disorder and has been associated preliminarily with transient ischemic attacks, stroke, systemic hypertension, and myocardial infarction. Further ramifications await discovery. Deposits of white material on the anterior lens surface are the most consistent and important diagnostic feature of XFS. The classic pattern consists of three distinct zones that become visible when the pupil is fully dilated. Whereas the classic picture of manifest XFS has been often described, the early stages of beginning exfoliation have not been well defined. Next to the lens, exfoliation material is most prominent at the pupillary border. Pigment loss from the iris sphincter region and its deposition on anterior chamber structures is a hallmark of XFS. Despite extensive research, the exact chemical composition of exfoliation material (XFM) remains unknown. An overproduction and abnormal metabolism of glycosaminoglycans have been suggested as one of the key changes in XFS. The protein components of XFM include both noncollagenous basement membrane components and epitopes of the elastic fiber system such as fibrillium. Regardless of etiology, typical exfoliation fibers have been demonstrated electron microscopically in close association with the pre-equatorial lens epithelium, the nonpigmented ciliary epithelium, the iris pigment epithelium, the corneal endothelium, the trabecular endothelium, and with almost all cell types of the iris stroma, such as fibrocytes, melanocytes, vascular endothelial cells, pericytes, and smooth muscle cells. The presence of XFS should alert the physician to the increased risks of intraocular surgery, most commonly zonular dehiscence, capsular rupture, and vitreous loss during cataract extraction. Heightened awareness of this condition and its associated clinical signs are important in the detection and management of glaucoma, and preoperative determination of those patients at increased risk for surgical complications.
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Affiliation(s)
- R Ritch
- Glaucoma Service, Department of Ophthalmology, The New York Eye and Ear Infirmary, 310 East 14th Street, New York, NY, USA
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Abstract
Exfoliation syndrome abnormal deposition in the anterior segment of the eye of an unknown substance thought to be related to elastic fibres and basement membrane components is associated with accelerated cataract progression. increased frequency of intraoperative and postoperative complications and increased risk for glaucoma and. therefore, is a clinically important finding. A clear association has been shown with age. The syndrome occurs worldwide but its prevalence seems to vary from country to country. The best-known sign of exfoliation syndrome is deposits of greyish-white material on the anterior lens surface. Sometimes exfoliation material can also be seen at the pupillary border, on the anterior iris surface, corneal endothelium, and on the anterior vitreous face. When clinically detected, exfoliation syndrome is somewhat more often unilateral than bilateral. According to recent investigations clinically unilateral exfoliation syndrome is probably never truly unilateral but rather asymmetric, because exfoliation material has been detected ultrastructurally and immunohistochemically around iris blood vessels of the nonexfoliative fellow eyes. Indeed, electron microscopy identifies in various organs of patients with exfoliation syndrome fibrils similar to those seen in intraocular exfoliation deposits. Other clinical signs associated with exfoliation syndrome are pigment dispersion, transillumination defects of the iris and reduced response to mydriatics. In unilateral exfoliation syndrome, intraocular pressure (IOP) of the exfoliative eye is approximately 2 mmHg higher than IOP of the nonexfoliative fellow eye. Whether elevated IOP, vascular changes or exfoliation syndrome itself is the main factor causing optic nerve head damage and conversion of an exfoliative eye to glaucomatous, is not known. Glaucoma in the exfoliation syndrome has been shown to have a more serious clinical course than in primary open-angle glaucoma (POAG). At the time of diagnosis, IOP and its diurnal variation are generally higher and visual field defects tend to be greater in exfoliation glaucoma than in POAG. Because the decrease in lOP variation and lowering of the mean IOP level has been shown to improve visual field prognosis more in exfoliation glaucoma than in POAG, the glaucomatous process is considered to be more pressure-related in exfoliation glaucoma. Furthermore, progression of optic disc damage has been shown to be similar in exfoliation glaucoma and POAG when lOPs are lowered to a comparable level by the treatment. However, vascular disturbances in the posterior segment of the eye might after all be of equal importance in these two types of glaucoma; optic disc haemorrhages and venous occlusions have been reported to be as frequent in exfoliation glaucoma as in POAG. Perhaps in exfoliation glaucoma circullatory disturbances combined with high IOP lead to a particularly relentlessly progressing form of the disease.
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Affiliation(s)
- E Vesti
- Glaucoma Service, Department of Ophthalmology, Helsinki University Central Hospital, Finland
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Amari F, Umihira J, Nohara M, Nagata S, Usuda N, Segawa K, Yoshimura N. Electron microscopic immunohistochemistry of ocular and extraocular pseudoexfoliative material. Exp Eye Res 1997; 65:51-6. [PMID: 9237864 DOI: 10.1006/exer.1997.0306] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
To investigate the nature of extraocular pseudoexfoliative (PSX) material, and to validate the hypothesis that the PSX syndrome is a systemic disorder, we studied the immunoreactivity of intraocular and extraocular PSX material from patients with the PSX syndrome using antibodies against proteins of extracellular matrices. Surgical specimens of four different tissues were obtained from human eyes with the PSX syndrome: nine trabecular tissues, three cataractous lenses, six bulbar conjunctivas, and seven lid skins. These tissues were processed for electron microscopic immunohistochemistry, and stained with antibodies against vitronectin, fibronectin, laminin, and elastin, by an indirect immunogold procedure. Density of the gold particles located on the PSX material was estimated by video image analysis. Statistical analysis of the data revealed that the PSX material from trabecular tissues, lenses, bulbar conjunctivas, and lid skins had almost identical immunoreactivity to the antibodies studied. PSX materials of trabecular tissues, lenses, bulbar conjunctivas, and lid skins were found to have not only a similar ultrastructure, but also almost identical immunohistochemical characteristics. These results support the hypothesis that the PSX syndrome is a systemic disorder.
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Affiliation(s)
- F Amari
- Department of Ophthalmology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390, Japan
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