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Keir LS, Firth R, Aponik L, Feitelberg D, Sakimoto S, Aguilar E, Welsh GI, Richards A, Usui Y, Satchell SC, Kuzmuk V, Coward RJ, Goult J, Bull KR, Sharma R, Bharti K, Westenskow PD, Michael IP, Saleem MA, Friedlander M. VEGF regulates local inhibitory complement proteins in the eye and kidney. J Clin Invest 2016; 127:199-214. [PMID: 27918307 PMCID: PMC5199702 DOI: 10.1172/jci86418] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 10/28/2016] [Indexed: 12/15/2022] Open
Abstract
Outer retinal and renal glomerular functions rely on specialized vasculature maintained by VEGF that is produced by neighboring epithelial cells, the retinal pigment epithelium (RPE) and podocytes, respectively. Dysregulation of RPE- and podocyte-derived VEGF is associated with neovascularization in wet age-related macular degeneration (ARMD), choriocapillaris degeneration, and glomerular thrombotic microangiopathy (TMA). Since complement activation and genetic variants in inhibitory complement factor H (CFH) are also features of both ARMD and TMA, we hypothesized that VEGF and CFH interact. Here, we demonstrated that VEGF inhibition decreases local CFH and other complement regulators in the eye and kidney through reduced VEGFR2/PKC-α/CREB signaling. Patient podocytes and RPE cells carrying disease-associated CFH genetic variants had more alternative complement pathway deposits than controls. These deposits were increased by VEGF antagonism, a common wet ARMD treatment, suggesting that VEGF inhibition could reduce cellular complement regulatory capacity. VEGF antagonism also increased markers of endothelial cell activation, which was partially reduced by genetic complement inhibition. Together, these results suggest that VEGF protects the retinal and glomerular microvasculature, not only through VEGFR2-mediated vasculotrophism, but also through modulation of local complement proteins that could protect against complement-mediated damage. Though further study is warranted, these findings could be relevant for patients receiving VEGF antagonists.
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Affiliation(s)
- Lindsay S. Keir
- Department of Cell and Molecular Biology, The Scripps Research Institute, La Jolla, California, USA
- Academic Renal Unit, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom
| | - Rachel Firth
- Academic Renal Unit, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom
| | - Lyndsey Aponik
- Department of Cell and Molecular Biology, The Scripps Research Institute, La Jolla, California, USA
| | - Daniel Feitelberg
- Department of Cell and Molecular Biology, The Scripps Research Institute, La Jolla, California, USA
| | - Susumu Sakimoto
- Department of Cell and Molecular Biology, The Scripps Research Institute, La Jolla, California, USA
| | - Edith Aguilar
- Department of Cell and Molecular Biology, The Scripps Research Institute, La Jolla, California, USA
| | - Gavin I. Welsh
- Academic Renal Unit, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom
| | - Anna Richards
- Queens Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Yoshihiko Usui
- Department of Cell and Molecular Biology, The Scripps Research Institute, La Jolla, California, USA
- Tokyo Medical University Hospital, Tokyo, Japan
| | - Simon C. Satchell
- Academic Renal Unit, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom
| | - Valeryia Kuzmuk
- Academic Renal Unit, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom
| | - Richard J. Coward
- Academic Renal Unit, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom
| | - Jonathan Goult
- Centre for Cellular and Molecular Physiology, University of Oxford, United Kingdom
| | - Katherine R. Bull
- Centre for Cellular and Molecular Physiology, University of Oxford, United Kingdom
| | - Ruchi Sharma
- National Eye Institute, NIH, Bethesda, Maryland, USA
| | - Kapil Bharti
- National Eye Institute, NIH, Bethesda, Maryland, USA
| | - Peter D. Westenskow
- Department of Cell and Molecular Biology, The Scripps Research Institute, La Jolla, California, USA
- The Lowy Medical Research Institute, La Jolla, California, USA
| | | | - Moin A. Saleem
- Academic Renal Unit, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom
| | - Martin Friedlander
- Department of Cell and Molecular Biology, The Scripps Research Institute, La Jolla, California, USA
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Paris LP, Johnson CH, Aguilar E, Usui Y, Cho K, Hoang LT, Feitelberg D, Benton HP, Westenskow PD, Kurihara T, Trombley J, Tsubota K, Ueda S, Wakabayashi Y, Patti GJ, Ivanisevic J, Siuzdak G, Friedlander M. Global metabolomics reveals metabolic dysregulation in ischemic retinopathy. Metabolomics 2016; 12:15. [PMID: 26617478 PMCID: PMC4651979 DOI: 10.1007/s11306-015-0877-5] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2015] [Accepted: 08/16/2015] [Indexed: 12/30/2022]
Abstract
Proliferative diabetic retinopathy (PDR) is the most severe form of diabetic retinopathy and, along with diabetic macular edema, is responsible for the majority of blindness in adults below the age of 65. Therapeutic strategies for PDR are ineffective at curtailing disease progression in all cases; however a deeper understanding of the ocular metabolic landscape in PDR through metabolomic analysis may offer new therapeutic targets. Here, global and targeted mass spectrometry-based metabolomics were used to investigate metabolism. Initial analyses on vitreous humor from patients with PDR (n = 9) and non-diabetic controls (n = 11) revealed an increase of arginine and acylcarnitine metabolism in PDR. The oxygen-induced-retinopathy (OIR) mouse model, which exhibits comparable pathological manifestations to human PDR, revealed similar increases of arginine and other metabolites in the urea cycle, as well as downregulation of purine metabolism. We validated our findings by targeted multiple reaction monitoring and through the analysis of a second set of patient samples [PDR (n = 11) and non-diabetic controls (n = 20)]. These results confirmed a predominant and consistent increase in proline in both the OIR mouse model and vitreous samples from patients with PDR, suggesting that over activity in the arginine-to-proline pathway could be used as a therapeutic target in diabetic retinopathy.
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Affiliation(s)
- Liliana P. Paris
- />Department of Cell and Molecular Biology, The Scripps Research Institute, MB 28, 10550 North Torrey Pines Road, La Jolla, CA 92037 USA
| | - Caroline H. Johnson
- />Scripps Center for Metabolomics and Mass Spectrometry, The Scripps Research Institute, 10550 North Torrey Pines Road, La Jolla, CA 92037 USA
| | - Edith Aguilar
- />Department of Cell and Molecular Biology, The Scripps Research Institute, MB 28, 10550 North Torrey Pines Road, La Jolla, CA 92037 USA
| | - Yoshihiko Usui
- />Department of Cell and Molecular Biology, The Scripps Research Institute, MB 28, 10550 North Torrey Pines Road, La Jolla, CA 92037 USA
- />Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023 Japan
| | - Kevin Cho
- />Departments of Chemistry, Genetics, and Medicine, Washington University School of Medicine, St. Louis, MO 63110 USA
| | - Lihn T. Hoang
- />Scripps Center for Metabolomics and Mass Spectrometry, The Scripps Research Institute, 10550 North Torrey Pines Road, La Jolla, CA 92037 USA
| | - Daniel Feitelberg
- />Department of Cell and Molecular Biology, The Scripps Research Institute, MB 28, 10550 North Torrey Pines Road, La Jolla, CA 92037 USA
| | - H. Paul Benton
- />Scripps Center for Metabolomics and Mass Spectrometry, The Scripps Research Institute, 10550 North Torrey Pines Road, La Jolla, CA 92037 USA
| | - Peter D. Westenskow
- />Department of Cell and Molecular Biology, The Scripps Research Institute, MB 28, 10550 North Torrey Pines Road, La Jolla, CA 92037 USA
- />The Lowy Medical Research Institute, 3030 N. Torrey Pines Court, La Jolla, CA 92037 USA
| | - Toshihide Kurihara
- />Department of Cell and Molecular Biology, The Scripps Research Institute, MB 28, 10550 North Torrey Pines Road, La Jolla, CA 92037 USA
| | - Jennifer Trombley
- />Department of Cell and Molecular Biology, The Scripps Research Institute, MB 28, 10550 North Torrey Pines Road, La Jolla, CA 92037 USA
- />The Lowy Medical Research Institute, 3030 N. Torrey Pines Court, La Jolla, CA 92037 USA
| | - Kinya Tsubota
- />Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023 Japan
| | - Shunichiro Ueda
- />Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023 Japan
| | - Yoshihiro Wakabayashi
- />Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023 Japan
| | - Gary J. Patti
- />Departments of Chemistry, Genetics, and Medicine, Washington University School of Medicine, St. Louis, MO 63110 USA
| | - Julijana Ivanisevic
- />Scripps Center for Metabolomics and Mass Spectrometry, The Scripps Research Institute, 10550 North Torrey Pines Road, La Jolla, CA 92037 USA
| | - Gary Siuzdak
- />Scripps Center for Metabolomics and Mass Spectrometry, The Scripps Research Institute, 10550 North Torrey Pines Road, La Jolla, CA 92037 USA
| | - Martin Friedlander
- />Department of Cell and Molecular Biology, The Scripps Research Institute, MB 28, 10550 North Torrey Pines Road, La Jolla, CA 92037 USA
- />The Lowy Medical Research Institute, 3030 N. Torrey Pines Court, La Jolla, CA 92037 USA
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Usui Y, Westenskow PD, Kurihara T, Aguilar E, Sakimoto S, Paris LP, Wittgrove C, Feitelberg D, Friedlander MSH, Moreno SK, Dorrell MI, Friedlander M. Neurovascular crosstalk between interneurons and capillaries is required for vision. J Clin Invest 2015; 125:2335-46. [PMID: 25915585 DOI: 10.1172/jci80297] [Citation(s) in RCA: 113] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Accepted: 03/19/2015] [Indexed: 12/21/2022] Open
Abstract
Functional interactions between neurons, vasculature, and glia within neurovascular units are critical for maintenance of the retina and other CNS tissues. For example, the architecture of the neurosensory retina is a highly organized structure with alternating layers of neurons and blood vessels that match the metabolic demand of neuronal activity with an appropriate supply of oxygen within perfused blood. Here, using murine genetic models and cell ablation strategies, we have demonstrated that a subset of retinal interneurons, the amacrine and horizontal cells, form neurovascular units with capillaries in 2 of the 3 retinal vascular plexuses. Moreover, we determined that these cells are required for generating and maintaining the intraretinal vasculature through precise regulation of hypoxia-inducible and proangiogenic factors, and that amacrine and horizontal cell dysfunction induces alterations to the intraretinal vasculature and substantial visual deficits. These findings demonstrate that specific retinal interneurons and the intraretinal vasculature are highly interdependent, and loss of either or both elicits profound effects on photoreceptor survival and function.
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Westenskow PD, Kurihara T, Bravo S, Feitelberg D, Sedillo ZA, Aguilar E, Friedlander M. Performing subretinal injections in rodents to deliver retinal pigment epithelium cells in suspension. J Vis Exp 2015:52247. [PMID: 25651341 DOI: 10.3791/52247] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The conversion of light into electrical impulses occurs in the outer retina and is accomplished largely by rod and cone photoreceptors and retinal pigment epithelium (RPE) cells. RPE provide critical support for photoreceptors and death or dysfunction of RPE cells is characteristic of age-related macular degeneration (AMD), the leading cause of permanent vision loss in people age 55 and older. While no cure for AMD has been identified, implantation of healthy RPE in diseased eyes may prove to be an effective treatment, and large numbers of RPE cells can be readily generated from pluripotent stem cells. Several interesting questions regarding the safety and efficacy of RPE cell delivery can still be examined in animal models, and well-accepted protocols used to inject RPE have been developed. The technique described here has been used by multiple groups in various studies and involves first creating a hole in the eye with a sharp needle. Then a syringe with a blunt needle loaded with cells is inserted through the hole and passed through the vitreous until it gently touches the RPE. Using this injection method, which is relatively simple and requires minimal equipment, we achieve consistent and efficient integration of stem cell-derived RPE cells in between the host RPE that prevents significant amount of photoreceptor degeneration in animal models. While not part of the actual protocol, we also describe how to determine the extent of the trauma induced by the injection, and how to verify that the cells were injected into the subretinal space using in vivo imaging modalities. Finally, the use of this protocol is not limited to RPE cells; it may be used to inject any compound or cell into the subretinal space.
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Affiliation(s)
- Peter D Westenskow
- Department of Cell and Molecular Biology, The Scripps Research Institute; Lowy Medical Research Institute;
| | - Toshihide Kurihara
- Department of Cell and Molecular Biology, The Scripps Research Institute
| | - Stephen Bravo
- Department of Cell and Molecular Biology, The Scripps Research Institute
| | - Daniel Feitelberg
- Department of Cell and Molecular Biology, The Scripps Research Institute
| | | | - Edith Aguilar
- Department of Cell and Molecular Biology, The Scripps Research Institute
| | - Martin Friedlander
- Department of Cell and Molecular Biology, The Scripps Research Institute; Lowy Medical Research Institute;
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