Glucocorticoid Receptor Transactivation Is Required for Glucocorticoid-Induced Ocular Hypertension and Glaucoma

dc.creatorPatel, Gaurang C.
dc.creatorMillar, J. Cameron
dc.creatorClark, Abbot F.
dc.creator.orcid0000-0003-3594-6560 (Clark, Abbot F.)
dc.description.abstractPurpose: Glucocorticoid (GC)-induced ocular hypertension (GC-OHT) is a serious side effect of prolonged GC therapy that can lead to glaucoma and permanent vision loss. GCs cause a plethora of changes in the trabecular meshwork (TM), an ocular tissue that regulates intraocular pressure (IOP). GCs act through the glucocorticoid receptor (GR), and the GR regulates transcription both through transactivation and transrepression. Many of the anti-inflammatory properties of GCs are mediated by GR transrepression, while GR transactivation largely accounts for GC metabolic effects and side effects of GC therapy. There is no evidence showing which of the two mechanisms plays a role in GC-OHT. Methods: GRdim transgenic mice (which have active transrepression and impaired transactivation) and wild-type (WT) C57BL/6J mice received weekly periocular dexamethasone acetate (DEX-Ac) injections. IOP, outflow facilities, and biochemical changes to the TM were determined. Results: GRdim mice did not develop GC-OHT after continued DEX treatment, while WT mice had significantly increased IOP and decreased outflow facilities. Both TM tissue in eyes of DEX-treated GRdim mice and cultured TM cells isolated from GRdim mice had reduced or no change in the expression of fibronectin, myocilin, collagen type I, and alpha-smooth muscle actin (alpha-SMA). GRdim mouse TM (MTM) cells also had a significant reduction in DEX-induced cytoskeletal changes, which was clearly seen in WT MTM cells. Conclusions: We provide the first evidence for the role of GR transactivation in regulating GC-mediated gene expression in the TM and in the development of GC-OHT. This discovery suggests a novel therapeutic approach for treating ocular inflammation without causing GC-OHT and glaucoma.
dc.description.sponsorshipSupported by National Eye Institute (NEI) Grant EY016242 (AFC).
dc.identifier.citationPatel, G. C., Millar, J. C., & Clark, A. F. (2019). Glucocorticoid Receptor Transactivation Is Required for Glucocorticoid-Induced Ocular Hypertension and Glaucoma. Investigative ophthalmology & visual science, 60(6), 1967-1978.
dc.publisherARVO Journals
dc.rights.holderCopyright 2019 The Authors
dc.rights.licenseAttribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)
dc.sourceInvestigative Ophthalmology & Visual Science
dc.subject.meshBlotting, Western
dc.subject.meshCells, Cultured
dc.subject.meshDisease Models, Animal
dc.subject.meshGene Expression Regulation
dc.subject.meshGlaucoma / chemically induced
dc.subject.meshGlaucoma / genetics
dc.subject.meshGlaucoma / metabolism
dc.subject.meshGlucocorticoids / adverse effects
dc.subject.meshIntraocular Pressure
dc.subject.meshMice, Inbred C57BL
dc.subject.meshMice, Transgenic
dc.subject.meshOcular Hypertension / chemically induced
dc.subject.meshOcular Hypertension / genetics
dc.subject.meshOcular Hypertension / metabolism
dc.subject.meshRNA / genetics
dc.subject.meshReceptors, Glucocorticoid / biosynthesis
dc.subject.meshReceptors, Glucocorticoid / genetics
dc.subject.meshTranscriptional Activation
dc.titleGlucocorticoid Receptor Transactivation Is Required for Glucocorticoid-Induced Ocular Hypertension and Glaucoma


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