1
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Eleftheriou CG, Corona C, Khattak S, Alam NM, Ivanova E, Bianchimano P, Liu Y, Sun D, Singh R, Batoki JC, Prusky GT, McAnany JJ, Peachey NS, Romano C, Sagdullaev BT. Retinoschisin Deficiency Induces Persistent Aberrant Waves of Activity Affecting Neuroglial Signaling in the Retina. J Neurosci 2022; 42:6983-7000. [PMID: 35906066 PMCID: PMC9464019 DOI: 10.1523/jneurosci.2128-21.2022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 07/18/2022] [Accepted: 07/22/2022] [Indexed: 11/21/2022] Open
Abstract
Genetic disorders that present during development make treatment strategies particularly challenging because there is a need to disentangle primary pathophysiology from downstream dysfunction caused at key developmental stages. To provide a deeper insight into this question, we studied a mouse model of X-linked juvenile retinoschisis, an early-onset inherited condition caused by mutations in the Rs1 gene encoding retinoschisin (RS1) and characterized by cystic retinal lesions and early visual deficits. Using an unbiased approach in expressing the fast intracellular calcium indicator GCaMP6f in neuronal, glial, and vascular cells of the retina of RS1-deficient male mice, we found that initial cyst formation is paralleled by the appearance of aberrant spontaneous neuroglial signals as early as postnatal day 15, when eyes normally open. These presented as glutamate-driven wavelets of neuronal activity and sporadic radial bursts of activity by Müller glia, spanning all retinal layers and disrupting light-induced signaling. This study confers a role to RS1 beyond its function as an adhesion molecule, identifies an early onset for dysfunction in the course of disease, establishing a potential window for disease diagnosis and therapeutic intervention.SIGNIFICANCE STATEMENT Developmental disorders make it difficult to distinguish pathophysiology due to ongoing disease from pathophysiology due to disrupted development. Here, we investigated a mouse model for X-linked retinoschisis, a well defined monogenic degenerative disease caused by mutations in the Rs1 gene, which codes for the protein retinoschisin. We evaluated the spontaneous activity of explanted retinas lacking retinoschisin at key stages of development using the unbiased approach of ubiquitously expressing GCaMP6f in all retinal neurons, vasculature, and glia. In mice lacking RS1, we found that an array of novel phenotypes, which present around eye opening, are linked to glutamatergic neurotransmission and affect visual processing. These data identify a novel pathophysiology linked to RS1, and define a window where treatments might be best targeted.
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Affiliation(s)
- Cyril G Eleftheriou
- Burke Neurological Institute, Weill Cornell Medicine, White Plains, New York 10605
| | - Carlo Corona
- Burke Neurological Institute, Weill Cornell Medicine, White Plains, New York 10605
| | | | - Nazia M Alam
- Burke Neurological Institute, Weill Cornell Medicine, White Plains, New York 10605
| | - Elena Ivanova
- Burke Neurological Institute, Weill Cornell Medicine, White Plains, New York 10605
- Regeneron Pharmaceuticals, Tarrytown, New York 10591
| | - Paola Bianchimano
- Burke Neurological Institute, Weill Cornell Medicine, White Plains, New York 10605
| | - Yang Liu
- Regeneron Pharmaceuticals, Tarrytown, New York 10591
| | - Duo Sun
- Regeneron Pharmaceuticals, Tarrytown, New York 10591
| | - Rupesh Singh
- Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio 44195
| | - Julia C Batoki
- Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio 44195
| | - Glen T Prusky
- Burke Neurological Institute, Weill Cornell Medicine, White Plains, New York 10605
| | - J Jason McAnany
- Department of Ophthalmology, College of Medicine, University of Illinois at Chicago, Chicago, Illinois 60612
| | - Neal S Peachey
- Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio 44195
- Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio 44106
- Department of Ophthalmology, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio 44195
| | | | - Botir T Sagdullaev
- Burke Neurological Institute, Weill Cornell Medicine, White Plains, New York 10605
- Regeneron Pharmaceuticals, Tarrytown, New York 10591
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Mey GM, Evonuk KS, Chappell MK, Wolfe LM, Singh R, Batoki JC, Yu M, Peachey NS, Anand-Apte B, Bermel R, Ontaneda D, Nakamura K, Mahajan KR, DeSilva TM. Correction to: Visual imaging as a predictor of neurodegeneration in experimental autoimmune demyelination and multiple sclerosis. Acta Neuropathol Commun 2022; 10:104. [PMID: 35841033 PMCID: PMC9284785 DOI: 10.1186/s40478-022-01405-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Gabrielle M Mey
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic Foundation, and Case Western Reserve University, 9500 Euclid Avenue, Cleveland, OH, 44195, USA
| | - Kirsten S Evonuk
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic Foundation, and Case Western Reserve University, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.,Hooke Laboratories, Inc, Lawrence, MA, USA
| | - McKenzie K Chappell
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic Foundation, and Case Western Reserve University, 9500 Euclid Avenue, Cleveland, OH, 44195, USA
| | - Laura M Wolfe
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic Foundation, and Case Western Reserve University, 9500 Euclid Avenue, Cleveland, OH, 44195, USA
| | - Rupesh Singh
- Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Julia C Batoki
- Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Minzhong Yu
- Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.,Department of Ophthalmology, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA
| | - Neal S Peachey
- Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.,Department of Ophthalmology, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA.,Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA
| | - Bela Anand-Apte
- Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.,Department of Ophthalmology, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA
| | - Robert Bermel
- Mellen Center for MS Treatment and Research, Neurological Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Daniel Ontaneda
- Mellen Center for MS Treatment and Research, Neurological Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Kunio Nakamura
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Kedar R Mahajan
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic Foundation, and Case Western Reserve University, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.,Mellen Center for MS Treatment and Research, Neurological Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Tara M DeSilva
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic Foundation, and Case Western Reserve University, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
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Mey GM, Evonuk KS, Chappell MK, Wolfe LM, Singh R, Batoki JC, Yu M, Peachey NS, Anand-Apte B, Bermel R, Ontaneda D, Nakamura K, Mahajan KR, DeSilva TM. Visual imaging as a predictor of neurodegeneration in experimental autoimmune demyelination and multiple sclerosis. Acta Neuropathol Commun 2022; 10:87. [PMID: 35706005 PMCID: PMC9199245 DOI: 10.1186/s40478-022-01391-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 05/28/2022] [Indexed: 11/10/2022] Open
Abstract
Thalamic volume is associated with clinical disability in multiple sclerosis (MS) and is vulnerable to secondary neurodegeneration due to its extensive connectivity throughout the central nervous system (CNS). Using a model of autoimmune demyelination that exhibits CNS-infiltrating immune cells in both spinal cord white matter and optic nerve, we sought to evaluate neurodegenerative changes due to lesions affecting the spino- and retino-thalamic pathways. We found comparable axonal loss in spinal cord white matter and optic nerve during the acute phase of disease consistent with synaptic loss, but not neuronal cell body loss in the thalamic nuclei that receive input from these discrete pathways. Loss of spinal cord neurons or retinal ganglion cells retrograde to their respective axons was not observed until the chronic phase of disease, where optical coherence tomography (OCT) documented reduced inner retinal thickness. In patients with relapsing–remitting MS without a history of optic neuritis, OCT measures of inner retinal volume correlated with retino-thalamic (lateral geniculate nucleus) and spino-thalamic (ventral posterior nucleus) volume as well as neuroperformance measures. These data suggest retinal imaging may serve as an important noninvasive predictor of neurodegeneration in MS.
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Affiliation(s)
- Gabrielle M Mey
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic Foundation, and Case Western Reserve University, 9500 Euclid Avenue, Cleveland, OH, 44195, USA
| | - Kirsten S Evonuk
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic Foundation, and Case Western Reserve University, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.,Hooke Laboratories, Inc., Lawrence, MA, USA
| | - McKenzie K Chappell
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic Foundation, and Case Western Reserve University, 9500 Euclid Avenue, Cleveland, OH, 44195, USA
| | - Laura M Wolfe
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic Foundation, and Case Western Reserve University, 9500 Euclid Avenue, Cleveland, OH, 44195, USA
| | - Rupesh Singh
- Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Julia C Batoki
- Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Minzhong Yu
- Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.,Department of Ophthalmology, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA
| | - Neal S Peachey
- Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.,Department of Ophthalmology, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA.,Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA
| | - Bela Anand-Apte
- Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.,Department of Ophthalmology, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA
| | - Robert Bermel
- Mellen Center for MS Treatment and Research, Neurological Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Daniel Ontaneda
- Mellen Center for MS Treatment and Research, Neurological Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Kunio Nakamura
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Kedar R Mahajan
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic Foundation, and Case Western Reserve University, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.,Mellen Center for MS Treatment and Research, Neurological Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Tara M DeSilva
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic Foundation, and Case Western Reserve University, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
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Jidigam VK, Singh R, Batoki JC, Milliner C, Sawant OB, Bonilha VL, Rao S. Histopathological assessments reveal retinal vascular changes, inflammation, and gliosis in patients with lethal COVID-19. Graefes Arch Clin Exp Ophthalmol 2021; 260:1275-1288. [PMID: 34714382 PMCID: PMC8553591 DOI: 10.1007/s00417-021-05460-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 09/14/2021] [Accepted: 10/15/2021] [Indexed: 02/06/2023] Open
Abstract
Purpose The purpose of this study is to assess for histopathological changes within the retina and the choroid and determine the long-term sequelae of the SARS-CoV-2 infection. Methods Eyes from seven COVID-19-positive and six similar age-matched control donors with a negative test for SARS-CoV-2 were assessed. Globes were evaluated ex vivo with macroscopic, SLO and OCT imaging. Macula and peripheral regions were processed for Epon embedding and immunocytochemistry. Results Fundus analysis shows hemorrhagic spots and increased vitreous debris in several of the COVID-19 eyes compared to the controls. OCT-based measurements indicated an increased trend in retinal thickness in the COVID-19 eyes; however, the difference was not statistically significant. Histology of the retina showed presence of hemorrhages and central cystoid degeneration in several of the donors. Whole mount analysis of the retina labeled with markers showed changes in retinal microvasculature, increased inflammation, and gliosis in the COVID-19 eyes compared to the controls. The choroidal vasculature displayed localized changes in density and signs of increased inflammation in the COVID-19 samples. Conclusions In situ analysis of the retinal tissue suggests that there are severe subclinical abnormalities that could be detected in the COVID-19 eyes. This study provides a rationale for evaluating the ocular physiology of patients that have recovered from COVID-19 infections to further understand the long-term effects caused by this virus.![]() Supplementary Information The online version contains supplementary material available at 10.1007/s00417-021-05460-1.
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Affiliation(s)
- Vijay K Jidigam
- Department of Ophthalmic Research, Cole Eye Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA
| | - Rupesh Singh
- Department of Ophthalmic Research, Cole Eye Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA
| | - Julia C Batoki
- Department of Ophthalmic Research, Cole Eye Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA
| | - Caroline Milliner
- Department of Ophthalmic Research, Cole Eye Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA
| | - Onkar B Sawant
- Center for Vision and Eye Banking Research, Eversight, 6700 Euclid Ave, Suite 101, Cleveland, OH, 44103, USA
| | - Vera L Bonilha
- Department of Ophthalmic Research, Cole Eye Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA. .,Department of Ophthalmology, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, 44195, USA.
| | - Sujata Rao
- Department of Ophthalmic Research, Cole Eye Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA. .,Department of Ophthalmology, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, 44195, USA.
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Howell SJ, Lee CA, Batoki JC, Zapadka TE, Lindstrom SI, Taylor BE, Taylor PR. Retinal Inflammation, Oxidative Stress, and Vascular Impairment Is Ablated in Diabetic Mice Receiving XMD8-92 Treatment. Front Pharmacol 2021; 12:732630. [PMID: 34456740 PMCID: PMC8385489 DOI: 10.3389/fphar.2021.732630] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 08/02/2021] [Indexed: 12/13/2022] Open
Abstract
The global number of diabetics continues to rise annually. As diabetes progresses, almost all of Type I and more than half of Type II diabetics develop diabetic retinopathy. Diabetic retinopathy is a microvascular disease of the retina, and is the leading cause of blindness in the working-age population worldwide. With such a significant health impact, new drugs are required to halt the blinding threat posed by this visual disorder. The cause of diabetic retinopathy is multifactorial, and an optimal therapeutic would halt inflammation, cease photoreceptor cell dysfunction, and ablate vascular impairment. XMD8-92 is a small molecule inhibitor that blocks inflammatory activity downstream of ERK5 (extracellular signal-related kinase 5) and BRD4 (bromodomain 4). ERK5 elicits inflammation, is increased in Type II diabetics, and plays a pathologic role in diabetic nephropathy, while BRD4 induces retinal inflammation and plays a role in retinal degeneration. Further, we provide evidence that suggests both pERK5 and BRD4 expression are increased in the retinas of our STZ (streptozotocin)-induced diabetic mice. Taken together, we hypothesized that XMD8-92 would be a good therapeutic candidate for diabetic retinopathy, and tested XMD8-92 in a murine model of diabetic retinopathy. In the current study, we developed an in vivo treatment regimen by administering one 100 μL subcutaneous injection of saline containing 20 μM of XMD8-92 weekly, to STZ-induced diabetic mice. XMD8-92 treatments significantly decreased diabetes-mediated retinal inflammation, VEGF production, and oxidative stress. Further, XMD8-92 halted the degradation of ZO-1 (zonula occludens-1), which is a tight junction protein associated with vascular permeability in the retina. Finally, XMD8-92 treatment ablated diabetes-mediated vascular leakage and capillary degeneration, which are the clinical hallmarks of non-proliferative diabetic retinopathy. Taken together, this study provides strong evidence that XMD8-92 could be a potentially novel therapeutic for diabetic retinopathy.
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Affiliation(s)
- Scott J. Howell
- Department of Ophthalmology and Visual Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH, United States
- Louis Stokes Cleveland VA Medical Center, VA Northeast Ohio Healthcare System, Cleveland, OH, United States
| | - Chieh A. Lee
- Department of Ophthalmology and Visual Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Julia C. Batoki
- Department of Ophthalmology and Visual Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Thomas E. Zapadka
- Department of Ophthalmology and Visual Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH, United States
- Louis Stokes Cleveland VA Medical Center, VA Northeast Ohio Healthcare System, Cleveland, OH, United States
| | - Sarah I. Lindstrom
- Department of Ophthalmology and Visual Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Brooklyn E. Taylor
- Department of Ophthalmology and Visual Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Patricia R. Taylor
- Department of Ophthalmology and Visual Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH, United States
- Louis Stokes Cleveland VA Medical Center, VA Northeast Ohio Healthcare System, Cleveland, OH, United States
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Zapadka TE, Lindstrom SI, Batoki JC, Lee CA, Taylor BE, Howell SJ, Taylor PR. Aryl Hydrocarbon Receptor Agonist VAF347 Impedes Retinal Pathogenesis in Diabetic Mice. Int J Mol Sci 2021; 22:4335. [PMID: 33919327 PMCID: PMC8122442 DOI: 10.3390/ijms22094335] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/19/2021] [Accepted: 04/19/2021] [Indexed: 12/17/2022] Open
Abstract
Diabetic retinopathy is the leading cause of blindness in the working-age population worldwide. Although the cause of diabetic retinopathy is multifactorial, IL-17A is a prevalent inflammatory cytokine involved in the promotion of diabetes-mediated retinal inflammation and the progression of diabetic retinopathy. The primary source of IL-17A is Th17 cells, which are T helper cells that have been differentiated by dendritic cells in a proinflammatory cytokine environment. Aryl hydrocarbon receptor (AhR) is a ligand-dependent transcription factor that can manipulate dendritic cell maturation, halt the production of IL-6 (a proinflammatory cytokine), and suppress Th17 cell differentiation. In the current study, we examined the efficacy of an AhR agonist, VAF347, as a potential therapeutic for the onset of non-proliferative diabetic retinopathy in streptozotocin (STZ)-induced diabetic C57BL/6 mice. We determined that diabetes-mediated leukostasis, oxidative stress, and inflammation in the retina of STZ-diabetic mice were all significantly lower when treated with the AhR agonist VAF347. Furthermore, when VAF347 was subcutaneously injected into STZ-diabetic mice, retinal capillary degeneration was ameliorated, which is the hallmark of non-proliferative diabetic retinopathy in this diabetes murine model. Collectively, these findings provide evidence that the AhR agonist VAF347 could be a potentially novel therapeutic for non-proliferative diabetic retinopathy.
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Affiliation(s)
- Thomas E. Zapadka
- Department of Ophthalmology and Visual Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA; (T.E.Z.); (S.I.L.); (J.C.B.); (C.A.L.); (B.E.T.); (S.J.H.)
- Louis Stokes Cleveland VA Medical Center, Cleveland, OH 44106, USA
| | - Sarah I. Lindstrom
- Department of Ophthalmology and Visual Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA; (T.E.Z.); (S.I.L.); (J.C.B.); (C.A.L.); (B.E.T.); (S.J.H.)
| | - Julia C. Batoki
- Department of Ophthalmology and Visual Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA; (T.E.Z.); (S.I.L.); (J.C.B.); (C.A.L.); (B.E.T.); (S.J.H.)
| | - Chieh A. Lee
- Department of Ophthalmology and Visual Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA; (T.E.Z.); (S.I.L.); (J.C.B.); (C.A.L.); (B.E.T.); (S.J.H.)
| | - Brooklyn E. Taylor
- Department of Ophthalmology and Visual Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA; (T.E.Z.); (S.I.L.); (J.C.B.); (C.A.L.); (B.E.T.); (S.J.H.)
| | - Scott J. Howell
- Department of Ophthalmology and Visual Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA; (T.E.Z.); (S.I.L.); (J.C.B.); (C.A.L.); (B.E.T.); (S.J.H.)
- Louis Stokes Cleveland VA Medical Center, Cleveland, OH 44106, USA
| | - Patricia R. Taylor
- Department of Ophthalmology and Visual Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA; (T.E.Z.); (S.I.L.); (J.C.B.); (C.A.L.); (B.E.T.); (S.J.H.)
- Louis Stokes Cleveland VA Medical Center, Cleveland, OH 44106, USA
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Jidigam VK, Singh R, Batoki JC, Milliner C, Sawant OB, Bonilha VL, Rao S. Histopathological assessments reveal retinal vascular changes, inflammation and gliosis in patients with lethal COVID-19. medRxiv 2021:2021.02.25.21251531. [PMID: 33655272 PMCID: PMC7924297 DOI: 10.1101/2021.02.25.21251531] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE To assess for histopathological changes within the retina and the choroid and determine the long-term sequelae of the SARS-CoV-2 infection. DESIGN Comparative analysis of human eyes. SUBJECTS Eleven donor eyes from COVID-19 positive donors and similar age-matched donor eyes from patients with a negative test for SARS-CoV-2 were assessed. METHODS Globes were evaluated ex-vivo with macroscopic, SLO and OCT imaging. Macula and peripheral regions were processed for epon-embedding and immunocytochemistry. MAIN OUTCOME MEASURES Retinal thickness and histopathology, detection of SARS-CoV-2 Spike protein, changes in vascular density, gliosis, and degree of inflammation. RESULTS Fundus analysis shows hemorrhagic spots and increased vitreous debris in several of the COVID-19 eyes compared to the control. OCT based measurements indicated an increased trend in retinal thickness in the COVID-19 eyes, however the difference was not statistically significant. Histology of the retina showed presence of hemorrhages and central cystoid degeneration in several of the donors. Whole mount analysis of the retina labeled with markers showed changes in retinal microvasculature, increased inflammation, and gliosis in the COVID-19 eyes compared to the controls. The choroidal vasculature displayed localized changes in density and signs of increased inflammation in the COVID-19 samples. CONCLUSIONS In situ analysis of the retinal tissue suggested that there are severe subclinical abnormalities that could be detected in the COVID-19 eyes. This study provides a rationale for evaluating the ocular physiology of patients that have recovered from COVID-19 infections to further understand the long-term effects caused by this virus.
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Affiliation(s)
- Vijay K. Jidigam
- Department of Ophthalmic Research, Cole Eye Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH
| | - Rupesh Singh
- Department of Ophthalmic Research, Cole Eye Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH
| | - Julia C. Batoki
- Department of Ophthalmic Research, Cole Eye Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH
| | - Caroline Milliner
- Department of Ophthalmic Research, Cole Eye Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH
| | - Onkar B. Sawant
- Center for Vision and Eye Banking Research, Eversight, 6700 Euclid Ave, Suite 101, Cleveland, OH
| | - Vera L. Bonilha
- Department of Ophthalmic Research, Cole Eye Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH
- Department of Ophthalmology, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH
| | - Sujata Rao
- Department of Ophthalmic Research, Cole Eye Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH
- Department of Ophthalmology, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH
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Singh R, Batoki JC, Ali M, Bonilha VL, Anand-Apte B. Inhibition of choroidal neovascularization by systemic delivery of gold nanoparticles. Nanomedicine 2020; 28:102205. [PMID: 32305594 DOI: 10.1016/j.nano.2020.102205] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 03/14/2020] [Accepted: 04/01/2020] [Indexed: 11/17/2022]
Abstract
Choroidal neovascularization (CNV) is the abnormal growth of blood vessels that sprout from the choroid vasculature and grow beneath and into the retina. The newly formed blood vessels in CNV often leak blood and fluid which deteriorates vision over time, eventually leading to blindness. In the present study, we examined the efficacy of intravenously injected gold nanoparticles in the laser-induced CNV animal model. Using optical coherence tomography (OCT) and fluorescein angiography, we evaluated CNV lesions longitudinally, over a period of 21 days, with and without nanoparticle treatment. Intravenously injected low concentration of bare gold nanoparticles showed significant anti-angiogenic properties by suppressing CNV development and progression. The treatment group showed significantly decreased fluorescein leakage at the CNV site compared to vehicle injected control mice. OCT assisted CNV volume measurement at all time points showed a significant reduction in lesion size in the treatment group compared with controls.
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Affiliation(s)
- Rupesh Singh
- Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH.
| | - Julia C Batoki
- Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH
| | - Mariya Ali
- Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH
| | - Vera L Bonilha
- Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH; Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, OH; Cleveland Clinic Lerner College of Medicine at Case Western Reserve University, Department of Ophthalmology and Molecular Medicine, Cleveland, OH
| | - Bela Anand-Apte
- Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH; Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, OH; Cleveland Clinic Lerner College of Medicine at Case Western Reserve University, Department of Ophthalmology and Molecular Medicine, Cleveland, OH
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