Positive association of free triiodothyronine with pancreatic β-cell function in people with prediabetes

AIM

To analyse the effects of thyroid hormones on β-cell function and glucose metabolism in people with prediabetes who are euthyroid.

METHODS

A total of 111 people who were euthyroid underwent 75-g oral glucose tolerance tests, of whom 52 were assigned to the normal glucose tolerance and 59 to the prediabetes groups. Homeostatic model assessment of β-cell function, insulinogenic index and areas under the curve for insulin and glucose were evaluated as indices of pancreatic β-cell function.

RESULTS

In both groups, BMI, fasting insulin, homeostasis model assessment ratio and HDL cholesterol correlated significantly with all indices of pancreatic β-cell function. Free triiodothyronine correlated positively with all insulin secretion indices in the prediabetes group. Multiple linear regression analysis showed that free triiodothyronine was an independent variable that had a positive correlation with all indices of β-cell function in the prediabetes group. By contrast, no such correlation was found in the normal glucose tolerance group.

CONCLUSIONS

Free triiodothyronine is associated with both basal and glucose-stimulated insulin secretion in people with prediabetes who are euthyroid; therefore, the regulation of insulin secretion by thyroid hormones is a potentially novel therapeutic target for the treatment of diabetes.

Stealth and non-stealth nanocapsules containing camptothecin: in-vitro and in-vivo activity on B16-F10 melanoma

Camptothecin (CPT) is an alkaloid that displays considerable antitumour activity, but clinical use has been limited by its poor water solubility and the instability of the lactone moiety (active form) in physiological media. We have therefore formulated the drug into nanocarrier systems in an attempt to improve its therapeutic properties. This study evaluates the effect of intraperitoneally administered stealth and non-stealth nanocapsules containing CPT on lung metastatic spread in mice inoculated with B16-F10 melanoma cells, and on the cytotoxic activity against B16-F10 melanoma cells in-vitro. Poly (d,l-lactide) PLA (non-stealth) and methoxy polyethylene glycol-(d,l-lactide) (PLA-PEG) (stealth) nanocapsules (49 and 66.6 kDa) were prepared by interfacial deposition of preformed polymer. CPT, as free drug or as drug-loaded nanocapsules, was administrated at a dose of 0.5 mg kg−1 at 3-day intervals for 17 days. Free drug and CPT-loaded nanocapsules reduced the number of metastatic nodules by 45.09–91.76% (P < 0.05 vs positive control). However, only CPT-loaded PLA-PEG 49 kD nanocapsules significantly decreased the number of lung metastases when compared with free drug (P < 0.05). The administration of CPT-loaded nanocapsules and free drug did not result in neutropenia at the administered dose. The improved effectiveness of pegylated nanocapsules was attributed to protection of the drug by nanoencapsulation and to reduced uptake of particles by macrophages located in the lymph nodes. This assumption was supported by the in-vitro study, in which both PLA and 49 kDa PLA-PEG nanocapsules containing CPT were more cytotoxic than the free drug against B16-F10 melanoma cells.

Retinal nerve fibre layer assessment in myopic glaucomatous eyes: comparison of GDx variable corneal compensation with GDx enhanced corneal compensation

Aim:

To compare the results of scanning laser polarimetry (GDx) with variable corneal compensation (VCC) and enhanced corneal compensation (ECC) when applied to myopic glaucomatous eyes.

Methods:

Forty glaucoma eyes with moderate myopia (between −3 and −6 D) and 35 glaucoma eyes with high myopia (−8 D or greater) were enrolled in this study. GDx VCC, GDx ECC and standard automated perimetry (SAP) were performed. The prevalence of an atypical retardation pattern (ARP), the typical scan score (TSS) and retinal nerve fibre layer (RNFL) thickness were compared between VCC and ECC in both groups of myopic subjects. A correlation analysis between RNFL thickness and visual sensitivity was also conducted.

Results:

In both myopic groups, the mean TSS is significantly lower (p<0.0001), and the prevalence of ARP was significantly higher (p<0.0001) by VCC scans than by ECC scans. Temporal, superior, nasal, inferior, temporal (TSNIT) average and temporal average thickness showed significantly higher values (p<0.001) by VCC than by ECC. A statistically significant association was observed between TSNIT average and mean deviation of SAP by ECC scan.

Conclusions:

ECC scans showed a better retardation pattern and structure–function relationship than did VCC, and ECC appeared to be more suitable for RNFL assessment in glaucomatous eyes that are moderately to highly myopic.

Proteolytic exposure of a cryptic site within collagen type IV is required for angiogenesis and tumor growth in vivo

Evidence is provided that proteolytic cleavage of collagen type IV results in the exposure of a functionally important cryptic site hidden within its triple helical structure. Exposure of this cryptic site was associated with angiogenic, but not quiescent, blood vessels and was required for angiogenesis in vivo. Exposure of the HUIV26 epitope was associated with a loss of alpha1beta1 integrin binding and the gain of alphavbeta3 binding. A monoclonal antibody (HUIV26) directed to this site disrupts integrin-dependent endothelial cell interactions and potently inhibits angiogenesis and tumor growth. Together, these studies suggest a novel mechanism by which proteolysis contributes to angiogenesis by exposing hidden regulatory elements within matrix-immobilized collagen type IV.

Systemically expressed soluble Tie2 inhibits intraocular neovascularization

Retinal and choroidal neovascularization are the most frequent causes of severe and progressive vision loss. Studies have demonstrated that Tie2, an endothelial-specific receptor tyrosine kinase, plays a key role in angiogenesis. In this study, we determined whether adenovirus-mediated gene delivery of extracellular domain of the Tie2 receptor (ExTek) could inhibit experimental retinal and choroidal neovascularization. Immunofluorescence histochemistry with a monoclonal antibody to human Tie2 showed that Tie2 expression is prominent around and within the base of newly formed blood vessels of retinal and choroidal neovascular lesions. A single intramuscular injection of adenovirus expressing ExTek genes achieved plasma levels of ExTek exceeding 500 microg/ml in mice for 10 days (in neonates) and 7 days (in adults). This treatment inhibited retinal neovascularization by 47% (p < 0.05) in a murine model of ischemia-induced retinopathy. The same treatment reduced the incidence and extent of sodium fluorescein leakage from choroidal neovascular lesions by 52% (p < 0.05) and 36% (p < 0.01), respectively, in a laser-induced murine choroidal neovascularization model. The same mice showed a 45% (p < 0.001) reduction of integrated area of the choroidal neovascularization. These findings indicate that Tie2 signaling is a common component of the angiogenic pathway in both retinal and choroidal neovascularization, providing a potentially useful target in the treatment of intraocular neovascular diseases.

Angiopoietin-1 upregulation by vascular endothelial growth factor in human retinal pigment epithelial cells

PURPOSE

To determine whether vascular endothelial growth factor (VEGF) regulates angiopoietin (Ang)-1 and -2 expression in retinal pigment epithelial (RPE) cells.

METHODS

Expression of VEGF, Ang1, and Ang2 in surgically removed human choroidal neovascular membranes (CNVMs) was analyzed by double-label confocal immunofluorescence microscopy. Total RNA was extracted from cultured human RPE cells treated with VEGF for mRNA analysis. Northern blot analysis was performed to examine the time course and dose response of Ang1 and Ang2 mRNA expression. mRNA stability and nuclear run-on analyses were performed. Secreted Ang1 and Ang2 protein levels in conditioned media from RPE cells were examined by Western blot analysis.

RESULTS

Ang1 and Ang2 immunostaining colocalized with VEGF-positive stromal cells in human CNVMS: Ang1 and Ang2 mRNAs were expressed by cultured serum-starved RPE cells. VEGF upregulated Ang1 mRNA in a time- and dose-dependent manner without a significant change in Ang2 mRNA. Ang1 and Ang2 mRNAs in RPE cells were as stable as that of S18. VEGF stimulation further increased the half-life of Ang1 mRNA, but did not alter its transcription rate. VEGF increased the amount of Ang1, but not Ang2, protein secreted into the medium.

CONCLUSIONS

The colocalization of Ang1 and Ang2 with VEGF in CNVM stromal cells and the upregulation of Ang1 expression by VEGF in cultured RPE cells suggest that VEGF may selectively modulate Ang expression during CNV.

Role of nitric oxide during the initial phase of reperfusion after retinal ischemia in the rat

The onset of reperfusion and the recovery of the ERG b-wave following retinal ischemia was examined among three groups of rats: group 1 (n = 12) and group 2 (n = 6) received pretreatment with NG-nitro-L-arginine (20 mg/kg, i.p., 2 h before ischemia) followed by intravenous injection of saline (group 1) or of 200 mg/kg L-arginine (group 2) 5 min before the end of ischemia; group 3 (n = 7) received saline pretreatment followed by intravenous injection of saline as a control. Group 1 showed delayed onset of reperfusion compared to the other two groups and a reduction in the rate of the b-wave recovery compared to the control on the 1st day after reperfusion (group 1 vs. group 3; p = 0.0357). The L-arginine posttreatment significantly increased the b-wave recovery (group 2 vs. group 1; p = 0.0005 on day 1 and p < 0.0006 on day 3). The rate of the b-wave recovery in group 1 was inversely proportional to the time to establish complete reperfusion. Inhibition of nitric oxide synthase during the initial phase of reperfusion may worsen the recovery of the b-wave following retinal ischemia, at least in part, by inhibiting establishment of reperfusion.

Peroxisome proliferator-activated receptor-gamma ligands inhibit choroidal neovascularization

PURPOSE

To determine the antiangiogenic effects of peroxisome proliferator-activated receptor (PPAR)-gamma agonists on ocular cells involved in the pathogenesis of choroidal neovascularization (CNV) in vitro and on experimental laser photocoagulation-induced CNV in vivo.

METHODS

PPAR-gamma expression in human retinal pigment epithelial (RPE) cells and bovine choroidal endothelial cells (CECs) was determined using an RNase protection assay and Western blot analysis. Two PPAR-gamma ligands, troglitazone (TRO) and rosiglitazone (RSG; 0.1-20 microM), were used to assess effects on RPE and CEC proliferation and migration and CEC tube formation in response to vascular endothelial growth factor (VEGF). The effects of intravitreal injection of TRO on laser photocoagulation-induced CNV lesions in rat eyes (15 experimental, 15 control, nine burns per eye) and cynomolgus monkey eyes (two experimental, two control, seven paramacular burns per eye) was assessed by fluorescein angiography and histologic evaluation. RESULTS. PPAR-gamma1 was expressed in both RPE and CEC. PPAR-gamma ligands significantly inhibited VEGF-induced migration and proliferation in both cell types and tube formation of CEC in a dose-response manner. CNV in rats was markedly inhibited by intravitreous injection of TRO (P < 0.001). Lesions showed significantly less fluorescein leakage and were histologically thinner in the TRO-treated animals. Similar findings were present in the TRO-treated lesions in two monkey eyes. The drug showed no apparent adverse effects in the adjacent retina or in control eyes.

CONCLUSIONS

The inhibition of VEGF-induced choroidal angiogenesis in vitro, and CNV in vivo by PPAR-gamma ligands suggests the potential application of these agents in the large group of patients with age-related macular degeneration complicated by CNV.

Expression of proteoglycan decorin in neural retina

PURPOSE

To identify the expression of chondroitin/dermatan sulfate proteoglycan decorin in retina and to elucidate its changes during development and ischemia-reperfusion.

METHODS

Expression of decorin in rat retina was investigated by reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemistry. Distributional changes during development and transient ischemia in model eyes also were investigated by immunohistochemical experiments.

RESULTS

Gene expression of decorin core protein was identified in rat retina by RT-PCR. Decorin immunoreactivities were shown throughout the retina, especially in the ganglion cell layer. In developing rat retinas, at embryonic stages (embryonic day 16), decorin was distributed uniformly throughout the retina. As retina matured, the intensity of decorin immunostaining in retinal inner layers and retinal pigment epithelium increased. Furthermore, in experimental transient retinal ischemia, after transient downregulation of the decorin core protein gene between 24 and 48 hours after the ischemia, recovered (or increased) expression was shown by semiquantitative RT-PCR experiments. Immunohistochemical studies revealed strong decorin immunoreactivities in the damaged inner layers 1 week later.

CONCLUSIONS

The expression of decorin was identified in adult and developing rat retina. The distributional changes of decorin during the retinal development suggest that this proteoglycan may play a role in the differentiation of retinal ganglion cells. Moreover, in rat ischemia-reperfusion models, the alterations in gene expression and immunohistochemical localization showed the contribution of this proteoglycan to the damage and repair processes in diseased retina.

Mutant herpes simplex virus-mediated suppression of retinoblastoma

PURPOSE

To test the ability of a mutant herpes simplex virus (HSV) hrR3 to inhibit growth of Y79 human retinoblastoma in vitro and in vivo.

METHODS

Cultured Y79 cells were infected with multiplicities of infection (MOI) ranging from 0.004 to 0.1 of hrR3. Surviving cells were counted using trypan blue dye exclusion. Using X-gal staining, expression of the lacZ gene was examined in vitro on day 3 postinfection to evaluate viral replication. Nude mice harboring Y79 tumors subcutaneously received an intraneoplasmic injection of 5 x 10(7) plaque-forming units of hrR3. The tumor sizes were measured weekly. Expression of the lacZ gene was also examined on one week postinfection.

RESULTS

There are 31% and 13% cells surviving in cultured Y79 cells infected by hrR3 at an MOI of 0.1 on days 3 and 5 postinfection respectively compared to those of mock-infected cells. Also more than 70% of Y79 cells were stained with X-gal at an MOI of 0.1 which demonstrated active viral replication in vitro. Virus-treated subcutaneous tumors were smaller than control tumors (p<<0.05, Student's t-test) on days 14, 21, and 28 postinfection. Positive X-gal staining was also observed in the tumor nodule which was challenged with this viral vector.

CONCLUSIONS

We have demonstrated that hrR3 is capable of inhibiting Y79 tumor growth both in cell culture and in nude mice. These data suggest that gene therapy using this mutant HSV vector can be a new supplementary therapeutic modality for retinoblastoma.

Hepatoma-specific antitumor activity of an albumin enhancer/promoter regulated herpes simplex virus in vivo

Targeting viral vectors to appropriate cell types so that normal cells are not adversely affected is an important goal for gene therapy. Previously, we described a novel approach to viral gene therapy using a conditional, replication-competent herpes simplex virus (HSV), where replication and associated cytotoxicity are limited to a specific cell-type by the regulated expression of an essential immediate-early viral gene product. In this report we analyze the hepatoma-specific replication, cytotoxicity and anti-tumor effect of recombinant HSV G92A, regulated by the albumin enhancer/promoter. G92A efficiently replicated in vitro in two human hepatoma cell lines expressing albumin, but not in four human non-hepatoma, albumin-non-expressing tumor cell lines, while all cell lines were equally susceptible to a tissue nonspecific HSV recombinant, hrR3. In vivo, G92A replicated well in subcutaneous xenografts of human hepatoma cells (Hep3B) in athymic mice, but not in non-hepatoma subcutaneous tumors (PC3 and HeLa), whereas, hrR3 replicated well in both tumor types. Intratumoral inoculation of G92A inhibited the growth of established subcutaneous hepatoma tumors in nude mice, but not prostate tumors. Replication-competent viral vectors controlled by cell-specific transcriptional regulatory sequences provide a new therapeutic strategy for tumor therapy.

Adenovirally expressed basic fibroblast growth factor rescues photoreceptor cells in RCS rats

PURPOSE

To evaluate the abilities of recombinant adenovirus carrying the basic fibroblast growth factor (bFGF) gene to (1) produce bFGF protein in vitro and (2) rescue retinal photoreceptors in Royal College of Surgeons (RCS) rats in vivo.

METHODS

Cultured human retinal pigment epithelial cells were infected with one of the following two replication-deficient adenoviral vectors that drive inserted genes by beta-actin promoter with cytomegalovirus enhancer: AxCAJSbFGF, which expresses the human bFGF gene, and AxCAlacZ, carrying the cDNA of bacterial beta-galactosidase as a viral control. These viruses and recombinant bFGF protein were also injected into the subretinal space of RCS rats at the age of 21 days. The production of bFGF was evaluated by an immunohistochemical method in vitro and in vivo. The secretion of bFGF produced in vitro was quantified by an enzyme-linked immunosorbent assay. The thickness of the outer nuclear layer (ONL) as a marker of photoreceptor cell rescue was estimated at 2, 28, and 56 days after the injections.

RESULTS

AxCAJSbFGF produced human bFGF protein effectively both in vitro and in vivo. The semiquantitative analysis of ONL thickness revealed a significant protective effect of AxCAJSbFGF and the recombinant bFGF protein injection up to 56 days after injection.

CONCLUSIONS

These results demonstrate that a recombinant adenoviral vector can achieve the transfer of bFGF gene in vitro and have a protective effect for photoreceptor cells in vivo. Gene therapy with a bFGF-expressing recombinant adenoviral vector may provide a new strategy with which to target retinal degenerative diseases.

Roles of constitutive nitric oxide synthase in postischemic rat retina

PURPOSE

Nitric oxide is a reactive species that could be protective or destructive to the retina depending on the stage of the evolving ischemic process. This study was conducted to obtain a better understanding of the roles of constitutive nitric oxide synthase (cNOS) during reperfusion after ischemia in rat retina.

METHODS

Retinal ischemia was induced for 60 minutes in Sprague-Dawley rats by ligating the optic nerve. Gene expression for endothelial and neuronal nitric oxide synthases (eNOS and nNOS) was studied by reverse transcription-polymerase chain reaction (RT-PCR). To inhibit cNOS, NG-nitro-L-arginine (L-NNA) was injected intraperitoneally four times (every 6 hours) beginning 2 hours after reperfusion, for a total dose of 80 mg/kg. Retinal damage was assessed by the rate of a- and b-wave recovery on electroretinograms and by the thickness of the retinal layers. Retinal circulation and vessel diameter were evaluated by the dye-dilution technique.

RESULTS

After ischemia ended, eNOS mRNA initially decreased until 6 hours, then increased to a peak at 12 hours, and decreased progressively beyond 24 hours until the final measurement at 96 hours of reperfusion. nNOS mRNA decreased to nearly undetectable levels during the same measurement periods. L-NNA treatment enhanced reduction of a- and b-wave amplitudes and increased thinning of the inner retina in postischemic eyes. Retinal mean circulation time was markedly prolonged in L-NNA-treated postischemic eyes. Arterial mean transit times were 2.1-fold and 4.5-fold longer in L-NNA-treated postischemic eyes than in L-NNA-treated nonischemic eyes and in D-NNA-treated postischemic eyes, respectively.

CONCLUSIONS

This study shows that postischemic inhibition of NOS worsens retinal damage after ischemia-reperfusion and alters postischemic retinal circulation. Nitric oxide may play an important role in protecting the retina from ischemic injury, possibly by preventing postischemic hypoperfusion.

Advanced glycation end products in age-related macular degeneration

OBJECTIVE

To investigate the localization of N epsilon-(carboxymethyl)lysine (CML), a component and major immunologic epitope of advanced glycation end products, in aged eyes and choroidal neovascular membranes (CNVMs) surgically excised from eyes with age-related macular degeneration.

METHODS

Immunohistochemistry for CML was performed using 8 snap-frozen, surgically excised CNVMs. Twelve eyes from patients aged 69 to 82 years and 2 donor eyes, 1 each from a 23-week-old fetus and 21-year-old patient, without age-related macular degeneration or diabetic retinopathy were also examined. To determine if retinal pigment epithelial cells in CNVMs accumulate advanced glycation end products, cytokeratin and CML were stained in paired serial sections.

RESULTS

Soft, macular drusen and/or basal laminar and basal linear deposits were observed in 8 of 12 aged eyes. Each case showed CML accumulation, while overlying retinal pigment epithelial cells showed no accumulation in all 12 eyes. In CNVMs, however, retinal pigment epithelial cells showed CML accumulation in their cytoplasm.

CONCLUSION

The additional accumulation of advanced glycation end products in soft, macular drusen and/or retinal pigment epithelial cells may play a role in the pathogenesis of CNVM formation in age-related macular degeneration.

CLINICAL RELEVANCE

Recently, advanced glycation end products have been found to play a role both in aging changes and neovascularization. Localization of advanced glycation end products in the above-mentioned tissue may lead to a better understanding of the pathogenesis of age-related macular degeneration.

Retrovirus-mediated gene transfer to photocoagulation-induced choroidal neovascular membranes

PURPOSE

To determine the feasibility of experimental gene transfer to laser-induced choroidal neovascular membrane (CNVM) in rats, with a retroviral vector containing the reporter construct beta-galactosidase (beta-gal).

METHODS

Laser photocoagulation was used to induce CNVM in rats. To ascertain the duration of beta-gal expression in the CNVM, 23 rats received 10 burns (75 microm, 100 mW, 0.1 seconds) in their right eyes, and beta-gal expression was examined from day 3 to 4 months. In addition, 14 pigmented rats were treated with 3 photocoagulation burns in their right eyes. beta-gal vector was injected into the vitreous or subretinal space 2 days later. On day 14, fluorescein angiography was performed to detect choroidal neovascularization. Then, beta-gal expression in each photocoagulation-induced CNVM was examined by observing the exposed fundus of the eyes stained with the beta-gal substrate X-Gal.

RESULTS

beta-gal expression was identified in the CNVM induced by photocoagulation from day 5 (16.2% +/- 6.8% of the lesions) to 4 months (3.7% +/- 2.4%). Histopathologic examination revealed beta-gal-transduced macrophages and spindle-shaped cells, which amounted to 1.12% +/- 0.58% (at 2 weeks) of the total cells in the CNVM. beta-gal expression was restricted to the CNVM, and there was no beta-gal transduction in surrounding normal retinochoroidal tissue. There was no correlation between choroidal neovascularization formation and beta-gal expression.

CONCLUSIONS

The feasibility of gene transduction targeted to the photocoagulation-induced CNVM was demonstrated using retroviral vectors. By transducing functional genes, this model could be useful for investigating the possibility of gene therapy to inhibit formation of the CNVM in age-related macular degeneration.

Growth inhibition of cultured human Tenon's fibroblastic cells by targeting the E2F transcription factor

The transcription factor E2F regulates the expression of several genes concerned with cell growth. The ability to inhibit transcription by blocking E2F expression has great potential in the treatment of proliferative disorders. The effect of double-stranded phosphorothioate oligonucleotides containing E2F transcription factor cis element, a so called 'decoy' has examined on the growth of cultured human Tenon's fibroblastic cells. Human Tenon's fibroblastic cells were cultured and challenged by E2F decoy coated with the Hemagglutinating virus of Japan (HVJ) cationic liposomes (HVJ-CL). The outcome was evaluated using fluorescence microscopy, RT-PCR and growth assays. HVJ-CL facilitated the transfer of external oligonucleotides to cultured human Tenon's fibroblastic cells. The E2F decoy, transferred by HVJ-CL, inhibited simultaneously the expression of the mRNAs of several cell cycle related genes such as c-myc, cdc2, proliferative cell nuclear antigen, and dehydrofolate reductase. Entry into S phase was also reduced to 42.7% of the positive control by the E2F decoy. The total increase of DNA at four days was reduced to 59.7% of the positive control by 5 microM and 29.9% by 15 microM of E2F decoy. It is concluded that gene therapy using the E2F transcription factor offers a potential therapeutic modality for the treatment of proliferative disorders such as proliferative vitreoretinopathy and fibrosis following filtering surgery.

Introduction of DNA into the rat and primate trabecular meshwork by fusogenic liposomes

PURPOSE

To evaluate the feasibility of introducing exogenous genes and phosphorothioate oligonucleotides into the anterior chamber tissues of rats and monkeys using the authors' fusogenic liposomes.

METHODS

Hemagglutinating virus of Japan liposomes containing LacZ DNA-high-mobility group 1 complexes or fluorescein isothiocyanate (FITC)-labeled phosphorothioate oligonucleotides were prepared and injected into the anterior chambers of rats (3 microliters) and rhesus monkeys (30 microliters). The expression of LacZ DNA was visualized histochemically by beta-Galactosidase assay and was followed for as long as 60 days in rats and 30 days in monkeys. FITC-labeled phosphorothioate oligonucleotides were observed by fluorescence microscopy for as long as 14 days in rats and 7 days in monkeys.

RESULTS

Injection of LacZ DNA-high-mobility group 1 complexes encapsulated in hemagglutinating virus of Japan liposomes resulted in blue staining in the trabecular meshwork and iris-ciliary body of rats and selectively in the trabecular meshwork of monkeys at the concentrations used. This LacZ expression lasted for as long as 14 days after injection in both animals. Phosphorothioate oligonucleotides (3 microM) also were introduced into the rat trabecular meshwork and iris-ciliary body and into the primate trabecular meshwork when encapsulated in hemagglutinating virus of Japan liposomes, although the injection of naked FITC-labeled phosphorothioate oligonucleotides at the same concentration resulted in little fluorescence in any anterior chamber tissue.

CONCLUSIONS

This study shows that the use of hemagglutinating virus of Japan liposomes can transfer LacZ DNA and phosphorothioate oligonucleotides to adult rat and primate trabecular meshwork. This system may enable progress in glaucoma research and in the development of nonviral somatic gene therapy of the trabecular meshwork to treat glaucoma.

In vivo delivery of phosphorothioate oligonucleotides into murine retina

OBJECTIVES

To determine the fate of phosphorothioate oligonucleotides (S-ODNs), which are commonly used for antisense strategy, in murine retina in vivo with the use of fluorescein isothiocyanate (FITC)-labeled S-ODNs, and to evaluate our fusogenic liposome system that may facilitate the delivery of S-ODNs.

METHODS

The FITC-labeled S-ODNs were encapsulated in liposomes, which were then coated with the envelope of inactivated hemagglutinating virus of Japan (HVJ; Sendai virus) by fusion (HVJ liposomes). Intravitreal injection of naked FITC-labeled S-ODNs or of the HVJ liposomes was done in ICR mice. After fixation, cryosections and flat-mounted retinas were prepared and examined by fluorescence microscopy.

RESULTS

Injection of naked FITC-labeled S-ODNs at 3 micromol/L exhibited weak fluorescence in 13% of the cells in the ganglion cell layer. When the concentration was increased to 30 micromol/L, high fluorescence was seen in 59% of cells in the ganglion cell layer at this time. This fluorescence diminished within a day. In contrast, injection of HVJ liposomes containing FITC-labeled S-ODNs at 3 micromol/L resulted in high fluorescence in 44% of the cells in the ganglion cell layer at 1 hour, and this fluorescence lasted for up to 3 days. This treatment also resulted in high fluorescence within retinal vessel walls, and weak fluorescence in photoreceptor cells.

CONCLUSIONS

Intravitreally injected S-ODNs were rapidly eliminated from neural retina, and the use of HVJ liposomes could improve the delivery of S-ODNs. This method may be a potentially useful system for the antisense-based therapies for retinal diseases.

Up-regulation of glial fibrillary acidic protein in the retina of primate eyes with experimental glaucoma

OBJECTIVE

To identify molecular mechanisms of retinal responses to intraocular pressure elevation in primate experimental glaucoma.

METHODS

An experimental glaucoma model was created by repeated laser trabeculophotocoagulation. After the preparation of complementary DNAs from extracted total RNAs in the retinas, polymerase chain reaction (PCR) experiments were performed for the following screening target genes: beta-tubulin beta 2 and beta 5 and glial fibrillary acidic protein (GFAP). To investigate the amplified sequences derived from the PCR experiments, sequencing, subcloning, and Southern blot analysis of PCR products were performed. In addition, an immunohistochemical analysis was performed in an attempt to show the distribution of the target gene products in the retinas.

RESULTS

A series of PCR experiments suggested up-regulation of gene expression for GFAP but not for beta-tubulins. Sequencing of the PCR products and results of the Southern blot analysis showed that the amplified sequences were derived mainly from the target gene, GFAP, and that increased expression of GFAP was found despite the severity of glaucoma. Immunohistochemical studies also demonstrated increased expression of GFAP proteins in Müller cells and astrocytes in the retinas of primate eyes with experimental glaucoma.

CONCLUSIONS

Our study showed up-regulation of GFAP at gene and protein levels, which suggests that glial components in the retina may contribute to the pathologic processes induced by elevated intraocular pressure.

Severe myopia as a risk factor for progressive visual field loss in primary open-angle glaucoma

The optic nerve head in severely myopic eyes may be particularly vulnerable to glaucomatous damage. To study this hypothesis, we examined 122 primary open-angle glaucoma eyes with fair to good control of the intraocular pressure and a sign of baseline optic nerve damage. Then, parameters for the progression of the visual field defects were evaluated by multivariate analysis. A high mean intraocular pressure (p = 0.007) and a large refractive error (p = 0.023) were significant risk factors for subsequent visual field loss. A high baseline cup-to-disk ratio (p = 0.100) was a marginal risk factor. Nonsignificant parameters included patient age (p = 0.692), the use of beta-adrenergic antagonists (p = 0.384), gender (p = 0.831) and left versus right side (p = 0.977). When the refractive error was used to subclassify patients into severely myopic (< or = -4 dpt), mildly myopic (-0.25 to -4 dpt), or emmetropic and hyperopic (> or = 0 dpt), only severe myopia was a significant risk factor for progressive visual field loss. Severe myopia, but not mild myopia, is a significant risk factor for subsequent visual field loss in patients with primary open-angle glaucoma.

In vivo gene transfer into the retina mediated by a novel liposome system

PURPOSE

To determine whether a reporter gene can be introduced into rat and mouse retinas in vivo using the authors' novel liposome system.

METHODS

Cytomegalovirus-promoted LacZ genes and nonhistone nuclear protein, high mobility group 1 (HMG1), were coencapsulated in liposomes by agitation and sonication. The liposomes were then coated with the envelope of inactivated hemagglutinating virus of Japan (HVJ; Sendai virus) by fusion (HVJ liposome). The HVJ liposome solution was injected into the vitreous cavity of adult Sprague-Dawley rats (n = 30) or the subretinal space of adult CD-1 mice (n = 42). LacZ expression was assessed by beta-galactosidase assay.

RESULTS

LacZ expression was demonstrated in the photoreceptors as long as 30 days after intravitreal and subretinal injections. beta-Gal activity was observed also in neurons and glial cells in the ganglion cell layer of the intravitreally injected rats and, although at lower intensity, in the retinal pigment epithelium of both animals. No inflammation or toxic effects secondary to the HVJ liposomes were detected on histologic examination.

CONCLUSIONS

In vivo transfer and expression of a reporter gene into adult mammalian retina can be achieved using HVJ liposomes. This method offers a promise as a nonviral system for in vivo gene transfer into adult mammalian neural retina.

Inducible nitric oxide synthase in retinal ischemia-reperfusion injury

The purpose of this study was to determine whether inducible nitric oxide synthase (iNOS) was implicated in the pathogenesis of retinal ischemia-reperfusion injury. Semi-quantitative reverse transcription-polymerase chain reaction showed that the level of iNOS mRNA expression was markedly increased in rat retina following transient ischemia, with peak expression at 12 hr after reperfusion (15.7-fold increase over pre-ischemic levels). In situ hybridization showed that iNOS mRNA was expressed by resident retinal cells, most likely glial cells in the innermost retina, and also by the neutrophils that had infiltrated the retina. Intraperitoneal administration of NG-(1-iminoethyl)-L-ornithine (L-NIO), an inhibitor of iNOS, significantly increased the rate of b-wave recovery compared to that of control animals. The values (mean +/- S.E.M.) were 55.0 +/- 4.4% versus 40.1 +/- 5.1% (P < 0.05) at 1 day and 68.6 +/- 6.6% versus 45.8 +/- 3.5% (P < 0.05) at 3 days. This study shows that iNOS mRNA is highly expressed by non-neuronal cells of the inner retina during reperfusion following transient retinal ischemia. It also shows that L-NIO treatment provides some protection against ischemia-reperfusion injury. We suggest that nitric oxide produced by iNOS may mediate retinal ischemia-reperfusion injury.

Trabeculotomy ab externo, cataract extraction, and intraocular lens implantation: preliminary report

PURPOSE

To compare the results of a triple procedure using either extracapsular cataract extraction (ECCE) or one of two phacoemulsification techniques combined with trabeculotomy ab externo and intraocular lens (IOL) implantation.

SETTING

Kyoto University Hospital, Kyoto, Japan, and Nagata Eye Hospital, Nara, Japan.

METHODS

In this comparative study, 25 eyes with primary open-angle glaucoma had ECCE combined with trabeculotomy ab externo and IOL implantation and 22 had the same procedure using phacoemulsification instead of ECCE. Of the eyes that had phacoemulsification, 10 had a single-flap and 12 had a double-flap procedure.

RESULTS

All 22 eyes that had phacoemulsification had a postoperative IOP of 21 mm Hg or less, as did all ECCE eyes except 2. Although the self-sealing incision might have caused the higher incidence of IOP spikes in the immediate postoperative period, IOPs in the phacoemulsification groups were lower after 3 months. Results were similar in the single-flap and double-flap phacoemulsification groups. There were no significant complications.

CONCLUSION

Cataract extraction by phacoemulsification or ECCE combined with IOL implantation and trabeculotomy ab externo is a safe, effective treatment for patients with coexisting glaucoma and cataract.

Role of nitric oxide synthase isozymes in endotoxin-induced uveitis

PURPOSE

The authors previously reported that in vitro treatment with N(G)-nitro L-arginine (L-NNA), an inhibitor of nitric oxide synthase (NOS), reduces aqueous humor (AH) protein and cellular infiltration in endotoxin-induced uveitis in the rat eye. The objective of the current study was to determine the role(s) of respective major forms (constitutive and inducible) of NOS by comparing the effects of relatively selective inhibitors of these NOS isozymes.

METHODS

N(G)-nitro L-arginine (L-NNA), a relatively selective inhibitor for constitutive NOS (c-NOS), and N-iminoethyl L-ornithine (L-NIO), a more selective inhibitor for inducible NOS (i-NOS), were administered in vivo. Male Lewis rats were footpad injected with bacterial lipopolysaccharide (LPS, 200 microgram) and were injected intraperitoneally at 0 hours, 6 hours, or both, after LPS injection with 10 mg of NIO, NNA, or saline as a control. Nitric oxide synthase activity in the ocular tissue and AH protein and cell content were determined at various times after treatment with LPS.

RESULTS

After in vivo treatment, L-NIO was found to be a more potent inhibitor than L-NNA for ocular i-NOS (87% versus 43% inhibition), and L-NNA was more potent than L-NIO for ocular c-NOS (81% versus 39%). Two injections of L-NNA, one at time 0 and one 6 hours after LPS injection, inhibited the AH protein increase by 71%, but L-NIO did so by only 30%. L-NNA inhibited cellular infiltration by 86%, whereas L-NIO had no significant effect on cellular infiltration. A significant inhibition of cellular infiltration and AH protein increase also was observed with a single injection of 10 mg of L-NNA but not of L-NIO when the inhibitors were given simultaneously with LPS. Thus, reduction of uveitis symptoms correlates with the inhibition of c-NOS.

CONCLUSIONS

The constitutive form of NOS in ocular tissue, presumably in vascular endothelial cells, appears to play a critical role at the onset of the development of endotoxin-induced uveitis.

Surgical results and complications of trabeculectomy with intraoperative application of mitomycin C

Trabeculectomy is reportedly less effective in aphakic eyes, secondary glaucoma, juvenile patients, and eyes with a history of unsuccessful glaucoma surgery. We evaluated the surgical effects and complications of trabeculectomy with the adjunctive use of mitomycin C, an antiproliferative drug, in a number of refractory cases. Forty patients (50 eyes) with refractory glaucoma were treated with trabeculectomy and the adjunctive use of mitomycin C and were followed postoperatively for at least 3 months. The mean follow-up period was 13.6 +/- 7.5 months (range: 3 to 31 months). In 43 eyes (86%), intraocular pressure was well controlled at < or = 21 mmHg. Complications included corneal epithelial damage (30 eyes), shallow anterior chamber (20 eyes), hyphema (19 eyes), choroidal detachment (18 eyes), leakage of aqueous humor from the conjunctival wound (4 eyes), and endophthalmitis (1 eye). The results of trabeculectomy with intraoperative use of mitomycin C in this series of procedures demonstrates that this can be a useful and effective treatment; however, mitomycin C may cause transient decreased visual acuity due to inhibited wound healing and the resultant overfiltration.

Increased cytokine gene expression in rat retina following transient ischemia

Tumor necrosis factor (TNF) gene expression in rat retina following transient ischemia was studied by semiquantitative reverse transcription-polymerase chain reaction (RT-PCR). Gene expression for other cytokines was also studied by RT-PCR. Although very little expression for TNF gene was detected in normal retina, it was markedly increased 0.5-48 h after reperfusion, with peak expression at 12 h (20-fold of control). Gene expression for interleukin-6, interferon-gamma, and transforming growth factor-beta 1 was also increased. The results provide evidence that retinal ischemia can up-regulate cytokine gene expression in the retina.

Interleukin-1 gene expression in transient retinal ischemia in the rat

PURPOSE

To determine in rats whether there are time-dependent changes in interleukin-1 alpha (IL-1 alpha) and interleukin-1 beta (IL-1 beta) gene expression in transient retinal ischemia and to localize their mRNAs in the retina.

METHODS

Retinal ischemia was induced in Sprague-Dawley rats by ligating the optic nerve. Two hours later, the ligature was released and reperfusion occurred. The levels of IL-1 alpha and IL-1 beta gene expression in the sensory retina were then compared at various times after reperfusion by a semiquantitative polymerase chain reaction method. Localization of their expressed mRNAs was examined by in situ hybridization histochemistry.

RESULTS

Little expression of IL-1 alpha and IL-1 beta genes was observed in normal retina. IL-1 alpha gene expression rapidly increased (about 30-fold greater than that of the control) as early as 1 hour after cessation of ischemia, reached a peak (about 50-fold) at 3 to 12 hours, and then gradually decreased to near baseline levels. IL-1 beta gene expression began to increase 2 hours later than did that of IL-1 alpha and had two peaks. IL-1 beta gene was found by in situ hybridization histochemistry to be expressed by retinal glial cells, endothelial cells, and neutrophils infiltrating the retina and vitreous. No gene expression was found in the control retinas.

CONCLUSIONS

Expression of IL-1 alpha and IL-1 beta genes was dramatically upregulated during reperfusion after induced retinal ischemia. IL-1 beta gene was expressed by retinal glial cells, endothelial cells, and neutrophils recruited into the retina. From these results, it appeared that IL-1 may have an important role in retinal ischemia-reperfusion injury.

Interleukin-1 alpha, interleukin-1 beta, and tumor necrosis factor gene expression in endotoxin-induced uveitis

PURPOSE

To localize and determine the levels of interleukin-1 alpha (IL-1 alpha), interleukin-1 beta (IL-1 beta), and tumor necrosis factor (TNF) gene expression in the process of endotoxin-induced uveitis (EIU) in rats.

METHOD

EIU was induced by lipopolysaccharide (LPS) injection in male Lewis rats weighing 150 to 200 g. The levels of IL-1 alpha, IL-1 beta, and TNF gene expression in the iris-ciliary body (ICB) were quantified by a semiquantitative polymerase chain reaction (PCR) method; in situ hybridization histochemistry was carried out to localize the gene transcripts.

RESULTS

Little expression of IL-1 alpha, IL-1 beta, and TNF genes was observed in normal ICB. IL-1 alpha gene expression began to increase (about 10-fold greater than that of the control) as early as 1 hour after the LPS treatment, reached a peak (about 100-fold) at 3 to 6 hours. A second peak (60-fold) was observed at 24 hours, and the expression returned to near basal levels (3-fold) at 48 hours. Expression of IL-1 beta and TNF genes showed a pattern similar to that of IL-1 alpha. Three hours after LPS treatment, IL-1 beta and TNF genes were found by in situ hybridization histochemistry to be expressed by "histiocyte-like" cells in the stroma of the ICB. None of these genes were detected in the control rats.

CONCLUSIONS

Expression of IL-1 alpha, IL-1 beta, and TNF genes was dramatically up-regulated in the process of EIU. These genes were found to be expressed in "histiocyte-like" cells in the ICB, and may have an important role in EIU.