1
|
Oshitari T. Translational Research and Therapies for Neuroprotection and Regeneration of the Optic Nerve and Retina: A Narrative Review. Int J Mol Sci 2024; 25:10485. [PMID: 39408817 PMCID: PMC11476551 DOI: 10.3390/ijms251910485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2024] [Revised: 09/23/2024] [Accepted: 09/27/2024] [Indexed: 10/20/2024] Open
Abstract
Most retinal and optic nerve diseases pose significant threats to vision, primarily due to irreversible retinal neuronal cell death, a permanent change, which is a critical factor in their pathogenesis. Conditions such as glaucoma, retinitis pigmentosa, diabetic retinopathy, and age-related macular degeneration are the top four leading causes of blindness among the elderly in Japan. While standard treatments-including reduction in intraocular pressure, anti-vascular endothelial growth factor therapies, and retinal photocoagulation-can partially delay disease progression, their therapeutic effects remain limited. To address these shortcomings, a range of neuroprotective and regenerative therapies, aimed at preventing retinal neuronal cell loss, have been extensively studied and increasingly integrated into clinical practice over the last two decades. Several of these neuroprotective therapies have achieved on-label usage worldwide. This narrative review introduces several neuroprotective and regenerative therapies for retinal and optic nerve diseases that have been successfully translated into clinical practice, providing foundational knowledge and success stories that serve as valuable references for researchers in the field.
Collapse
Affiliation(s)
- Toshiyuki Oshitari
- Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, Inohana 1-8-1, Chuo-ku, Chiba 260-8670, Japan; ; Tel.: +81-43-226-2124; Fax: +81-43-224-4162
- Department of Ophthalmology, International University of Health and Welfare School of Medicine, 4-3 Kozunomori, Narita 286-8686, Japan
| |
Collapse
|
2
|
Hassanzadeh K, Vahabzadeh Z, Bucarello L, Dragotto J, Corbo M, Maccarone R, Feligioni M. Protective Effect of Curcuma Extract in an Ex Vivo Model of Retinal Degeneration via Antioxidant Activity and Targeting the SUMOylation. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:8923615. [PMID: 35941902 PMCID: PMC9356244 DOI: 10.1155/2022/8923615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/22/2022] [Accepted: 07/12/2022] [Indexed: 11/17/2022]
Abstract
Retinal degeneration is the major and principal cause behind many incurable blindness diseases. Several studies indicated the neuroprotective effect of Curcuma longa in eye pathologies, specifically retinopathy. However, the molecular mechanism behind its effect has not been completely elucidated. Using an ex vivo model of retinal degeneration obtained from an ex vivo optic nerve cut (ONC), we demonstrated that Curcuma extract (Cur) exerted a neuroprotective effect. Importantly, Cur was able to modulate apoptosis and MAPK signaling pathway activation and prevent retinal ganglion cell (RGC) loss. Other well-known neuroprotective pharmacological tools, including memantine (Mem), citicoline (Cit), and ginkgolic acid (GA), were used to compare the potential mechanisms of Cur. The antioxidant activity of retinas treated with Cur following optic nerve cut was significantly higher than control, but Cur failed to change the retina glutamate content. Considering the antioxidant effect of Cur and taking advantage of our recent findings on the crosstalk between oxidative stress and post-translational protein modifiers, in particular, small ubiquitin-related modifier (SUMO), we were interested in exploring the effect of Cur on SUMOylation. We found that Cur significantly prevented the increase of protein SUMOylation, confirming our previous in vitro data indicating the cytoprotective effect of curcumin through modulating the oxidative stress and SUMO-JNK axis. Altogether, these results suggest that Curcuma protects the retina from degeneration via antioxidant activity and targets SUMOylation. Therefore, it might be considered for the combination therapy with other neuroprotective agents with different mechanisms in preclinical studies on retinal degeneration.
Collapse
Affiliation(s)
- Kambiz Hassanzadeh
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
- Laboratory of Neuronal Cell Signaling, EBRI Rita Levi-Montalcini Foundation, Rome 00161, Italy
| | - Zakaria Vahabzadeh
- Cellular and Molecular Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Lucia Bucarello
- Laboratory of Neuronal Cell Signaling, EBRI Rita Levi-Montalcini Foundation, Rome 00161, Italy
- Need Institute, Milan, Italy
| | - Jessica Dragotto
- Laboratory of Neuronal Cell Signaling, EBRI Rita Levi-Montalcini Foundation, Rome 00161, Italy
| | - Massimo Corbo
- Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico, Milan 20144, Italy
| | - Rita Maccarone
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Marco Feligioni
- Laboratory of Neuronal Cell Signaling, EBRI Rita Levi-Montalcini Foundation, Rome 00161, Italy
- Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico, Milan 20144, Italy
| |
Collapse
|
3
|
Boccuni I, Fairless R. Retinal Glutamate Neurotransmission: From Physiology to Pathophysiological Mechanisms of Retinal Ganglion Cell Degeneration. Life (Basel) 2022; 12:638. [PMID: 35629305 PMCID: PMC9147752 DOI: 10.3390/life12050638] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 04/22/2022] [Accepted: 04/22/2022] [Indexed: 12/12/2022] Open
Abstract
Glutamate neurotransmission and metabolism are finely modulated by the retinal network, where the efficient processing of visual information is shaped by the differential distribution and composition of glutamate receptors and transporters. However, disturbances in glutamate homeostasis can result in glutamate excitotoxicity, a major initiating factor of common neurodegenerative diseases. Within the retina, glutamate excitotoxicity can impair visual transmission by initiating degeneration of neuronal populations, including retinal ganglion cells (RGCs). The vulnerability of RGCs is observed not just as a result of retinal diseases but has also been ascribed to other common neurodegenerative and peripheral diseases. In this review, we describe the vulnerability of RGCs to glutamate excitotoxicity and the contribution of different glutamate receptors and transporters to this. In particular, we focus on the N-methyl-d-aspartate (NMDA) receptor as the major effector of glutamate-induced mechanisms of neurodegeneration, including impairment of calcium homeostasis, changes in gene expression and signalling, and mitochondrial dysfunction, as well as the role of endoplasmic reticular stress. Due to recent developments in the search for modulators of NMDA receptor signalling, novel neuroprotective strategies may be on the horizon.
Collapse
Affiliation(s)
- Isabella Boccuni
- Institute for Physiology and Pathophysiology, Heidelberg University, 69120 Heidelberg, Germany
- Department of Neurology, University Clinic Heidelberg, 69120 Heidelberg, Germany;
| | - Richard Fairless
- Department of Neurology, University Clinic Heidelberg, 69120 Heidelberg, Germany;
- Clinical Cooperation Unit (CCU) Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| |
Collapse
|
4
|
[The role of citicoline in glaucoma]. Ophthalmologe 2021; 118:439-448. [PMID: 33730306 PMCID: PMC7967777 DOI: 10.1007/s00347-021-01362-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2021] [Indexed: 11/05/2022]
Abstract
Hintergrund In den letzten Jahren wurde in vielen experimentellen und klinischen Studien gezeigt, dass bei der Glaukomerkrankung die neuronale Degeneration nicht nur auf der Höhe von Netzhaut und Sehnerv, sondern im Verlauf der gesamten Sehbahn und des Gehirns erfolgt. Fragestellung Dargestellt werden die neuroprotektive Wirkung und ihre Mechanismen von Citicolin bei der Glaukomerkrankung. Material und Methode Vor dem Hintergrund der Neuroanatomie, des Neuroimaging und der Pathogenese der Glaukomerkrankung wird die Relevanz erläutert. Die Daten der experimentellen und klinischen Studien werden dargelegt und ein Fazit für die klinische Anwendung gezogen. Ergebnisse Citicolin wirkt neuroprotektiv über glaukomrelevante Mechanismen. Die neuroprotektive Wirkung von Citicolin bei Offenwinkelglaukomen ist funktionell und morphologisch nachweisbar. Sie ist unabhängig vom Glaukomschaden und Augeninnendruck und tritt i. d. R. erst nach einem Jahr auf. Die Effekte von oralem Citicolin treten bei einer Tagesdosis von 500–1000 mg auf. Die Einnahme von Citicolin kann dauerhaft oder in Zyklen erfolgen. In den Studien traten bei der Einnahme von Citicolin keine Nebenwirkungen auf. Citicolin kann kognitive Leistungen und somit Therapieadhärenz sowie die Lebensqualität bei Glaukompatienten verbessern Schlussfolgerung Diese relativ alte nootrope Substanz, welche jetzt als Nahrungsergänzungsmittel vertrieben wird, scheint eine wertvolle Ergänzung zur konventionellen Therapie der Glaukomerkrankung und eine rationale Option zur Neuroprotektion und Prophylaxe zu sein.
Collapse
|
5
|
Kelada M, Hill D, Yap TE, Manzar H, Cordeiro MF. Innovations and revolutions in reducing retinal ganglion cell loss in glaucoma. EXPERT REVIEW OF OPHTHALMOLOGY 2020. [DOI: 10.1080/17469899.2021.1835470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Mary Kelada
- The Imperial College Ophthalmic Research Group (ICORG), Imperial College London NW1 5QH, UK
| | - Daniel Hill
- Glaucoma and Retinal Neurodegeneration Group, UCL Institute of Ophthalmology, London, UK
| | - Timothy E. Yap
- The Imperial College Ophthalmic Research Group (ICORG), Imperial College London NW1 5QH, UK
- The Western Eye Hospital, Imperial College Healthcare NHS Trust (ICHNT), London, UK
| | - Haider Manzar
- The Imperial College Ophthalmic Research Group (ICORG), Imperial College London NW1 5QH, UK
| | - M. Francesca Cordeiro
- The Imperial College Ophthalmic Research Group (ICORG), Imperial College London NW1 5QH, UK
- Glaucoma and Retinal Neurodegeneration Group, UCL Institute of Ophthalmology, London, UK
- The Western Eye Hospital, Imperial College Healthcare NHS Trust (ICHNT), London, UK
| |
Collapse
|
6
|
Saccà SC, Vernazza S, Iorio EL, Tirendi S, Bassi AM, Gandolfi S, Izzotti A. Molecular changes in glaucomatous trabecular meshwork. Correlations with retinal ganglion cell death and novel strategies for neuroprotection. PROGRESS IN BRAIN RESEARCH 2020; 256:151-188. [PMID: 32958211 DOI: 10.1016/bs.pbr.2020.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Glaucoma is a chronic neurodegenerative disease characterized by retinal ganglion cell loss. Although significant advances in ophthalmologic knowledge and practice have been made, some glaucoma mechanisms are not yet understood, therefore, up to now there is no effective treatment able to ensure healing. Indeed, either pharmacological or surgical approaches to this disease aim in lowering intraocular pressure, which is considered the only modifiable risk factor. However, it is well known that several factors and metabolites are equally (if not more) involved in glaucoma. Oxidative stress, for instance, plays a pivotal role in both glaucoma onset and progression because it is responsible for the trabecular meshwork cell damage and, consequently, for intraocular pressure increase as well as for glaucomatous damage cascade. This review at first shows accurately the molecular-derived dysfunctions in antioxidant system and in mitochondria homeostasis which due to both oxidative stress and aging, lead to a chronic inflammation state, the trabecular meshwork damage as well as the glaucoma neurodegeneration. Therefore, the main molecular events triggered by oxidative stress up to the proapoptotic signals that promote the ganglion cell death have been highlighted. The second part of this review, instead, describes some of neuroprotective agents such as polyphenols or polyunsaturated fatty acids as possible therapeutic source against the propagation of glaucomatous damage.
Collapse
Affiliation(s)
- Sergio C Saccà
- Policlinico San Martino University Hospital, Department of Neuroscience and sense organs, Ophthalmology Unit, Genoa, Italy.
| | | | | | - Sara Tirendi
- Department of Experimental Medicine (DIMES), University of Genoa, Genoa, Italy; Inter-University Center for the Promotion of the 3Rs Principles in Teaching & Research (Centro 3R), Pisa, Italy
| | - Anna Maria Bassi
- Department of Experimental Medicine (DIMES), University of Genoa, Genoa, Italy; Inter-University Center for the Promotion of the 3Rs Principles in Teaching & Research (Centro 3R), Pisa, Italy
| | - Stefano Gandolfi
- Ophthalmology Unit, Department of Biological, Biotechnological and Translational Sciences, University of Parma, Parma, Italy
| | - Alberto Izzotti
- Department of Experimental Medicine (DIMES), University of Genoa, Genoa, Italy; Mutagenesis Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| |
Collapse
|
7
|
Sánchez-López E, Egea MA, Davis BM, Guo L, Espina M, Silva AM, Calpena AC, Souto EMB, Ravindran N, Ettcheto M, Camins A, García ML, Cordeiro MF. Memantine-Loaded PEGylated Biodegradable Nanoparticles for the Treatment of Glaucoma. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2018; 14:1701808. [PMID: 29154484 DOI: 10.1002/smll.201701808] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 08/10/2017] [Indexed: 05/20/2023]
Abstract
Glaucoma is a multifactorial neurodegenerative disease associated with retinal ganglion cells (RGC) loss. Increasing reports of similarities in glaucoma and other neurodegenerative conditions have led to speculation that therapies for brain neurodegenerative disorders may also have potential as glaucoma therapies. Memantine is an N-methyl-d-aspartate (NMDA) antagonist approved for Alzheimer's disease treatment. Glutamate-induced excitotoxicity is implicated in glaucoma and NMDA receptor antagonism is advocated as a potential strategy for RGC preservation. This study describes the development of a topical formulation of memantine-loaded PLGA-PEG nanoparticles (MEM-NP) and investigates the efficacy of this formulation using a well-established glaucoma model. MEM-NPs <200 nm in diameter and incorporating 4 mg mL-1 of memantine were prepared with 0.35 mg mL-1 localized to the aqueous interior. In vitro assessment indicated sustained release from MEM-NPs and ex vivo ocular permeation studies demonstrated enhanced delivery. MEM-NPs were additionally found to be well tolerated in vitro (human retinoblastoma cells) and in vivo (Draize test). Finally, when applied topically in a rodent model of ocular hypertension for three weeks, MEM-NP eye drops were found to significantly (p < 0.0001) reduce RGC loss. These results suggest that topical MEM-NP is safe, well tolerated, and, most promisingly, neuroprotective in an experimental glaucoma model.
Collapse
Affiliation(s)
- Elena Sánchez-López
- Department of Pharmacy and Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy, Institute of Nanoscience and Nanotechnology (IN2UB), University of Barcelona, Barcelona, 08028, Spain
- Biomedical Research and Networking Center in Neurodegenerative diseases (CIBERNED), Madrid, 28031, Spain
| | - Maria Antonia Egea
- Department of Pharmacy and Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy, Institute of Nanoscience and Nanotechnology (IN2UB), University of Barcelona, Barcelona, 08028, Spain
| | - Benjamin Michael Davis
- Glaucoma and Retinal Neurodegeneration Research, Visual Neuroscience, UCL Institute of Ophthalmology, Bath Street, London, EC1V 9EL, UK
| | - Li Guo
- Glaucoma and Retinal Neurodegeneration Research, Visual Neuroscience, UCL Institute of Ophthalmology, Bath Street, London, EC1V 9EL, UK
| | - Marta Espina
- Department of Pharmacy and Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy, Institute of Nanoscience and Nanotechnology (IN2UB), University of Barcelona, Barcelona, 08028, Spain
| | - Amelia Maria Silva
- Department of Biology and Environment, School of Life and Environmental sciences (ECVA, UTAD), and Centre for Research and Technology of Agro-Environmental and Biological Sciences (CITAB-UTAD), University of Trás-os-Montes e Alto Douro, Quinta de Prados, 5001-801, Vila Real, Portugal
| | - Ana Cristina Calpena
- Department of Pharmacy and Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy, Institute of Nanoscience and Nanotechnology (IN2UB), University of Barcelona, Barcelona, 08028, Spain
| | - Eliana Maria Barbosa Souto
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra (FFUC) and REQUIMTE/Group of Pharmaceutical Technology, Polo das Ciências da Saúde Azinhaga de Santa Comba, 3000-548, Coimbra, Portugal
| | - Nivedita Ravindran
- Glaucoma and Retinal Neurodegeneration Research, Visual Neuroscience, UCL Institute of Ophthalmology, Bath Street, London, EC1V 9EL, UK
| | - Miren Ettcheto
- Biomedical Research and Networking Center in Neurodegenerative diseases (CIBERNED), Madrid, 28031, Spain
- Department of Pharmacology, Toxicology and Therapeutic Chemistry, Faculty of Pharmacy, University of Barcelona, Barcelona, 08028, Spain
| | - Antonio Camins
- Biomedical Research and Networking Center in Neurodegenerative diseases (CIBERNED), Madrid, 28031, Spain
- Department of Pharmacology, Toxicology and Therapeutic Chemistry, Faculty of Pharmacy, University of Barcelona, Barcelona, 08028, Spain
| | - Maria Luisa García
- Department of Pharmacy and Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy, Institute of Nanoscience and Nanotechnology (IN2UB), University of Barcelona, Barcelona, 08028, Spain
| | - Maria Francesca Cordeiro
- Glaucoma and Retinal Neurodegeneration Research, Visual Neuroscience, UCL Institute of Ophthalmology, Bath Street, London, EC1V 9EL, UK
- Western Eye Hospital, Imperial College Healthcare Trust, London, UK
| |
Collapse
|
8
|
Neurodegeneration in diabetic retinopathy: Potential for novel therapies. Vision Res 2017; 139:82-92. [PMID: 28988945 DOI: 10.1016/j.visres.2017.06.014] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 06/12/2017] [Accepted: 06/14/2017] [Indexed: 11/20/2022]
Abstract
The complex pathology of diabetic retinopathy (DR) affects both vascular and neural tissue. The characteristics of neurodegeneration are well-described in animal models but have more recently been confirmed in the clinical setting, mostly by using non-invasive imaging approaches such as spectral domain optical coherence tomography (SD-OCT). The most frequent observations report loss of tissue in the nerve fiber layer and inner plexiform layer, confirming earlier findings from animal models. In several cases the reduction in inner retinal layers is reported in patients with little evidence of vascular lesions or macular edema, suggesting that degenerative loss of neural tissue in the inner retina can occur after relatively short durations of diabetes. Animal studies also suggest that neurodegeneration leading to retinal thinning is not limited to cell death and tissue loss but also includes changes in neuronal morphology, reduced synaptic protein expression and alterations in neurotransmission, including changes in expression of neurotransmitter receptors as well as neurotransmitter release, reuptake and metabolism. The concept of neurodegeneration as an early component of DR introduces the possibility to explore alternative therapies to prevent the onset of vision loss, including neuroprotective therapies and drugs targeting individual neurotransmitter systems, as well as more general neuroprotective approaches to preserve the integrity of the neural retina. In this review we consider some of the evidence for progressive retinal neurodegeneration in diabetes, and explore potential neuroprotective therapies.
Collapse
|
9
|
Jutley G, Luk SM, Dehabadi MH, Cordeiro MF. Management of glaucoma as a neurodegenerative disease. Neurodegener Dis Manag 2017; 7:157-172. [PMID: 28540772 DOI: 10.2217/nmt-2017-0004] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Glaucoma is a neurodegenerative disease with an estimated prevalence of 60 million people, and the most common cause of irreversible blindness worldwide. The mainstay of treatment has been aimed at lowering intraocular pressure, currently the only modifiable risk factor. Unfortunately, despite adequate pressure control, many patients go on to suffer irreversible visual loss. We first briefly examine currently established intraocular pressure lowering-treatments, with a discussion of their roles in neuroprotection as demonstrated by both animal and clinical studies. The review then examines currently available intraocular pressure independent agents that have shown promise for possessing neuroprotective effects in the management of glaucoma. Finally, we explore potential future treatments such as immune-modulation, stem cell therapy and neural regeneration as they may provide further protection against the neurodegenerative processes involved in glaucomatous optic neuropathy.
Collapse
Affiliation(s)
- Gurjeet Jutley
- Western Eye Hospital, Imperial College Healthcare Trust, London, UK
| | - Sheila Mh Luk
- Medical Retina, Moorfields Eye Hospital, NHS Foundation Trust, London, UK
| | - Mohammad H Dehabadi
- Glaucoma & Retinal Neurodegeneration Research Group, Visual Neuroscience, UCL Institute of Ophthalmology, London, UK.,Medical Retina, Moorfields Eye Hospital, NHS Foundation Trust, London, UK
| | - M Francesca Cordeiro
- Glaucoma & Retinal Neurodegeneration Research Group, Visual Neuroscience, UCL Institute of Ophthalmology, London, UK.,Western Eye Hospital, Imperial College Healthcare Trust, London, UK
| |
Collapse
|