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Kim HJ, Cha S, Choi JS, Lee JY, Kim KE, Kim JK, Kim J, Moon SY, Lee SHS, Park K, Won SY. scAAV2-Mediated Expression of Thioredoxin 2 and C3 Transferase Prevents Retinal Ganglion Cell Death and Lowers Intraocular Pressure in a Mouse Model of Glaucoma. Int J Mol Sci 2023; 24:16253. [PMID: 38003443 PMCID: PMC10671512 DOI: 10.3390/ijms242216253] [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: 09/15/2023] [Revised: 11/04/2023] [Accepted: 11/07/2023] [Indexed: 11/26/2023] Open
Abstract
Elevated intraocular pressure (IOP) in glaucoma causes retinal ganglion cell (RGC) loss and damage to the optic nerve. Although IOP is controlled pharmacologically, no treatment is available to restore retinal and optic nerve function. In this paper, we aimed to develop a novel gene therapy for glaucoma using an AAV2-based thioredoxin 2 (Trx2)-exoenzyme C3 transferase (C3) fusion protein expression vector (scAAV2-Trx2-C3). We evaluated the therapeutic effects of this vector in vitro and in vivo using dexamethasone (DEX)-induced glaucoma models. We found that scAAV2-Trx2-C3-treated HeLa cells had significantly reduced GTP-bound active RhoA and increased phosphor-cofilin Ser3 protein expression levels. scAAV2-Trx2-C3 was also shown to inhibit oxidative stress, fibronectin expression, and alpha-SMA expression in DEX-treated HeLa cells. NeuN immunostaining and TUNEL assay in mouse retinal tissues was performed to evaluate its neuroprotective effect upon RGCs, whereas changes in mouse IOP were monitored via rebound tonometer. The present study showed that scAAV2-Trx2-C3 can protect RGCs from degeneration and reduce IOP in a DEX-induced mouse model of glaucoma, while immunohistochemistry revealed that the expression of fibronectin and alpha-SMA was decreased after the transduction of scAAV2-Trx2-C3 in murine eye tissues. Our results suggest that AAV2-Trx2-C3 modulates the outflow resistance of the trabecular meshwork, protects retinal and other ocular tissues from oxidative damage, and may lead to the development of a gene therapeutic for glaucoma.
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Affiliation(s)
- Hee Jong Kim
- Institute of New Drug Development Research, Cdmogen Co., Ltd., Seoul 05855, Republic of Korea; (H.J.K.); (S.C.); (J.-S.C.); (J.K.K.); (J.K.); (S.Y.M.); (S.H.S.L.); (K.P.)
- Cdmogen Co., Ltd., Cheongju 28577, Republic of Korea
| | - Seho Cha
- Institute of New Drug Development Research, Cdmogen Co., Ltd., Seoul 05855, Republic of Korea; (H.J.K.); (S.C.); (J.-S.C.); (J.K.K.); (J.K.); (S.Y.M.); (S.H.S.L.); (K.P.)
- Cdmogen Co., Ltd., Cheongju 28577, Republic of Korea
| | - Jun-Sub Choi
- Institute of New Drug Development Research, Cdmogen Co., Ltd., Seoul 05855, Republic of Korea; (H.J.K.); (S.C.); (J.-S.C.); (J.K.K.); (J.K.); (S.Y.M.); (S.H.S.L.); (K.P.)
- Cdmogen Co., Ltd., Cheongju 28577, Republic of Korea
| | - Joo Yong Lee
- Department of Ophthalmology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul 05505, Republic of Korea; (J.Y.L.); (K.E.K.)
- Bio-Medical Institute of Technology, College of Medicine, University of Ulsan, Seoul 05505, Republic of Korea
| | - Ko Eun Kim
- Department of Ophthalmology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul 05505, Republic of Korea; (J.Y.L.); (K.E.K.)
- Bio-Medical Institute of Technology, College of Medicine, University of Ulsan, Seoul 05505, Republic of Korea
| | - Jin Kwon Kim
- Institute of New Drug Development Research, Cdmogen Co., Ltd., Seoul 05855, Republic of Korea; (H.J.K.); (S.C.); (J.-S.C.); (J.K.K.); (J.K.); (S.Y.M.); (S.H.S.L.); (K.P.)
- Cdmogen Co., Ltd., Cheongju 28577, Republic of Korea
| | - Jin Kim
- Institute of New Drug Development Research, Cdmogen Co., Ltd., Seoul 05855, Republic of Korea; (H.J.K.); (S.C.); (J.-S.C.); (J.K.K.); (J.K.); (S.Y.M.); (S.H.S.L.); (K.P.)
- Cdmogen Co., Ltd., Cheongju 28577, Republic of Korea
| | - Seo Yun Moon
- Institute of New Drug Development Research, Cdmogen Co., Ltd., Seoul 05855, Republic of Korea; (H.J.K.); (S.C.); (J.-S.C.); (J.K.K.); (J.K.); (S.Y.M.); (S.H.S.L.); (K.P.)
- Cdmogen Co., Ltd., Cheongju 28577, Republic of Korea
| | - Steven Hyun Seung Lee
- Institute of New Drug Development Research, Cdmogen Co., Ltd., Seoul 05855, Republic of Korea; (H.J.K.); (S.C.); (J.-S.C.); (J.K.K.); (J.K.); (S.Y.M.); (S.H.S.L.); (K.P.)
- Cdmogen Co., Ltd., Cheongju 28577, Republic of Korea
| | - Keerang Park
- Institute of New Drug Development Research, Cdmogen Co., Ltd., Seoul 05855, Republic of Korea; (H.J.K.); (S.C.); (J.-S.C.); (J.K.K.); (J.K.); (S.Y.M.); (S.H.S.L.); (K.P.)
- Cdmogen Co., Ltd., Cheongju 28577, Republic of Korea
| | - So-Yoon Won
- Institute of New Drug Development Research, Cdmogen Co., Ltd., Seoul 05855, Republic of Korea; (H.J.K.); (S.C.); (J.-S.C.); (J.K.K.); (J.K.); (S.Y.M.); (S.H.S.L.); (K.P.)
- Cdmogen Co., Ltd., Cheongju 28577, Republic of Korea
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Qin M, Yu-Wai-Man C. Glaucoma: Novel antifibrotic therapeutics for the trabecular meshwork. Eur J Pharmacol 2023; 954:175882. [PMID: 37391006 PMCID: PMC10804937 DOI: 10.1016/j.ejphar.2023.175882] [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: 04/03/2023] [Revised: 06/23/2023] [Accepted: 06/26/2023] [Indexed: 07/02/2023]
Abstract
Glaucoma is a chronic and progressive neurodegenerative disease characterized by the loss of retinal ganglion cells and visual field defects, and currently affects around 1% of the world's population. Elevated intraocular pressure (IOP) is the best-known modifiable risk factor and a key therapeutic target in hypertensive glaucoma. The trabecular meshwork (TM) is the main site of aqueous humor outflow resistance and therefore a critical regulator of IOP. Fibrosis, a reparative process characterized by the excessive deposition of extracellular matrix components and contractile myofibroblasts, can impair TM function and contribute to the pathogenesis of primary open-angle glaucoma (POAG) as well as the failure of minimally invasive glaucoma surgery (MIGS) devices. This paper provides a detailed overview of the current anti-fibrotic therapeutics targeting the TM in glaucoma, along with their anti-fibrotic mechanisms, efficacy as well as the current research progress from pre-clinical to clinical studies.
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Affiliation(s)
- Mengqi Qin
- King's College London, London, SE1 7EH, UK
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Germanova VN, Karlova EV, Zolotarev AV. [Medicated prevention of scarring after glaucoma surgery]. Vestn Oftalmol 2020; 136:130-137. [PMID: 32779467 DOI: 10.17116/oftalma2020136041130] [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] [Indexed: 11/17/2022]
Abstract
Modulation of wound healing is one of the main challenges in glaucoma surgery. Modern antiproliferative agents used to reduce postoperative scarring are either insufficiently effective or inadequate in terms of safety. In the search for novel agents devoid of such drawbacks, specialists directed their attention to selective inhibitors of proinflammatory cytokines and growth factors. The article reviews pathophysiologic basis of wound healing, characteristics of inflammatory mediators affecting fibroblast proliferation and scarring, and provides description of the currently used and new, potentially promising antiproliferative agents.
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Affiliation(s)
- V N Germanova
- Samara State Medical University, Department of Ophthalmology, Samara, Russia.,Samara Regional Clinical Ophthalmological Hospital named after T.I. Eroshevsky, Samara, Russia
| | - E V Karlova
- Samara State Medical University, Department of Ophthalmology, Samara, Russia.,Samara Regional Clinical Ophthalmological Hospital named after T.I. Eroshevsky, Samara, Russia
| | - A V Zolotarev
- Samara State Medical University, Department of Ophthalmology, Samara, Russia.,Samara Regional Clinical Ophthalmological Hospital named after T.I. Eroshevsky, Samara, Russia
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Tejwani S, Machiraju P, Nair AP, Ghosh A, Das RK, Ghosh A, Sethu S. Treatment of glaucoma by prostaglandin agonists and beta-blockers in combination directly reduces pro-fibrotic gene expression in trabecular meshwork. J Cell Mol Med 2020; 24:5195-5204. [PMID: 32267082 PMCID: PMC7205793 DOI: 10.1111/jcmm.15172] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 12/19/2019] [Accepted: 02/19/2020] [Indexed: 02/06/2023] Open
Abstract
Prostaglandin analogues (PG), beta-blockers (BB) or their combination (PG+BB) are used primarily to reduce the intraocular pressure (IOP) pathologically associated with glaucoma. Since, fibrosis of the trabecular meshwork (TM) is a major aetiological factor in glaucoma, we studied the effect of these drugs on fibrosis-associated gene expression in TM of primary glaucoma patients. In the present study, TM and iris of primary open-angle (n = 32) and angle-closure (n = 37) glaucoma patients were obtained surgically during trabeculectomy and categorized based on the type of IOP-lowering medications use as PG, BB or PG+BB. mRNA expression of pro-fibrotic and anti-fibrotic genes was quantified using qPCR in these tissues. The gene expression levels of pro-fibrotic genes were significantly lower in PG+BB as compared to other groups. These observations and underlying signalling validated in vitro in human TM cells also showed reduced fibrotic gene and protein expression levels following PG+BB treatment. In conclusion, it is observed that PG+BB combination rather than their lone use renders a reduced fibrotic status in TM. This further suggests that IOP-lowering medications, in combination, would also modulate fibrosis-associated molecular changes in the TM, which may be beneficial for maintaining aqueous out-flow mechanisms over the clinical treatment duration.
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Affiliation(s)
- Sushma Tejwani
- Department of Glaucoma and Cataract services, Narayana Nethralaya, Bangalore, India.,School of Bio Sciences and Technology, Vellore Institute of Technology, Vellore, India
| | - Praveen Machiraju
- GROW Research Laboratory, Narayana Nethralaya Foundation, Bangalore, India
| | - Archana Padmanabhan Nair
- GROW Research Laboratory, Narayana Nethralaya Foundation, Bangalore, India.,Manipal Academy of Higher Education, Manipal, India
| | - Anuprita Ghosh
- GROW Research Laboratory, Narayana Nethralaya Foundation, Bangalore, India
| | - Raunak Kumar Das
- Centre for Biomaterials, Cellular and Molecular Theranostics, Vellore Institute of Technology, Vellore, India
| | - Arkasubhra Ghosh
- GROW Research Laboratory, Narayana Nethralaya Foundation, Bangalore, India.,Singapore Eye Research Institute, Singapore City, Singapore
| | - Swaminathan Sethu
- GROW Research Laboratory, Narayana Nethralaya Foundation, Bangalore, India
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NikhalaShree S, Karthikkeyan G, George R, Shantha B, Vijaya L, Ratra V, Sulochana KN, Coral K. Lowered Decorin With Aberrant Extracellular Matrix Remodeling in Aqueous Humor and Tenon's Tissue From Primary Glaucoma Patients. Invest Ophthalmol Vis Sci 2020; 60:4661-4669. [PMID: 31725165 DOI: 10.1167/iovs.19-27091] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To evaluate the inflammatory cytokine, growth factors, extracellular matrix (ECM) remodeling genes, profibrotic and antifibrotic molecules in patients undergoing glaucoma filtration surgery (GFS). Additionally, the effect of preoperative antiglaucoma medications (AGMs) and postoperative bleb status were related to these parameters. Methods Tenon's tissue and aqueous humour (AH) were collected from 207 patients undergoing GFS with primary open-angle glaucoma (POAG) (n = 77), primary angle-closure glaucoma (PACG) (n = 62), and cataract controls (n = 68). Monocyte chemoattractant protein-1 (MCP-1), connective tissue growth factor (CTGF), transforming growth factor β1/2 (TGF-β1/2), lysyl oxidase (LOX), lysyl oxidase L2 (LOXL2), elastin (ELN), collagen type 1 α 1 (COL1A1), secreted protein acidic and rich in cysteine (SPARC), α-smooth muscle actin (α-SMA), and decorin (DCN) were determined in tenon's tissue by real-time PCR and in AH using ELISA. Results A significant increase was observed in the transcripts of MCP-1, TGF-β2, and SPARC in POAG and PACG (P < 0.05); CTGF, TGF-β1, LOX, LOXL2, ELN, COL1A1, and α-SMA in PACG (P < 0.05) compared with control. DCN transcript was significantly decreased in POAG and PACG (P < 0.05) compared with control. The protein levels of CTGF, TGF-β1/β2, ELN, SPARC, and LOXL2 was significantly elevated in POAG and PACG (P < 0.05); DCN was decreased (P < 0.05) compared with control. These parameters showed significant association with duration of preoperative AGMs and postoperative bleb status. Conclusions This study demonstrates increased expression of growth factors and ECM molecules, both at protein and transcript levels in GFS patients. A decreased DCN in AH seems striking, and if restored might have a therapeutic role in minimizing postoperative scarring to improve GFS outcome.
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Affiliation(s)
- Sampath NikhalaShree
- R.S. Mehta Jain Department of Biochemistry and Cell Biology, KBIRVO, Vision Research Foundation, Sankara Nethralaya, Chennai, India.,School of Chemical and Biotechnology, SASTRA Deemed-to-be University, Thanjavur, India
| | - Gayathree Karthikkeyan
- R.S. Mehta Jain Department of Biochemistry and Cell Biology, KBIRVO, Vision Research Foundation, Sankara Nethralaya, Chennai, India
| | - Ronnie George
- Smt Jadhavbai Nathmal Singhvee Glaucoma Services, Medical Research Foundation, Sankara Nethralaya, Chennai, India
| | - Balekudaru Shantha
- Smt Jadhavbai Nathmal Singhvee Glaucoma Services, Medical Research Foundation, Sankara Nethralaya, Chennai, India
| | - Lingam Vijaya
- Smt Jadhavbai Nathmal Singhvee Glaucoma Services, Medical Research Foundation, Sankara Nethralaya, Chennai, India
| | - Vineet Ratra
- Smt Jadhavbai Nathmal Singhvee Glaucoma Services, Medical Research Foundation, Sankara Nethralaya, Chennai, India
| | | | - Karunakaran Coral
- R.S. Mehta Jain Department of Biochemistry and Cell Biology, KBIRVO, Vision Research Foundation, Sankara Nethralaya, Chennai, India
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A self-healing hydrogel eye drop for the sustained delivery of decorin to prevent corneal scarring. Biomaterials 2019; 210:41-50. [PMID: 31055049 DOI: 10.1016/j.biomaterials.2019.04.013] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 04/09/2019] [Indexed: 02/06/2023]
Abstract
Scarring/Opacity on the surface of the eye and vascularisation following infectious diseases, inflammation and corneal trauma are often a leading cause of blindness. The 'gold standard' treatment to prevent corneal scarring is the application of amniotic membrane (AM) to the ocular surface in the acute stage of injury. Although clinically effective, the use of the AM is associated with biological variability and unpredictable responses. Potential health risks including disease transmission, significant ethical issues surrounding the tissue donation process and stringent regulations/storage conditions, preclude widespread use. Consequently, there is a demand for the development of a new, synthetic alternative, that is stable at room temperature, capable of protecting the wound and has the capacity to deliver anti-scarring and anti-inflammatory mediators. Here we have developed a micro-structured fluid gel eye drop, to deliver a potent anti-scarring molecule, decorin. We have compared the release of decorin from the formulated dressing to a typical gel film, demonstrating enhanced release for the fluid gel eye-drops. Therefore, we have investigated the effect of the fluid gel system in 2D human corneal fibroblast culture models, as well as shown the retention of the gellan fluid gel in an in vivo rat model. At the same time the efficacy of the fluid gel eye drop was studied in an organ culture model, whereby the fluid gel containing decorin, significantly (P < 0.05) increased re-epithelialisation within 4 days of treatment.
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