Browsing by Subject "Glaucoma, Open-Angle"
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Item The Effects of Ad5.CMV.hTGFβ2C226/228S on AHD in Mice(2021-05) Stevenson, Cooper H.; Millar, J. Cameron; Tovar-Vidales, Tara; Stankowska, Dorota L.Elevated intraocular pressure (IOP) is a key risk factor for the development of primary open-angle glaucoma (POAG), a leading cause of blindness in people over the age of 40 years. Transforming growth factor beta-2 is a cytokine known to contribute to the pathogenesis of POAG due to its deleterious effects on aqueous humor outflow via the conventional, or trabecular, outflow pathway in the eye. However, its effects on the rate of aqueous outflow (Fu) via the unconventional or uveoscleral outflow pathway, rate of aqueous humor production (Fin), and episcleral venous pressure (Pe) are unknown. Further, effects of euthanasia and enucleation in our hands on TGFβ2-mediated effects on Fu are also unknown. The goal of the present study was to quantify the impact of over-expression of TGFβ2 on aqueous humor dynamics (AHD) in the mouse eye, with special emphasis on Fu, Fin, and Pe in the mouse eye. To simulate TGFβ2 over-expression, left (OS) eyes were injected intravitreally (IVT) with a mutant form of TGFβ2 (Ad5.CMV.hTGFβ2C226/228S, 2×10⁷pfu in 2μL), while right (OD) eyes were injected IVT with a null virus (Ad5.CMV.null, same titer and volume). Following 14 days, after which time mean IOP (determined tonometrically in conscious mice) had become elevated in TGFβ2-injected eyes (84.29% increase in IOP, P < 0.001), Fu was determined directly by cannulating the anterior aqueous chamber (AC) and perfusing it with fluorescein isothiocyanate-dextran (1×10⁻⁹ M), followed by dissection of the retina/choroid/iris-ciliary body/scleral shell, homogenization, and measurement of each sample's fluorescence, and then inference of flow rate using a standard curve. Those perfusion were performed in living eyes, also in eyes in situ in the animal immediately following euthanasia, and enucleated eyes perfused in vivo either (i) exposed to air, or (ii) submerged in PBS. In a further group of experiments in living animals aqueous humor outflow conductance (C) (also known as aqueous humor outflow facility), and Pe were measured, and then Fin and Fu were calculated using a constant flow infusion method. Further, we sought to determine whether IOP elevation would lead to a reduction in RGC numbers in the retina, so retinal flat mounts from both treated and untreated eyes from 5 of our animals were prepared and RGC counts were made. For eyes perfused in-vivo, Fu was reduced in OS (0.0048 ± 0.0017 μL/min) compared to OD (0.0987 ± 0.0126 μL/min, P = 0.025). For eyes perfused in euthanatized mice, Fu was reduced in OS (0.0215 ± 0.0101 μL/min) compared to OD (0.1543 ± 0.0241 μL/min, P = 0.010). For eyes perfused ex-vivo while submerged in PBS, there was no difference in Fu between OS (0.0222 ± 0.0065 μL/min) and OD (0.0137 ± 0.0078 μL/min, P = 0.175). For eyes perfused ex-vivo while exposed to air, Fu was reduced in OS (0.0702 ± 0.0087 μL/min) compared to OD (0.1377 ± 0.0106 μL/min, P = 0.008). Fin showed a trend towards a reduction in the eyes in which TGFβ2 was over-expressed, but this effect did not reach statistical significance. There was a significant increase in Pe in eyes in which TGFβ2 was expressed (8.6 ± 0.7 mmHg in OS to 6.4 ± 0.2 mmHg in OD, P = 0.015). Given these results, the present study further quantifies the effect of TGFβ2 in POAG, providing more insight into its mechanism of action in this disease.Item The Role of Mechanosensory TRPV4 Channels and Nitric Oxide Signaling in Intraocular Pressure Homeostasis and its Impairment in Glaucoma(2020-08) Patel, Pinkal D.; Zode, Gulab S.; Clark, Abbot F.; Pang, Iok-Hou; Krishnamoorthy, Raghu R.; Rickards, Caroline A.Several population-based studies have identified elevated intraocular pressure (IOP) as a major causative risk factor associated with primary open angle glaucoma (POAG), the most common form of glaucoma that affects millions of people worldwide. Moreover, multi-ethnic clinical trials in several different countries over the last few decades have provided overwhelming evidence showing correlation between lowering of IOP and reduced progression of vision loss. As a result, IOP reducing therapeutic interventions are the gold standard in glaucoma therapy. Although the role of IOP is evident in pathology of POAG, very few studies have delved into the complex physiological mechanisms that regulate IOP homeostasis. From continuous telemetry recordings in nonhuman primates, we now know that IOP is a dynamic variable that fluctuates throughout the day. However, despite the fluctuations, the mean IOP is still maintained within a narrow physiological range. The level of IOP elevation at any given time depends on the resistance to aqueous humor outflow encountered in the conventional outflow pathway consisting of the trabecular meshwork (TM), Schlemm's canal (SC), and the distal episcleral vessels. Recent studies have suggested that the cells of the outflow pathway have intrinsic ability to detect biomechanical stimuli in their environment (like shear stress) and convert these stimuli into biochemical signals to elicit specific cellular responses. Although mechanotransduction at the TM is deemed critical for IOP homeostasis, we are yet to conclusively identify the exact signaling pathway involved. In this study, we identify the role of transient receptor potential vanilloid IV channels (TRPV4) in sensing mechanical stress on the TM. We show that shear stress activates TRPV4 channels in human primary TM cells, which leads to endothelial nitric oxide synthase (eNOS)-dependent nitric oxide (NO) production. NO, itself has been identified as a key regulator of IOP. Exogenous NO delivery to the eye has been shown to reduce IOP in humans. However, the underlying mechanism that regulates endogenous levels of NO still remains unknown. To this end, we demonstrate that TRPV4 channels regulate eNOS-dependent NO production in primary human TM cells and ex vivo cultured human TM tissues. We show that TRPV4 activation by mechanical shear leads to activation of eNOS signaling and NO production. Furthermore, pharmacological activation of TRPV4 channels via a selective agonist GSK1016790A (GSK101) leads to eNOS phosphorylation and NO production. In animal models, we demonstrate a role of TRPV4 channels in regulating physiological IOP. Treatment of C57BL/6J mouse eyes with TRPV4 agonist GSK101 leads to reduction in baseline night-time IOP and nominal improvement in outflow facility. We also show that conditional knockout of TRPV4 channels in Ad5-Cre injected TRPV4f/f mice leads to increase in IOP. We use the NOS3-/- (eNOS) to further show that TRPV4 mediated lowering of IOP is eNOS dependent. Dysregulation of the TM cells leads to increase in resistance and IOP elevation. Furthermore, glaucomatous human TM cells show impaired activity of TRPV4 channels and disrupted TRPV4-eNOS signaling. Flow/shear stress activation of TRPV4 channels and subsequent NO release were also impaired in glaucomatous primary human TM cells. Together, our studies demonstrate a central role for TRPV4-eNOS signaling in lowering the resting IOP. Our results also provide evidence that impaired TRPV4 channel activity in TM cells contributes to TM dysfunction and elevated IOP in glaucoma.Item The Role of Transforming Growth Factor Beta 2 Signaling and MicroRNAs in Optic Nerve Head Remodeling(2020-08) Lopez, Navita N.; Clark, Abbot F.; Tovar-Vidales, Tara; Liu, Yang; Pang, Iok-HouPrimary open-angle glaucoma (POAG) is a prevalent age-related neurodegenerative disease of the visual system. There are functional and morphological changes in the retina, optic nerve head (ONH) and brain that lead to an irreversible loss of vision. POAG is characterised by degeneration of retinal ganglion cells (RGC), thinning of the neuro-retinal rim and structural deformation of the ONH. The primary site of injury is the lamina cribrosa, which is a fibro-elastic connective tissue that supports the ONH and unmyelinated RGC axons as they exit the intraocular space. Pathological changes to the lamina cribrosa include posterior displacement of the lamina cribrosa, loss of trophic support, and remodeling of the extracellular matrix (ECM). An important growth factor associated with tissue remodeling is TGFb2. TGFb2 activates the SMAD-dependent TGFb2 pathway and increases transcription of several ECM genes including collagen, fibronectin and crosslinking enzymes. In POAG, the levels of TGFb2 are increased in the lamina cribrosa and is associated with excess deposition of ECM molecules. This study proposes to investigate the intermediary mechanisms that lead to tissue remodeling. microRNAs (miRNAs) regulate gene expression by inhibiting protein translation. We hypothesized that miRNAs are dysregulated in POAG and in response to TGFb2, which leads to excess ECM synthesis and tissue remodeling. We isolated primary human ONH astrocytes and lamina cribrosa cells from POAG and normal donor eyes. We used miRNA PCR arrays to determine differentially expressed miRNAs in POAG and TGFb2 treated cells. Several anti-fibrotic miRNAs were downregulated, including downregulation of miR-29c-3p in POAG and TGFb2 treated lamina cribrosa cells, and downregulation of miR-200b-3p in TGFb2 treated ONH astrocytes. To validate mRNA targets and determine the functional role of differentially expressed miRNAs, we modulated miRNA biology using miRNA mimics and inhibitors. Overexpression of miR-29c-3p and miR-200b- decreased the expression of ECM proteins. Treatment with TGFb2 increased the expression of collagens and fibronectin and overexpression of miR-29c-3p and miR-200b-3p decreased this effect, suggesting that miR-29c-3p and miR-200b-3p regulate the TGFb2 signaling pathway. It is possible that increased TGFb2 is responsible for tissue remodeling through inhibition of anti-fibrotic miRNAs and a subsequent increase in ECM synthesis.