Advances in pharmacological strategies for the prevention of cataract development

Natural Product Isolation of the Extract of Cleome rupicola Fruits Exhibiting Antioxidant Activity

Cataracts are the leading cause of blindness worldwide, however, there is currently no drug-based treatment. Plants that exhibit antioxidant properties have shown promising anticataract effects, likely because they supplement the activity of glutathione, the major antioxidant in lens cells. An extract of Cleome rupicola, a desert plant found in the United Arab Emirates, has traditionally been used to treat cataracts. Phytochemical screening of the aqueous extract established the presence of flavonoids, tannins, steroid derivatives, and reducing sugars. Fractioning of extracts from the fruits using high-performance liquid chromatography (HPLC) yielded the isolation of the anthelmintic compound cleomin, and its structure was confirmed using mass spectrometry (MS) and nuclear magnetic resonance (NMR) spectroscopy.

Exploring the Protective Effect and Mechanism of Buddlejae Flos on Sodium Selenite-Induced Cataract in Rats by Network Pharmacology, Molecular Docking, and Experimental Validation

Objective

Buddlejae Flos has a long history of utilization by humans to treat ophthalmic diseases. Although in vitro study revealed that it can be used for treating cataract, the bioactive components and the mechanism of efficacy remained unclear. This study aims to discover the bioactive components and mode of efficacy of Buddlejae Flos in cataract treatment.

Methods

Several databases were screened for bioactive components and corresponding targets, as well as cataract-related targets. Using the String database, common targets were determined and utilized to construct protein-protein interactions (PPI). The drug-component-target-disease network map was drawn using Cytoscape software. R language was utilized to execute Kyoto Encyclopedia of Genes and Genomes (KEGG) and Gene Ontology (GO) pathway enrichment analysis. Molecular docking was done through Schrödinger Maestro software utilization. Luteolin's (LUT) effect on cataract induced by sodium selenite in rat pups was evaluated.

Results

Six bioactive components with 38 common targets were identified as being associated with cataract. TP53, AKT1, EGFR, CASP3, TNF, ESR1, INS, IL6, HIF1A, and VEGFA were identified as core targets in PPI analysis, and the binding energy of LUT with AKT was the lowest. LUT has been demonstrated to significantly lower MDA levels, raise glutathione (GSH) levels, and boost the activity of antioxidant enzymes like GST, SOD, GPx, and CAT. After LUT treatment, TNF-a, IL-2, and IL-6 levels were significantly lowered. Bcl-2 mRNA expression levels and p-PI3K and p-AKT protein expression were significantly elevated. In contrast, caspase-3 and Bax mRNA expression levels were significantly decreased.

Conclusion

This study demonstrates that LUT is a possible bioactive component that may be utilized for cataract treatment. Its mode of action includes oxidative stress suppression, reducing inflammation, and inhibiting apoptosis via regulating the PI3K/AKT single pathway.

Biochemistry of Eye Lens in the Norm and in Cataractogenesis

The absence of cellular organelles in fiber cells and very high cytoplasmic protein concentration (up to 900 mg/ml) minimize light scattering in the lens and ensure its transparency. Low oxygen concentration, powerful defense systems (antioxidants, antioxidant enzymes, chaperone-like protein alpha-crystallin, etc.) maintain lens transparency. On the other hand, the ability of crystallins to accumulate age-associated post-translational modifications, which reduce the resistance of lens proteins to oxidative stress, is an important factor contributing to the cataract formation. Here, we suggest a mechanism of cataractogenesis common for the action of different cataractogenic factors, such as age, radiation, ultraviolet light, diabetes, etc. Exposure to these factors leads to the damage and death of lens epithelium, which allows oxygen to penetrate into the lens through the gaps in the epithelial layer and cause oxidative damage to crystallins, resulting in protein denaturation, aggregation, and formation of multilamellar bodies (the main cause of lens opacification). The review discusses various approaches to the inhibition of lens opacification (cataract development), in particular, a combined use of antioxidants and compounds enhancing the chaperone-like properties of alpha-crystallin. We also discuss the paradox of high efficiency of anti-cataract drugs in laboratory settings with the lack of their clinical effect, which might be due to the late use of the drugs at the stage, when the opacification has already formed. A probable solution to this situation will be development of new diagnostic methods that will allow to predict the emergence of cataract long before the manifestation of its clinical signs and to start early preventive treatment.

Topical Administration of ACE Inhibitor Interrupts the Progression of Cataract in Two Kidney One Clip Induced Hypertensive Cataract Model

PURPOSE

Previously, we assessed that hypertension increases cataractogenesis. In the present study, we evaluated the effect of oral and topical administration of enalapril on two kidney one clip (2K1C)-induced hypertensive cataract model by evaluating the biochemical alteration of lenticular antioxidants, ionic content, ATPase activity, protein content and careful examination of the lenticular opacity.

MATERIALS AND METHOD

Animals were divided into normal and hypertensive animals. Hypertensive animals were divided into hypertensive control group (0.3% CMC), enalapril (oral) treatment group (20 mg/kg/day; p.o), and enalapril (topical) treatment group (0.1% w/v on the eye cornea) for a period of twelve weeks. During experimental study blood pressure, heart rate and morphology of the eyes were monitored biweekly. After twelve weeks, lenses were photographed and various catractogenic biochemical parameters were assessed.

RESULTS

Enalapril (oral) treatment conserved the blood pressure (systolic and diastolic), restored the level of antioxidants, restored the lipid peroxidation marker, nitrite content, ionic content, ATPase function, protein content, and thus delayed the cataract formation. While, enalapril (topical) treatment exhibited anti-cataract effect without affecting the systolic and diastolic blood pressure that could be by restoring the antioxidant level, maintaining the ionic balance, balancing the protein levels, and by inhibiting the upregulated ocular renin angiotensin system. The overall results suggest that enalapril (topical) treatment showed conspicuous effect than enalapril (oral) treatment in adjourning the cataract formation.

CONCLUSION

Based on the results, it may be concluded that upregulated ocular RAS by increasing oxidative stress and by misbalancing the lenticular ionic and protein content may lead to cataract formation in hypertensive condition.

Age-related ocular conditions: Current treatments and role of cyclodextrin-based nanotherapies

Age-related eye disorders are chronic diseases that affect millions of people worldwide. They cause visual impairment and, in some cases, irreversible blindness. Drug targeting to the retina is still a challenge due to the difficulties with drug distribution, crossing eye barriers, and reaching intraocular tissues in an effective therapeutic concentration. Although intravitreal injections can directly deliver drugs to the posterior segment of the eye, it remains an invasive technique and leads to several side effects. Conventional formulations such as emulsions, suspensions, or ointments have been related to frequent instillation and inability to reach intraocular tissues. New drug delivery systems and medical devices have also been designed. Nevertheless, these treatments are not always effective and sometimes require the presence of a specialist for the administration of the dose. Therefore, treatments for age-related ocular diseases remain as one of the major unmet clinical needs to manage these widespread eye conditions. Nanotechnology may become the adequate tool for developing effective and non-invasive therapies suitable for self-administration. In this review, we discuss emerging therapeutic options based on nanoengineering of cyclodextrin nanocarriers for the treatment of age-related eye disorders, including their pathophysiology, pharmacological options, and feasibility of clinical translation.

Advances in pharmacotherapy of cataracts

Cataracts, the leading cause of vision impairment worldwide, arise from abnormal aggregation of lens proteins. According to the World Health Organization, cataracts cause more than 40% of blindness cases. As the population ages, the prevalence of cataracts will increase rapidly. Although cataract surgery is regarded as effective, it still suffers from complications and high cost, and could not meet the increasingly surgery demand. Therefore, pharmacological treatment for cataracts is a cheaper and more readily available option for patients, which is also a hot topic for years. Anti-cataract drug screening was previously mainly based on the specific pathogenic factors: oxidative stress, excess of quinoid substances, and aldose reductase (AR) activation. And several anti-cataract drugs have been applied in the clinic, while the effect is still unsatisfied. Makley and Zhao recently identified two kinds of novel pharmacological substances (25-hydroxycholesterol, lanosterol) that can reverse lens opacity by dissolving the aggregation of crystallin proteins, indicating that protein aggregation is not an endpoint and could be reversed with specific small-molecule drugs, significantly boosting the development of the cataract pharmacopeia and being regarded as a new dawn for cataract treatment. Our team built a novel optimized platform and had screened several potential therapeutic agents from a collection of lanosterol derivatives. In this review, we would mainly focus on the advancement of cataract pharmacotherapy based on the targets for anti-cataract drugs.

A Mechanistic Review of β-Carotene, Lutein, and Zeaxanthin in Eye Health and Disease

Carotenoids are natural lipid-soluble antioxidants abundantly found as colorful pigments in fruits and vegetables. At least 600 carotenoids occur naturally, although about 20 of them, including β-carotene, α-carotene, lycopene, lutein, zeaxanthin, meso-zeaxanthin, and cryptoxanthin, are detectable in the human blood. They have distinct physiological and pathophysiological functions ranging from fetal development to adult homeostasis. β-carotene is a precursor of vitamin A that essentially functions in many biological processes including vision. The human macula lutea and eye lens are rich in lutein, zeaxanthin, and meso-zeaxanthin, collectively known as macular xanthophylls, which help maintain eye health and prevent ophthalmic diseases. Ocular carotenoids absorb light from the visible region (400-500 nm wavelength), enabling them to protect the retina and lens from potential photochemical damage induced by light exposure. These natural antioxidants also aid in quenching free radicals produced by complex physiological reactions and, consequently, protect the eye from oxidative stress, apoptosis, mitochondrial dysfunction, and inflammation. This review discusses the protective mechanisms of macular xanthophylls in preventing eye diseases such as cataract, age-related macular degeneration, and diabetic retinopathy. Moreover, some preclinical animal studies and some clinical trials are discussed briefly to understand carotenoid safety and efficacy.

Immunoreactivity of ICAM-1, MMP-2, and Nesfatin-1 in lens epithelial cells of patients with diabetes mellitus with or without diabetic retinopathy

PURPOSE

The aim of this study was to evaluate the immunoreactivity of matrix metalloproteinases-2 (MMP-2), intercellular adhesion molecule-1 (ICAM-1), and nesfatin-1 in cataract lens epithelial cells (LECs) of patients with diabetes mellitus (DM) and to investigate the relationship of these markers with DM cataract and diabetic retinopathy (DR).

MATERIALS AND METHODS

Ninety patients were included in the study. The patients were divided into three groups (n = 30): Group 1 (control; patients without DM or DR); Group 2 (patients with DM only), and Group 3 (patients with both DM and DR). Lens capsule samples were collected during intraoperative cataract surgery. Samples were immunohistochemically stained for MMP-2, ICAM-1, and nesfatin-1 and their immunoreactivity was evaluated. The number of immunoreactive cells was determined with a microscope at ×400 magnification.

RESULTS

Increased MMP-2 and ICAM-1 immunoreactivity was detected in the LECs of patients with DM, and especially in patients with DR (p < 0.001, p < 0.001, respectively). Nesfatin-1 immunoreactivity was significantly lower in LECs of diabetic patients (p < 0.001). The mean of MMP-2 immunoreactive cells were 7.47 ± 8.18, 22.80 ± 15.70, and 34.80 ± 20.85 in Groups 1, 2, and 3, respectively. The mean of ICAM-1 immunoreactive cells were 17.10 ± 9.83, 38.50 ± 23.55, and 56.93 ± 20.94 in Groups 1, 2, and 3, respectively.

CONCLUSION

Nesfatin-1, MMP-2, and ICAM-1 and could potentially play important roles in the pathogenesis of cataracts in patients with DM.

Current Trends in the Pharmacotherapy of Cataracts

Cataracts, one of the leading causes of preventable blindness worldwide, refers to lens degradation that is characterized by clouding, with consequent blurry vision. As life expectancies improve, the number of people affected with cataracts is predicted to increase worldwide, especially in low-income nations with limited access to surgery. Although cataract surgery is considered safe, it is associated with some complications such as retinal detachment, warranting a search for cheap, pharmacological alternatives to the management of this ocular disease. The lens is richly endowed with a complex system of non-enzymatic and enzymatic antioxidants which scavenge reactive oxygen species to preserve lens proteins. Depletion and/or failure in this primary antioxidant defense system contributes to the damage observed in lenticular molecules and their repair mechanisms, ultimately causing cataracts. Several attempts have been made to counteract experimentally induced cataract using in vitro, ex vivo, and in vivo techniques. The majority of the anti-cataract compounds tested, including plant extracts and naturally-occurring compounds, lies in their antioxidant and/or free radical scavenging and/or anti-inflammatory propensity. In addition to providing an overview of the pathophysiology of cataracts, this review focuses on the role of various categories of natural and synthetic compounds on experimentally-induced cataracts.

Standardization of a new method for assessing the development of cataract in cultured bovine lenses

PURPOSE

To standardize a new method for assessing cataractogenesis in isolated cultured bovine lenses using L-cysteine as the standard anti-cataract agent.

METHODS

Intact bovine lenses were cultured in DMEM with L-cysteine in presence or absence of hydrogen peroxide (H₂O₂). Lens opacity (transmittance) was determined using a plate reader. Lens homogenate glutathione (GSH) and superoxide dismutase (SOD) contents were measured using enzyme immunoassays kits.

RESULTS

DMEM-cultured lenses exhibited a time-dependent loss in transmittance (230-710 nm) up to 120 h, achieving the highest reduction of 38.6 ± 0.09% at 420 nm (p < .001;n = 12). Compared to untreated lenses (time in hours [t] = 0), L-cysteine (10^-6 M and 10^-5 M) significantly (p < .001;n = 6) increased time-dependent transmittance (420 nm) by 31.6 ± 0.17% and 28.0 ± 0.07%(t = 120), respectively. When compared to DMEM-cultured lenses (t = 0), H₂O₂ (10 mM, 50 mM and 100 mM) significantly (p < .001;n = 12) reduced transmittance by 57.8 ± 0.1, 57.4 ± 0.04 and 87.7 ± 0.6%(t = 120), respectively. Moreover, L-cysteine significantly (p < .001;n = 6) attenuated H₂O₂ (50 mM)-induced decrease in transmittance by 12.5 ± 0.05%(10^-6 M), 13.0 ± 0.09%(10^-5 M), 14.5 ± 0.08%(10^-4 M) and 8.6 ± 0.11%(10^-3 M)(t = 120), respectively. When compared to untreated lenses (t = 0), the time-dependent decrease (p < .001;n = 5) in lenticular total GSH content and total SOD activity of 46.1 ± 0.06% and 42.0 ± 1.65% (t = 120) was attenuated (p < .001;n = 5) by L-cysteine (10^-6 M) by 76.6 ± 0.06% and 7.4 ± 1.98%, respectively. Similarly, the H₂O₂(50 mM)-induced decline (p < .001; n = 5) in total GSH content and SOD activity of 82.6 ± 0.08% and 86.6 ± 0.66% (t = 120) was attenuated by L-cysteine (10^-4 M) by 74.7 ± 1.05% and 161.1 ± 4.9%, respectively.

CONCLUSION

Measurement of spectral transmission coupled with assessment of the activity of antioxidant enzymes in bovine cultured lens can provide a useful tool in studies of cataracts in an animal model of this disease.

Risk of cataract in smokers: A meta-analysis of observational studies

OBJECTIVE

The aim of the study was to compare the risk of cataract in smokers and ex-smokers.

METHODS

A systematic search of observational studies was carried out in Medline, Embase, and Lilacs databases. Studies that have evaluated the association between cigarette smoking and any type of clinically diagnosed cataract were selected. The association estimators were extracted, adjusted at least by age, and were combined using random-effects models, by subtype of study (cohort, case control and cross sectional), subtype of cataract (nuclear, cortical, and posterior subcapsular), and exposure (current smoker or ex-smoker). Statistical heterogeneity, meta-regression analysis and publication bias were assessed.

RESULTS

A total of 13 cohort studies, 12 case-control studies, and 18 cross-sectional studies were selected. A risk of cataract was found in current smokers: cohort (OR: 1.41; 95%CI: 1.24-1.60), cases and controls (OR: 1.45; 95%CI: 1.08-1.96), and cross-sectional studies (OR: 1.21; 95%CI: 1.09-1.34); risk of nuclear cataract: cohort (OR: 1.71; 95%CI: 1.47-1.98), case-control (OR: 1.79; 95%CI: 1.43-2.25), and cross sectional studies (OR: 1.45; 95%CI: 1.27-1.65). There was no risk of cortical or posterior subcapsular cataract in ex-smokers.

CONCLUSIONS

There is a risk of cataract in smokers, particularly nuclear type. With cross-sectional studies, similar results are obtained with cohorts and cases and controls.

Ursodeoxycholic acid suppresses the formation of fructose/streptozotocin-induced diabetic cataract in rats

The main objective of this study was to investigate the potential protective effect of ursodeoxycholic acid (UDCA) on fructose/streptozotocin-induced diabetic cataract in rats. The diabetic model (DM) was induced through the administration of 10% fructose in drinking water for 2 weeks followed by streptozotocin injection (intraperitoneal). One week later, hyperglycemia was assisted and diabetic animals were treated with UDCA either as local eye drops (0.5% solution, four times/day) or orally (100 mg/kg b.w.). Cataract formation was monitored biweekly and scored into four stages. After 12 weeks of treatment, rats were subjected to ophthalmological examination, and then, their blood and lenses were prepared for biochemical analysis of glucose, insulin, reduced glutathione, total antioxidant capacity, malondialdehyde, hydrogen peroxide, caspase-12, and lenticular total proteins. In addition, tertiary structure and conformational changes of lenticular soluble proteins were analyzed using SDS-PAGE and UV absorption while changes in lenticular α-crystallin structure were investigated using intrinsic tryptophan fluorescence. Results demonstrated that both local and oral UDCA restored the normal levels of lens T-AOC, MDA, H₂ O₂ , and caspase-12 and improved noticeably the levels of the lens GSH and total proteins. In addition, conformational and tertiary structure changes of soluble lens proteins were significantly reduced in UDCA-treated groups. Morphological examination of lenses revealed decreased score of cataract progression in UDCA-treated groups compared to DM animals. It was concluded that UDCA decreased the incidence of diabetic cataract by maintaining the antioxidant status, reducing the endoplasmic reticulum stress, and suppressing the structural changes of soluble lens proteins.

Expression of SIRT1 and P53 in Rat Lens Epithelial cells in Experimentally Induced DM

PURPOSE

To determine the etiopathogenesis of diabetic cataract by studying changes in relative expressions of silent information regulator protein-1 (SIRT1) and P53 in rat lens epithelial cells (LECs) in experimentally induced diabetes mellitus (DM).

METHODS

Six-week-old male SD rats (n = 120) were randomly divided into experimental (n = 80 rats) and control (n = 40 rats) groups. DM was induced in the experimental group (diabetic model) by intraperitoneal (i.p.) injection of 60 mg/kg streptozotocin (STZ). Control group rats were injected similarly with phosphate-buffered saline (PBS). Four and eight weeks after successful induction of DM, relative expressions of SIRT1 and P53 in LECs were analyzed using quantitative real-time (qRT) fluorescence polymerase chain reaction (qRT-PCR) and Western blot analysis.

RESULTS

Expression of both SIRT1 and P53 was observed in LECs of control and experimental group rats at 4 and 8 weeks but was significantly greater in experimental compared with control group rats (p < 0.05).

CONCLUSIONS

Expression of both SIRT1 and P53 increases in the early stages of diabetic cataract formation, indicating that they play potentially important roles in the pathogenesis of diabetic cataract.

A silent mutation in human alpha-A crystallin gene in patients with age-related nuclear or cortical cataract

A cataract is a complex multifactorial disease that results from alterations in the cellular architecture, i.e. lens proteins. Genes associated with the development of lens include crystallin genes. Although crystallins are highly conserved proteins among vertebrates, a significant number of polymorphisms exist in human population. In this study, we screened for polymorphisms in crystallin alpha A (CRYAA) and alpha B (CRYAB) genes in 200 patients over 40 years of age, diagnosed with age-related cataract (ARC; nuclear and cortical cataracts). Genomic DNA was extracted from the peripheral blood. The coding regions of the CRYAA and CRYAB gene were amplified using polymerase chain reaction and subjected to restriction digestion. Restriction fragment length polymorphism (RFLP) was performed using known restriction enzymes for CRYAA and CRYAB genes. Denaturing high performance liquid chromatography and direct sequencing were performed to detect sequence variation in CRYAA gene. In silico analysis of secondary CRYAA mRNA structure was performed using CLC RNA Workbench. RFLP analysis did not show any changes in the restriction sites of CRYAA and CRYAB genes. In 6 patients (4 patients with nuclear cataract and 2 with cortical cataract), sequence analysis of the exon 1 in the CRYAA gene showed a silent single nucleotide polymorphism [D2D] (CRYAA: C to T transition). One of the patients with nuclear cataract was homozygous for this allele. The in silico analysis revealed that D2D mutation results in a compact CRYAA mRNA secondary structure, while the wild type CRYAA mRNA has a weak or loose secondary structure. D2D mutation in the CRYAA gene may be an additional risk factor for progression of ARC.

Comparison of the impact of epigallocatechin gallate and ellagic acid in an experimental cataract model induced by sodium selenite

AIM

To compare the potential protective effects of epi-gallocatechin gallate (EGCG) and ellagic acid (EA) in an experimental cataract model.

METHODS

Twenty-eight Spraque-Dawley rat pups were assigned into four groups. All the rats, except for those in the control group, were injected subcutaneously sodium selenite to induce experimental cataract on the postpartum ninth day, and between 10^th and 14^th days. Rats in the sham, EGCG, and EA groups were intraperitoneally administered 50 mg/(kg·d) saline solution, 50 mg/(kg·d) EGCG and 200 mg/(kg·d) EA, respectively. The reduced glutathione (GSH) and malondialdehyde (MDA) levels, total antioxidant status (TAS) and total oxidant status (TOS) in lens supernatants were measured.

RESULTS

The mean cataract gradings in EGCG and EA groups were found to be significantly lower than that in sham group (P<0.001). The mean GSH levels and TASs in EGCG and EA groups were significantly higher than that in sham group while mean MDA levels and TOSs in EGCG and EA groups were significantly lower than that in the sham group (P<0.001).

CONCLUSION

EGCG and EA have protective effects on cataract development via the inhibition of oxidative stress.

Functional food supplements to ameliorate the secondary complications in high fructose fed diabetic rats

Poly-herbal functional food supplements inhibited high fructose induced glycation in diabetic rats and showed promise for effective management of secondary complications of diabetes such as improved lipid profile, kidney function and reduction of oxidative stress.

Therapeutic targets of renin-angiotensin system in ocular disorders

Purpose

To review current literature on the renin-angiotensin system (RAS)-mediated pathogenic mechanisms and therapeutic targets in ocular diseases.

Methods

A comprehensive literature survey was performed on PubMed, Scopus, and Google Scholar databases published from 1977 to 2016. The search terms were a RAS, angiotensin, angiotensin receptor, prorenin, pro (renin) receptor, angiotensin converting enzyme inhibitor, angiotensin receptor blocker associated with ocular disorders like cataract, glaucoma, diabetic retinopathy (DR), macular degeneration, and uveitis. Articles were reviewed on the basis of the association between ocular disorders and RAS and relevant articles were discussed.

Results

The literature revealed that the individual RAS components including renin, angiotensins, angiotensin converting enzymes, and RAS receptors have been expressed in the specific ocular tissues like retina, choroid, and ciliary body. The activation of both circulatory and local RAS potentiate the various inflammatory and angiogenic signaling molecules, including vascular endothelial growth factor (VEGF), extracellular signal-regulated kinase, and advanced glycation end products (AGE) in the ocular tissues and leads to several blinding disorders like DR, glaucoma, and macular degeneration. The classical and newer RAS inhibitors have illustrated protective effects on blinding disorders, including DR, glaucoma, macular degeneration, uveitis, and cataract.

Conclusions

The RAS components are present in the extrarenal tissues including ocular tissue and have an imperative role in the ocular pathophysiology. The clinical studies are needed to show the role of therapeutic modalities targeting RAS in the treatment of different ocular disorders.

Olmesartan, an angiotensin II receptor blocker inhibits the progression of cataract formation in cadmium chloride induced hypertensive albino rats

AIMS

Previously we found that cadmium chloride (CdCl₂) exposure substantially elevates hypertension and potentiates cataract formation. In the present study, we investigated the protective effects of olmesartan, an angiotensin II receptor blocker against cataractogenesis in the CdCl₂-induced hypertensive animal model.

MAIN METHODS

Male Sprague-Dawley albino rats (150-180g) were randomly selected and assigned to four groups (n=6). Among the four groups, one group (normal) received 0.3% carboxymethyl cellulose (10ml/kg/day, p.o.), another group (CdCl₂ control) received CdCl₂ (0.5mg/kg/day, i.p.), and remaining two groups received olmesartan at two doses level (2 and 4mg/kg/day, p.o.) concurrently with CdCl₂ for six consecutive weeks. Blood pressure and cataract formation were examined biweekly, and pathophysiological parameters in serum and eye lenses were evaluated after six weeks of the experimental protocol.

KEY FINDINGS

The olmesartan treatment significantly restored the blood pressure, lenticular opacity, serum and lens antioxidants (catalase, superoxide dismutase, glutathione peroxidase, and glutathione reduced), and malondialdehyde level. Additionally, it significantly restored the proteins, ions (Na⁺, K⁺, and Ca²⁺), and ATPase pumps activity (Na⁺K⁺ ATPase and Ca²⁺ ATPase) in the lens as compared to CdCl₂ control group.

SIGNIFICANCE

The findings demonstrate that olmesartan potentially inhibits the risk of cataract formation in the hypertensive state via restoration of lenticular oxidative stress, ATPase function, and ionic contents in the eye lenses. The results suggest that angiotensin II receptor blockers play an important role to prevent cataract formation in several pathogenic conditions like hypertension, diabetes, and oxidative stress.

Mechanism of the anticataract effect of liposomal MgT in galactose-fed rats

PURPOSE

Increased lenticular oxidative stress and altered calcium/magnesium (Ca/Mg) homeostasis underlie cataractogenesis. We developed a liposomal formulation of magnesium taurate (MgT) and studied its effects on Ca/Mg homeostasis and lenticular oxidative and nitrosative stress in galactose-fed rats.

METHODS

The galactose-fed rats were topically treated with liposomal MgT (LMgT), liposomal taurine (LTau), or corresponding vehicles twice daily for 28 days with weekly anterior segment imaging. At the end of the experimental period, the lenses were removed and subjected to analysis for oxidative and nitrosative stress, Ca and Mg levels, ATP content, Ca(2+)-ATPase, Na(+),K(+)-ATPase, and calpain II activities.

RESULTS

The LTau and LMgT groups showed significantly lower opacity index values at all time points compared to the corresponding vehicle groups (p<0.001). However, the opacity index in the LMgT group was lower than that in the LTau group (p<0.05). Significantly reduced oxidative and nitrosative stress was observed in the LTau and LMgT groups. The lens Ca/Mg ratio in LMgT group was decreased by 1.15 times compared to that in the LVh group. Calpain II activity in the LMgT group was decreased by 13% compared to the LVh group. The ATP level and Na(+),K(+)-ATPase and Ca(2+)-ATPase activities were significantly increased in the LMgT group compared to the LVh group (p<0.05).

CONCLUSIONS

Topical liposomal MgT delays cataractogenesis in galactose-fed rats by maintaining the lens mineral homeostasis and reducing lenticular oxidative and nitrosative stress.

Anticataractogenic effect of hesperidin in galactose-induced cataractogenesis in Wistar rats

AIM: To explore the anticataractogenic potential of hesperidin, a flavanone, in galactose-induced cataractogenesis.

METHODS: In this study, cataract was induced by administering galactose enriched food in a set of rats. Effect of different dosages of hesperidin (25, 50 and 75 mg/kg body weight) were administered simultaneously with galactose in prevention of cataract was determined in another set. In both sets of animals, the levels of peroxidation, oxidants (NO and OH), antioxidants (enzymatic: Superoxide dismutase, catalase, glutathione S-transferase, GPx and non-enzymatic: Reduced glutathione, vitamin E), aldose reductase and sorbitol were determined in the eye lens. In addition, glucose and lipid peroxidation levels were also tested in serum. The quantitative changes in lens inducible nitric oxide synthase (iNOS) and its expression were also determined using Western blot and real-time polymerase chain reaction analyses.

RESULTS: Galactose enriched food produced cataract in both the eye lens as a sequel to elevated serum glucose. Simultaneous administration of hesperidin not only reduced serum glucose but also prevented cataract development, through reduced levels of reactive oxygen species (NO and OH) and iNOS expression as well as elevated enzymic and non-enzymic antioxidants were observed in the eye lens.

CONCLUSION: These results indicate the preventive effect of hesperidin against cataract in hyperglycemic rats.

Role of Cytochrome Modulators in Altering the Occurrence of Cataract in Rats

BACKGROUND

Cataract is one of the primary causes of blindness all over the world. It indicates the onset of secondary complications of diabetes. The only treatment available is surgery as there are no satisfactory drugs which can prevent or retard the initiation and maturation of cataract. It was hypothesized that cytochrome P 450 (CYP) inducers or inhibitors can modify the cataract occurrence by accelerating or delaying the occurrence of cataract respectively.

OBJECTIVE

To study the effect of two commonly used drugs, phenytoin (CYP inducer) and ciprofloxacin (CYP inhibitor) on the initiation and maturation of cataract with the galactose- induced cataract model.

MATERIALS AND METHODS

The experiment was conducted in 24 new born male Wistar rats. Cataract formation was induced with a 50% galactose diet. The rats were randomized into four groups of 6 rats each: Group 1 rats received a normal diet; Group 2, 3 and 4 rats received 50% galactose diet day 23 onwards. In addition, Group 3 rats were pre-treated with ciprofloxacin (20mg/kg) and Group 4 rats were pre-treated with phenytoin (50mg/kg) day 18 onwards once a day orally. The appearance of cataract was checked daily with an ophthalmoscope. The maturation pattern was examined using Fundus Fluorsen Angiographer (FFA). The cataract was graded according to Sippel's classification. The experimental and control groups were compared by chi square test and the results were considered significant at p< 0.05.

RESULTS

The initiation of cataract was significantly delayed with ciprofloxacin as compared to galactose; however, there was no difference in the maturation pattern of cataract in both the groups. In spite of being a CYP inducer, the initiation of cataract was not accelerated in phenytoin group. Rather, it was significantly delayed and the cataract did not progress to stage 5 even on 30(th) day of galactose administration.

CONCLUSION

CYP450 modulators have a significant effect on the initiation of cataract without significantly altering the maturation pattern. It is not reasonable to extrapolate the results of one enzyme inhibitor or inducer to other CYP modulators. Hence, further studies are needed to identify the pharmacological profile of various CYP modulators on the occurrence of cataractogenesis.

Phytochemical characterization and evaluation of anticataract potential of seabuckthorn leaf extract

OBJECTIVE

This study was undertaken to carry out phytochemical characterization of aqueous extract of Seabuckthorn (SBT, Hippophae rhamnoides L.) leaves and evaluation of its therapeutic role in oxidative stress-induced cataract in isolated goat lenses using Vit. E as reference compound.

ANIMAL STUDIED

A total of 42 goat eye lenses were used in the present study.

PROCEDURE

Seabuckthorn leaf extract was characterized by total phenol content estimation and HPLC analysis of quercetin and catechin. Further, cataract was induced in goat lenses using hydrogen peroxide (H2O2) and anticataract activity was evaluated using the extract in the dose range of 100, 200, 500, and 1000 μg/mL concentrations through estimation of biochemical markers such as superoxide dismutase (SOD), reduced glutathione (GSH), and malonaldehyde (MDA).

RESULTS

The results of the phytochemical characterization showed the total phenol content of the extract to be 365 mg/g in terms of gallic acid equivalents. Quercetin and catechin were estimated to be 0.01 and 0.12% w/w, respectively. In biochemical analysis, H2O2 introduction resulted in a decrease in SOD (approximately 85%) and GSH (approximately 63%) contents and an increase in MDA content (approximately 300%). The decreased levels of SOD and GSH were significantly restored in experimental groups receiving 500 and 1000 1g/mL of SBT extract. All the experimental groups showed significantly reduced MDA level in all the doses.

CONCLUSION

Aqueous extract of SBT leaves showed the potential to delay onset and/or progression of cataract, at least during in vitro conditions. Results indicate the possibilities of evaluating this extract for its use as anticataract agent during in vivo conditions.

Acetylated 8-oxoguanine DNA glycosylase 1 and its relationship with p300 and SIRT1 in lens epithelium cells from age-related cataract

The human 8-oxoguanine-DNA glycosylase 1 (OGG1) is the major DNA glycosylase responsible for repair of 7,8-dihydro-8-oxoguanine (8-oxoG) and ring-opened fapyguanine, critical mutagenic DNA lesions that are induced by reactive oxygen species. OGG1 acetylation has been demonstrated playing an important role in response to DNA damage. Here, we investigated the relationship between acetylated OGG1 (Ac-OGG1) and ARC, and clarified the effect of p300 and SIRT1 on the 8-oxoG excision ability of OGG1 in ARC development. Our results showed that anterior lens capsules from ARC group had higher proportion of 8-oxoG positive LECs than those from control group. OGG1 mRNA and protein levels significantly increased in ARC group compared with control group, while the protein levels of Ac-OGG1 were lower in ARC group. We investigated the factors involved in OGG1 acetylation and found that p300 and SIRT1 are the major acetyltransferases for OGG1 acetylation. We also identified acetylation of K338/K341 lysine residues in OGG1 has an important role on the repair activity of OGG1 to oxidative damage after H2O2 exposure in human lens epithelial cells (HLE-B3). Taken together, these data demonstrate that OGG1 acetylation regulates its function in response to DNA damage and could be one of the mechanisms of ARC.

Prevention of Selenite-Induced Cataratogenesis by Ginkgo biloba Extract (Egb761) in Wistar Rats

OBJECTIVE

To investigate whether Ginkgo biloba extract retards selenite-induced cataractogenesis in Wistar rat pups.

METHODS

On postpartum day eight, Group I rat pups (n = 12) received an intraperitoneal injection of physiological saline. Groups II and III rat pups (n = 12) received a subcutaneous injection of sodium selenite. Group III also received an intraperitoneal injection of G. biloba extract once daily on postpartum days 9-14. Both eyes of each pup were examined from postpartum day 16 up to day 30. After sacrifice, encapsulated pup lens were analyzed for mean activities of catalase, superoxide dismutase, glutathione peroxidase (GPx), glutathione S-transferase and glutathione reductase. In addition, the mean concentrations of reduced glutathione (GSH) and malondialdehyde were analyzed in samples of lens and serum.

RESULTS

Dense lenticular opacification occurs 100% in Group II, but only minimal opacification occurs in three pups of Group III (25%), no opacification in 75% of Group III, none in Group I. Compared with Groups I and III, Group II rat showed lower lenticular antioxidant enzyme activity, lower level of GSH, and higher level of malondidehyde (mean ± standard deviation SD, p < 0.05 respectively).

CONCLUSIONS

The treatment with G. biloba extract is effective against oxidative stress - a crucial factor of cataractogenesis in rat pups, possibly by preventing depletion of antioxidant enzymes and by inhibiting lipid peroxidation.

Histological and histometrical study of the protective role of α-tocopherol against sodium arsenite toxicity in rat ovaries

This study examines histometrical changes induced by sodium arsenite (SA), as an environmental pollutant, and investigates the protective effect of α-tocopherol on ovaries of SA-treated rats during the prenatal stage until sexual maturity. Rats were classified into groups: control, SA (8 ppm/day), α-tocopherol (100 ppm/day), and SA+α-tocopherol. Treatment was performed from pregnancy until maturation when the rats and ovaries were weighed. The Cavalieri method was used to estimate volume of the ovaries, cortex, medulla, and corpus luteum. The mean diameter of oocytes, granulosa cells, and nuclei were measured and volume was estimated using the Nucleator method. The number of oocytes and thickness of the zona pellucida (ZP) were determined using an optical dissector and orthogonal intercept method, respectively. SA reduced the body and ovary weight, the number of secondary, antral and Graafian oocytes, volume of the ovaries, cortex, medulla and corpus luteum, mean diameter and volume of oocytes in primordial and primary follicles, mean diameter and volume of oocyte nuclei in all types of follicles, and mean thickness of the ZP in secondary and antral follicles. Also, the mean diameter and volume of granulosa cells and their nuclei in antral and Graafian follicles decreased significantly. Vacuolization and vascular congestion in the corpus luteum and an increase in the number of atretic oocytes were seen in the SA group. Most of these parameters were unchanged from the control level in the SA+α-tocopherol group. It was concluded that α-tocopherol supplementation reduced the toxic effects of SA exposure on ovarian tissue in rats.

Inhibitory effect of r-hirudin variant III on streptozotocin-induced diabetic cataracts in rats

The in vivo inhibitory effect of r-hirudin variant III (rHV3) on streptozotocin (STZ)-induced diabetic cataracts in rats was investigated. SD-rats were firstly made diabetic by a single intraperitoneal injection of 2% (W/V) STZ (65 mg/kg). Two weeks later, cataract formation was examined by slit lamp microscope, and the cataracted animals were randomly grouped. The animals in the treated groups received rHV3 drops administration to the eyes with various doses. After 4 weeks treatment, the animals were sacrificed to evaluate the biochemical changes of aldose reductase (AR), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and malondialdehyde (MDA) levels in the eye lens. Meanwhile, the cataract progression was monitored by slit lamp microscope. As a result, rHV3 drops treatment significantly increased the activities of SOD and GSH-Px in the lens in a dose-dependent manner, whereas AR activity and MDA level in the lens were dramatically decreased. Also, the morphological observation further confirmed the inhibition of the development of STZ-induced diabetic cataracts by the rHV3 drops treatment. Thus, our data suggest that rHV3 drops are pharmacologically effective for the protection against STZ-induced diabetic cataracts in rats.

Scopoletin inhibits rat aldose reductase activity and cataractogenesis in galactose-fed rats

Cataracts are a major cause of human blindness. Aldose reductase (AR) is an important rate-limiting enzyme that contributes to cataract induction in diabetic patients. Scopoletin is the main bioactive constituent of flower buds from Magnolia fargesii and is known to inhibit AR activity. To assess scopoletin's ability to mitigate sugar cataract formation in vivo, we studied its effects in a rat model of dietary galactose-induced sugar cataracts. Galactose-fed rats were orally dosed with scopoletin (10 or 50 mg/kg body weight) once a day for 2 weeks. Administering scopoletin delayed the progression of the cataracts that were induced by dietary galactose. Scopoletin also prevented galactose-induced changes in lens morphology, such as lens fiber swelling and membrane rupture. Scopoletin's protective effect against sugar cataracts was mediated by inhibiting both AR activity and oxidative stress. These results suggest that scopoletin is a useful treatment for sugar cataracts.

Evaluation of pharmacological activities and assessment of intraocular penetration of an ayurvedic polyherbal eye drop (Itone™) in experimental models

Background

The polyherbal eye drop (Itone™) is a mixture of aqueous distillates of nineteen traditionally used ingredients that sum up to impart potency to the formulation and make it a useful adjunct in various ocular pathologies. However, as there have been no controlled experimental studies accounting to the above claim, therefore, the present study was designed to evaluate the polyherbal formulation (PHF) for antiangiogenic, anti-inflammatory, anticataract, antioxidant and cytotoxicity in addition to the evaluation of intraocular penetration of PHF in rabbit eyes using LC-MS/MS.

Materials and methods

Antiangiogenic activity of the PHF was evaluated using in ovo chick chorio-allantoic membrane (CAM) assay and in vivo cautery induced corneal neovascularization assay in rats. Anticataract potential was evaluated using steroid induced cataract in developing chick embryos, sodium selenite induced cataract in rat pups and galactose induced cataract in rats. The antioxidant activity was evaluated using di-phenyl picryl hydrazyl (DPPH) radical scavenging assay. Anti-inflammatory activity was evaluated in vitro using inhibition of LTB₄ formation in human WBCs and in vivo using carrageenan induced paw edema assay in rats. The cytotoxicity was evaluated against HeLa cancer cell lines using (3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Furthermore evaluation of the intraocular penetration of the PHF was carried out in rabbit eyes via aqueous humor paracentesis and further analysis using LC-MS/MS.

Results

PHF significantly inhibited VEGF induced proliferation of new blood vessels in CAM assay and inhibited the cautery induced corneal neovascularization in rats. Additionally, PHF showed noticeable delay in the progression of cataract in the selenite and galactose induced cataract models whereby the PHF treated lenses were graded for stages II and III respectively. However, the PHF did not show any anticataract activity in the hydrocortisone induced cataract model. Moreover, PHF exhibited anti-inflammatory activity whereby it showed 39.34% inhibition of LTB₄ formation and significantly inhibited carrageenan induced paw edema in rats. Eight compounds of PHF viz. camphor, casticin, curcumin-II, quercetin, rosmarinic acid, γ-terpinene, β-pinene and dipentene exhibited transcorneal penetration in rabbit eyes.

Conclusion

The significant antiangiogenic and anti-inflammatory activities evinced by the PHF merits further investigation for ocular neovascular and inflammatory diseases in humans.

Evaluation of anticataract potential of Triphala in selenite-induced cataract: In vitro and in vivo studies

Triphala (TP) is composed of Emblica officinalis, Terminalia chebula, and Terminalia belerica. The present study was undertaken to evaluate its anticataract potential in vitro and in vivo in a selenite-induced experimental model of cataract. In vitro enucleated rat lenses were maintained in organ culture containing Dulbecco’s Modified Eagles Medium alone or with the addition of 100μM selenite. These served as the normal and control groups, respectively. In the test group, the medium was supplemented with selenite and different concentrations of TP aqueous extract. The lenses were incubated for 24 h at 37°C. After incubation, the lenses were processed to estimate reduced glutathione (GSH), lipid peroxidation product, and antioxidant enzymes. In vivo selenite cataract was induced in 9-day-old rat pups by subcutaneous injection of sodium selenite (25 μmole/kg body weight). The test groups received 25, 50, and 75 mg/kg of TP intraperitoneally 4 h before the selenite challenge. At the end of the study period, the rats’ eyes were examined by slit-lamp. TP significantly (P < 0.01) restored GSH and decreased malondialdehyde levels. A significant restoration in the activities of antioxidant enzymes such as superoxide dismutase (P < 0.05), catalase (P < 0.05), glutathione peroxidase (P < 0.05), and glutathione-s-transferase (P < 0.005) was observed in the TP-supplemented group compared to controls. In vivo TF 25mg/kg developed only 20% nuclear cataract as compared to 100% in control. TP prevents or retards experimental selenite-induced cataract. This effect may be due to antioxidant activity. Further studies are warranted to explore its role in human cataract.

Natural flavonoids as potential multifunctional agents in prevention of diabetic cataract

Cataract is one of the earliest secondary complications of diabetes mellitus. The lens is a closed system with limited capability to repair or regenerate itself. Current evidence supports the view that cataractogenesis is a multifactorial process. Mechanisms related to glucose toxicity, namely oxidative stress, processes of non-enzymatic glycation and enhanced polyol pathway significantly contribute to the development of eye lens opacity under conditions of diabetes. There is an urgent need for inexpensive, non-surgical approaches to the treatment of cataract. Recently, considerable attention has been devoted to the search for phytochemical therapeutics. Several pharmacological actions of natural flavonoids may operate in the prevention of cataract since flavonoids are capable of affecting multiple mechanisms or etiological factors responsible for the development of diabetic cataract. In the present paper, natural flavonoids are reviewed as potential agents that could reduce the risk of cataract formation via affecting multiple pathways pertinent to eye lens opacification. In addition, the bioavailability of flavonoids for the lens is considered.

Contribution of cholesterol and oxysterols in the physiopathology of cataract: implication for the development of pharmacological treatments

The development of cataract is associated with some lipid changes in human lens fibers, especially with increased accumulation and redistribution of cholesterol inside these cells. Some direct and indirect lines of evidence, also suggest an involvement of cholesterol oxide derivatives (also named oxysterols) in the development of cataract. Oxysterol formation can result either from nonenzymatic or enzymatic processes, and some oxysterols can induce a wide range of cytotoxic effects (overproduction of reactive oxygen species (ROS); phospholipidosis) which might contribute to the initiation and progression of cataract. Thus, the conception of molecules capable of regulating cholesterol homeostasia and oxysterol levels in human lens fibers can have some interests and constitute an alternative to surgery at least at early stages of the disease.

Multifunctional antioxidants for the treatment of age-related diseases

Analogues of N,N-dimethyl-4-(pyrimidin-2-yl)piperazine-1-sulfonamide possessing a free radical scavenger group (FRS), chelating groups (CHL), or both (FRS + CHL) have been synthesized. Electrospray ionization mass spectrometry studies indicate that select members of this series bind ions in the relative order of Cu(1+) = Cu(2+) > Fe(2+) = Fe(3+) > Zn(2+) with no binding of Ca(2+) or Mg(2+) observed. In vitro evaluation of these compounds in human lens epithelial, human retinal pigmented epithelial, and human hippocampal astrocyte cell lines indicates that all analogues possessing the FRS group as well as the water-soluble vitamin E analogue 6-hydroxy-2,5,7,8-tetramethylchroman-2-carboxylic acid protect these cells against decreased cell viability and glutathione levels induced by hydrogen peroxide. In addition, those compounds possessing CHL groups also protected these cells against hydroxyl radicals generated by the Fenton reaction. These compounds are good candidates for the preventive treatment of cataract, age-related macular degeneration (AMD), and Alzheimer's dementia (AD).