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Ng HJ, Vermeer KA, La Heij EC, Kuip CP, van Meurs JC. Retinal damage extends beyond the border of the detached retina in fovea-on retinal detachment. Acta Ophthalmol 2024; 102:285-295. [PMID: 37221643 DOI: 10.1111/aos.15713] [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: 01/08/2023] [Revised: 04/21/2023] [Accepted: 05/05/2023] [Indexed: 05/25/2023]
Abstract
PURPOSE The aim of this study was to investigate the preoperative and postoperative change in retinal sensitivity in relation to the distance to the retinal detachment (RD) in patients with fovea-on RD. METHODS We prospectively evaluated 13 patients with fovea-on RD and a healthy control eye. Preoperatively, OCT scans of the RD border and the macula were obtained. The RD border was highlighted on the SLO image. Microperimetry was used to assess the retinal sensitivity at the macula, the RD border and the retina around the RD border. At 6 weeks, 3 and 6 months postoperatively, follow-up examinations of OCT and microperimetry were performed in the study eye. Microperimetry was performed once in control eyes. Microperimetry data were overlaid on the SLO image. The shortest distance to the RD border was calculated for each sensitivity measurement. The change in retinal sensitivity was calculated as control-study. The relation between the change in retinal sensitivity and the distance to the RD border was assessed using a locally weighted scatterplot smoothing curve. RESULTS Preoperatively, the greatest loss in retinal sensitivity was 21 dB at 3° inside the RD which decreased linearly, through the RD border, and reached a plateau of 2 dB at 4°. For 6 weeks and 3 months postoperatively, the greatest retinal sensitivity loss remained at 3° inside the RD but was 4 dB and sensitivity loss decreased linearly to a plateau of 0 dB at 5° outside the RD. At 6 months postoperatively, the greatest sensitivity loss was 2 dB at 3° inside the RD, and decreased linearly to a plateau of 0 dB at 2° outside the RD. CONCLUSIONS Retinal damage extends beyond the detached retina. Retinal sensitivity loss of the attached retina decreased drastically as the distance to the RD increased. Postoperative recovery occurred for both attached and detached retina.
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Affiliation(s)
- Hei Jan Ng
- The Rotterdam Eye Hospital, Rotterdam Ophthalmic Institute, Rotterdam, The Netherlands
| | - Koenraad A Vermeer
- The Rotterdam Eye Hospital, Rotterdam Ophthalmic Institute, Rotterdam, The Netherlands
| | - Ellen C La Heij
- The Rotterdam Eye Hospital, Vitreoretinal Surgery, Rotterdam, The Netherlands
| | - Caroline P Kuip
- The Rotterdam Eye Hospital, Rotterdam Ophthalmic Institute, Rotterdam, The Netherlands
| | - Jan C van Meurs
- The Rotterdam Eye Hospital, Vitreoretinal Surgery, Rotterdam, The Netherlands
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands
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McLaughlin T, Wang G, Medina A, Perkins J, Nihlawi R, Seyfried D, Hu Z, Wang JJ, Zhang SX. Essential Role of XBP1 in Maintaining Photoreceptor Synaptic Integrity in Early Diabetic Retinopathy. Invest Ophthalmol Vis Sci 2023; 64:40. [PMID: 38015176 PMCID: PMC10691399 DOI: 10.1167/iovs.64.14.40] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 11/04/2023] [Indexed: 11/29/2023] Open
Abstract
Purpose Diabetic retinopathy (DR) is a leading cause of blindness in working-age adults characterized by retinal dysfunction and neurovascular degeneration. We previously reported that deletion of X-box binding protein 1 (XBP1) leads to accelerated retinal neurodegeneration in diabetes; however, the mechanisms remain elusive. The goal of this study is to determine the role of XBP1 in the regulation of photoreceptor synaptic integrity in early DR. Methods Diabetes was induced by streptozotocin in retina-specific XBP1 conditional knockout (cKO) or wild-type (WT) mice to generate diabetic cKO (cKO/DM) or WT/DM mice for comparison with nondiabetic cKO (cKO/NDM) and WT/NDM mice. Retinal morphology, structure, and function were assessed by immunohistochemistry, optical coherence tomography, and electroretinogram (ERG) after 3 months of diabetes. The synapses between photoreceptors and bipolar cells were examined by confocal microscopy, and synaptic integrity was quantified using the QUANTOS algorithm. Results We found a thinning of the outer nuclear layer and a decline in the b-wave amplitude in dark- and light-adapted ERG in cKO/DM mice compared to all other groups. In line with these changes, cKO mice showed increased loss of synaptic integrity compared to WT mice, regardless of diabetes status. In searching for candidate molecules responsible for the loss of photoreceptor synaptic integrity in diabetic and XBP1-deficient retinas, we found decreased mRNA and protein levels of DLG4/PSD-95 in cKO/DM retina compared to WT/DM. Conclusions These findings suggest that XBP1 is a crucial regulator in maintaining synaptic integrity and retinal function, possibly through regulation of synaptic scaffold proteins.
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Affiliation(s)
- Todd McLaughlin
- Department of Ophthalmology and Ross Eye Institute, University at Buffalo, State University of New York, Buffalo, New York, United States
| | - Grant Wang
- Department of Ophthalmology and Ross Eye Institute, University at Buffalo, State University of New York, Buffalo, New York, United States
| | - Andy Medina
- Department of Ophthalmology and Ross Eye Institute, University at Buffalo, State University of New York, Buffalo, New York, United States
| | - Jacob Perkins
- Department of Ophthalmology and Ross Eye Institute, University at Buffalo, State University of New York, Buffalo, New York, United States
| | - Rhudwan Nihlawi
- Department of Ophthalmology and Ross Eye Institute, University at Buffalo, State University of New York, Buffalo, New York, United States
| | - Don Seyfried
- Department of Ophthalmology and Ross Eye Institute, University at Buffalo, State University of New York, Buffalo, New York, United States
| | - Zihua Hu
- Department of Ophthalmology and Ross Eye Institute, University at Buffalo, State University of New York, Buffalo, New York, United States
- Center for Computational Research, New York State Center of Excellence in Bioinformatics and Life Sciences, State University of New York, Buffalo, New York, United States
| | - Joshua J. Wang
- Department of Ophthalmology and Ross Eye Institute, University at Buffalo, State University of New York, Buffalo, New York, United States
- Department of Biochemistry, State University of New York, Buffalo, New York, United States
| | - Sarah X. Zhang
- Department of Ophthalmology and Ross Eye Institute, University at Buffalo, State University of New York, Buffalo, New York, United States
- Department of Biochemistry, State University of New York, Buffalo, New York, United States
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Townes-Anderson E, Halász É, Sugino I, Davidow AL, Frishman LJ, Fritzky L, Yousufzai FAK, Zarbin M. Injury to Cone Synapses by Retinal Detachment: Differences from Rod Synapses and Protection by ROCK Inhibition. Cells 2023; 12:1485. [PMID: 37296606 PMCID: PMC10253016 DOI: 10.3390/cells12111485] [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: 04/15/2023] [Revised: 05/22/2023] [Accepted: 05/24/2023] [Indexed: 06/12/2023] Open
Abstract
Attachment of a detached retina does not always restore vision to pre-injury levels, even if the attachment is anatomically successful. The problem is due in part to long-term damage to photoreceptor synapses. Previously, we reported on damage to rod synapses and synaptic protection using a Rho kinase (ROCK) inhibitor (AR13503) after retinal detachment (RD). This report documents the effects of detachment, reattachment, and protection by ROCK inhibition on cone synapses. Conventional confocal and stimulated emission depletion (STED) microscopy were used for morphological assessment and electroretinograms for functional analysis of an adult pig model of RD. RDs were examined 2 and 4 h after injury or two days later when spontaneous reattachment had occurred. Cone pedicles respond differently than rod spherules. They lose their synaptic ribbons, reduce invaginations, and change their shape. ROCK inhibition protects against these structural abnormalities whether the inhibitor is applied immediately or 2 h after the RD. Functional restoration of the photopic b-wave, indicating cone-bipolar neurotransmission, is also improved with ROCK inhibition. Successful protection of both rod and cone synapses with AR13503 suggests this drug will (1) be a useful adjunct to subretinal administration of gene or stem cell therapies and (2) improve recovery of the injured retina when treatment is delayed.
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Affiliation(s)
- Ellen Townes-Anderson
- Department of Pharmacology, Physiology and Neuroscience, Rutgers New Jersey Medical School, 185 South Orange Avenue, Newark, NJ 07103, USA;
| | - Éva Halász
- Department of Pharmacology, Physiology and Neuroscience, Rutgers New Jersey Medical School, 185 South Orange Avenue, Newark, NJ 07103, USA;
| | - Ilene Sugino
- Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, 90 Bergen Street, Newark, NJ 07103, USA; (I.S.); (M.Z.)
| | - Amy L. Davidow
- Department of Biostatistics, New York University School of Global Public Health, 708 Broadway, New York, NY 10003, USA;
| | - Laura J. Frishman
- Department of Vision Sciences, College of Optometry, University of Houston, Martin Luther King Blvd, Houston, TX 77204, USA;
| | - Luke Fritzky
- Cellular Imaging and Histology Core, Rutgers New Jersey Medical School, 205 South Orange Avenue, Newark, NJ 07103, USA; (L.F.); (F.A.K.Y.)
| | - Fawad A. K. Yousufzai
- Cellular Imaging and Histology Core, Rutgers New Jersey Medical School, 205 South Orange Avenue, Newark, NJ 07103, USA; (L.F.); (F.A.K.Y.)
| | - Marco Zarbin
- Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, 90 Bergen Street, Newark, NJ 07103, USA; (I.S.); (M.Z.)
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Microglia in Cultured Porcine Retina: Qualitative Immunohistochemical Analyses of Reactive Microglia in the Outer Retina. Int J Mol Sci 2023; 24:ijms24010871. [PMID: 36614320 PMCID: PMC9820911 DOI: 10.3390/ijms24010871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/26/2022] [Accepted: 12/29/2022] [Indexed: 01/05/2023] Open
Abstract
A late stage of several retinal disorders is retinal detachment, a complication that results in rapid photoreceptor degeneration and synaptic damages. Experimental retinal detachment in vivo is an invasive and complicated method performed on anesthetized animals. As retinal detachment may result in visual impairment and blindness, research is of fundamental importance for understanding degenerative processes. Both morphological and ethical issues make the porcine retina a favorable organotypic model for studies of the degenerative processes that follow retinal detachment. In the cultured retina, photoreceptor degeneration and synaptic injuries develop rapidly and correlate with resident microglial cells' transition into a reactive phenotype. In this immunohistochemical study, we have begun to analyze the transition of subsets of reactive microglia which are known to localize close to the outer plexiform layer (OPL) in degenerating in vivo and in vitro retina. Biomarkers for reactive microglia included P2Ry12, CD63 and CD68 and the general microglial markers were CD11b, Iba1 and isolectin B4 (IB4). The reactive microglia markers labeled microglia subpopulations, suggesting that protective or harmful reactive microglia may be present simultaneously in the injured retina. Our findings support the usage of porcine retina cultures for studies of photoreceptor injuries related to retinal detachment.
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Muni RH, Lee WW, Bansal A, Ramachandran A, Hillier RJ. A paradigm shift in retinal detachment repair: The concept of integrity. Prog Retin Eye Res 2022; 91:101079. [DOI: 10.1016/j.preteyeres.2022.101079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 05/15/2022] [Accepted: 05/17/2022] [Indexed: 11/09/2022]
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McKay BR, Bansal A, Kryshtalskyj M, Wong DT, Berger A, Muni RH. Evaluation of Subretinal fluid Drainage Techniques during Pars Plana Vitrectomy for Primary Rhegmatogenous Retinal Detachment - ELLIPSOID study. Am J Ophthalmol 2022; 241:227-237. [PMID: 35597323 DOI: 10.1016/j.ajo.2022.05.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 05/05/2022] [Accepted: 05/09/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE To compare visual acuity and photoreceptor integrity following vitrectomy (PPV) with drainage from the peripheral retinal break(s) (PRB) vs. posterior retinotomy (PR) vs. perfluorocarbon liquid (PFCL) for macula-off rhegmatogenous retinal detachment (RRD). DESIGN Retrospective consecutive interventional comparative clinical study. METHODS 300 consecutive patients (300 eyes) with primary macula-off RRD underwent 23-gauge PPV with SRF drainage through 1) PRB (n=100), 2) PR (n=100), or 3) with PFCL (n=100). Visual acuity and SD-OCT were performed preoperatively and at 3, 6, and 12 months postoperatively. Primary outcomes were visual acuity and discontinuity of the external limiting membrane, ELM; ellipsoid zone, EZ; interdigitation zone, IDZ; and retinal pigment epithelium, RPE at 1-year. RESULTS Baseline characteristics were similar. Single-operation reattachment rates were: PRB 86%; PR 85%; PFCL 83%,p=0.9. Mean(±SD) logMAR visual acuity at 1-year was greater with PRB and PR compared to PFCL (PRB=0.6±0.5;PR=0.7±0.6;PFCL=0.9±0.6,p=0.002). There was an association between drainage technique and discontinuity of the ELM (PRB 26%,PR 24%,PFCL 44%,p=0.001), EZ (PRB 29%,PR 31%,PFCL 49%,p<0.001) and IDZ (PRB 43%,PR 39%,PFCL 56%, p=0.004). There was an association between drainage technique and risk of cystoid macular edema (CME) (PRB 28%,PR 39%,PFCL 46%,p=0.003) and ERM (PRB 64%,PR 90%,PFCL 61%,P<0.001). CONCLUSIONS PFCL-assisted drainage is associated with worse visual acuity and greater risk of outer retinal band discontinuity and CME compared with PRB or PR. PR had a greater risk of ERM compared with PRB and PFCL. PRB had the best outcomes overall. Drainage technique may impact long-term anatomic and functional outcomes.
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Rempel SK, Welch MJ, Ludwig AL, Phillips MJ, Kancherla Y, Zack DJ, Gamm DM, Gómez TM. Human photoreceptors switch from autonomous axon extension to cell-mediated process pulling during synaptic marker redistribution. Cell Rep 2022; 39:110827. [PMID: 35584680 DOI: 10.1016/j.celrep.2022.110827] [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: 01/10/2022] [Revised: 03/18/2022] [Accepted: 04/26/2022] [Indexed: 11/19/2022] Open
Abstract
Photoreceptors (PRs) are the primary visual sensory cells, and their loss leads to blindness that is currently incurable. Although cell replacement therapy holds promise, success is hindered by our limited understanding of PR axon growth during development and regeneration. Here, we generate retinal organoids from human pluripotent stem cells to study the mechanisms of PR process extension. We find that early-born PRs exhibit autonomous axon extension from dynamic terminals. However, as PRs age from 40 to 80 days of differentiation, they lose dynamic terminals on 2D substrata and in 3D retinal organoids. Interestingly, PRs without motile terminals are still capable of extending axons but only by process stretching via attachment to motile non-PR cells. Immobile PR terminals of late-born PRs have fewer and less organized actin filaments but more synaptic proteins compared with early-born PR terminals. These findings may help inform the development of PR transplantation therapies.
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Affiliation(s)
- Sarah K Rempel
- Department of Neuroscience, University of Wisconsin - Madison, Madison, WI 53706, USA; McPherson Eye Research Institute, University of Wisconsin - Madison, Madison, WI 53706, USA
| | - Madalynn J Welch
- Department of Neuroscience, University of Wisconsin - Madison, Madison, WI 53706, USA
| | - Allison L Ludwig
- Department of Ophthalmology and Visual Sciences, University of Wisconsin - Madison, Madison, WI 53705, USA; McPherson Eye Research Institute, University of Wisconsin - Madison, Madison, WI 53706, USA; Waisman Center, University of Wisconsin - Madison, Madison, WI 53705, USA
| | - M Joseph Phillips
- McPherson Eye Research Institute, University of Wisconsin - Madison, Madison, WI 53706, USA; Waisman Center, University of Wisconsin - Madison, Madison, WI 53705, USA
| | - Yochana Kancherla
- Department of Neuroscience, University of Wisconsin - Madison, Madison, WI 53706, USA
| | - Donald J Zack
- Department of Ophthalmology, Johns Hopkins University, Baltimore, MD 21287, USA
| | - David M Gamm
- Department of Ophthalmology and Visual Sciences, University of Wisconsin - Madison, Madison, WI 53705, USA; McPherson Eye Research Institute, University of Wisconsin - Madison, Madison, WI 53706, USA; Waisman Center, University of Wisconsin - Madison, Madison, WI 53705, USA
| | - Timothy M Gómez
- Department of Neuroscience, University of Wisconsin - Madison, Madison, WI 53706, USA; McPherson Eye Research Institute, University of Wisconsin - Madison, Madison, WI 53706, USA.
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Townes-Anderson E, Halasz E, Wang W, Zarbin M. Coming of Age for the Photoreceptor Synapse. Invest Ophthalmol Vis Sci 2021; 62:24. [PMID: 34550300 PMCID: PMC8475281 DOI: 10.1167/iovs.62.12.24] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Purpose To discuss the potential contribution of rod and cone synapses to the loss of visual function in retinal injury and disease. Methods The published literature and the authors' own work were reviewed. Results Retinal detachment is used as a case study of rod spherule and cone pedicle plasticity after injury. Both rod and cone photoreceptors terminals are damaged after detachment although the structural changes observed are only partially overlapping. For second-order neurons, only those associated with rod spherules respond consistently to injury by remodeling. Examination of signaling pathways involved in plasticity of conventional synapses and in neural development has been and may continue to be productive in discovering novel therapeutic targets. Rho kinase (ROCK) inhibition is an example of therapy that may reduce synaptic damage by preserving normal synaptic structure of rod and cone cells. Conclusions We hypothesize that synaptic damage contributes to poor visual restoration after otherwise successful anatomical repair of retinal detachment. A similar situation may exist for patients with degenerative retinal disease. Thus, synaptic structure and function should be routinely studied, as this information may disclose therapeutic strategies to mitigate visual loss.
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Affiliation(s)
- Ellen Townes-Anderson
- Department of Pharmacology, Physiology, and Neuroscience, Rutgers New Jersey Medical School, Newark, New Jersey, United States
| | - Eva Halasz
- Department of Pharmacology, Physiology, and Neuroscience, Rutgers New Jersey Medical School, Newark, New Jersey, United States
| | - Weiwei Wang
- Schepens Eye Research Institute and Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard University, Boston, Massachusetts, United States
| | - Marco Zarbin
- Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, New Jersey, United States
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Koizumi Y, Mizutari K, Kawauchi S, Sato S, Shiotani A, Kakehata S. Y-27632, a ROCK inhibitor, improved laser-induced shock wave (LISW)-induced cochlear synaptopathy in mice. Mol Brain 2021; 14:105. [PMID: 34217338 PMCID: PMC8254252 DOI: 10.1186/s13041-021-00819-1] [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: 04/07/2021] [Accepted: 06/28/2021] [Indexed: 11/10/2022] Open
Abstract
Recently, a pathological condition called cochlear synaptopathy has been clarified, and as a disorder of the auditory nerve synapses that occurs prior to failure of hair cells, it has been recognized as a major cause of sensorineural hearing loss. However, cochlear synaptopathy is untreatable. Inhibition of rho-associated coiled-coil containing protein kinase (ROCK), a serine-threonine protein kinase, has been reported to have neuroprotective and regenerative effects on synaptic pathways in the nervous system, including those in the inner ear. We previously demonstrated the regenerative effect of the ROCK inhibitor, Y-27632, on an excitotoxic cochlear nerve damage model in vitro. In this study, we aimed to validate the effect of ROCK inhibition on mice with cochlear synaptopathy induced by laser-induced shock wave (LISW) in vivo. After the elevation of ROCK1/2 expression in the damaged cochlea was confirmed, we administered Y-27632 locally via the middle ear. The amplitude of wave I in the auditory brainstem response and the number of synapses in the Y-27632-treated cochlea increased significantly. These results clearly demonstrate that ROCK inhibition has a promising clinical application in the treatment of cochlear synaptopathy, which is the major pathology of sensorineural hearing loss.
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Affiliation(s)
- Yutaka Koizumi
- Department of Otolaryngology-Head and Neck Surgery, Yamagata University Faculty of Medicine, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Kunio Mizutari
- Department of Otolaryngology-Head and Neck Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan.
| | - Satoko Kawauchi
- Division of Bioinformation and Therapeutic Systems, National Defense Medical College Research Institute, Saitama, 359-8513, Japan
| | - Shunichi Sato
- Division of Bioinformation and Therapeutic Systems, National Defense Medical College Research Institute, Saitama, 359-8513, Japan
| | - Akihiro Shiotani
- Department of Otolaryngology-Head and Neck Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan
| | - Seiji Kakehata
- Department of Otolaryngology-Head and Neck Surgery, Yamagata University Faculty of Medicine, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan.
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Zhang Y, Erhard AL, Plagemann T, Eter N, Heiduschka P. A modified protocol for isolation of retinal microglia from the pig. Exp Eye Res 2021; 207:108584. [PMID: 33910034 DOI: 10.1016/j.exer.2021.108584] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 03/31/2021] [Accepted: 04/14/2021] [Indexed: 11/27/2022]
Abstract
Microglia are the resident immune cells in the retina. To investigate their properties and behaviour, a reliable and yielding procedure to culture them is necessary. We here describe a way of isolation of microglial cells from the porcine retina, as pig eyes are similar to human eyes in size, structure and vasculature, including similarities in proteins and pathways. Retina was isolated from fresh pig eyes, dissociated by a mixture of collagenase, hyaluronidase and DNAse, and passed through a cell strainer. After triple centrifugation with decreasing velocity and re-suspension, cells were seeded into poly-d-lysine coated culture flasks and cultured using DMEM and macrophage-colony stimulating factor (M-CSF). Number of cells increased gradually during the first 10-14 days, till they could be split and used for experiments. Identity of isolated cells as microglia was assessed by immunostaining against the microglia/macrophage markers Iba1, CD11b, CD68, CD45 and TMEM119. Phagocytic function of microglia could be demonstrated by phagocytosis of fluorescence beads and their response to lipopolysaccharide (LPS). As a conclusion, we developed a protocol for isolation and cultivation of pig retinal microglial cells that are suitable for research in the laboratory.
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Affiliation(s)
- Yahan Zhang
- University of Münster Medical School, Department of Ophthalmology, Münster, Germany
| | - Anna Lena Erhard
- University of Münster Medical School, Department of Ophthalmology, Münster, Germany
| | - Tanja Plagemann
- University of Münster Medical School, Department of Ophthalmology, Münster, Germany
| | - Nicole Eter
- University of Münster Medical School, Department of Ophthalmology, Münster, Germany
| | - Peter Heiduschka
- University of Münster Medical School, Department of Ophthalmology, Münster, Germany.
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Macks C, Jeong D, Lee JS. Local delivery of RhoA siRNA by PgP nanocarrier reduces inflammatory response and improves neuronal cell survival in a rat TBI model. NANOMEDICINE : NANOTECHNOLOGY, BIOLOGY, AND MEDICINE 2021; 32:102343. [PMID: 33259960 PMCID: PMC8714129 DOI: 10.1016/j.nano.2020.102343] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 10/23/2020] [Accepted: 11/19/2020] [Indexed: 12/19/2022]
Abstract
Traumatic brain injury (TBI) is a leading cause of death and disability with complex pathophysiology including prolonged neuroinflammation, apoptosis, and glial scar formation. The upregulation of RhoA is a key factor in the pathological development of secondary injury following TBI. Previously, we developed a novel cationic, amphiphilic copolymer, poly (lactide-co-glycolide)-graft-polyethylenimine (PgP), as a nanocarrier for delivery of therapeutic nucleic acids. In a rat compression spinal cord injury model, delivery of siRNA targeting RhoA (siRhoA) by PgP resulted in RhoA knockdown; reduced astrogliosis and inflammation; and promoted axonal regeneration/sparing. Here, we evaluated the effect of RhoA knockdown by PgP/siRhoA nanoplexes in a rat controlled cortical impact TBI model. A single intraparenchymal injection of PgP/siRhoA nanoplexes significantly reduced RhoA expression, lesion volume, neuroinflammation, and apoptosis, and increased neuronal survival in the ipsilateral cortex. These results suggest that PgP/siRhoA nanoplexes can efficiently knockdown RhoA expression in the injured brain and reduce secondary injury.
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Affiliation(s)
- Christian Macks
- Department of Bioengineering, Clemson University, Clemson, SC 29634, USA.
| | - DaUn Jeong
- Department of Bioengineering, Clemson University, Clemson, SC 29634, USA.
| | - Jeoung Soo Lee
- Department of Bioengineering, Clemson University, Clemson, SC 29634, USA.
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Hathibelagal AR, Mulani Y, Dave VP. Visual function deficits in eyes with resolved endophthalmitis. Sci Rep 2021; 11:2285. [PMID: 33504844 PMCID: PMC7840664 DOI: 10.1038/s41598-021-81530-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 01/05/2021] [Indexed: 12/19/2022] Open
Abstract
To evaluate the changes in functional vision in patients with resolved endophthalmitis. This was a cross-sectional study. The study included 20 patients with resolved endophthalmitis and best-corrected visual acuity of 20/100 or better. Visual acuity (VA), contrast threshold (CT), red/green (RG) and yellow/blue (YB) colour vision and 15 Hz flicker modulation threshold (FMT) were assessed using standard psychophysical techniques. The median age was 54 years. The median visual acuity was 0.27 (~ 20/40-Snellen Equivalent) ((interquartile range [IQR]), 0.30) logMAR). The median log contrast threshold (CT) was - 1.13 (IQR, 0.36) log units (normative value for age-matched CT: - 1.61 log units). The median red/green (RG) and yellow/blue (YB) thresholds were 11.52 (IQR, 26.19) and 9.45 (IQR, 16.20) CAD units respectively, which were at least 5 times higher than age-matched normative RG and YB thresholds. The median central cone- mediated FMT was 17.64% (IQR, 23.40%), which was much higher compared to age-matched FMT (5.48% [IQR, 3.47]). Linear regression revealed significant relationship between contrast thresholds and foveal thickness (y = 0.001x-1.47, R2 = 0.20, p = 0.048). Though endophthalmitis may resolve with a good visual acuity, deficits in visual functions like chromatic discrimination, cone-mediated flicker and contrast sensitivity persist.
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Affiliation(s)
- Amithavikram R Hathibelagal
- Brien Holden Institute of Optometry and Vision Sciences, Kallam Anji Reddy Campus, LV Prasad Eye Institute, Hyderabad, India
| | - Yasmeen Mulani
- Brien Holden Institute of Optometry and Vision Sciences, Kallam Anji Reddy Campus, LV Prasad Eye Institute, Hyderabad, India
| | - Vivek Pravin Dave
- Smt. Kanuri Santhamma Center for Vitreoretinal Diseases, Kallam Anji Reddy Campus, LV Prasad Eye Institute, Hyderabad, India.
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ROCK inhibition reduces morphological and functional damage to rod synapses after retinal injury. Sci Rep 2021; 11:692. [PMID: 33436892 PMCID: PMC7804129 DOI: 10.1038/s41598-020-80267-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 12/16/2020] [Indexed: 01/29/2023] Open
Abstract
Retinal detachment (RD) causes damage, including disjunction, of the rod photoreceptor-bipolar synapse, which disrupts vision and may contribute to the poor visual recovery observed after retinal reattachment surgery. We created a model of iatrogenic RD in adult female pigs to study damage to the rod-bipolar synapse after injury and the ability of a highly specific Rho-kinase (ROCK) inhibitor to preserve synaptic structure and function. This model mimics procedures used in humans when viral vectors or cells are injected subretinally for treatment of retinal disease. Synaptic disjunction by retraction of rod spherules, quantified by image analysis of confocal sections, was present 2 h after detachment and remained 2 days later even though the retina had spontaneously reattached by then. Moreover, spherule retraction occurred in attached retina 1-2 cms from detached retina. Synaptic damage was significantly reduced by ROCK inhibition in detached retina whether injected subretinally or intravitreally. Dark-adapted full-field electroretinograms were recorded in reattached retinas to assess rod-specific function. Reduction in synaptic injury correlated with increases in rod-driven responses in drug-treated eyes. Thus, ROCK inhibition helps prevent synaptic damage and improves functional outcomes after retinal injury and may be a useful adjunctive treatment in iatrogenic RD and other retinal degenerative diseases.
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Zhang ZY, Sun YJ, Song JY, Fan B, Li GY. Experimental models and examination methods of retinal detachment. Brain Res Bull 2021; 169:51-62. [PMID: 33434623 DOI: 10.1016/j.brainresbull.2021.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 12/11/2020] [Accepted: 01/04/2021] [Indexed: 12/19/2022]
Abstract
Retinal detachment refers to the separation of the retinal neuroepithelium and pigment epithelium, usually involving the death of photoreceptor cells. Severe detachment may lead to permanent visual impairment if not treated properly and promptly. According to the underlying causes, retinal detachment falls into one of three categories: exudative retinal detachment, traction detachment, and rhegmatogenous retinal detachment. Like many other diseases, it is difficult to study the pathophysiology of retinal detachment directly in humans, because the human retinal tissues are precious, scarce and non-regenerative; thus, establishing experimental models that better mimic the disease is necessary. In this review, we summarize the existing models of the three categories of retinal detachment both in vivo and in vitro, along with an overview of their examination methods and the major strengths and weaknesses of each model.
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Affiliation(s)
- Zi-Yuan Zhang
- Second Hosp Jilin Univ, Dept Ophthalmol, 218 Zi Qiang St, Changchun, 130041, PR China.
| | - Ying-Jian Sun
- Second Hosp Jilin Univ, Dept Ophthalmol, 218 Zi Qiang St, Changchun, 130041, PR China.
| | - Jing-Yao Song
- Second Hosp Shandong Univ, Dept Ophthalmol, 247 Bei Yuan St, Jinan, 250031, PR China.
| | - Bin Fan
- Second Hosp Jilin Univ, Dept Ophthalmol, 218 Zi Qiang St, Changchun, 130041, PR China.
| | - Guang-Yu Li
- Second Hosp Jilin Univ, Dept Ophthalmol, 218 Zi Qiang St, Changchun, 130041, PR China.
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Effects of different tamponade materials on macular segmentation after retinal detachment repair. Jpn J Ophthalmol 2021; 65:227-236. [PMID: 33420541 DOI: 10.1007/s10384-020-00800-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: 06/17/2020] [Accepted: 09/25/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE This study used spectral domain-optical coherence tomography (SD-OCT) to evaluate individual retinal layer thickness in eyes with macula-off rhegmatogenous retinal detachment (RRD) treated with silicone oil (SiO) or gas endotamponades. STUDY DESIGN This was a retrospective, interventional, comparative study. METHODS The study included 86 eyes of 43 patients who were divided into 3 groups according to endotamponades: SiO, perfluoropropane (C3F8), and sulfur hexafluoride (SF6). The affected eyes were compared with the fellow eyes of the same patient via SD-OCT automated segmentation analysis. Patients with a follow-up of at least 6 months were included in the final analysis. Macular segmentation including the retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL), outer nuclear layer (ONL), retinal pigment epithelium (RPE), inner retinal layers (IRLs), and outer retinal layers (ORLs) was analyzed. RESULTS In the SiO group, the mean thickness of each retinal layer including the RNFL, GCL, IPL, ONL, and IRLs within a 1-mm ETDRS subfield of the affected eyes was significantly lower than that of the fellow eyes (P = 0.036, P = 0.028, P = 0.003, P < 0.001, P = 0.013, respectively). There was no significant difference in the C3F8 and SF6 groups (all P > 0.05). The difference between the ONL and IRLs in the SiO-treated eyes differed significantly from that of the gas groups (P = 0.001 and P = 0.045, respectively) The difference in the GCL thickness of the affected eyes and healthy eyes showed a significant correlation with postoperative BCVA changes in the SiO, C3F8, and SF6 groups (P = 0.041, P = 0.048, and P = 0.045, respectively). CONCLUSION The findings of our study show that endotamponades used in RRD surgery may have different effects on retinal layers. In addition, SiO may cause undesirable effects on the retinal layers.
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Johansson K, Svensson LA, Mohlin C. Morphological analyzes of microglia heterogeneity and dynamics during photoreceptor degeneration in vitro: Presumptive dark microglia in porcine retina. Exp Eye Res 2020; 200:108217. [PMID: 32896534 DOI: 10.1016/j.exer.2020.108217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 08/31/2020] [Accepted: 09/01/2020] [Indexed: 11/18/2022]
Abstract
In the adult retina, ramifying microglia interact with the outer plexiform layer (OPL) monitoring the synaptic integrity between photoreceptors and post-synaptic target cells. Microglia are reactive during photoreceptor diseases, but their disease-related function(s) are not fully understood. Retinal explant cultures are model systems used to study degenerative events including photoreceptor degeneration and gliosis. Our culture paradigm, with adult porcine retinas subjected to coculture with human A-retinal pigment epithelia-19 (ARPE) cells, is an experimental approach resulting in improved photoreceptor survival and reduced gliosis. Under the in vitro pathological conditions with photoreceptor degeneration, reactive Iba1-and CD11b-immunoreactive microglia and their processes positioned in proximity with the OPL and among photoreceptor outer segments. Coculture for 3 days with ARPE-cells resulted in a significantly increased density of microglia at the OPL. After 5 days of culture, the density of microglia at the OPL was similar between coculture and control specimens. Electron microscopy revealed the presence of two subtypes of microglia: one exhibiting a dark nucleus and cytosol with dilated endoplasmic reticulum, vacuoles, endosomes and mitochondrial variations. This subtype localized close to synaptic structures in the OPL. The other subtype appeared as pale phagocytic microglia localized among degenerating outer segments. The Iba1-and CD11b-immunoreactive microglia in degenerating retina may be of two separate subtypes, which differ in localization, subcellular morphology and perhaps function.
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Affiliation(s)
| | | | - Camilla Mohlin
- Department of Chemistry and Biomedicine, Linnaeus University, Kalmar, Sweden
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17
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Li B, Xu Y, Quan Y, Cai Q, Le Y, Ma T, Liu Z, Wu G, Wang F, Bao C, Li H. Inhibition of RhoA/ROCK Pathway in the Early Stage of Hypoxia Ameliorates Depression in Mice via Protecting Myelin Sheath. ACS Chem Neurosci 2020; 11:2705-2716. [PMID: 32667781 DOI: 10.1021/acschemneuro.0c00352] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Neuroplasticity and connectivity in the central nervous system (CNS) are easily damaged after hypoxia. Long-term exposure to an anoxic environment can lead to neuropsychiatric symptoms and increases the likelihood of depression. Demyelination is an important lesion of CNS injury that may occur in depression. Previous studies have found that the RhoA/ROCK pathway is upregulated in neuropsychiatric disorders such as multiple sclerosis, stroke, and neurodegenerative diseases. Therefore, the chief aim of this study is to explore the regulatory role of the RhoA/ROCK pathway in the development of depression after hypoxia by behavioral tests, Western blotting, immunostaining as well as electron microscopy. Results showed that HIF-1α, S100β, RhoA/ROCK, and immobility time in FST were increased, sucrose water preference ratio in SPT was decreased, and the aberrant activity of neurocyte and demyelination occurred after hypoxia. After the administration of Y-27632 and fluoxetine in hypoxia, these alterations were improved. Lingo1, a negative regulatory factor, was also overexpressed after hypoxia and its expression was decreased when the pathway blocked. However, fluoxetine had no effect on the expression of Lingo1. Then, we demonstrated that demyelination was associated with failures of oligodendrocyte precursor cell proliferation and differentiation and increased apoptosis of oligodendrocytes. Collectively, our data indicate that the RhoA/ROCK pathway plays a vital role in the initial depression during hypoxia. Blocking this pathway in the early stage of hypoxia can enhance the effectiveness of antidepressants, rescue myelin damage, and reduce the expression of the negative regulatory protein of myelination. The findings provide new insight into the prophylaxis and treatment of depression.
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Affiliation(s)
- Baichuan Li
- Department of Histology and Embryology, Chongqing Key Laboratory of Neurobiology, Army Medical University, Chongqing 400038, China
| | - Yang Xu
- Department of Histology and Embryology, Chongqing Key Laboratory of Neurobiology, Army Medical University, Chongqing 400038, China
| | - Yong Quan
- Department of Teaching Experiment Center, Army Medical University, Chongqing 400038, China
| | - Qiyan Cai
- Department of Histology and Embryology, Chongqing Key Laboratory of Neurobiology, Army Medical University, Chongqing 400038, China
| | - Yifan Le
- Department of Histology and Embryology, Chongqing Key Laboratory of Neurobiology, Army Medical University, Chongqing 400038, China
| | - Teng Ma
- Department of Histology and Embryology, Chongqing Key Laboratory of Neurobiology, Army Medical University, Chongqing 400038, China
| | - Zhi Liu
- Department of Histology and Embryology, Chongqing Key Laboratory of Neurobiology, Army Medical University, Chongqing 400038, China
| | - Guangyan Wu
- Department of Teaching Experiment Center, Army Medical University, Chongqing 400038, China
| | - Fei Wang
- Department of Histology and Embryology, Chongqing Key Laboratory of Neurobiology, Army Medical University, Chongqing 400038, China
| | - Chuncha Bao
- Department of Teaching Experiment Center, Army Medical University, Chongqing 400038, China
| | - Hongli Li
- Department of Histology and Embryology, Chongqing Key Laboratory of Neurobiology, Army Medical University, Chongqing 400038, China
- Department of Teaching Experiment Center, Army Medical University, Chongqing 400038, China
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Improving outcomes in retinal detachment: the potential role of rho-kinase inhibitors. Curr Opin Ophthalmol 2020; 31:192-198. [PMID: 32235252 DOI: 10.1097/icu.0000000000000658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PURPOSE OF REVIEW Retinal detachment initiates a series of events that lead to degenerative changes in retinal synaptic architecture as well as the well-known phenomena of gliosis and photoreceptor apoptosis. Retinal reattachment does not always result in complete visual recovery, even if the fovea is not directly involved in the detachment. Rho-kinase (ROCK) inhibitors may mitigate some of these deleterious changes including disruption of synaptic architecture, photoreceptor apoptosis, and initiation of the epithelial-mesenchymal transition that characterizes proliferative vitreoretinopathy (PVR). This review focuses on the use of ROCK inhibitors to modulate synaptic disjunction. RECENT FINDINGS ROCK inhibition prevents retinal detachment-induced photoreceptor synaptic terminal retraction (i.e., synaptic disjunction), thereby diminishing the damage of the first synapse in the visual pathway. ROCK inhibition also reduces retinal detachment-induced photoreceptor apoptosis and suppresses PVR progression in preclinical models. SUMMARY Inhibition of ROCK may help to optimize visual recovery after retinal detachment surgery or iatrogenic detachments during cell transplantation or viral subretinal injection and might play a role in reducing the risk of PVR after retinal detachment surgery.
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RhoA-ROCK Signaling as a Therapeutic Target in Traumatic Brain Injury. Cells 2020; 9:cells9010245. [PMID: 31963704 PMCID: PMC7016605 DOI: 10.3390/cells9010245] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 01/09/2020] [Accepted: 01/16/2020] [Indexed: 12/19/2022] Open
Abstract
Traumatic brain injury (TBI) is a leading cause of death and disability worldwide. TBIs, which range in severity from mild to severe, occur when a traumatic event, such as a fall, a traffic accident, or a blow, causes the brain to move rapidly within the skull, resulting in damage. Long-term consequences of TBI can include motor and cognitive deficits and emotional disturbances that result in a reduced quality of life and work productivity. Recovery from TBI can be challenging due to a lack of effective treatment options for repairing TBI-induced neural damage and alleviating functional impairments. Central nervous system (CNS) injury and disease are known to induce the activation of the small GTPase RhoA and its downstream effector Rho kinase (ROCK). Activation of this signaling pathway promotes cell death and the retraction and loss of neural processes and synapses, which mediate information flow and storage in the brain. Thus, inhibiting RhoA-ROCK signaling has emerged as a promising approach for treating CNS disorders. In this review, we discuss targeting the RhoA-ROCK pathway as a therapeutic strategy for treating TBI and summarize the recent advances in the development of RhoA-ROCK inhibitors.
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20
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Wang W, Halasz E, Townes-Anderson E. Actin Dynamics, Regulated by RhoA-LIMK-Cofilin Signaling, Mediates Rod Photoreceptor Axonal Retraction After Retinal Injury. Invest Ophthalmol Vis Sci 2019; 60:2274-2285. [PMID: 31112612 PMCID: PMC6530517 DOI: 10.1167/iovs.18-26077] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Purpose Retraction of the axon terminals of rod photoreceptors after retinal detachment breaks the first synapse in the visual pathway, resulting in visual impairment. Previous work showed that the mechanism of axonal retraction involves RhoA signaling and its downstream effector LIM Kinase (LIMK) activation. We examined the response of the downstream component cofilin, a direct binding protein of actin filaments, as well as the regulation by RhoA-LIMK-Cofilin signaling of actin assembly/disassembly, in the presynaptic ribbon terminal of injured rod cells. Methods Injury was produced by retinal detachment or rod cell isolation. Detached porcine retina was probed for levels and localization of phosphorylated cofilin with Western blots and confocal microscopy, whereas rod cell cultures of dissociated salamander retina were examined for filamentous actin assembly/disassembly with a barbed end assay and phalloidin staining. Results A detachment increased phosphorylation of cofilin in retinal explants; phosphorylation occurred in rod terminals in sections of detached retina. Isolation of rod cells resulted in axon retraction accompanied by an increase in actin barbed ends and a decrease in net filament labeling. All changes were significantly reduced by either Rho kinase (ROCK) or LIMK inhibition, using Y27632 or BMS-5, respectively. Cytochalasin D also reduced retraction and stabilized filaments in isolated rod cells. Conclusions These results indicate that actin depolymerization via activation of RhoA downstream kinases and cofilin contributes to axon retraction. Preventing depolymerization, in addition to actomyosin contraction, may stabilize ribbon synapses after trauma.
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Affiliation(s)
- Weiwei Wang
- Department of Pharmacology, Physiology and Neuroscience, New Jersey Medical School, Graduate School of Biomedical Sciences, Rutgers Biomedical and Health Sciences, Rutgers, The State University of New Jersey, Newark, New Jersey, United States
| | - Eva Halasz
- Department of Pharmacology, Physiology and Neuroscience, New Jersey Medical School, Graduate School of Biomedical Sciences, Rutgers Biomedical and Health Sciences, Rutgers, The State University of New Jersey, Newark, New Jersey, United States
| | - Ellen Townes-Anderson
- Department of Pharmacology, Physiology and Neuroscience, New Jersey Medical School, Graduate School of Biomedical Sciences, Rutgers Biomedical and Health Sciences, Rutgers, The State University of New Jersey, Newark, New Jersey, United States
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Zarbin M, Sugino I, Townes‐Anderson E. Concise Review: Update on Retinal Pigment Epithelium Transplantation for Age-Related Macular Degeneration. Stem Cells Transl Med 2019; 8:466-477. [PMID: 30748126 PMCID: PMC6477002 DOI: 10.1002/sctm.18-0282] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 01/15/2019] [Indexed: 12/16/2022] Open
Abstract
Retinal cell therapy can have the objectives of rescue (i.e., modulation of metabolic abnormalities primarily for sight preservation) as well as replacement (i.e., replace cells lost due to injury or disease for sight restoration as well as preservation). The first clinical trials of retinal pigment epithelium (RPE) transplantation for vision-threatening complications of age-related macular degeneration (AMD) have begun with some preliminary signs of success (e.g., improvement in vision in some patients, anatomic evidence of transplant-host integration with some evidence of host photoreceptor recovery, long-term survival of autologous induced pluripotent stem cell-derived RPE transplants without immune suppression) as well as limitations (e.g., limited RPE suspension survival in the AMD eye, limited tolerance for long-term systemic immune suppression in elderly patients, suggestion of uncontrolled cell proliferation in the vitreous cavity). RPE survival on aged and AMD Bruch's membrane can be improved with chemical treatment, which may enhance the efficacy of RPE suspension transplants in AMD patients. Retinal detachment, currently used to deliver transplanted RPE cells to the subretinal space, induces disjunction of the first synapse in the visual pathway: the photoreceptor-bipolar synapse. This synaptic change occurs even in areas of attached retina near the locus of detachment. Synaptic disjunction and photoreceptor apoptosis associated with retinal detachment can be reduced with Rho kinase inhibitors. Addition of Rho kinase inhibitors may improve retinal function and photoreceptor survival after subretinal delivery of cells either in suspension or on scaffolds.
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Affiliation(s)
- Marco Zarbin
- Institute of Ophthalmology and Visual ScienceRutgers‐New Jersey Medical School, Rutgers UniversityNewarkNew JerseyUSA
| | - Ilene Sugino
- Institute of Ophthalmology and Visual ScienceRutgers‐New Jersey Medical School, Rutgers UniversityNewarkNew JerseyUSA
| | - Ellen Townes‐Anderson
- Department of Pharmacology, Physiology, and NeuroscienceRutgers‐New Jersey Medical SchoolNewarkNew JerseyUSA
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Moura-Coelho N, Tavares Ferreira J, Bruxelas CP, Dutra-Medeiros M, Cunha JP, Pinto Proença R. Rho kinase inhibitors-a review on the physiology and clinical use in Ophthalmology. Graefes Arch Clin Exp Ophthalmol 2019; 257:1101-1117. [PMID: 30843105 DOI: 10.1007/s00417-019-04283-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 02/11/2019] [Accepted: 02/25/2019] [Indexed: 02/07/2023] Open
Abstract
The Rho kinase (ROCK) signaling pathway is involved in several cellular events that include cell proliferation and cytoskeleton modulation leading to cell adhesion. The ROCK pathway in the human eye has been hypothesized to play important roles in corneal endothelial cell physiology and pathologic states. In addition, ROCK signaling has been identified as an important regulator of trabecular meshwork (TM) outflow, which is altered in glaucomatous eyes. These roles in corneal and glaucomatous disease states have led to the growing interest in the development of drugs selectively targeting this pathway (ROCK inhibitors). The authors provide a review of the literature on the pathobiology of the ROCK signaling in corneal endothelial disease, glaucoma, and vitreoretinal disease, as well as the clinical usefulness of ROCK inhibitors in Ophthalmology.
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Affiliation(s)
- Nuno Moura-Coelho
- Ophthalmology Department, Centro Hospitalar Universitário Lisboa Central (CHULC), Alameda Santo António Capuchos, 1169-050, Lisbon, Portugal. .,Faculty of Medical Sciences
- NOVA Medical School-Nova University of Lisbon (FCM
- NMS-UNL), Lisbon, Portugal. .,Instituto Português de Retina (IPR), Lisbon, Portugal. .,Associação Médica Olhar Bem (AMO Bem), Lisbon, Portugal.
| | - Joana Tavares Ferreira
- Ophthalmology Department, Centro Hospitalar Universitário Lisboa Central (CHULC), Alameda Santo António Capuchos, 1169-050, Lisbon, Portugal.,Faculty of Medical Sciences
- NOVA Medical School-Nova University of Lisbon (FCM
- NMS-UNL), Lisbon, Portugal.,Associação Médica Olhar Bem (AMO Bem), Lisbon, Portugal
| | - Carolina Pereira Bruxelas
- Faculty of Medical Sciences
- NOVA Medical School-Nova University of Lisbon (FCM
- NMS-UNL), Lisbon, Portugal.,Ophthalmology Department, Ocidental Lisbon Hospital Center (CHLO), Lisbon, Portugal
| | - Marco Dutra-Medeiros
- Ophthalmology Department, Centro Hospitalar Universitário Lisboa Central (CHULC), Alameda Santo António Capuchos, 1169-050, Lisbon, Portugal.,Faculty of Medical Sciences
- NOVA Medical School-Nova University of Lisbon (FCM
- NMS-UNL), Lisbon, Portugal.,Instituto Português de Retina (IPR), Lisbon, Portugal.,Associação Protectora dos Diabéticos de Portugal (APDP), Lisbon, Portugal
| | - João Paulo Cunha
- Ophthalmology Department, Centro Hospitalar Universitário Lisboa Central (CHULC), Alameda Santo António Capuchos, 1169-050, Lisbon, Portugal.,Faculty of Medical Sciences
- NOVA Medical School-Nova University of Lisbon (FCM
- NMS-UNL), Lisbon, Portugal.,Associação Médica Olhar Bem (AMO Bem), Lisbon, Portugal
| | - Rita Pinto Proença
- Ophthalmology Department, Centro Hospitalar Universitário Lisboa Central (CHULC), Alameda Santo António Capuchos, 1169-050, Lisbon, Portugal.,Associação Médica Olhar Bem (AMO Bem), Lisbon, Portugal.,Faculdade de Medicina de Lisboa-Universidade de Lisboa (FML-UL), Lisbon, Portugal
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Abstract
The availability of noninvasive high-resolution imaging technology, the immune-suppressive nature of the subretinal space, and the existence of surgical techniques that permit transplantation surgery to be a safe procedure all render the eye an ideal organ in which to begin cell-based therapy in the central nervous system. A number of early stage clinical trials are underway to assess the safety and feasibility of cell-based therapy for retinal blindness. Cell-based therapy using embryonic stem cell-derived differentiated cells (e.g., retinal pigment epithelium (RPE)), neural progenitor cells, photoreceptor precursors, and bone marrow-derived hematopoietic stem/progenitor cells has demonstrated successful rescue and/or replacement in preclinical models of human retinal degenerative disease. Additional research is needed to identify the mechanisms that control synapse formation/disjunction (to improve photoreceptor transplant efficacy), to identify factors that limit RPE survival in areas of geographic atrophy (to improve RPE transplant efficacy in eyes with age-related macular degeneration), and to identify factors that regulate immune surveillance of the subretinal space (to improve long-term photoreceptor and RPE transplant survival).
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Affiliation(s)
- Marco Zarbin
- Institute of Ophthalmology and Visual Science, Rutgers-New Jersey Medical School, Rutgers University, Newark, NJ, USA.
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Evaluation of tolerance to lentiviral LV-RPE65 gene therapy vector after subretinal delivery in non-human primates. Transl Res 2017; 188:40-57.e4. [PMID: 28754419 DOI: 10.1016/j.trsl.2017.06.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 04/30/2017] [Accepted: 06/30/2017] [Indexed: 12/17/2022]
Abstract
Several approaches have been developed for gene therapy in RPE65-related Leber congenital amaurosis. To date, strategies that have reached the clinical stages rely on adeno-associated viral vectors and two of them documented limited long-term effect. We have developed a lentiviral-based strategy of RPE65 gene transfer that efficiently restored protein expression and cone function in RPE65-deficient mice. In this study, we evaluated the ocular and systemic tolerances of this lentiviral-based therapy (LV-RPE65) on healthy nonhuman primates (NHPs), without adjuvant systemic anti-inflammatory prophylaxis. For the first time, we describe the early kinetics of retinal detachment at 2, 4, and 7 days after subretinal injection using multimodal imaging in 5 NHPs. We revealed prolonged reattachment times in LV-RPE65-injected eyes compared to vehicle-injected eyes. Low- (n = 2) and high-dose (n = 2) LV-RPE65-injected eyes presented a reduction of the outer nuclear and photoreceptor outer segment layer thickness in the macula, that was more pronounced than in vehicle-injected eyes (n = 4). All LV-RPE65-injected eyes showed an initial perivascular reaction that resolved spontaneously within 14 days. Despite foveal structural changes, full-field electroretinography indicated that the overall retinal function was preserved over time and immunohistochemistry identified no difference in glial, microglial, or leucocyte ocular activation between low-dose, high-dose, and vehicle-injected eyes. Moreover, LV-RPE65-injected animals did not show signs of vector shedding or extraocular targeting, confirming the safe ocular restriction of the vector. Our results evidence a limited ocular tolerance to LV-RPE65 after subretinal injection without adjuvant anti-inflammatory prophylaxis, with complications linked to this route of administration necessitating to block this transient inflammatory event.
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Lajko M, Cardona HJ, Taylor JM, Farrow KN, Fawzi AA. Photoreceptor oxidative stress in hyperoxia-induced proliferative retinopathy accelerates rd8 degeneration. PLoS One 2017; 12:e0180384. [PMID: 28671996 PMCID: PMC5495396 DOI: 10.1371/journal.pone.0180384] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Accepted: 06/14/2017] [Indexed: 12/13/2022] Open
Abstract
To investigate the impact of photoreceptor oxidative stress on photoreceptor degeneration in mice carrying the rd8 mutation (C57BL/6N). We compared the hyperoxia-induced proliferative retinopathy (HIPR) model in two mouse strains (C57BL/6J and C57BL/6N). Pups were exposed to 75% oxygen, starting at birth and continuing for 14 days (P14). Mice were euthanized at P14, or allowed to recover in room air for one day (P15), seven days (P21), or 14 days (P28). We quantified retinal thickness and the length of residual photoreceptors not affected by rosette formation. In addition we explored differences in retinal immunostaining for NADPH oxidase 4 (NOX4), Rac1, vascular endothelium, and activated Mϋller cells. We analyzed photoreceptor oxidative stress using DCF staining in cross sections and quantified NOX4 protein levels using western blotting. C57BL/6N mice in HIPR showed increased oxidative stress, NOX4, and Rac1 in the photoreceptors at P14 and P15 compared to C57BL/6J. In addition, we observed significant progression of photoreceptor degeneration, with significantly accelerated rosette formation in C57BL/6N under HIPR, compared to their room air counterparts. Furthermore, C57BL/6N under HIPR had significantly thinner central retinas than C57BL/6J in HIPR. We did not find a difference in vascular disruption or Mϋller cell activation comparing the two strains in hyperoxia. In HIPR, the C57BL/6N strain carrying the rd8 mutation showed significantly accelerated photoreceptor degeneration, mediated via exacerbated photoreceptor oxidative stress, which we believe relates to Rac1-NOX dysregulation in the setting of Crb1 loss-of-function.
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Affiliation(s)
- Michelle Lajko
- Department of Ophthalmology, Feinberg School of Medicine at Northwestern University, Chicago, Illinois, United States of America
| | - Herminio J. Cardona
- Department of Pediatrics, Feinberg School of Medicine at Northwestern University, Chicago, Illinois, United States of America
| | - Joann M. Taylor
- Department of Pediatrics, Feinberg School of Medicine at Northwestern University, Chicago, Illinois, United States of America
| | - Kathryn N. Farrow
- Department of Pediatrics, Feinberg School of Medicine at Northwestern University, Chicago, Illinois, United States of America
| | - Amani A. Fawzi
- Department of Ophthalmology, Feinberg School of Medicine at Northwestern University, Chicago, Illinois, United States of America
- * E-mail:
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Townes-Anderson E, Wang J, Halász É, Sugino I, Pitler A, Whitehead I, Zarbin M. Fasudil, a Clinically Used ROCK Inhibitor, Stabilizes Rod Photoreceptor Synapses after Retinal Detachment. Transl Vis Sci Technol 2017; 6:22. [PMID: 28660097 PMCID: PMC5482187 DOI: 10.1167/tvst.6.3.22] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Accepted: 05/08/2017] [Indexed: 12/20/2022] Open
Abstract
Purpose Retinal detachment disrupts the rod-bipolar synapse in the outer plexiform layer by retraction of rod axons. We showed that breakage is due to RhoA activation whereas inhibition of Rho kinase (ROCK), using Y27632, reduces synaptic damage. We test whether the ROCK inhibitor fasudil, used for other clinical applications, can prevent synaptic injury after detachment. Methods Detachments were made in pigs by subretinal injection of balanced salt solution (BSS) or fasudil (1, 10 mM). In some animals, fasudil was injected intravitreally after BSS-induced detachment. After 2 to 4 hours, retinae were fixed for immunocytochemistry and confocal microscopy. Axon retraction was quantified by imaging synaptic vesicle label in the outer nuclear layer. Apoptosis was analyzed using propidium iodide staining. For biochemical analysis by Western blotting, retinal explants, detached from retinal pigmented epithelium, were cultured for 2 hours. Results Subretinal injection of fasudil (10 mM) reduced retraction of rod spherules by 51.3% compared to control detachments (n = 3 pigs, P = 0.002). Intravitreal injection of 10 mM fasudil, a more clinically feasible route of administration, also reduced retraction (28.7%, n = 5, P < 0.05). Controls had no photoreceptor degeneration at 2 hours, but by 4 hours apoptosis was evident. Fasudil 10 mM reduced pyknotic nuclei by 55.7% (n = 4, P < 0.001). Phosphorylation of cofilin and myosin light chain, downstream effectors of ROCK, was decreased with 30 μM fasudil (n = 8–10 explants, P < 0.05). Conclusions Inhibition of ROCK signaling with fasudil reduced photoreceptor degeneration and preserved the rod-bipolar synapse after retinal detachment. Translational Relevance These results support the possibility, previously tested with Y27632, that ROCK inhibition may attenuate synaptic damage in iatrogenic detachments.
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Affiliation(s)
- Ellen Townes-Anderson
- Department of Pharmacology, Physiology, and Neuroscience, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Jianfeng Wang
- Department of Pharmacology, Physiology, and Neuroscience, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Éva Halász
- Department of Pharmacology, Physiology, and Neuroscience, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Ilene Sugino
- Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Amy Pitler
- Department of Microbiology, Biochemistry, and Medical Genetics, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Ian Whitehead
- Department of Microbiology, Biochemistry, and Medical Genetics, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Marco Zarbin
- Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, NJ, USA
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