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Botello-Marabotto M, Martínez-Bisbal MC, Pinazo-Durán MD, Martínez-Máñez R. Tear metabolomics for the diagnosis of primary open-angle glaucoma. Talanta 2024; 273:125826. [PMID: 38479028 DOI: 10.1016/j.talanta.2024.125826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 02/14/2024] [Accepted: 02/21/2024] [Indexed: 04/09/2024]
Abstract
Primary Open-Angle Glaucoma (POAG) is the most prevalent glaucoma type, and the leading cause of irreversible visual impairment and blindness worldwide. Identification of early POAG biomarkers is of enormous value, as there is not an effective treatment for the glaucomatous optic nerve degeneration (OND). In this pilot study, a metabolomic analysis, by using proton (1H) nuclear magnetic resonance (NMR) spectroscopy was conducted in tears, in order to determine the changes of specific metabolites in the initial glaucoma eyes and to discover potential diagnostic biomarkers. A classification model, based on the metabolomic fingerprint in tears was generated as a non-invasive tool to support the preclinical and clinical POAG diagnosis. 1H NMR spectra were acquired from 30 tear samples corresponding to the POAG group (n = 11) and the control group (n = 19). Data were analysed by multivariate statistics (partial least squares-discriminant analysis: PLS-DA) to determine a model capable of differentiating between groups. The whole data set was split into calibration (65%)/validation (35%), to test the performance and the ability for glaucoma discrimination. The calculated PLS-DA model showed an area under the curve (AUC) of 1, as well as a sensitivity of 100% and a specificity of 83.3% to distinguish POAG group versus control group tear data. This model included 11 metabolites, potential biomarkers of the disease. When comparing the study groups, a decrease in the tear concentration of phenylalanine, phenylacetate, leucine, n-acetylated compounds, formic acid, and uridine, was found in the POAG group. Moreover, an increase in the tear concentration of taurine, glycine, urea, glucose, and unsaturated fatty acids was observed in the POAG group. These results highlight the potential of tear metabolomics by 1H NMR spectroscopy as a non-invasive approach to support early POAG diagnosis and in order to prevent visual loss.
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Affiliation(s)
- Marina Botello-Marabotto
- Instituto Interuniversitario de Investigación de Reconocimiento Molecular y Desarrollo Tecnológico (IDM), Universitat Politècnica de València - Universitat de València, Valencia, Spain; Unidad Mixta de Investigación en Nanomedicina y Sensores, Instituto de Investigación Sanitaria La Fe (IISLAFE) - Universitat Politècnica de València, Valencia, Spain; CIBER de Bioingeniería, Biomateriales y Nanomedicina, Instituto de Salud Carlos III, Spain
| | - M Carmen Martínez-Bisbal
- Instituto Interuniversitario de Investigación de Reconocimiento Molecular y Desarrollo Tecnológico (IDM), Universitat Politècnica de València - Universitat de València, Valencia, Spain; Unidad Mixta de Investigación en Nanomedicina y Sensores, Instituto de Investigación Sanitaria La Fe (IISLAFE) - Universitat Politècnica de València, Valencia, Spain; CIBER de Bioingeniería, Biomateriales y Nanomedicina, Instituto de Salud Carlos III, Spain; Departamento de Química Física, Universitat de València, Valencia, Spain.
| | - M Dolores Pinazo-Durán
- Ophthalmic Research Unit "Santiago Grisolia"/FISABIO, Valencia, Spain; Cellular and Molecular Ophthalmobiology Research Group at the University of Valencia, Valencia, Spain; Spanish Net of Inflammatory Research (REI-RICORS: RD21/0002/0032) Institute of Health Carlos III, Madrid, Spain
| | - Ramón Martínez-Máñez
- Instituto Interuniversitario de Investigación de Reconocimiento Molecular y Desarrollo Tecnológico (IDM), Universitat Politècnica de València - Universitat de València, Valencia, Spain; Unidad Mixta de Investigación en Nanomedicina y Sensores, Instituto de Investigación Sanitaria La Fe (IISLAFE) - Universitat Politècnica de València, Valencia, Spain; CIBER de Bioingeniería, Biomateriales y Nanomedicina, Instituto de Salud Carlos III, Spain; Departamento de Química, Universitat Politècnica de València, Valencia, Spain; Unidad Mixta UPV-CIPF de Investigación en Mecanismos de Enfermedades y Nanomedicina, València, Universitat Politècnica de València, Centro de Investigación Príncipe Felipe, Valencia, Spain
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Shui YB, Liu Y, Huang AJW, Siegfried CJ. SDPR expression in human trabecular meshwork and its potential role in racial disparities of glaucoma. Sci Rep 2024; 14:10258. [PMID: 38704467 PMCID: PMC11069504 DOI: 10.1038/s41598-024-61071-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 04/30/2024] [Indexed: 05/06/2024] Open
Abstract
In order to identify how differential gene expression in the trabecular meshwork (TM) contributes to racial disparities of caveolar protein expression, TM dysfunction and development of primary open angle glaucoma (POAG), RNA sequencing was performed to compare TM tissue obtained from White and Black POAG surgical (trabeculectomy) specimens. Healthy donor TM tissue from White and Black donors was analyzed by PCR, qPCR, immunohistochemistry staining, and Western blot to evaluate SDPR (serum deprivation protein response; Cavin 2) and CAV1/CAV2 (Caveolin 1/Caveolin 2). Standard transmission electron microscopy (TEM) and immunogold labeled studies were performed. RNA sequencing demonstrated reduced SDPR expression in TM from Black vs White POAG patients' surgical specimens, with no significant expression differences in other caveolae-associated genes, confirmed by qPCR analysis. No racial differences in SDPR gene expression were noted in healthy donor tissue by PCR analysis, but there was greater expression as compared to specimens from patients with glaucoma. Analysis of SDPR protein expression confirmed specific expression in the TM regions, but not in adjacent tissues. TEM studies of TM specimens from healthy donors did not demonstrate any racial differences in caveolar morphology, but a significant reduction of caveolae with normal morphology and immuno-gold staining of SDPR were noted in glaucomatous TM as compared to TM from healthy donors. Linkage of SDPR expression levels in TM, POAG development, and caveolar ultrastructural morphology may provide the basis for a novel pathway of exploration of the pathologic mechanisms of glaucoma. Differential gene expression of SDPR in TM from Black vs White subjects with glaucoma may further our understanding of the important public health implications of the racial disparities of this blinding disease.
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Affiliation(s)
- Ying-Bo Shui
- Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Ying Liu
- Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Andrew J W Huang
- Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Carla J Siegfried
- Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, MO, 63110, USA.
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Zhou X, Xu J, Zhang X, Zhao Y, Duan X. Causal relationships between Gut microbiota and primary open-angle Glaucoma: A Mendelian randomization and mediation analysis of Glaucoma endophenotypes. Exp Eye Res 2024; 240:109788. [PMID: 38218362 DOI: 10.1016/j.exer.2024.109788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/08/2024] [Accepted: 01/10/2024] [Indexed: 01/15/2024]
Abstract
Primary open-angle glaucoma (POAG) is a widespread condition responsible for irreversible blindness, and its prevalence is expected to increase substantially in the coming decades. Despite its significance, the exact cause of POAG remains elusive, necessitating a comprehensive exploration of its pathogenesis. Emerging research suggests a potential link between alterations in gut microbiota composition and POAG. However, establishing causality in these associations remains a challenge. In this study, we employed Mendelian randomization (MR) analysis to investigate the potential causal relationships between gut microbiota (GM) and POAG. Significant bacteria taxa were further analyzed with POAG endophenotypes. We utilized data from genome-wide association studies (GWAS) for GM and POAG, as well as for glaucoma endophenotypes, including intraocular pressure (IOP), retinal nerve fiber layer (RNFL) thickness, vertical cup-to-disc ratio (VCDR), and central corneal thickness (CCT). Univariable, multivariable MR and mediation effect analysis were conducted. Our analysis revealed that certain taxa, including phylum Euryarchaeota, genus Odoribacter, Rumnicoccaceae UCG009, Ruminiclostridium9, unknown genus id.2071, and Eubacterium rectale group, were associated with an increased risk of POAG. On the other hand, family Victivallaceae, Lacchnospiraceae, genus Lachnoclostridium, Oscillospira, Ruminococcaceae UCG011, Alloprevotella, and Faecalibacterium were found to be associated with a decreased risk of POAG. Furthermore, some of these taxa were found to be connected to glaucoma endophenotypes. Through further multivariable MR analysis, it was determined that IOP, VCDR, and CCT might played mediating roles between GM and POAG. In conclusion, this study utilizes MR analysis to elucidate potential causal associations between GM and POAG, providing insights into specific GM taxa that influence POAG risk and related endophenotypes. These findings emphasize the potential role of the gut microbiota in the pathogenesis of POAG and pave the way for future research and therapeutic interventions.
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Affiliation(s)
- Xiaoyu Zhou
- Aier Glaucoma Institute, Hunan Engineering Research Center for Glaucoma with Artificial Intelligence in Diagnosis and Application of New Materials, Changsha Aier Eye Hospital, Changsha, Hunan, China; The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Jiahao Xu
- Aier Glaucoma Institute, Hunan Engineering Research Center for Glaucoma with Artificial Intelligence in Diagnosis and Application of New Materials, Changsha Aier Eye Hospital, Changsha, Hunan, China; The Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Xinyue Zhang
- Aier Glaucoma Institute, Hunan Engineering Research Center for Glaucoma with Artificial Intelligence in Diagnosis and Application of New Materials, Changsha Aier Eye Hospital, Changsha, Hunan, China; The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Yang Zhao
- Aier Glaucoma Institute, Hunan Engineering Research Center for Glaucoma with Artificial Intelligence in Diagnosis and Application of New Materials, Changsha Aier Eye Hospital, Changsha, Hunan, China; The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Xuanchu Duan
- Aier Glaucoma Institute, Hunan Engineering Research Center for Glaucoma with Artificial Intelligence in Diagnosis and Application of New Materials, Changsha Aier Eye Hospital, Changsha, Hunan, China.
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Hwang HS, Lee EJ, Kim JA, Lee SH, Kim TW. Influence of choroidal microvasculature dropout on progressive retinal nerve fibre layer thinning in primary open-angle glaucoma: comparison of parapapillary β-zones and γ-zones. Br J Ophthalmol 2024; 108:357-365. [PMID: 36690420 DOI: 10.1136/bjo-2022-322505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 01/11/2023] [Indexed: 01/24/2023]
Abstract
BACKGROUND/AIMS To compare the influence of choroidal microvasculature dropout (cMvD) on progressive retinal nerve fibre layer (RNFL) thinning in glaucomatous eyes with parapapillary β-zones and γ-zones. METHODS 294 eyes with primary open-angle glaucoma (POAG) and parapapillary atrophy (PPA) underwent optical coherence tomography (OCT) to determine the type of PPA and OCT angiography scanning of the optic nerve head to determine the presence of cMvD. Eyes were classified based on the type of PPA (β-zones and γ-zones), and their clinical characteristics were compared. Factors associated with the rate of rapid progressive RNFL thinning were determined in each group, including the presence of cMvD as an independent variable. RESULTS Of the 294 eyes, 186 and 108 were classified as having β-zones and γ-zones, respectively. The rate of RNFL thinning was slower (p<0.001), axial length was longer (p<0.001) and presence of cMvD was less frequent (57.4% vs 73.1%, p=0.006) in eyes with γ-zone than those with β-zone. Multivariate analyses showed that greater lamina cribrosa curvature (p=0.047) and the presence of cMvD (p=0.010) were associated with a faster rate of RNFL thinning in eyes with β-zone, whereas larger intraocular pressure fluctuation (p<0.001), shorter axial length (p=0.042) and greater baseline RNFL thickness (p<0.001) were associated with a faster rate of RNFL thinning in eyes with γ-zone. CONCLUSIONS The presence of cMvD was significantly associated with a faster rate of RNFL thinning in POAG eyes with β-zone, but not γ-zone. The pathogenic consequences of cMvD in POAG eyes may depend on accompanying peripapillary structures.
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Affiliation(s)
- Hye Seong Hwang
- Department of Ophthalmology, Seoul National University College of Medicine, Bundang Hospital, Seongnam, Korea
| | - Eun Ji Lee
- Department of Ophthalmology, Seoul National University College of Medicine, Bundang Hospital, Seongnam, Korea
| | - Jeong-Ah Kim
- Department of Ophthalmology, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Seung Hyen Lee
- Department of Ophthalmology, Nowon Eulji Medical Center, Eulji University College of Medicine, Seoul, Korea
| | - Tae-Woo Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Bundang Hospital, Seongnam, Korea
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Liang Z, Yang K, Lv K, Ma Y, Chen X, Ren Z, Liang Y, Hou X, Wu H. Direct observation and measurement of circumlental space and its relation to anterior chamber angle characteristics in iridotomized phakic eyes with primary angle closure disease. Sci Rep 2024; 14:3881. [PMID: 38365883 PMCID: PMC10873345 DOI: 10.1038/s41598-024-54562-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 02/14/2024] [Indexed: 02/18/2024] Open
Abstract
Primary angle closure disease (PACD) is a major cause of blindness worldwide. It has a high prevalence in East Asia, especially in China, which leads to a higher incidence of blindness than open-angle glaucoma. The aim of this study was to directly observe the circumlental space (CLS) in laser peripheral iridotomized eyes with PACD and to determine whether this structure plays a role in the pathogenesis of PACD. Fifty eyes of 50 patients with PACD, who had received laser peripheral iridotomy performed with neodymium:yttrium-aluminum-garnet were recruited from glaucoma clinics from March 2021 to May 2022, including 17 primary angle closure suspect (PACS), 16 primary angle closure (PAC) and 17 primary angle closure glaucoma (PACG). They were classified into two groups based on whether the ciliary process and the crystalline lens equator were in contact using slit-lamp photograph: the attached group and the unattached group. The demographic, clinical characteristics and anterior segment parameters measured from ultrasound biomicroscopy were compared between the attached group and the unattached group. Thirty-three eyes were assigned to the attached group and 17 eyes belonged to the unattached group. In the unattached group, the mean CLS was 0.10 ± 0.07 mm. No significant differences were identified between the different diagnosis groups in age, sex, best-corrected visual acuity, intraocular pressure, white-to-white, axial length, central corneal thickness, anterior chamber depth, flat keratometry, steep keratometry or iridotomy diameter (p > 0.05). The unattached group had shorter trabecular-ciliary process distance (p = 0.021) and larger ciliary process area (p = 0.001) compared with the attached group. Small CLS and its potential effect (partial ciliary block) might be considered as one of the mechanisms of PACD.
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Affiliation(s)
- Zhiqiao Liang
- Department of Ophthalmology, Peking University People's Hospital, Eye Diseases and Optometry Institute, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, No. 11 Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Kangyi Yang
- Department of Ophthalmology, Peking University People's Hospital, Eye Diseases and Optometry Institute, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, No. 11 Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Kun Lv
- Department of Ophthalmology, Peking University People's Hospital, Eye Diseases and Optometry Institute, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, No. 11 Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Yao Ma
- Department of Ophthalmology, Peking University People's Hospital, Eye Diseases and Optometry Institute, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, No. 11 Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Xuanzhu Chen
- Department of Ophthalmology, Peking University People's Hospital, Eye Diseases and Optometry Institute, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, No. 11 Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Zeqin Ren
- Department of Ophthalmology, Peking University People's Hospital, Eye Diseases and Optometry Institute, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, No. 11 Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Yong Liang
- Department of Ophthalmology, Peking University People's Hospital, Eye Diseases and Optometry Institute, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, No. 11 Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Xianru Hou
- Department of Ophthalmology, Peking University People's Hospital, Eye Diseases and Optometry Institute, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, No. 11 Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Huijuan Wu
- Department of Ophthalmology, Peking University People's Hospital, Eye Diseases and Optometry Institute, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, No. 11 Xizhimen South Street, Xicheng District, Beijing, 100044, China.
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Rong S, Yu X, Wiggs JL. Genetic Basis of Pigment Dispersion Syndrome and Pigmentary Glaucoma: An Update and Functional Insights. Genes (Basel) 2024; 15:142. [PMID: 38397132 PMCID: PMC10887877 DOI: 10.3390/genes15020142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 01/16/2024] [Accepted: 01/18/2024] [Indexed: 02/25/2024] Open
Abstract
Pigment Dispersion Syndrome (PDS) and Pigmentary Glaucoma (PG) comprise a spectrum of ocular disorders characterized by iris pigment dispersion and trabecular meshwork changes, resulting in increased intraocular pressure and potential glaucomatous optic neuropathy. This review summarizes recent progress in PDS/PG genetics including rare pathogenic protein coding alterations (PMEL) and susceptibility loci identified from genome-wide association studies (GSAP and GRM5/TYR). Areas for future research are also identified, especially the development of efficient model systems. While substantial strides have been made in understanding the genetics of PDS/PG, our review identifies key gaps and outlines the future directions necessary for further advancing this important field of ocular genetics.
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Affiliation(s)
- Shisong Rong
- Ocular Genomics Institute, Department of Ophthalmology, Massachusetts Eye and Ear, Mass General Brigham, Harvard Medical School, Boston, MA 02114, USA;
| | - Xinting Yu
- Department of Medicine, Brigham and Women’s Hospital, Mass General Brigham, Harvard Medical School, Boston, MA 02115, USA;
| | - Janey L. Wiggs
- Ocular Genomics Institute, Department of Ophthalmology, Massachusetts Eye and Ear, Mass General Brigham, Harvard Medical School, Boston, MA 02114, USA;
- Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA
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Latif K, Nishida T, Moghimi S, Micheletti E, Du K, Weinreb RN. Relationship of Choroidal Microvasculature Dropout and Beta Zone Parapapillary Area With Visual Field Changes in Glaucoma. Am J Ophthalmol 2024; 257:16-24. [PMID: 37573989 DOI: 10.1016/j.ajo.2023.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 08/01/2023] [Accepted: 08/08/2023] [Indexed: 08/15/2023]
Abstract
PURPOSE To evaluate the association between rates of choroidal microvasculature dropout (MvD) change, beta zone parapapillary atrophy (β-PPA) area change, and visual field (VF) changes in eyes with primary open-angle glaucoma (POAG). DESIGN Retrospective, observational cohort study. METHODS In a tertiary glaucoma clinic, we included 76 eyes from 58 patients with POAG with and without localized MvD, who had ≥2 years of follow-up with a minimum of 4 visits with optical coherence tomography angiography and optical coherence tomography scans. β-PPA area was evaluated using scanning laser ophthalmoscopy-like images and compared with the area of MvD on an en face choroidal vessel density map during the follow-up period. Joint longitudinal mixed effects models were used to estimate the rates of change in β-PPA area or MvD area and VF mean deviation (MD). RESULTS Mean rates of change in β-PPA and MvD area were 0.037 mm2 (95% confidence interval [CI] 0.030-0.043 mm2) per year and 0.039 mm2 (95% CI 0.029-0.048 mm2) per year, respectively, over the mean follow-up of 4.1 years. In multivariable models, MvD area enlargement was significantly associated with faster rates of VF MD loss (0.03 mm2 [95% CI 0.02-0.04 mm2] per 1-dB worse, P < .001) but not β-PPA area enlargement (0.04 mm2 [95% CI 0.03-0.05 mm2] per 1-dB worse, P = .252). CONCLUSION MvD area rates, but not β-PPA area rates, were associated with VF MD loss changes in eyes with POAG. Assessment of MvD is useful for the detection of patients with glaucoma who are at an increased risk of faster VF loss.
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Affiliation(s)
- Kareem Latif
- From the Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California, USA
| | - Takashi Nishida
- From the Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California, USA
| | - Sasan Moghimi
- From the Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California, USA
| | - Eleonora Micheletti
- From the Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California, USA
| | - Kelvin Du
- From the Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California, USA
| | - Robert N Weinreb
- From the Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California, USA.
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Chrysou A, Heikka T, van der Zee S, Boertien JM, Jansonius NM, van Laar T. Reduced Thickness of the Retina in de novo Parkinson's Disease Shows A Distinct Pattern, Different from Glaucoma. J Parkinsons Dis 2024; 14:507-519. [PMID: 38517802 DOI: 10.3233/jpd-223481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/24/2024]
Abstract
Background Parkinson's disease (PD) patients experience visual symptoms and retinal degeneration. Studies using optical coherence tomography (OCT) have shown reduced thickness of the retina in PD, also a key characteristic of glaucoma. Objective To identify the presence and pattern of retinal changes in de novo, treatment-naive PD patients compared to healthy controls (HC) and early primary open angle glaucoma (POAG) patients. Methods Macular OCT data (10×10 mm) were collected from HC, PD, and early POAG patients, at the University Medical Center Groningen. Bayesian informative hypotheses statistical analyses were carried out comparing HC, PD-, and POAG patients, within each retinal cell layer. Results In total 100 HC, 121 PD, and 78 POAG patients were included. We showed significant reduced thickness of the inner plexiform layer and retinal pigment epithelium in PD compared to HC. POAG patients presented with a significantly thinner retinal nerve fiber layer, ganglion cell layer, inner plexiform layer, outer plexiform layer, and outer photoreceptor and subretinal virtual space compared to PD. Only the outer segment layer and retinal pigment epithelium were significantly thinner in PD compared to POAG. Conclusions De novo PD patients show reduced thickness of the retina compared to HC, especially of the inner plexiform layer, which differs significantly from POAG, showing a more extensive and widespread pattern of reduced thickness across layers. OCT is a useful tool to detect retinal changes in de novo PD, but its specificity versus other neurodegenerative disorders has to be established.
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Affiliation(s)
- Asterios Chrysou
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Tuomas Heikka
- Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Sygrid van der Zee
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jeffrey M Boertien
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Nomdo M Jansonius
- Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Teus van Laar
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Ameen Ismail A, Hatata RM, Sadek SH. Relative Flow Index as a Novel Optical Coherence Tomography Angiography Biomarker in Primary Open Angle Glaucoma. J Glaucoma 2023; 32:1064-1075. [PMID: 37974316 DOI: 10.1097/ijg.0000000000002326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 10/10/2023] [Indexed: 11/19/2023]
Abstract
PRCIS Relative flow indices as novel optical coherence tomography angiography (OCTA) biomarkers demonstrated reduced optic nerve head and peripapillary large vessel and capillary perfusion in primary open angle glaucoma (POAG). Large vessel perfusion correlated with disease severity and progression. PURPOSE To introduce relative flow indices as novel OCTA biomarkers and their pathologic insights in POAG. MATERIALS AND METHODS This is a retrospective case-control study where 57 POAG and 57 control eyes were included. OCTA 4.5×4.5 mm optic nerve head (ONH) were analyzed using ImageJ 1.53t to calculate global flow indices (GFIs) and relative flow indices (RFIs) for whole image optic nerve head, isolated radial peripapillary capillary plexus, and isolated large vessel angiograms. RESULTS Retinal nerve fiber layer thickness (RNFLT), ONH vascular density (VD), except inside disc and large vessel VD, GFIs, and RFIs were lower in POAG than control. There was a positive correlation between RNFLT and both VD and GFIs. Among RFIs, only large vessel RFI (ONHLVRFI) demonstrated a positive correlation with average RNFLT. Linear regression demonstrated a significant positive coefficient for ONHLVRFI with RNFLT as the dependent variable. The area under receiver operating characteristic curve showed diagnostic accuracy ranging fair, good, and excellent for all biomarkers. Inferior RNFLT had the highest area under the curve (0.922) while optic nerve head large vessel density had the lowest (0.523). CONCLUSIONS POAG showed structural loss of RNFL neurovascular unit manifesting as positively correlated reduction of VD and RNFLT. Also, POAG had lower global perfusion of the optic nerve head and peripapillary area, resulting in the positively correlated reduction of GFIs and RNFLT. Although RFIs were lower in POAG, only ONHLVRFI demonstrated a positive correlation and regression with RNFLT, implying that large vessel hypoperfusion was associated with POAG severity and progression.
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Affiliation(s)
- Ahmed Ameen Ismail
- Department of Ophthalmology, Faculty of Medicine, Fayoum University, Al Fayoum, Egypt
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Santos KS, Cruz NFS, Matuoka ML, Kasahara N. Estimated intracranial pressure in glaucoma patients and its correlation with disease severity. Int J Neurosci 2023; 133:1196-1203. [PMID: 35440260 DOI: 10.1080/00207454.2022.2068416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 08/28/2021] [Indexed: 10/18/2022]
Abstract
PURPOSE To compare the intracranial pressure (ICP) and the translaminar pressure difference (TLPD) between primary open-angle glaucoma (POAG) patients and non-glaucoma subjects and to assess the correlation between the ICP (and TLPD) and glaucoma severity. METHODS This was a cross-sectional study. Patients with POAG and age-matched controls were included. ICP was calculated using proxy algorithm to attain indirect surrogate parameter values. Differences were compared between groups. The correlation between ICP (and TLPD) and both structural and functional variables was evaluated using linear and non-linear regression analysis and estimated with Pearson's correlation coefficient. RESULTS Fifty patients with POAG and 25 normal controls were included. The mean estimated ICP was lower in POAG (10.9 ± 3.2 mmHg) as compared to controls (15.0 ± 3.7 mmHg, p < 0.001). The TLPD was higher in POAG (2.6 ± 4.1 mmHg) when compared to non-glaucoma (-0.3 ± 3.6 mmHg, p = 0.002). ICP displayed a negative correlation with cup-to-disk ratio (r = -0.566; 95% CI, -0.699 to -0.369, p'0.000) and a positive correlation with retinal nerve fiber layer thickness (r = 0.441; 95% CI, 0.230 to 0.612; p'0.000). There was a positive correlation between ICP and mean deviation (r = 0.280; 95% CI, 0.05 to 0.482, p = 0.017). CONCLUSION Glaucoma patients presented lower ICP values; lower ICP values were associated with more advanced disease. These observations strengthen the role of ICP as a potential player on the glaucoma pathogeny.
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Affiliation(s)
- Katia Santana Santos
- Department of Ophthalmology, Irmandade da Santa Casa de Misericordia de Sao Paulo, Sao Paulo, Brazil
| | | | - Mateus Lial Matuoka
- Department of Ophthalmology, Irmandade da Santa Casa de Misericordia de Sao Paulo, Sao Paulo, Brazil
| | - Niro Kasahara
- Department of Ophthalmology, Irmandade da Santa Casa de Misericordia de Sao Paulo, Sao Paulo, Brazil
- Santa Casa de Sao Paulo School of Medical Sciences, Sao Paulo, Brazil
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11
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Wang D, Xiao H, Lin S, Fang L, Gan Y, Zhang Y, Chen X, Huang Z, Zheng S, Shi H, Xu Z, Li Y, Li J, Liu X, Zuo C. Comparison of the Choroid in Primary Open Angle and Angle Closure Glaucoma Using Optical Coherence Tomography. J Glaucoma 2023; 32:e137-e144. [PMID: 37671543 DOI: 10.1097/ijg.0000000000002303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 08/17/2023] [Indexed: 09/07/2023]
Abstract
PRCIS The current study highlights distinct choroidal alterations in primary open angle (POAG) and primary angle closure (PACG) glaucomas, underscoring the potential of the Choroidal Vascularity Index (CVI) as a valuable indicator for understanding glaucoma pathogenesis. PURPOSE To evaluate choroidal structural changes in patients with POAG and PACG and healthy controls utilizing the CVI and subfoveal choroidal thickness by enhanced depth imaging optical coherence tomography. METHODS This study was cross-sectional. A total of 171 eyes of 171 subjects, comprising 69 eyes with untreated POAG, 58 eyes with untreated PACG, and 44 healthy eyes, were enrolled in this study. Subfoveal choroidal thickness, luminal area (LA), stromal area (SA), and total choroidal area were measured on enhanced depth imaging-optical coherence tomography scans. The CVI parameter is calculated as the proportion of LA to the total choroidal area. RESULTS This study included 69 patients with POAG with a mean age of 51.4 ± 13.3 years, 58 patients with PACG with a mean age of 57.0 ± 7.3 years, and 44 healthy subjects with a mean age of 51.11 ± 10.7 years. The CVI in the POAG and PACG groups was significantly lower than that in the control group ( P = 0.001 and P = 0.005, respectively); however, not significantly different between the two glaucoma groups ( P = 1.000). POAG eyes had significantly lower LA than PACG and controls ( P = 0.014 and P = 0.049, respectively), whereas PACG eyes had significantly greater SA than controls ( P = 0.041). CONCLUSIONS The CVI of POAG and PACG eyes was significantly lower than that of normal eyes. A reduced LA was observed mainly in eyes with POAG, and an increased SA was observed mainly in eyes with PACG. The role of the choroid may differ between POAG and PACG eyes.
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Affiliation(s)
- Dingqiao Wang
- Department of Glaucoma, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science
- Guangdong Provincial Clinical Research Center for Ocular Diseases
| | - Hui Xiao
- Department of Glaucoma, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science
- Guangdong Provincial Clinical Research Center for Ocular Diseases
| | - Shufen Lin
- Department of Glaucoma, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science
- Guangdong Provincial Clinical Research Center for Ocular Diseases
| | - Lei Fang
- Department of Glaucoma, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science
- Guangdong Provincial Clinical Research Center for Ocular Diseases
| | - Yuhong Gan
- Department of Glaucoma, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science
- Guangdong Provincial Clinical Research Center for Ocular Diseases
| | - Yuxin Zhang
- Department of Ophthalmology, The First Affiliated Hospital of Kunming Medical University, Kunming Yunnan
| | - Xiangxi Chen
- Aier School of Ophthalmology, Wuhan Aier Eye Hospital, Central South University, Wuhan, China
| | - Zhihong Huang
- Department of Glaucoma, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science
- Guangdong Provincial Clinical Research Center for Ocular Diseases
| | - Shaoyang Zheng
- Department of Glaucoma, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science
- Guangdong Provincial Clinical Research Center for Ocular Diseases
| | - Huanyang Shi
- Department of Glaucoma, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science
- Guangdong Provincial Clinical Research Center for Ocular Diseases
| | - Zixing Xu
- Zhongshan School of Medicine Sun Yat-sen University Guangzhou, Guangzhou
| | - Yixuan Li
- Zhongshan School of Medicine Sun Yat-sen University Guangzhou, Guangzhou
| | - Junyi Li
- Zhongshan School of Medicine Sun Yat-sen University Guangzhou, Guangzhou
| | - Xing Liu
- Department of Glaucoma, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science
- Guangdong Provincial Clinical Research Center for Ocular Diseases
| | - Chengguo Zuo
- Department of Glaucoma, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science
- Guangdong Provincial Clinical Research Center for Ocular Diseases
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12
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Chen J, Chen DF, Cho KS. The Role of Gut Microbiota in Glaucoma Progression and Other Retinal Diseases. Am J Pathol 2023; 193:1662-1668. [PMID: 37490970 PMCID: PMC10616709 DOI: 10.1016/j.ajpath.2023.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 06/19/2023] [Accepted: 06/29/2023] [Indexed: 07/27/2023]
Abstract
As a rapidly growing field, microbiota research offers novel approaches to promoting ocular health and treating major retinal diseases, such as glaucoma. Gut microbiota changes throughout life; however, certain patterns of population changes have been increasingly associated with specific diseases. It has been well established that a disrupted microbiome contributes to central nervous system diseases, including Alzheimer disease, Parkinson disease, multiple sclerosis, and glioma, suggesting a prominent role of microbiome in neurodegenerative diseases. This review summarizes the progress in identifying significant changes in the microbial composition of patients with glaucoma by compiling studies on the association between microbiota and disease progression. Of interest is the relationship between increased Firmicutes/Bacteroidetes ratio in patients with primary open-angle glaucoma, increased taurocholic acid, decreased glutathione, and a reduction in retinal ganglion cell survival. Connecting these microbes to specific metabolites sheds light on the pathogenic mechanism and novel treatment strategies. In summary, the current review synthesizes the findings of several studies investigating the effects of shifting bacterial population in retinal diseases, particularly glaucoma, with the aim to identify the current direction of treatment and help direct future endeavors.
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Affiliation(s)
- Julie Chen
- Department of Ophthalmology, Schepens Eye Research Institute of Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - Dong Feng Chen
- Department of Ophthalmology, Schepens Eye Research Institute of Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts.
| | - Kin-Sang Cho
- Department of Ophthalmology, Schepens Eye Research Institute of Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
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13
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Patel PD, Kodati B, Clark AF. Role of Glucocorticoids and Glucocorticoid Receptors in Glaucoma Pathogenesis. Cells 2023; 12:2452. [PMID: 37887296 PMCID: PMC10605158 DOI: 10.3390/cells12202452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 10/07/2023] [Accepted: 10/09/2023] [Indexed: 10/28/2023] Open
Abstract
The glucocorticoid receptor (GR), including both alternative spliced isoforms (GRα and GRβ), has been implicated in the development of primary open-angle glaucoma (POAG) and iatrogenic glucocorticoid-induced glaucoma (GIG). POAG is the most common form of glaucoma, which is the leading cause of irreversible vision loss and blindness in the world. Glucocorticoids (GCs) are commonly used therapeutically for ocular and numerous other diseases/conditions. One serious side effect of prolonged GC therapy is the development of iatrogenic secondary ocular hypertension (OHT) and OAG (i.e., GC-induced glaucoma (GIG)) that clinically and pathologically mimics POAG. GC-induced OHT is caused by pathogenic damage to the trabecular meshwork (TM), a tissue involved in regulating aqueous humor outflow and intraocular pressure. TM cells derived from POAG eyes (GTM cells) have a lower expression of GRβ, a dominant negative regulator of GC activity, compared to TM cells from age-matched control eyes. Therefore, GTM cells have a greater pathogenic response to GCs. Almost all POAG patients develop GC-OHT when treated with GCs, in contrast to a GC responder rate of 40% in the normal population. An increased expression of GRβ can block GC-induced pathogenic changes in TM cells and reverse GC-OHT in mice. The endogenous expression of GRβ in the TM may relate to differences in the development of GC-OHT in the normal population. A number of studies have suggested increased levels of endogenous cortisol in POAG patients as well as differences in cortisol metabolism, suggesting that GCs may be involved in the development of POAG. Additional studies are warranted to better understand the molecular mechanisms involved in POAG and GIG in order to develop new disease-modifying therapies to better treat these two sight threatening forms of glaucoma. The purpose of this timely review is to highlight the pathological and clinical features of GC-OHT and GIG, mechanisms responsible for GC responsiveness, potential therapeutic options, as well as to compare the similar features of GIG with POAG.
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Affiliation(s)
| | | | - Abbot F. Clark
- Department of Pharmacology & Neuroscience, North Texas Eye Research Institute, University of North Texas Health Science Center, Fort Worth, TX 76107, USA; (P.D.P.); (B.K.)
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14
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Karabulut S, Kaderli A, Karabulut M, Sül S, Karalezli A. Optic nerve head vascular variations in pseudoexfoliative and primary open-angle glaucoma. Arq Bras Oftalmol 2023; 86:e20210420. [PMID: 37878951 DOI: 10.5935/0004-2749.2021-0420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 12/23/2021] [Indexed: 10/27/2023] Open
Abstract
PURPOSE The purpose of this study was to assess the optic nerve head microvascular changes in pseudoexfoliative and primary open-angle glaucoma and define the relationship between vessel density and retinal nerve fiber layer thickness. METHODS This observational cross-sectional study assessed 72 eyes with primary open-angle glaucoma, 41 eyes with pseudoexfoliative glaucoma, and 60 healthy eyes. On the basis of optic nerve head-centered, 4.5 mm × 4.5 mm scan size images, we evaluated the vessel density, as well as the peripapillary sector, inside disk, and all sectoral quadrants. RESULTS Both glaucoma Groups had lower vessel density in all regions compared with the healthy Group (p<0.05 for all variables). Vessel densities of the nasal inferior, inferior nasal, and inferior temporal sectors in both glaucoma Groups showed similar results (p=0.157, p=0.128, p=0.143, respectively). Eyes with pseudoexfoliative glaucoma had significantly lower vessel densities than eyes with primary open-angle glaucoma in all other regions (p<0.05 for all variables). For both glaucoma Groups, the average retinal nerve fiber layer thickness positively correlated with vessel density in all peripapillary sectors (p<0.05 for all variables). CONCLUSIONS Reduction in vessel density correlated with the thinning of retinal nerve fiber layer in both glaucoma Groups. Decreased vessel density in the optic nerve head can be used to demonstrate the microvascular pathologies and possible ischemic changes that lead to faster progression and worse prognosis in pseudoexfoliative glaucoma.
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Affiliation(s)
- Sinem Karabulut
- Department of Ophthalmology, Mugla Sıtkı Kocman University Medical School, Mugla, Turkey
| | - Ahmet Kaderli
- Department of Ophthalmology, Mugla Sıtkı Kocman University Medical School, Mugla, Turkey
| | - Müjdat Karabulut
- Department of Ophthalmology, Mugla Sıtkı Kocman University Medical School, Mugla, Turkey
| | - Sabahattin Sül
- Department of Ophthalmology, Mugla Sıtkı Kocman University Medical School, Mugla, Turkey
| | - Aylin Karalezli
- Department of Ophthalmology, Mugla Sıtkı Kocman University Medical School, Mugla, Turkey
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15
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Wu YC, Chou, CC, Wang CY. The Association between Cholesterol Levels and Severity of Normal Tension Glaucoma. Mol Vis 2023; 29:153-159. [PMID: 38222452 PMCID: PMC10784211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 09/27/2023] [Indexed: 01/16/2024] Open
Abstract
Purpose To evaluate the serum lipid levels, including total cholesterol, high-density lipoprotein (HDL), and low-density lipoprotein (LDL) of patients with normal tension glaucoma (NTG) and to investigate the relationship between serum HDL levels and the severity of NTG. Methods In this cross-sectional, case-control study, 282 NTG subjects and 202 control subjects were enrolled from the outpatient clinic of the Department of Ophthalmology at Taichung Veterans General Hospital in central Taiwan from 2015 to 2021. Fasting cholesterol, HDL, and LDL levels were evaluated using a biochemical analyzer (ARCHITECT c16000). Glaucoma severity was classified by visual field test as mild (mean deviation [MD] ≥ -6.0dB), moderate (-12dB ≤ MD < -6 dB), and severe (MD < -12dB), based on the mean deviation. Results HDL levels were significantly lower in the NTG group compared with the control subjects (47 ± 18mg/dl versus 53 ± 18mg/dl; p = 0.03). There were no statistically significant differences in total cholesterol or LDL levels between the NTG and control subjects (total cholesterol levels: 194 ± 39mg/dl versus 190 ± 32mg/dl; p > 0.05; LDL levels: 113 ± 30mg/dl versus 110 ± 29mg/dl; p > 0.05). The mean serum HDL levels were lowest in the severe group (41 ± 11mg/dl) followed by the moderate (45 ± 16mg/dl) and mild (50 ± 15mg/dl) groups, with significant differences among the three groups (p = 0.02). The multivariate regression analysis revealed a statistically significant negative correlation between HDL and vertical cup-to-disc ratio (VCDR; B =-0.16, p = 0.03) among all NTG patients and a positive correlation between HDL and retinal nerve fiber layer (RNFL; r = 0.34, p = 0.03) among all NTG patients. Conclusions A significantly lower serum HDL concentration was found in the NTG patients, which was negatively associated with disease severity. The findings warrant further study to elucidate the role of these phenomena in the pathogenesis of glaucoma.
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Affiliation(s)
- Yu-Chieh Wu
- Department of Ophthalmology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Chien-Chih Chou,
- Department of Ophthalmology, Taichung Veterans General Hospital, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Chun-Yuan Wang
- Department of Ophthalmology, Taichung Veterans General Hospital, Taichung, Taiwan
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16
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Qin M, Yu-Wai-Man C. Glaucoma: Novel antifibrotic therapeutics for the trabecular meshwork. Eur J Pharmacol 2023; 954:175882. [PMID: 37391006 PMCID: PMC10804937 DOI: 10.1016/j.ejphar.2023.175882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/23/2023] [Accepted: 06/26/2023] [Indexed: 07/02/2023]
Abstract
Glaucoma is a chronic and progressive neurodegenerative disease characterized by the loss of retinal ganglion cells and visual field defects, and currently affects around 1% of the world's population. Elevated intraocular pressure (IOP) is the best-known modifiable risk factor and a key therapeutic target in hypertensive glaucoma. The trabecular meshwork (TM) is the main site of aqueous humor outflow resistance and therefore a critical regulator of IOP. Fibrosis, a reparative process characterized by the excessive deposition of extracellular matrix components and contractile myofibroblasts, can impair TM function and contribute to the pathogenesis of primary open-angle glaucoma (POAG) as well as the failure of minimally invasive glaucoma surgery (MIGS) devices. This paper provides a detailed overview of the current anti-fibrotic therapeutics targeting the TM in glaucoma, along with their anti-fibrotic mechanisms, efficacy as well as the current research progress from pre-clinical to clinical studies.
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Affiliation(s)
- Mengqi Qin
- King's College London, London, SE1 7EH, UK
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17
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Bahrani Fard MR, Chan J, Sanchez Rodriguez G, Yonk M, Kuturu SR, Read AT, Emelianov SY, Kuehn MH, Ethier CR. Improved magnetic delivery of cells to the trabecular meshwork in mice. Exp Eye Res 2023; 234:109602. [PMID: 37488007 PMCID: PMC10530071 DOI: 10.1016/j.exer.2023.109602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 07/22/2023] [Indexed: 07/26/2023]
Abstract
Glaucoma is the leading cause of irreversible blindness worldwide and its most prevalent subtype is primary open angle glaucoma (POAG). One pathological change in POAG is loss of cells in the trabecular meshwork (TM), which is thought to contribute to ocular hypertension and has thus motivated development of cell-based therapies to refunctionalize the TM. TM cell therapy has shown promise in intraocular pressure (IOP) control, but existing cell delivery techniques suffer from poor delivery efficiency. We employed a novel magnetic delivery technique to reduce the unwanted side effects of off-target cell delivery. Mesenchymal stem cells (MSCs) were labeled with superparamagnetic iron oxide nanoparticles (SPIONs) and after intracameral injection were magnetically steered towards the TM using a focused magnetic apparatus ("point magnet"). This technique delivered the cells significantly closer to the TM at higher quantities and with more circumferential uniformity compared to either unlabeled cells or those delivered using a "ring magnet" technique. We conclude that our point magnet cell delivery technique can improve the efficiency of TM cell therapy and in doing so, potentially increase the therapeutic benefits and lower the risk of complications such as tumorigenicity and immunogenicity.
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Affiliation(s)
- M Reza Bahrani Fard
- Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Jessica Chan
- School of Chemistry and Biochemistry, Georgia Institute of Technology, Atlanta, GA, USA
| | | | - Marybeth Yonk
- College of Sciences, Georgia Institute of Technology, Atlanta, GA, USA
| | - Shreya R Kuturu
- Department of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, USA
| | - A Thomas Read
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology/Emory University, Atlanta, GA, USA
| | - Stanislav Y Emelianov
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, USA; Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology/Emory University, Atlanta, GA, USA
| | - Markus H Kuehn
- Departments of Ophthalmology and Visual Sciences, The University of Iowa, Iowa City, IA, USA; Veterans Administration Center for the Prevention and Treatment of Visual Loss, Iowa City VA Healthcare System, Iowa City, IA, USA
| | - C Ross Ethier
- Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, USA; Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology/Emory University, Atlanta, GA, USA.
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18
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Aboobakar IF, Collantes ERA, Hauser MA, Stamer WD, Wiggs JL. Rare protective variants and glaucoma-relevant cell stressors modulate Angiopoietin-like 7 expression. Hum Mol Genet 2023; 32:2523-2531. [PMID: 37220876 PMCID: PMC10360392 DOI: 10.1093/hmg/ddad083] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/10/2023] [Accepted: 05/11/2023] [Indexed: 05/25/2023] Open
Abstract
Rare missense and nonsense variants in the Angiopoietin-like 7 (ANGPTL7) gene confer protection from primary open-angle glaucoma (POAG), though the functional mechanism remains uncharacterized. Interestingly, a larger variant effect size strongly correlates with in silico predictions of increased protein instability (r = -0.98), suggesting that protective variants lower ANGPTL7 protein levels. Here, we show that missense and nonsense variants cause aggregation of mutant ANGPTL7 protein in the endoplasmic reticulum (ER) and decreased levels of secreted protein in human trabecular meshwork (TM) cells; a lower secreted:intracellular protein ratio strongly correlates with variant effects on intraocular pressure (r = 0.81). Importantly, accumulation of mutant protein in the ER does not increase expression of ER stress proteins in TM cells (P > 0.05 for all variants tested). Cyclic mechanical stress, a glaucoma-relevant physiologic stressor, also significantly lowers ANGPTL7 expression in primary cultures of human Schlemm's canal (SC) cells (-2.4-fold-change, P = 0.01). Collectively, these data suggest that the protective effects of ANGPTL7 variants in POAG stem from lower levels of secreted protein, which may modulate responses to physiologic and pathologic ocular cell stressors. Downregulation of ANGPTL7 expression may therefore serve as a viable preventative and therapeutic strategy for this common, blinding disease.
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Affiliation(s)
- Inas F Aboobakar
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA 02115, USA
| | - Edward Ryan A Collantes
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA 02115, USA
| | - Michael A Hauser
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC 27710, USA
| | - W Daniel Stamer
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC 27710, USA
- Department of Biomedical Engineering, Duke University School of Medicine, Durham, NC 27710, USA
| | - Janey L Wiggs
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA 02115, USA
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19
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Diaz-Torres S, He W, Thorp J, Seddighi S, Mullany S, Hammond CJ, Hysi PG, Pasquale LR, Khawaja AP, Hewitt AW, Craig JE, Mackey DA, Wiggs JL, van Duijn C, Lupton MK, Ong JS, MacGregor S, Gharahkhani P. Disentangling the genetic overlap and causal relationships between primary open-angle glaucoma, brain morphology and four major neurodegenerative disorders. EBioMedicine 2023; 92:104615. [PMID: 37201334 PMCID: PMC10206164 DOI: 10.1016/j.ebiom.2023.104615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 04/21/2023] [Accepted: 04/28/2023] [Indexed: 05/20/2023] Open
Abstract
BACKGROUND Primary open-angle glaucoma (POAG) is an optic neuropathy characterized by progressive degeneration of the optic nerve that leads to irreversible visual impairment. Multiple epidemiological studies suggest an association between POAG and major neurodegenerative disorders (Alzheimer's disease, amyotrophic lateral sclerosis, frontotemporal dementia, and Parkinson's disease). However, the nature of the overlap between neurodegenerative disorders, brain morphology and glaucoma remains inconclusive. METHOD In this study, we performed a comprehensive assessment of the genetic and causal relationship between POAG and neurodegenerative disorders, leveraging genome-wide association data from studies of magnetic resonance imaging of the brain, POAG, and four major neurodegenerative disorders. FINDINGS This study found a genetic overlap and causal relationship between POAG and its related phenotypes (i.e., intraocular pressure and optic nerve morphology traits) and brain morphology in 19 regions. We also identified 11 loci with a significant local genetic correlation and a high probability of sharing the same causal variant between neurodegenerative disorders and POAG or its related phenotypes. Of interest, a region on chromosome 17 corresponding to MAPT, a well-known risk locus for Alzheimer's and Parkinson's disease, was shared between POAG, optic nerve degeneration traits, and Alzheimer's and Parkinson's diseases. Despite these local genetic overlaps, we did not identify strong evidence of a causal association between these neurodegenerative disorders and glaucoma. INTERPRETATION Our findings indicate a distinctive and likely independent neurodegenerative process for POAG involving several brain regions although several POAG or optic nerve degeneration risk loci are shared with neurodegenerative disorders, consistent with a pleiotropic effect rather than a causal relationship between these traits. FUNDING PG was supported by an NHMRC Investigator Grant (#1173390), SM by an NHMRC Senior Research Fellowship and an NHMRC Program Grant (APP1150144), DM by an NHMRC Fellowship, LP is funded by the NEIEY015473 and EY032559 grants, SS is supported by an NIH-Oxford Cambridge Fellowship and NIH T32 grant (GM136577), APK is supported by a UK Research and Innovation Future Leaders Fellowship, an Alcon Research Institute Young Investigator Award and a Lister Institute for Preventive Medicine Award.
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Affiliation(s)
- Santiago Diaz-Torres
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia; Faculty of Medicine, University of Queensland (UQ), Brisbane, QLD, Australia.
| | - Weixiong He
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Jackson Thorp
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Sahba Seddighi
- Nuffield Department of Population Health, Oxford University, Oxford, UK; Medical Scientist Training Program, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sean Mullany
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - Christopher J Hammond
- Departments of Ophthalmology & Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - Pirro G Hysi
- Departments of Ophthalmology & Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - Louis R Pasquale
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Anthony P Khawaja
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Alex W Hewitt
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Jamie E Craig
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - David A Mackey
- Centre for Ophthalmology and Visual Science, University of Western Australia, Lions Eye Institute, Australia
| | - Janey L Wiggs
- Department of Ophthalmology, Harvard Medical School, Boston, 02114, MA, USA
| | | | - Michelle K Lupton
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Jue-Sheng Ong
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Stuart MacGregor
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia; Faculty of Medicine, University of Queensland (UQ), Brisbane, QLD, Australia
| | - Puya Gharahkhani
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia; Faculty of Medicine, University of Queensland (UQ), Brisbane, QLD, Australia; School of Biomedical Sciences, Queensland University of Technology (QUT), Brisbane, Australia.
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20
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Zeleznik OA, Kang JH, Lasky-Su J, Eliassen AH, Frueh L, Clish CB, Rosner BA, Elze T, Hysi P, Khawaja A, Wiggs JL, Pasquale LR. Plasma metabolite profile for primary open-angle glaucoma in three US cohorts and the UK Biobank. Nat Commun 2023; 14:2860. [PMID: 37208353 PMCID: PMC10199010 DOI: 10.1038/s41467-023-38466-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 05/04/2023] [Indexed: 05/21/2023] Open
Abstract
Glaucoma is a progressive optic neuropathy and a leading cause of irreversible blindness worldwide. Primary open-angle glaucoma is the most common form, and yet the etiology of this multifactorial disease is poorly understood. We aimed to identify plasma metabolites associated with the risk of developing POAG in a case-control study (599 cases and 599 matched controls) nested within the Nurses' Health Studies, and Health Professionals' Follow-Up Study. Plasma metabolites were measured with LC-MS/MS at the Broad Institute (Cambridge, MA, USA); 369 metabolites from 18 metabolite classes passed quality control analyses. For comparison, in a cross-sectional study in the UK Biobank, 168 metabolites were measured in plasma samples from 2,238 prevalent glaucoma cases and 44,723 controls using NMR spectroscopy (Nightingale, Finland; version 2020). Here we show higher levels of diglycerides and triglycerides are adversely associated with glaucoma in all four cohorts, suggesting that they play an important role in glaucoma pathogenesis.
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Affiliation(s)
- Oana A Zeleznik
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.
- Department of Medicine, Harvard Medical School, Boston, MA, USA.
| | - Jae H Kang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Jessica Lasky-Su
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - A Heather Eliassen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Lisa Frueh
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Clary B Clish
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA, USA
| | - Bernard A Rosner
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Tobias Elze
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Department of Ophthalmology, Schepens Research Eye Institute of Massachusetts Eye and Ear, Boston, MA, USA
| | - Pirro Hysi
- Department of Ophthalmology, King's College London, London, UK
- Department of Twin Research & Genetic Epidemiology, King's College London, London, UK
- St. Thomas' Hospital, London, UK
| | - Anthony Khawaja
- National Institute for Health and Care Research Biomedical Research Centre, Moorfields Eye Hospital, London, UK
- National Institute for Health and Care Research Biomedical Research Centre, Institute of Ophthalmology, University College London, London, UK
| | - Janey L Wiggs
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Department of Ophthalmology, Massachusetts Eye and Ear, Boston, MA, USA
| | - Louis R Pasquale
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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21
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Jiang J, Ye C, Zhang C, Lin Z, Tang Y, Ye W, Xu X, Zhang S, Lu F, Liang Y. The Patterns of Visual Field Defects in Primary Angle-Closure Glaucoma Compared to High-Tension Glaucoma and Normal-Tension Glaucoma. Ophthalmic Res 2023; 66:940-948. [PMID: 37062276 DOI: 10.1159/000530175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 03/06/2023] [Indexed: 04/18/2023]
Abstract
INTRODUCTION The aim of this study was to compare the patterns of visual field (VF) defects in primary angle-closure glaucoma (PACG) to control groups of eyes with high-tension glaucoma (HTG) and normal-tension glaucoma (NTG). METHODS Forty-eight eyes with PACG were enrolled, and control eyes with HTG and NTG matched for age, sex, and mean deviation of VF defect were selected. VF tests were performed using the 24-2 program of the Humphrey field analyzer. VF defects were classified into six patterns with the Ocular Hypertension Treatment Study classification system and were categorized into three stages (early, moderate, and advanced). Each hemifield was divided into five regions according to the Glaucoma Hemifield Test (GHT). The mean total deviation (TD) of each GHT region was calculated. RESULTS Compared with HTG and NTG groups, the partial arcuate VF defects were more common in the PACG group. In the PACG group, the nasal GHT region in the inferior hemifield had the worst mean TD (-8.48 ± 8.62 dB), followed by the arcuate 1 (-7.81 ± 7.91 dB), arcuate 2 (-7.46 ± 7.43 dB), paracentral (-7.19 ± 7.98 dB), and central (-5.14 ± 6.24 dB) regions; the mean TD of the central region was significantly better than those for all other regions (all p < 0.05). A similar trend was observed in the superior hemifield in the PACG group but not the VF hemifields of the HTG and NTG groups. CONCLUSION Patterns of VF defect in PACG patients differ from those with HTG and NTG. This discrepancy might be due to the differences in the pathogenic mechanisms of glaucomatous optic neuropathy.
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Affiliation(s)
- Junhong Jiang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
- National Clinical Research Center for Ocular Disease, Wenzhou, China
| | - Cong Ye
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
- National Clinical Research Center for Ocular Disease, Wenzhou, China
| | - Cong Zhang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
- National Clinical Research Center for Ocular Disease, Wenzhou, China
| | - Zhong Lin
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
- National Clinical Research Center for Ocular Disease, Wenzhou, China
| | - Yihua Tang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
- National Clinical Research Center for Ocular Disease, Wenzhou, China
| | - Wenqing Ye
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
- National Clinical Research Center for Ocular Disease, Wenzhou, China
| | - Xiang Xu
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
- National Clinical Research Center for Ocular Disease, Wenzhou, China
| | - Shaodan Zhang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
- National Clinical Research Center for Ocular Disease, Wenzhou, China
- Glaucoma Institute, Wenzhou Medical University, Wenzhou, China
| | - Fan Lu
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
- National Clinical Research Center for Ocular Disease, Wenzhou, China
| | - Yuanbo Liang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
- National Clinical Research Center for Ocular Disease, Wenzhou, China
- Glaucoma Institute, Wenzhou Medical University, Wenzhou, China
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22
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Mahmoudinezhad G, Salazar D, Morales E, Tran P, Lee J, Hubschman JP, Nouri-Mahdavi K, Caprioli J. Risk factors for microcystic macular oedema in glaucoma. Br J Ophthalmol 2023; 107:505-510. [PMID: 34740886 PMCID: PMC9068828 DOI: 10.1136/bjophthalmol-2021-320137] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 10/12/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND/AIMS To identify clinical characteristics and factors associated with microcystic macular edema (MME) in patients with primary open-angle glaucoma (POAG). METHODS We included 315 POAG eyes between 2010 and 2019 with good-quality macular volume scans that had reliable visual fields (VF) available within 6 months in this observational retrospective cohort study. Eyes with retinal pathologies except for epiretinal membrane (ERM) were excluded. The inner nuclear layer was qualitatively assessed for the presence of MME. Global mean deviation (MD) and Visual Field Index (VFI) decay rates, superior and inferior MD rates and pointwise total deviation rates of change were estimated with linear regression. Logistic regression was performed to identify baseline factors associated with the presence of MME and to determine whether MME is associated with progressive VF loss. RESULTS 25 out of 315 eyes (7.9%) demonstrated MME. The average (±SD) age and MD in eyes with and without MME was 57.2 (±8.7) versus 62.0 (±9.9) years (p=0.02) and -9.8 (±5.7) versus -4.9 (±5.3) dB (p<0.001), respectively. Worse global MD at baseline (p=0.001) and younger age (p=0.02) were associated with presence of MME. ERM was not associated with the presence of MME (p=0.84) in this cohort. MME was not associated with MD and VFI decay rates (p>0.49). CONCLUSIONS More severe glaucoma and younger age were associated with MME. MME was not associated with faster global VF decay in this cohort. MME may confound monitoring of glaucoma with full macular thickness.
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Affiliation(s)
| | - Diana Salazar
- Ophthalmology, Glaucoma, University of California Los Angeles, Los Angeles, CA, USA
| | - Esteban Morales
- Ophthalmology, Glaucoma, University of California Los Angeles, Los Angeles, CA, USA
| | - Peter Tran
- Ophthalmology, Glaucoma, University of California Los Angeles, Los Angeles, CA, USA
| | - Janet Lee
- Ophthalmology, Retina, University of California Los Angeles, Los Angeles, CA, USA
| | | | - Kouros Nouri-Mahdavi
- Ophthalmology, Glaucoma, University of California Los Angeles, Los Angeles, CA, USA
| | - Joseph Caprioli
- Ophthalmology, Glaucoma, University of California Los Angeles, Los Angeles, CA, USA
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23
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Zhu W, Zhang X, Wu S, Wang N, Kuehn MH. iPSCs-Based Therapy for Trabecular Meshwork. Handb Exp Pharmacol 2023; 281:277-300. [PMID: 37495850 DOI: 10.1007/164_2023_671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
The trabecular meshwork (TM) of the eye serves as an essential tissue in controlling aqueous humor (AH) outflow and intraocular pressure (IOP) homeostasis. However, dysfunctional TM cells and/or decreased TM cellularity is become a critical pathogenic cause for primary open-angle glaucoma (POAG). Consequently, it is particularly valuable to investigate TM characteristics, which, in turn, facilitates the development of new treatments for POAG. Since 2006, the advancement in induced pluripotent stem cells (iPSCs) provides a new tool to (1) model the TM in vitro and (2) regenerate degenerative TM in POAG. In this context, we first summarize the current approaches to induce the differentiation of TM-like cells from iPSCs and compare iPSC-derived TM models to the conventional in vitro TM models. The efficacy of iPSC-derived TM cells for TM regeneration in POAG models is also discussed. Through these approaches, iPSCs are becoming essential tools in glaucoma modeling and for developing personalized treatments for TM regeneration.
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Affiliation(s)
- Wei Zhu
- Department of Pharmacology, School of Pharmacy, Qingdao University, Qingdao, China.
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Beihang University & Capital Medical University, Beijing, China.
| | - Xiaoyan Zhang
- Department of Pharmacology, School of Pharmacy, Qingdao University, Qingdao, China
| | - Shen Wu
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital Eye Center, Capital Medical University, Beijing, China
| | - Ningli Wang
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Beihang University & Capital Medical University, Beijing, China
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital Eye Center, Capital Medical University, Beijing, China
| | - Markus H Kuehn
- Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, IA, USA
- Center for the Prevention and Treatment of Visual Loss, Iowa City Veterans Affairs Medical Center, Iowa City, IA, USA
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24
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Bogolepova AN, Makhnovich EV, Kovalenko EA, Osinovskaya NA, Beregov MM. [Features of neuropsychological status and results of magnetic resonance morphometry in patients with Alzheimer's disease and glaucoma]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:43-51. [PMID: 37796067 DOI: 10.17116/jnevro202312309143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
OBJECTIVE To identify the relationship of neuropsychological changes in patients with Alzheimer's disease (AD) and primary open-angle glaucoma (POAG) and to evaluate the results of magnetic resonance (MR)-morphometry in patients with these diseases. MATERIAL AND METHODS We examined 32 patients (median age 67 [61.25; 76.75] years, 78.1% women) diagnosed with AD and POAG. The patients were divided into the AD group (n=16) and the POAG group (n=16). Complaints and anamnesis were collected for all patients, neurological status and neuropsychological status were assessed. MRI of the brain, followed by morphometry, was performed. RESULTS Cognitive impairments (CI) were revealed in patients of both groups. The severity of CI in patients with AD was more pronounced than in patients with POAG (p<0.001). Alzheimer's type of CI was detected in both groups. MR-morphometry revealed a decrease in the volume of the left hippocampus, the volume of the right and left amygdala as well as a decrease in the thickness of the right and left entorhinal cortex in the AD group compared with the POAG group (p<0.05). A significant decrease in the thickness of the right medial orbitofrontal cortex was found in the POAG group compared with the AD group (p<0.05). CONCLUSION In AD and POAG, there is a similarity of the neuropsychological profile, which reflects the neurodegeneration characteristic of these diseases. MRI morphometry requires an assessment of both volumes and thickness of brain structures. A neuroimaging pattern identified in patients with POAG can be regarded as an indicator of the glaucomatous process.
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Affiliation(s)
- A N Bogolepova
- Pirogov Russian National Research Medical University, Moscow, Russia
- Federal Center of Brain Research and Neurotechnologies, Moscow, Russia
| | - E V Makhnovich
- Pirogov Russian National Research Medical University, Moscow, Russia
- Federal Center of Brain Research and Neurotechnologies, Moscow, Russia
| | - E A Kovalenko
- Pirogov Russian National Research Medical University, Moscow, Russia
- Federal Center of Brain Research and Neurotechnologies, Moscow, Russia
| | - N A Osinovskaya
- Federal Center of Brain Research and Neurotechnologies, Moscow, Russia
| | - M M Beregov
- Federal Center of Brain Research and Neurotechnologies, Moscow, Russia
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25
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Li X, Sun W, Xiao X, Fang L, Li S, Liu X, Zhang Q. Biallelic variants in CPAMD8 are associated with primary open-angle glaucoma and primary angle-closure glaucoma. Br J Ophthalmol 2022; 106:1710-1715. [PMID: 34154991 DOI: 10.1136/bjophthalmol-2020-318668] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 06/11/2021] [Indexed: 01/04/2023]
Abstract
BACKGROUND/AIMS This study aims to assess the contribution of biallelic CPAMD8 variants in patients with different forms of glaucoma, especially primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG), based on a systematic analysis of exome sequencing (ES). METHODS Potentially pathogenic CPAMD8 variants were selected from the ES data of 5307 subjects with various eye conditions through multiple bioinformatics analyses. Of the 5307 subjects, 1221 probands had different forms of primary glaucoma. The genotype-phenotype correlation was assessed by a systematic review of biallelic CPAMD8 variants that including our data and data from the literature. The expression profile of CPAMD8 in human tissues was determined at the mRNA and protein levels. RESULTS Biallelic CPAMD8 variants, including one frameshift and six missense variants, were exclusively present and significantly enriched in patients with glaucoma (one with juvenile open-angle glaucoma (JOAG), two with POAG and two with PACG) compared with none of the 4086 probands with other eye conditions in this cohort (p=4.1E-07). The effect of variants in these patients is relatively mild compared with that reported in patients with anterior segment dysgenesis or primary congenital glaucoma. CPAMD8 mRNA was highly expressed in the optic nerve, ciliary body, retina and iris, whereas the CPAMD8 protein was mainly detected in the nonpigmented epithelium of the iris and ciliary process, determined by immunohistochemistry. CONCLUSIONS The data from this study not only provide further evidence to support the association of biallelic CPAMD8 variants with JOAG but also suggest that biallelic CPAMD8 variants might be associated with POAG and PACG.
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Affiliation(s)
- Xueqing Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Wenmin Sun
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xueshan Xiao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Lei Fang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Shiqiang Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xing Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Qingjiong Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
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Li L, Liu Q, Shi L, Zhou X, Wu W, Wang X, Wang L, Wu Z. Baicalin prevents fibrosis of human trabecular meshwork cells via inhibiting the MyD88/NF-κB pathway. Eur J Pharmacol 2022; 938:175425. [PMID: 36442621 DOI: 10.1016/j.ejphar.2022.175425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 11/14/2022] [Accepted: 11/22/2022] [Indexed: 11/27/2022]
Abstract
Trabecular meshwork fibrosis contributes to increased aqueous humor outflow resistance, leading to elevated intraocular pressure in primary open-angle glaucoma. Baicalin, an extract from Scutellaria baicalensis Georgi, has shown anti-fibrotic effects in liver, lung, and kidney diseases. However, its anti-fibrotic effect on human trabecular meshwork (HTM) cells has not yet been clarified. In this study, we investigated its effects on TGF-β2-induced HTM fibrosis as well as the underlying regulatory mechanisms. HTM cells were pretreated with baicalin, TAK-242, and baicalin + TAK-242 for 2 h followed by treatment with or without 5 ng/mL TGF-β2 for 48 h. Cell viability was assayed using cell counting Kit-8 and fibronectin (FN), laminin (LN), and α-smooth muscle actin (α-SMA) were assessed by western blotting, reverse transcription-polymerase chain reaction (RT-PCR), and immunocytochemistry. Further, the protein and gene expression levels of the TLR4/MyD88/NF-κB pathway (TLR4, MyD88, and NF-κB p65) were also examined by western blotting and RT-PCR, respectively. Thus, we observed that high doses of baicalin (40 μM) decreased (p < 0.1) HTM cell viability and 20 μM baicalin pretreatment was identified as the optimum pretreatment concentration. TGF-β2 upregulated (p < 0.5) the expression of FN, LN, α-SMA, MyD88, NF-κB p65 proteins and mRNA in HTM cells, and these effects were inhibited by baicalin and TAK-242 (p < 0.5). However, western blot analysis showed that baicalin did not repress TLR4 expression in HTM cells. Therefore, our findings suggested that baicalin could prevent TGF-β2-induced extracellular matrix (FN, LN) deposition and α-SMA expression in HTM cells by inhibiting the MyD88/NF-κB pathway.
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Affiliation(s)
- Li Li
- Weifang Medical University, Weifang, 261053, China; Senior Department of Ophthalmology, The Third Medical Center of PLA General Hospital, BeiJing, 100039, China; Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, 100005, China
| | - Qian Liu
- Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, 100005, China; Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, 100005, China
| | - Lijuan Shi
- Weifang Medical University, Weifang, 261053, China; Senior Department of Ophthalmology, The Third Medical Center of PLA General Hospital, BeiJing, 100039, China
| | - Xibin Zhou
- Senior Department of Ophthalmology, The Third Medical Center of PLA General Hospital, BeiJing, 100039, China
| | - Wei Wu
- Senior Department of Ophthalmology, The Third Medical Center of PLA General Hospital, BeiJing, 100039, China
| | - Xue Wang
- Senior Department of Ophthalmology, The Third Medical Center of PLA General Hospital, BeiJing, 100039, China
| | - Lihua Wang
- Senior Department of Ophthalmology, The Third Medical Center of PLA General Hospital, BeiJing, 100039, China
| | - Zhihong Wu
- Senior Department of Ophthalmology, The Third Medical Center of PLA General Hospital, BeiJing, 100039, China.
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27
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Ko MK, Woo JI, Gonzalez JM, Kim G, Sakai L, Peti-Peterdi J, Kelber JA, Hong YK, Tan JC. Fibrillin-1 mutant mouse captures defining features of human primary open glaucoma including anomalous aqueous humor TGF beta-2. Sci Rep 2022; 12:10623. [PMID: 35739142 PMCID: PMC9226129 DOI: 10.1038/s41598-022-14062-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 07/16/2021] [Accepted: 05/31/2022] [Indexed: 11/09/2022] Open
Abstract
Primary open angle glaucoma (POAG) features an optic neuropathy, elevated aqueous humor (AH) TGFβ2, and major risk factors of central corneal thickness (CCT), increasing age and intraocular pressure (IOP). We examined Tight skin (Tsk) mice to see if mutation of fibrillin-1, a repository for latent TGFβ, is associated with characteristics of human POAG. We measured: CCT by ocular coherence tomography (OCT); IOP; retinal ganglion cell (RGC) and optic nerve axon counts by microscopic techniques; visual electrophysiologic scotopic threshold responses (STR) and pattern electroretinogram (PERG); and AH TGFβ2 levels and activity by ELISA and MINK epithelial cell-based assays respectively. Tsk mice had open anterior chamber angles and compared with age-matched wild type (WT) mice: 23% thinner CCT (p < 0.003); IOP that was higher (p < 0.0001), more asymmetric (p = 0.047), rose with age (p = 0.04) and had a POAG-like frequency distribution. Tsk mice also had RGCs that were fewer (p < 0.04), declined with age (p = 0.0003) and showed increased apoptosis and glial activity; fewer optic nerve axons (p = 0.02); abnormal axons and glia; reduced STR (p < 0.002) and PERG (p < 0.007) visual responses; and higher AH TGFβ2 levels (p = 0.0002) and activity (p = 1E-11) especially with age. Tsk mice showed defining features of POAG, implicating aberrant fibrillin-1 homeostasis as a pathogenic contributor to emergence of a POAG phenotype.
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Affiliation(s)
| | | | | | | | - Lynn Sakai
- Department of Medical and Molecular Genetics, Oregon Health Sciences University, Portland, OR, USA
| | - Janos Peti-Peterdi
- Departments of Physiology, Biophysics and Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jonathan A Kelber
- Developmental Oncogene Laboratory, California State University Northridge, Northridge, CA, USA
| | - Young-Kwon Hong
- Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - James C Tan
- Doheny Eye Institute, Los Angeles, CA, USA.
- Department of Ophthalmology, University of California Los Angeles, Los Angeles, CA, USA.
- Sightgene, Inc., 9227 Reseda Blvd, #182, Northridge, CA, 91324-3137, USA.
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28
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Prasov L, Bohnsack BL, El Husny AS, Tsoi LC, Guan B, Kahlenberg JM, Almeida E, Wang H, Cowen EW, De Jesus AA, Jani P, Billi AC, Moroi SE, Wasikowski R, Almeida I, Almeida LN, Kok F, Garnai SJ, Mian SI, Chen MY, Warner BM, Ferreira CR, Goldbach-Mansky R, Hur S, Brooks BP, Richards JE, Hufnagel RB, Gudjonsson JE. DDX58(RIG-I)-related disease is associated with tissue-specific interferon pathway activation. J Med Genet 2022; 59:294-304. [PMID: 33495304 PMCID: PMC8310534 DOI: 10.1136/jmedgenet-2020-107447] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 12/10/2020] [Accepted: 12/19/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Singleton-Merten syndrome (SGMRT) is a rare immunogenetic disorder that variably features juvenile open-angle glaucoma (JOAG), psoriasiform skin rash, aortic calcifications and skeletal and dental dysplasia. Few families have been described and the genotypic and phenotypic spectrum is poorly defined, with variants in DDX58 (DExD/H-box helicase 58) being one of two identified causes, classified as SGMRT2. METHODS Families underwent deep systemic phenotyping and exome sequencing. Functional characterisation with in vitro luciferase assays and in vivo interferon signature using bulk and single cell RNA sequencing was performed. RESULTS We have identified a novel DDX58 variant c.1529A>T p.(Glu510Val) that segregates with disease in two families with SGMRT2. Patients in these families have widely variable phenotypic features and different ethnic background, with some being severely affected by systemic features and others solely with glaucoma. JOAG was present in all individuals affected with the syndrome. Furthermore, detailed evaluation of skin rash in one patient revealed sparse inflammatory infiltrates in a unique distribution. Functional analysis showed that the DDX58 variant is a dominant gain-of-function activator of interferon pathways in the absence of exogenous RNA ligands. Single cell RNA sequencing of patient lesional skin revealed a cellular activation of interferon-stimulated gene expression in keratinocytes and fibroblasts but not in neighbouring healthy skin. CONCLUSIONS These results expand the genotypic spectrum of DDX58-associated disease, provide the first detailed description of ocular and dermatological phenotypes, expand our understanding of the molecular pathogenesis of this condition and provide a platform for testing response to therapy.
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Affiliation(s)
- Lev Prasov
- Ophthalmology and Visual Sciences, University of Michigan Medical School, Ann Arbor, Michigan, USA
- Human Genetics, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Brenda L Bohnsack
- Ophthalmology and Visual Sciences, University of Michigan Medical School, Ann Arbor, Michigan, USA
- Ophthalmology, Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
- Ophthalmology, Northwestern University, Chicago, IL, USA
| | - Antonette S El Husny
- Children and Adolescents' Health Care Unit, Bettina Ferro De Souza University Hospital, Federal University of Para, Belem, Brazil
| | - Lam C Tsoi
- Dermatology, University of Michigan Medical School, Ann Arbor, Michigan, USA
- Computational Medicine & Bioinformatics, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Bin Guan
- Ophthalmic Genetics and Visual Function Branch, National Eye Institute, Bethesda, Maryland, USA
| | - J Michelle Kahlenberg
- Dermatology, University of Michigan Medical School, Ann Arbor, Michigan, USA
- Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | | | - Haitao Wang
- Cellular and Molecular Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Edward W Cowen
- Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, Bethesda, Maryland, USA
| | - Adriana A De Jesus
- Translational Autoinflammatory Diseases Section, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, USA
| | - Priyam Jani
- Craniofacial Anomalies and Regeneration Section, National Institute of Dental and Craniofacial Research, Bethesda, Maryland, USA
| | - Allison C Billi
- Dermatology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Sayoko E Moroi
- Ophthalmology and Visual Sciences, University of Michigan Medical School, Ann Arbor, Michigan, USA
- Ophthalmology and Visual Sciences, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Rachael Wasikowski
- Dermatology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Izabela Almeida
- Ophthalmology and Visual Sciences, Federal University of Sao Paulo, Sao Paulo, Brazil
| | | | | | - Sarah J Garnai
- Ophthalmology and Visual Sciences, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Shahzad I Mian
- Ophthalmology and Visual Sciences, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Marcus Y Chen
- Cardiovascular Branch, National Heart, Lung, and Blood Institute, Bethesda, Maryland, USA
| | - Blake M Warner
- Salivary Disorders Unit, National Institute of Dental and Craniofacial Research, Bethesda, MD, USA
| | - Carlos R Ferreira
- Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, Bethesda, Maryland, USA
| | - Raphaela Goldbach-Mansky
- Translational Autoinflammatory Diseases Section, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, USA
| | - Sun Hur
- Cellular and Molecular Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Brian P Brooks
- Ophthalmic Genetics and Visual Function Branch, National Eye Institute, Bethesda, Maryland, USA
| | - Julia E Richards
- Ophthalmology and Visual Sciences, University of Michigan Medical School, Ann Arbor, Michigan, USA
- Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Robert B Hufnagel
- Ophthalmic Genetics and Visual Function Branch, National Eye Institute, Bethesda, Maryland, USA
| | - Johann E Gudjonsson
- Dermatology, University of Michigan Medical School, Ann Arbor, Michigan, USA
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Yan X, Li M, Chen Z, Zhou X. The anterior scleral thickness in eyes with primary open-angle glaucoma. Graefes Arch Clin Exp Ophthalmol 2022; 260:1601-1610. [PMID: 35067770 PMCID: PMC9007782 DOI: 10.1007/s00417-021-05523-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 12/07/2021] [Accepted: 12/14/2021] [Indexed: 11/24/2022] Open
Abstract
Abstract
Purpose
To investigate the anterior scleral thickness (AST) and its associations with Schlemm’s canal (SC) area, trabecular meshwork (TM) thickness and length, and scleral spur (SS) length in healthy and primary open-angle glaucoma (POAG) groups.
Methods
Thirty-five eyes of 35 healthy subjects and 23 eyes of 23 patients with POAG were included. The AST, SC area, TM thickness and length, and SS length were measured using swept-source optical coherence tomography. AST was measured at 0 mm (AST0), 1 mm (AST1), 2 mm (AST2), and 3 mm (AST3) from SS. Associations between AST and SC area, TM thickness and length, and SS length were also estimated.
Results
AST0 (728.84 ± 99.33 vs. 657.39 ± 67.02 μm, p < 0.001), AST1 (537.79 ± 79.55 vs. 506.83 ± 57.37 μm, p = 0.038), AST3 (571.09 ± 79.15 vs. 532.13 ± 59.84 μm, p = 0.009), SC area (6304.26 ± 1238.72 vs. 4755.64 ± 1122.71 μm2, p < 0.001), TM thickness (107.21 ± 31.26 vs. 94.51 ± 24.18 μm, p = 0.035), TM length (736.20 ± 141.85 vs. 656.43 ± 127.03 μm, p = 0.004), and SS length (219.89 ± 50.29 vs. 174.54 ± 35.58 μm, p < 0.001) were significantly greater in healthy group than in POAG group. In addition, SC area, TM thickness, and SS length were significantly and positively associated with AST0 in the healthy group, whereas no similar associations were observed in the POAG group.
Conclusions
Compared with the healthy group, AST was significantly thinner in the POAG group, which also had smaller SC and TM dimensions. Moreover, the SC area, TM thickness, and SS length were significantly and positively associated with AST in the healthy group. Thus, AST might play an important role in maintaining TM and SC morphology and further in the pathogenesis of POAG.
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Affiliation(s)
- Xiaoqin Yan
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Mu Li
- Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Zhiqi Chen
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xiongwu Zhou
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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30
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Kasetti RB, Maddineni P, Kodati B, Nagarajan B, Yacoub S. Astragaloside IV Attenuates Ocular Hypertension in a Mouse Model of TGFβ2 Induced Primary Open Angle Glaucoma. Int J Mol Sci 2021; 22:ijms222212508. [PMID: 34830390 PMCID: PMC8619727 DOI: 10.3390/ijms222212508] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 11/15/2021] [Accepted: 11/16/2021] [Indexed: 12/12/2022] Open
Abstract
Elevated intraocular pressure (IOP) is a major risk factor in developing primary open angle glaucoma (POAG), which is the most common form of glaucoma. Transforming growth factor-beta 2 (TGFβ2) is a pro-fibrotic cytokine that plays an important role in POAG pathogenesis. TGFβ2 induced extracellular matrix (ECM) production, deposition and endoplasmic reticulum (ER) stress in the trabecular meshwork (TM) contribute to increased aqueous humor (AH) outflow resistance and IOP elevation. Drugs which alter the glaucomatous fibrotic changes and ER stress in the TM may be effective in reducing ocular hypertension. Astragaloside IV (AS.IV), a novel saponin isolated from the roots of Astragalus membranaceus, has demonstrated antifibrotic and ER stress lowering effects in various tissues during disease conditions. However, the effect of AS.IV on glaucomatous TM fibrosis, ER stress and ocular hypertension has not been studied. Primary human TM cells treated with AS.IV decreased TGFβ2 induced ECM (FN, Col-I) deposition and ER stress (KDEL, ATF4 and CHOP). Moreover, AS.IV treatment reduced TGFβ2 induced NF-κB activation and αSMA expression in TM cells. We found that AS.IV treatment significantly increased levels of matrix metalloproteases (MMP9 and MMP2) and MMP2 enzymatic activity, indicating that the antifibrotic effects of AS.IV are mediated via inhibition of NF-κB and activation of MMPs. AS.IV treatment also reduced ER stress in TM3 cells stably expressing mutant myocilin. Interestingly, the topical ocular AS.IV eye drops (1 mM) significantly decreased TGFβ2 induced ocular hypertension in mice, and this was associated with a decrease in FN, Col-1 (ECM), KDEL (ER stress) and αSMA in mouse TM tissues. Taken together, the results suggest that AS.IV prevents TGFβ2 induced ocular hypertension by modulating ECM deposition and ER stress in the TM.
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Vernazza S, Tirendi S, Passalacqua M, Piacente F, Scarfì S, Oddone F, Bassi AM. An Innovative In Vitro Open-Angle Glaucoma Model (IVOM) Shows Changes Induced by Increased Ocular Pressure and Oxidative Stress. Int J Mol Sci 2021; 22:ijms222212129. [PMID: 34830007 PMCID: PMC8622817 DOI: 10.3390/ijms222212129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 10/26/2021] [Accepted: 11/08/2021] [Indexed: 02/07/2023] Open
Abstract
Primary Open-Angle Glaucoma (POAG) is a neurodegenerative disease, and its clinical outcomes lead to visual field constriction and blindness. POAG's etiology is very complex and its pathogenesis is mainly explained through both mechanical and vascular theories. The trabecular meshwork (TM), the most sensitive tissue of the eye anterior segment to oxidative stress (OS), is the main tissue involved in early-stage POAG, characterized by an increase in pressure. Preclinical assessments of neuroprotective drugs on animal models have not always shown correspondence with human clinical studies. In addition, intra-ocular pressure management after a glaucoma diagnosis does not always prevent blindness. Recently, we have been developing an innovative in vitro 3Dadvanced human trabecular cell model on a millifluidicplatform as a tool to improve glaucoma studies. Herein, we analyze the effects of prolonged increased pressure alone and, in association with OS, on such in vitro platform. Moreover, we verify whethersuch damaged TM triggers apoptosis on neuron-like cells. The preliminary results show that TM cells are less sensitive to pressure elevation than OS, and OS-damaging effects were worsened by the pressure increase. The stressed TM releases harmful signals, which increase apoptosis stimuli on neuron-like cells, suggesting its pivotal role in the glaucoma cascade.
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Affiliation(s)
- Stefania Vernazza
- Department of Experimental Medicine (DIMES), University of Genoa, 16132 Genoa, Italy; (S.V.); (S.T.); (F.P.); (A.M.B.)
| | - Sara Tirendi
- Department of Experimental Medicine (DIMES), University of Genoa, 16132 Genoa, Italy; (S.V.); (S.T.); (F.P.); (A.M.B.)
- Inter-University Center for the Promotion of the 3Rs Principles in Teaching & Research (Centro 3R), 56122 Pisa, Italy;
| | - Mario Passalacqua
- Department of Experimental Medicine (DIMES), University of Genoa, 16132 Genoa, Italy; (S.V.); (S.T.); (F.P.); (A.M.B.)
- Inter-University Center for the Promotion of the 3Rs Principles in Teaching & Research (Centro 3R), 56122 Pisa, Italy;
- Correspondence:
| | - Francesco Piacente
- Department of Experimental Medicine (DIMES), University of Genoa, 16132 Genoa, Italy; (S.V.); (S.T.); (F.P.); (A.M.B.)
| | - Sonia Scarfì
- Inter-University Center for the Promotion of the 3Rs Principles in Teaching & Research (Centro 3R), 56122 Pisa, Italy;
- Department of Earth, Environmental and Life Sciences (DISTAV), University of Genoa, 16132 Genoa, Italy
| | | | - Anna Maria Bassi
- Department of Experimental Medicine (DIMES), University of Genoa, 16132 Genoa, Italy; (S.V.); (S.T.); (F.P.); (A.M.B.)
- Inter-University Center for the Promotion of the 3Rs Principles in Teaching & Research (Centro 3R), 56122 Pisa, Italy;
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Thomson BR, Liu P, Onay T, Du J, Tompson SW, Misener S, Purohit RR, Young TL, Jin J, Quaggin SE. Cellular crosstalk regulates the aqueous humor outflow pathway and provides new targets for glaucoma therapies. Nat Commun 2021; 12:6072. [PMID: 34663817 PMCID: PMC8523664 DOI: 10.1038/s41467-021-26346-0] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [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: 07/11/2020] [Accepted: 09/30/2021] [Indexed: 11/09/2022] Open
Abstract
Primary congenital glaucoma (PCG) is a severe disease characterized by developmental defects in the trabecular meshwork (TM) and Schlemm's canal (SC), comprising the conventional aqueous humor outflow pathway of the eye. Recently, heterozygous loss of function variants in TEK and ANGPT1 or compound variants in TEK/SVEP1 were identified in children with PCG. Moreover, common variants in ANGPT1and SVEP1 have been identified as risk alleles for primary open angle glaucoma (POAG) in GWAS studies. Here, we show tissue-specific deletion of Angpt1 or Svep1 from the TM causes PCG in mice with severe defects in the adjacent SC. Single-cell transcriptomic analysis of normal and glaucomatous Angpt1 deficient eyes allowed us to identify distinct TM and SC cell populations and discover additional TM-SC signaling pathways. Furthermore, confirming the importance of angiopoietin signaling in SC, delivery of a recombinant ANGPT1-mimetic promotes developmental SC expansion in healthy and Angpt1 deficient eyes, blunts intraocular pressure (IOP) elevation and RGC loss in a mouse model of PCG and lowers IOP in healthy adult mice. Our data highlight the central role of ANGPT1-TEK signaling and TM-SC crosstalk in IOP homeostasis and provide new candidates for SC-targeted glaucoma therapy.
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Affiliation(s)
- Benjamin R Thomson
- Division of Nephrology and Hypertension, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- The Feinberg Cardiovascular and Renal Research Institute, Chicago, IL, USA
| | - Pan Liu
- Division of Nephrology and Hypertension, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- The Feinberg Cardiovascular and Renal Research Institute, Chicago, IL, USA
| | - Tuncer Onay
- Division of Nephrology and Hypertension, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jing Du
- Division of Nephrology and Hypertension, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- The Feinberg Cardiovascular and Renal Research Institute, Chicago, IL, USA
| | - Stuart W Tompson
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, WI, USA
| | - Sol Misener
- Division of Nephrology and Hypertension, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- The Feinberg Cardiovascular and Renal Research Institute, Chicago, IL, USA
| | - Raj R Purohit
- Division of Nephrology and Hypertension, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- The Feinberg Cardiovascular and Renal Research Institute, Chicago, IL, USA
| | - Terri L Young
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, WI, USA
| | - Jing Jin
- Division of Nephrology and Hypertension, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- The Feinberg Cardiovascular and Renal Research Institute, Chicago, IL, USA
| | - Susan E Quaggin
- Division of Nephrology and Hypertension, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
- The Feinberg Cardiovascular and Renal Research Institute, Chicago, IL, USA.
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Meer E, Qin VL, Gudiseva HV, McGeehan B, Salowe R, Pistilli M, He J, Daniel E, Ying GS, Chavali VRM, O’Brien JM. LMX1B Locus Associated with Low-Risk Baseline Glaucomatous Features in the POAAGG Study. Genes (Basel) 2021; 12:1252. [PMID: 34440426 PMCID: PMC8394298 DOI: 10.3390/genes12081252] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/12/2021] [Accepted: 08/13/2021] [Indexed: 01/11/2023] Open
Abstract
Primary open-angle glaucoma (POAG) is the leading cause of irreversible blindness worldwide and has been associated with multiple genetic risk factors. The LMX1B gene is a genetic susceptibility factor for POAG, and several single-nucleotide polymorphisms (SNPs) were shown to be associated with POAG in our own prior Primary Open-Angle African American Glaucoma Genetics (POAAGG) study genome-wide association study (GWAS). This study evaluated the association of the LMX1B locus with baseline optic disc and clinical phenotypic characteristics of glaucoma patients from our African American cohort. Compared to the GG genotype in SNP rs187699205, the GC genotype in this SNP was found to be significantly associated with a smaller cup-to-disc ratio (CDR) and increased (better) visual field mean deviation (MD) in glaucoma cases. None of the glaucoma cases with the GC genotype had disc hemorrhages, disc notching, or beanpot disc appearance. In conclusion, glaucoma phenotypes differed significantly by LMX1B variant in African American patients with POAG, and a SNP variant was associated with certain disease features considered lower risk.
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Affiliation(s)
- Elana Meer
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA;
| | - Vivian L. Qin
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA 19104, USA; (V.L.Q.); (H.V.G.); (B.M.); (R.S.); (M.P.); (J.H.); (E.D.); (G.S.Y.); (V.R.M.C.)
| | - Harini V. Gudiseva
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA 19104, USA; (V.L.Q.); (H.V.G.); (B.M.); (R.S.); (M.P.); (J.H.); (E.D.); (G.S.Y.); (V.R.M.C.)
| | - Brendan McGeehan
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA 19104, USA; (V.L.Q.); (H.V.G.); (B.M.); (R.S.); (M.P.); (J.H.); (E.D.); (G.S.Y.); (V.R.M.C.)
| | - Rebecca Salowe
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA 19104, USA; (V.L.Q.); (H.V.G.); (B.M.); (R.S.); (M.P.); (J.H.); (E.D.); (G.S.Y.); (V.R.M.C.)
| | - Maxwell Pistilli
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA 19104, USA; (V.L.Q.); (H.V.G.); (B.M.); (R.S.); (M.P.); (J.H.); (E.D.); (G.S.Y.); (V.R.M.C.)
| | - Jie He
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA 19104, USA; (V.L.Q.); (H.V.G.); (B.M.); (R.S.); (M.P.); (J.H.); (E.D.); (G.S.Y.); (V.R.M.C.)
| | - Ebenezer Daniel
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA 19104, USA; (V.L.Q.); (H.V.G.); (B.M.); (R.S.); (M.P.); (J.H.); (E.D.); (G.S.Y.); (V.R.M.C.)
| | - Gui Shang Ying
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA 19104, USA; (V.L.Q.); (H.V.G.); (B.M.); (R.S.); (M.P.); (J.H.); (E.D.); (G.S.Y.); (V.R.M.C.)
| | - Venkata R. M. Chavali
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA 19104, USA; (V.L.Q.); (H.V.G.); (B.M.); (R.S.); (M.P.); (J.H.); (E.D.); (G.S.Y.); (V.R.M.C.)
| | - Joan M. O’Brien
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA 19104, USA; (V.L.Q.); (H.V.G.); (B.M.); (R.S.); (M.P.); (J.H.); (E.D.); (G.S.Y.); (V.R.M.C.)
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Hohberger B, Hosari S, Wallukat G, Kunze R, Krebs J, Müller M, Hennig T, Lämmer R, Horn F, Muñoz LE, Herrmann M, Mardin C. Agonistic autoantibodies against ß2-adrenergic receptor influence retinal microcirculation in glaucoma suspects and patients. PLoS One 2021; 16:e0249202. [PMID: 33961631 PMCID: PMC8104926 DOI: 10.1371/journal.pone.0249202] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 03/14/2021] [Indexed: 01/11/2023] Open
Abstract
Purpose Agonistic β2-adrenergic receptor autoantibodies (β2-agAAb) have been observed in sera of patients with ocular hypertension and open-angle glaucoma (OAG). They target the β2-receptors on trabecular meshwork, ciliary body and pericytes (Junemann et al. 2018; Hohberger et al. 2019). In addition to their influence on the intraocular pressure, an association to retinal microcirculation is discussed. This study aimed to investigate foveal avascular zone (FAZ) characteristics by en face OCT angiography (OCT-A) in glaucoma suspects and its relationship to β2-agAAb status in patients with OAG. Material and methods Thirty-four patients (28 OAG, 6 glaucoma suspects) underwent standardized, clinical examination including sensory testing as white-on-white perimetry (Octopus G1, mean defect, MD) and structural measures as retinal nerve fibre layer (RNFL) thickness, neuroretinal rim width (BMO-MRW), retinal ganglion cell layer (RGCL) thickness, and inner nuclear layer (INL) thickness with high-resolution OCT. FAZ characteristics were measured by OCT-A scans of superficial vascular plexus (SVP), intermediate capillary plexus (ICP), and deep capillary plexus (DCP). FAZ-R was calculated (area FAZ (SVP)/area FAZ (ICP)). Using cardiomyocyte bioassays we analysed serum samples for the presence of β2-agAAb. Results (I) Total mean FAZ area [mm2]: 0.34±0.16 (SVP), 0.24±0.12 (ICP), and 0.49±0.24 (DCP); mean FAZ-R 1.58±0.94. No correlation was seen for FAZ-R with MD, RNFL, BMO-MRW, RGCL thickness and INL thickness (p>0.05). (II) ß2-agAAb have been observed in 91% patients and showed no correlation with MD, RNFL, BMO-MRW, RGCL thickness and INL thickness (p>0.05). (III) FAZ-R correlated significantly with the β2-agAAb-induced increase of the beat rate of cardiomyocyte (p = 0.028). Conclusion FAZ characteristics did not correlate with any glaucoma associated functional and morphometric follow-up parameter in the present cohort. However, level of β2-agAAb showed a significantly correlation with FAZ-ratio. We conclude that β2-agAAb might be a novel biomarker in glaucoma pathogenesis showing association to FAZ-ratio with OCT-A.
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Affiliation(s)
- Bettina Hohberger
- Department of Ophthalmology, University of Erlangen-Nürnberg, Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Germany
- * E-mail:
| | - Sami Hosari
- Department of Ophthalmology, University of Erlangen-Nürnberg, Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Germany
| | - Gerd Wallukat
- Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - Rudolf Kunze
- Science Office, Berlin-Buch, Campus Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - Johann Krebs
- Department of Ophthalmology, University of Erlangen-Nürnberg, Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Germany
| | - Meike Müller
- Department of Ophthalmology, University of Erlangen-Nürnberg, Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Germany
| | - Till Hennig
- Department of Ophthalmology, University of Erlangen-Nürnberg, Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Germany
| | - Robert Lämmer
- Department of Ophthalmology, University of Erlangen-Nürnberg, Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Germany
| | - Folkert Horn
- Department of Ophthalmology, University of Erlangen-Nürnberg, Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Germany
| | - Luis E. Muñoz
- Department of Internal Medicine 3—Rheumatology and Immunology, University of Erlangen-Nürnberg, Friedrich-Alexander University (FAU) Erlangen-Nürnberg, Germany
| | - Martin Herrmann
- Department of Internal Medicine 3—Rheumatology and Immunology, University of Erlangen-Nürnberg, Friedrich-Alexander University (FAU) Erlangen-Nürnberg, Germany
| | - Christian Mardin
- Department of Ophthalmology, University of Erlangen-Nürnberg, Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Germany
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Angée C, Nedelec B, Erjavec E, Rozet JM, Fares Taie L. Congenital Microcoria: Clinical Features and Molecular Genetics. Genes (Basel) 2021; 12:genes12050624. [PMID: 33922078 PMCID: PMC8143514 DOI: 10.3390/genes12050624] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 04/11/2021] [Accepted: 04/19/2021] [Indexed: 01/05/2023] Open
Abstract
Iris integrity is required to regulate both the amount of light reaching the retina and intraocular pressure (IOP), with elevated IOP being a major risk factor for glaucoma. Congenital microcoria (MCOR) is an extremely rare, autosomal dominant disease affecting iris development and hindering both of these functions. It is characterized by absent or underdeveloped dilator muscle fibers and immaturity of the iridocorneal angle—where the aqueous humor is drained—which play a central role in IOP regulation. The dilator muscle anomaly is manifested in pinhole pupils (<2 mm) and thin transilluminable irises, causing both hemeralopia and photoaversion. Axial myopia and juvenile open-angle glaucoma are very frequent (80% and 30% of all cases, respectively). It has been suggested that the immaturity of the chamber angle contributes to glaucoma, and myopia has been ascribed to photoaversion and elevated IOP. Though possible, these mechanisms are insufficient. The disease has been tied to chromosome 13q32.1 structural variations. In addition to compromising iris development, modification of the 13q32.1 architecture could alter signaling pathways for axial ocular length and IOP regulation. Here, we summarize the clinical, histological, and molecular features of this disease, and we discuss the possible etiology of associated anomalies.
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Li H, Bagué T, Kirschner A, Strat AN, Roberts H, Weisenthal RW, Patteson AE, Annabi N, Stamer WD, Ganapathy PS, Herberg S. A tissue-engineered human trabecular meshwork hydrogel for advanced glaucoma disease modeling. Exp Eye Res 2021; 205:108472. [PMID: 33516765 PMCID: PMC11097970 DOI: 10.1016/j.exer.2021.108472] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 01/15/2021] [Accepted: 01/20/2021] [Indexed: 12/21/2022]
Abstract
Abnormal human trabecular meshwork (HTM) cell function and extracellular matrix (ECM) remodeling contribute to HTM stiffening in primary open-angle glaucoma (POAG). Most current cellular HTM model systems do not sufficiently replicate the complex native three dimensional (3D) cell-ECM interface, limiting their use for investigating POAG pathology. Tissue-engineered hydrogels are ideally positioned to overcome shortcomings of current models. Here, we report a novel biomimetic HTM hydrogel and test its utility as a POAG disease model. HTM hydrogels were engineered by mixing normal donor-derived HTM cells with collagen type I, elastin-like polypeptide and hyaluronic acid, each containing photoactive functional groups, followed by UV crosslinking. Glaucomatous conditions were induced with dexamethasone (DEX), and effects of the Rho-associated kinase (ROCK) inhibitor Y27632 on cytoskeletal organization and tissue-level function, contingent on HTM cell-ECM interactions, were assessed. DEX exposure increased HTM hydrogel contractility, f-actin and alpha smooth muscle actin abundance and rearrangement, ECM remodeling, and fibronectin deposition - all contributing to HTM hydrogel condensation and stiffening consistent with glaucomatous HTM tissue behavior. Y27632 treatment produced precisely the opposite effects and attenuated the DEX-induced pathologic changes, resulting in HTM hydrogel relaxation and softening. For model validation, confirmed glaucomatous HTM (GTM) cells were encapsulated; GTM hydrogels showed increased contractility, fibronectin deposition, and stiffening vs. normal HTM hydrogels despite reduced GTM cell proliferation. We have developed a biomimetic HTM hydrogel model for detailed investigation of 3D cell-ECM interactions under normal and simulated glaucomatous conditions. Its bidirectional responsiveness to pharmacological challenge and rescue suggests promising potential to serve as screening platform for new POAG treatments with focus on HTM biomechanics.
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Affiliation(s)
- Haiyan Li
- Department of Ophthalmology and Visual Sciences, SUNY Upstate Medical University, Syracuse, NY, 13210, USA; Department of Cell and Developmental Biology, SUNY Upstate Medical University, Syracuse, NY, 13210, USA; BioInspired Institute, Syracuse University, Syracuse, NY, 13244, USA
| | - Tyler Bagué
- Department of Ophthalmology and Visual Sciences, SUNY Upstate Medical University, Syracuse, NY, 13210, USA
| | - Alexander Kirschner
- Department of Ophthalmology and Visual Sciences, SUNY Upstate Medical University, Syracuse, NY, 13210, USA
| | - Ana N Strat
- Department of Ophthalmology and Visual Sciences, SUNY Upstate Medical University, Syracuse, NY, 13210, USA
| | - Haven Roberts
- Duke Eye Center, Duke University, Durham, NC, 27708, USA
| | - Robert W Weisenthal
- Department of Ophthalmology and Visual Sciences, SUNY Upstate Medical University, Syracuse, NY, 13210, USA
| | - Alison E Patteson
- BioInspired Institute, Syracuse University, Syracuse, NY, 13244, USA; Department of Physics, Syracuse University, Syracuse, NY, 13244, USA
| | - Nasim Annabi
- Department of Chemical and Biomolecular Engineering, University of California Los Angeles, Los Angeles, CA, 90095, USA
| | | | - Preethi S Ganapathy
- Department of Ophthalmology and Visual Sciences, SUNY Upstate Medical University, Syracuse, NY, 13210, USA; BioInspired Institute, Syracuse University, Syracuse, NY, 13244, USA; Department of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, 13210, USA
| | - Samuel Herberg
- Department of Ophthalmology and Visual Sciences, SUNY Upstate Medical University, Syracuse, NY, 13210, USA; Department of Cell and Developmental Biology, SUNY Upstate Medical University, Syracuse, NY, 13210, USA; BioInspired Institute, Syracuse University, Syracuse, NY, 13244, USA; Department of Biochemistry and Molecular Biology, SUNY Upstate Medical University, Syracuse, NY, 13210, USA; Department of Biomedical and Chemical Engineering, Syracuse University, Syracuse, NY, 13244, USA.
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Aydın R, Barış M, Durmaz-Engin C, Al-Aswad LA, Blumberg DM, Cioffi GA, Liebmann JM, Tezel TH, Tezel G. Early localized alterations of the retinal inner plexiform layer in association with visual field worsening in glaucoma patients. PLoS One 2021; 16:e0247401. [PMID: 33630899 PMCID: PMC7906339 DOI: 10.1371/journal.pone.0247401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 02/06/2021] [Indexed: 01/16/2023] Open
Abstract
Glaucoma is a chronic neurodegenerative disease of the optic nerve and a leading cause of irreversible blindness, worldwide. While the experimental research using animal models provides growing information about cellular and molecular processes, parallel analysis of the clinical presentation of glaucoma accelerates the translational progress towards improved understanding, treatment, and clinical testing of glaucoma. Optic nerve axon injury triggers early alterations of retinal ganglion cell (RGC) synapses with function deficits prior to manifest RGC loss in animal models of glaucoma. For testing the clinical relevance of experimental observations, this study analyzed the functional correlation of localized alterations in the inner plexiform layer (IPL), where RGCs establish synaptic connections with retinal bipolar and amacrine cells. Participants of the study included a retrospective cohort of 36 eyes with glaucoma and a control group of 18 non-glaucomatous subjects followed for two-years. The IPL was analyzed on consecutively collected macular SD-OCT scans, and functional correlations with corresponding 10–2 visual field scores were tested using generalized estimating equations (GEE) models. The GEE-estimated rate of decrease in IPL thickness (R = 0.36, P<0.001) and IPL density (R = 0.36, P<0.001), as opposed to unchanged or increased IPL thickness or density, was significantly associated with visual field worsening at corresponding analysis locations. Based on multivariate logistic regression analysis, this association was independent from the patients’ age, the baseline visual field scores, or the baseline thickness or alterations of retinal nerve fiber or RGC layers (P>0.05). These findings support early localized IPL alterations in correlation with progressing visual field defects in glaucomatous eyes. Considering the experimental data, glaucoma-related increase in IPL thickness/density might reflect dendritic remodeling, mitochondrial redistribution, and glial responses for synapse maintenance, but decreased IPL thickness/density might correspond to dendrite atrophy. The bridging of experimental data with clinical findings encourages further research along the translational path.
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Affiliation(s)
- Rukiye Aydın
- Department of Ophthalmology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States of America
| | - Mine Barış
- Department of Ophthalmology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States of America
| | - Ceren Durmaz-Engin
- Department of Ophthalmology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States of America
| | - Lama A. Al-Aswad
- Department of Ophthalmology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States of America
| | - Dana M. Blumberg
- Department of Ophthalmology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States of America
| | - George A. Cioffi
- Department of Ophthalmology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States of America
| | - Jeffrey M. Liebmann
- Department of Ophthalmology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States of America
| | - Tongalp H. Tezel
- Department of Ophthalmology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States of America
| | - Gülgün Tezel
- Department of Ophthalmology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States of America
- * E-mail:
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Neroev V, Malishevskaya T, Weinert D, Astakhov S, Kolomeichuk S, Cornelissen G, Kabitskaya Y, Boiko E, Nemtsova I, Gubin D. Disruption of 24-Hour Rhythm in Intraocular Pressure Correlates with Retinal Ganglion Cell Loss in Glaucoma. Int J Mol Sci 2020; 22:ijms22010359. [PMID: 33396443 PMCID: PMC7795318 DOI: 10.3390/ijms22010359] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 12/27/2020] [Accepted: 12/28/2020] [Indexed: 02/08/2023] Open
Abstract
Parameters of 24-h rhythm in intraocular pressure (IOP) were assessed in patients with stable or advanced primary open-angle glaucoma (S-POAG/A-POAG) and referenced to the phase of “marker” circadian temperature rhythm of each patient. Body temperature and IOP were measured over a 72-h span in 115 participants (65 S-POAG and 50 A-POAG). Retinal Ganglion Cell (RGC) damage was assessed by high-definition optical coherence tomography. The 24-h IOP rhythm in A-POAG patients peaked during the night, opposite to the daytime phase position in S-POAG patients (p < 0.0001). The 24-h IOP phase correlated with RGC loss (p < 0.0001). The internal phase shift between IOP and body temperature gradually increased with POAG progression (p < 0.001). Angiotensin converting enzyme Alu-repeat deletion/insertion (ACE I/D) emerged as a candidate gene polymorphism, which may play a role in the alteration of the circadian IOP variability in advanced glaucoma. To conclude, a reliable estimation of the 24-h rhythm in IOP requires the degree of RGC damage to be assessed. In advanced POAG, the 24-h phase of IOP tended to occur during the night and correlated with RGC loss, being progressively delayed relative to the phase of temperature.
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Affiliation(s)
- Vladimir Neroev
- Helmholtz Research Institute of Eye Diseases, 105062 Moscow, Russia; (V.N.); (T.M.)
| | | | - Dietmar Weinert
- Institute of Biology/Zoology, Martin Luther University, 06108 Halle-Wittenberg, Germany;
| | - Sergei Astakhov
- Department of Ophthalmology, Pavlov First Saint Petersburg State Medical University, 197022 St. Petersburg, Russia;
| | - Sergey Kolomeichuk
- Laboratory of Genetics, Institute of Biology of the Karelian Science Center of the Russian Academy of Sciences, 185910 Petrozavodsk, Russia;
| | - Germaine Cornelissen
- Halberg Chronobiology Center, University of Minnesota, Minneapolis, MN 55455, USA;
| | - Yana Kabitskaya
- Сenter for Genomic Technologies, Northern Trans-Ural State Agricultural University, 625003 Tyumen, Russia; (Y.K.); (E.B.)
| | - Elena Boiko
- Сenter for Genomic Technologies, Northern Trans-Ural State Agricultural University, 625003 Tyumen, Russia; (Y.K.); (E.B.)
| | - Irina Nemtsova
- State Autonomous Health Care Institution Tyumen Regional Ophthalmological Dispensary, 625048 Tyumen, Russia;
| | - Denis Gubin
- Department of Biology, Medical University, 625023 Tyumen, Russia
- Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Science, 634009 Tomsk, Russia
- Correspondence:
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Kasetti RB, Patel PD, Maddineni P, Patil S, Kiehlbauch C, Millar JC, Searby CC, Raghunathan V, Sheffield VC, Zode GS. ATF4 leads to glaucoma by promoting protein synthesis and ER client protein load. Nat Commun 2020; 11:5594. [PMID: 33154371 PMCID: PMC7644693 DOI: 10.1038/s41467-020-19352-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [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: 04/16/2019] [Accepted: 10/08/2020] [Indexed: 02/06/2023] Open
Abstract
The underlying pathological mechanisms of glaucomatous trabecular meshwork (TM) damage and elevation of intraocular pressure (IOP) are poorly understood. Here, we report that the chronic endoplasmic reticulum (ER) stress-induced ATF4-CHOP-GADD34 pathway is activated in TM of human and mouse glaucoma. Expression of ATF4 in TM promotes aberrant protein synthesis and ER client protein load, leading to TM dysfunction and cell death. These events lead to IOP elevation and glaucomatous neurodegeneration. ATF4 interacts with CHOP and this interaction is essential for IOP elevation. Notably, genetic depletion or pharmacological inhibition of ATF4-CHOP-GADD34 pathway prevents TM cell death and rescues mouse models of glaucoma by reducing protein synthesis and ER client protein load in TM cells. Importantly, glaucomatous TM cells exhibit significantly increased protein synthesis along with induction of ATF4-CHOP-GADD34 pathway. These studies indicate a pathological role of ATF4-CHOP-GADD34 pathway in glaucoma and provide a possible treatment for glaucoma by targeting this pathway.
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Affiliation(s)
- Ramesh B Kasetti
- Department of Pharmacology and Neuroscience and the North Texas Eye Research Institute, University of North Texas Health Science Center at Fort Worth, TX, 76107, Fort Worth, USA
| | - Pinkal D Patel
- Department of Pharmacology and Neuroscience and the North Texas Eye Research Institute, University of North Texas Health Science Center at Fort Worth, TX, 76107, Fort Worth, USA
| | - Prabhavathi Maddineni
- Department of Pharmacology and Neuroscience and the North Texas Eye Research Institute, University of North Texas Health Science Center at Fort Worth, TX, 76107, Fort Worth, USA
| | - Shruti Patil
- Department of Pharmacology and Neuroscience and the North Texas Eye Research Institute, University of North Texas Health Science Center at Fort Worth, TX, 76107, Fort Worth, USA
| | - Charles Kiehlbauch
- Department of Pharmacology and Neuroscience and the North Texas Eye Research Institute, University of North Texas Health Science Center at Fort Worth, TX, 76107, Fort Worth, USA
| | - J Cameron Millar
- Department of Pharmacology and Neuroscience and the North Texas Eye Research Institute, University of North Texas Health Science Center at Fort Worth, TX, 76107, Fort Worth, USA
| | - Charles C Searby
- Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, IA, 52242, USA
| | - VijayKrishna Raghunathan
- Department of Basic Sciences and the Ocular Surface Institute, College of Optometry, University of Houston, Houston, TX, USA
- Department of Biomedical Engineering, Cullen College of Engineering, University of Houston, Houston, TX, USA
| | - Val C Sheffield
- Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, IA, 52242, USA
| | - Gulab S Zode
- Department of Pharmacology and Neuroscience and the North Texas Eye Research Institute, University of North Texas Health Science Center at Fort Worth, TX, 76107, Fort Worth, USA.
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Nakao Y, Kiuchi Y, Okumichi H. Evaluation of biomechanically corrected intraocular pressure using Corvis ST and comparison of the Corvis ST, noncontact tonometer, and Goldmann applanation tonometer in patients with glaucoma. PLoS One 2020; 15:e0238395. [PMID: 32966284 PMCID: PMC7510959 DOI: 10.1371/journal.pone.0238395] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 08/15/2020] [Indexed: 11/29/2022] Open
Abstract
Purpose The aim of the study was to investigate the effects of various anatomical structures on intraocular pressure (IOP) measurements obtained by the Corneal Visualization Scheimpflug Technology (Corvis ST), Goldmann applanation tonometer (GAT), and noncontact tonometer (NCT), as well as to assess the interchangeability among the four types of IOP measurement: IOP-GAT, IOP-NCT, IOP-Corvis, and biomechanically corrected IOP (bIOP-Corvis), with a particular focus on bIOP-Corvis. Materials and methods We included 71 patients with primary open-angle glaucoma and assessed their IOP measurements obtained with the GAT, NCT, and Corvis ST using a repeated measures ANOVA, a paired t-test with Bonferroni correction, stepwise multiple regression analyses and Bland–Altman plots. Results IOP-GAT showed the highest values (13.5 ± 2.1 mmHg [mean ± standard deviation]), followed by IOP-NCT (13.2 ± 2.7 mmHg), IOP-Corvis (10.6 ± 2.8 mmHg), and bIOP-Corvis (10.0 ± 2.3 mmHg). With exceptions of bIOP-Corvis and IOP-GAT, all IOP variations were explained by regression coefficients involving the central corneal thickness. Bland–Altman plots showed a mean difference between IOP-GAT and the other IOP measurements (IOP-Corvis, bIOP-Corvis, and IOP-NCT), which were -2.90, -3.48, and -0.29 mmHg, respectively. The widths of the 95% limits of agreement between all pairs of IOP measurements were greater than 3 mmHg. Conclusion IOP values obtained with the Corvis ST, NCT, and GAT were not interchangeable. The bIOP-Corvis measurement corrected for the ocular structure.
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Affiliation(s)
- Yoshitaka Nakao
- Ophthalmology and Visual Science Department, Hiroshima University, Hiroshima, Japan
- * E-mail:
| | - Yoshiaki Kiuchi
- Ophthalmology and Visual Science Department, Hiroshima University, Hiroshima, Japan
| | - Hideaki Okumichi
- Ophthalmology and Visual Science Department, Hiroshima University, Hiroshima, Japan
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Lee KM, Park SW, Kim M, Oh S, Kim SH. Relationship between Three-Dimensional Magnetic Resonance Imaging Eyeball Shape and Optic Nerve Head Morphology. Ophthalmology 2020; 128:532-544. [PMID: 32916169 DOI: 10.1016/j.ophtha.2020.08.034] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 08/12/2020] [Accepted: 08/31/2020] [Indexed: 01/22/2023] Open
Abstract
PURPOSE To determine if the 3-dimensional (3D) eyeball shape is associated with the positions of the central retinal vascular trunk (CRVT) and the externally oblique border (EOB) in the optic nerve head (ONH). DESIGN Prospective, cross-sectional study. PARTICIPANTS Fifty-six subjects (112 eyes) with a diagnosis of glaucoma or glaucoma suspect. METHODS The eyeball shape on 3D magnetic resonance imaging (MRI) scans was classified according to the dimension of the longest diameter: axial dimension (prolate sphere), group 1; horizontal dimension (horizontally oblate sphere), group 2; and vertical dimension (vertically oblate sphere), group 3. The deviation of the CRVT, as a surrogate of lamina cribrosa (LC) shift, was measured from the center of the Bruch's membrane opening (BMO) demarcated by OCT imaging, with the horizontal midline as 0° and the superior location as a positive value. The angular location of the longest EOB was also measured. MAIN OUTCOME MEASURE Positions of CRVT and EOB according to the 3D eyeball shape. RESULTS Among 112 eyes, 54 (48%) had a prolate shape (group 1), 23 (21%) had a horizontally oblate shape (group 2), and 35 (31%) had a vertically oblate shape (group 3). The angular deviation of the CRVT differed among the groups: to the nasal side in group 1, to the temporal side in group 2, and along the vertical meridian in group 3. In cases of asymmetric eyeball shape, the CRVT was deviated toward the undergrown side from the overgrown side, regardless of grouping. The angular location of the longest EOB was in the direction opposite to the CRVT position (P < 0.001). A generalized estimating equation analysis revealed that the temporal location of the CRVT was associated with older age (P = 0.001), nasal location of the longest EOB (P < 0.001), and oblate shape of the eyeball (P < 0.001, group 2; P = 0.007, group 3). CONCLUSIONS The position of the CRVT and EOB were associated with the 3D eyeball shape. Considering that infant ONH morphology is highly uniform, various modes of eyeball expansion during growth can result in diverse directionalities of offset between the LC and the BMO in adults.
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Affiliation(s)
- Kyoung Min Lee
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea; Department of Ophthalmology, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Sun-Won Park
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea; Department of Radiology, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Martha Kim
- Department of Ophthalmology, Dongguk University Ilsan Hospital, Goyang, Korea
| | - Sohee Oh
- Department of Biostatistics, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Seok Hwan Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea; Department of Ophthalmology, Seoul National University Boramae Medical Center, Seoul, Korea.
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Rathi S, Danford I, Gudiseva HV, Verkuil L, Pistilli M, Vishwakarma S, Kaur I, Dave TV, O’Brien JM, Chavali VRM. Molecular Genetics and Functional Analysis Implicate CDKN2BAS1-CDKN2B Involvement in POAG Pathogenesis. Cells 2020; 9:cells9091934. [PMID: 32825664 PMCID: PMC7564117 DOI: 10.3390/cells9091934] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 06/16/2020] [Revised: 08/10/2020] [Accepted: 08/17/2020] [Indexed: 12/13/2022] Open
Abstract
The genes in the 9p21 locus (CDKN2B-AS1 & CDKN2B) are widely associated with Primary open-angle glaucoma (POAG). However, the functional importance of this locus in POAG pathogenesis is still unexplored. This study investigated the role of CDKN2BAS1-CDKN2B axis in POAG. We observed significant association of CDKN2B-AS1 SNP rs4977756 with POAG and its endophenotypic traits (vertical cup-disc ratio (p = 0.033) and central corneal thickness (p = 0.008)) by screening African American POAG cases (n = 1567) and controls (n = 1600). A luciferase reporter assay in Human embryonic kidney 293T (HEK293T) cells revealed that the region surrounding rs4977756 likely serves as a transcriptional repressor. siRNA-mediated knockdown of CDKN2B-AS1 in HEK293T cells and trabecular meshwork (TM) cells resulted in significantly increased expression of CDKN2B, which was also observed in human POAG ocular tissues. Pathway focused qRT-PCR gene expression analysis showed increased cellular senescence, TGFβ signaling and ECM deposition in TM cells after CDKN2B-AS1 suppression. In conclusion, we report that CDKN2B-AS1 may act as a regulator, and it could function by modulating the expression of CDKN2B. In addition, increase in CDKN2B levels due to CDKN2B-AS1 suppression may result in the senescence of trabecular meshwork cells leading to POAG pathogenesis.
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Affiliation(s)
- Sonika Rathi
- Scheie Eye Institute, Department of Ophthalmology, Philadelphia, PA 19104, USA; (S.R.); (I.D.); (H.V.G.); (L.V.); (M.P.)
| | - Ian Danford
- Scheie Eye Institute, Department of Ophthalmology, Philadelphia, PA 19104, USA; (S.R.); (I.D.); (H.V.G.); (L.V.); (M.P.)
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Harini V. Gudiseva
- Scheie Eye Institute, Department of Ophthalmology, Philadelphia, PA 19104, USA; (S.R.); (I.D.); (H.V.G.); (L.V.); (M.P.)
| | - Lana Verkuil
- Scheie Eye Institute, Department of Ophthalmology, Philadelphia, PA 19104, USA; (S.R.); (I.D.); (H.V.G.); (L.V.); (M.P.)
| | - Maxwell Pistilli
- Scheie Eye Institute, Department of Ophthalmology, Philadelphia, PA 19104, USA; (S.R.); (I.D.); (H.V.G.); (L.V.); (M.P.)
| | - Sushma Vishwakarma
- Prof Brien Holden Eye Research Centre, L. V. Prasad Eye Institute, Hyderabad, Telangana 500034, India; (S.V.); (I.K.)
| | - Inderjeet Kaur
- Prof Brien Holden Eye Research Centre, L. V. Prasad Eye Institute, Hyderabad, Telangana 500034, India; (S.V.); (I.K.)
| | - Tarjani Vivek Dave
- Ophthalmic Plastic Surgery Service, Prof Brien Holden Eye Research Centre, L. V. Prasad Eye Institute, Hyderabad, Telangana 500034, India;
| | - Joan M. O’Brien
- Scheie Eye Institute, Department of Ophthalmology, Philadelphia, PA 19104, USA; (S.R.); (I.D.); (H.V.G.); (L.V.); (M.P.)
- Correspondence: Joan.O’ (J.M.O.); (V.R.M.C.)
| | - Venkata R. M. Chavali
- Scheie Eye Institute, Department of Ophthalmology, Philadelphia, PA 19104, USA; (S.R.); (I.D.); (H.V.G.); (L.V.); (M.P.)
- Correspondence: Joan.O’ (J.M.O.); (V.R.M.C.)
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Siesky B, Wentz SM, Januleviciene I, Kim DH, Burgett KM, Verticchio Vercellin AC, Rowe LW, Eckert GJ, Harris A. Baseline structural characteristics of the optic nerve head and retinal nerve fiber layer are associated with progressive visual field loss in patients with open-angle glaucoma. PLoS One 2020; 15:e0236819. [PMID: 32817645 PMCID: PMC7444539 DOI: 10.1371/journal.pone.0236819] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 07/14/2020] [Indexed: 11/18/2022] Open
Abstract
Aims To examine the relationship between baseline structural characteristics of the optic nerve head (ONH) and retinal nerve fiber layer (RNFL) and functional disease progression in patients with open-angle glaucoma (OAG) over 5 years. Methods 112 OAG patients were prospectively examined at baseline and every 6 months over a period of five years. Structural glaucomatous changes were examined with optical coherence tomography (OCT) and Heidelberg retinal tomography-III (HRT-III), and functional disease progression with automated perimetry (Humphrey visual fields). Cox proportional hazard models were used to assess the relationship between baseline structural measurements and functional disease progression. Results From baseline over a 5-year period, statistically significant increases were found in OCT disc (D) area (p<0.001), cup (C) area (p<0.001), C/D area ratio (p<0.001), C/D horizontal ratio (p<0.001), C/D vertical ratio (p = 0.018), and a decrease in superior RNFL thickness (p = 0.008). Statistically significant increases were found in HRT-III C volume (p = 0.021), C/D area ratio (p = 0.046), mean C depth (p = 0.036), C shape (p = 0.008), and height variation contour (p = 0.020). Functional disease progression was detected in 37 of the 112 patients (26 of European descent and 11 of African descent; 33%). A statistically significant shorter time to functional progression was seen in patients with larger baseline OCT D area (p = 0.008), C area (p = 0.003), thicker temporal RNFL (p = 0.003), and in patients with a larger HRT-III C area (p = 0.004), C/D area ratio (p = 0.004), linear C/D ratio (p = 0.007), C shape (p = 0.032), or smaller rim area (p = 0.039), rim volume (p = 0.005), height variation contour (p = 0.041), mean RNFL thickness (p<0.001), or RNFL cross-sectional area (p = 0.002). Conclusion Baseline ONH and RNFL structural characteristics were associated with a significantly shorter time to functional glaucomatous progression and visual field loss through the five-year period in OAG patients.
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Affiliation(s)
- Brent Siesky
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Scott M. Wentz
- Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
| | - Ingrida Januleviciene
- Eye Clinic of Medical Academy of Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Daniel H. Kim
- Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
| | - Kendall M. Burgett
- Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
| | - Alice C. Verticchio Vercellin
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- University of Pavia, Pavia, Lombardy, Italy
- IRCCS—Fondazione Bietti, Rome, Lazio, Italy
| | - Lucas W. Rowe
- Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
| | - George J. Eckert
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
| | - Alon Harris
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- * E-mail:
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Schmitt HM, Johnson WM, Aboobakar IF, Strickland S, Gomez-Caraballo M, Parker M, Finnegan L, Corcoran DL, Skiba NP, Allingham RR, Hauser MA, Stamer WD. Identification and activity of the functional complex between hnRNPL and the pseudoexfoliation syndrome-associated lncRNA, LOXL1-AS1. Hum Mol Genet 2020; 29:1986-1995. [PMID: 32037441 PMCID: PMC7390937 DOI: 10.1093/hmg/ddaa021] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 01/09/2020] [Accepted: 02/03/2020] [Indexed: 12/28/2022] Open
Abstract
Individuals with pseudoexfoliation (PEX) syndrome exhibit various connective tissue pathologies associated with dysregulated extracellular matrix homeostasis. PEX glaucoma is a common, aggressive form of open-angle glaucoma resulting from the deposition of fibrillary material in the conventional outflow pathway. However, the molecular mechanisms that drive pathogenesis and genetic risk remain poorly understood. PEX glaucoma-associated single-nucleotide polymorphisms are located in and affect activity of the promoter of LOXL1-AS1, a long non-coding RNA (lncRNA). Nuclear and non-nuclear lncRNAs regulate a host of biological processes, and when dysregulated, contribute to disease. Here we report that LOXL1-AS1 localizes to the nucleus where it selectively binds to the mRNA processing protein, heterogeneous nuclear ribonucleoprotein-L (hnRNPL). Both components of this complex are critical for the regulation of global gene expression in ocular cells, making LOXL1-AS1 a prime target for investigation in PEX syndrome and glaucoma.
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Affiliation(s)
- Heather M Schmitt
- Department of Ophthalmology, Duke University, Duke Eye Center AERI Rm 4014, Durham, NC 27710, USA
| | - William M Johnson
- Department of Ophthalmology, Duke University, Duke Eye Center AERI Rm 4014, Durham, NC 27710, USA
| | - Inas F Aboobakar
- Department of Ophthalmology, Duke University, Duke Eye Center AERI Rm 4014, Durham, NC 27710, USA
| | - Shelby Strickland
- Duke Molecular Physiology Institute, Duke University, Durham, NC 27701 USA
| | - María Gomez-Caraballo
- Department of Ophthalmology, Duke University, Duke Eye Center AERI Rm 4014, Durham, NC 27710, USA
| | - Megan Parker
- Department of Ophthalmology, Duke University, Duke Eye Center AERI Rm 4014, Durham, NC 27710, USA
| | - Laura Finnegan
- Department of Ophthalmology, Duke University, Duke Eye Center AERI Rm 4014, Durham, NC 27710, USA
- School of Genetics and Microbiology, Department of Genetics, Smurfit Institute, Trinity College Dublin, Dublin 2, Ireland
| | - David L Corcoran
- Genomic Analysis and Bioinformatics Shared Resource, Duke University, Duke University CIEMAS, Durham, NC 27708, USA
| | - Nikolai P Skiba
- Department of Ophthalmology, Duke University, Duke Eye Center AERI Rm 4014, Durham, NC 27710, USA
| | - R Rand Allingham
- Department of Ophthalmology, Duke University, Duke Eye Center AERI Rm 4014, Durham, NC 27710, USA
| | - Michael A Hauser
- Department of Ophthalmology, Duke University, Duke Eye Center AERI Rm 4014, Durham, NC 27710, USA
- Duke Molecular Physiology Institute, Duke University, Durham, NC 27701 USA
- Department of Medicine, Duke University, Durham, NC 27710, USA
| | - W Daniel Stamer
- Department of Ophthalmology, Duke University, Duke Eye Center AERI Rm 4014, Durham, NC 27710, USA
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Zabel K, Zabel P, Kaluzna M, Lamkowski A, Jaworski D, Wietlicka-Piszcz M, Kaluzny JJ. Correlation of retinal sensitivity in microperimetry with vascular density in optical coherence tomography angiography in primary open-angle glaucoma. PLoS One 2020; 15:e0235571. [PMID: 32628706 PMCID: PMC7337279 DOI: 10.1371/journal.pone.0235571] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 06/17/2020] [Indexed: 12/19/2022] Open
Abstract
Purpose To evaluate the correlation between retinal sensitivity in microperimetry (MP) with vessel density (VD) using optical coherence tomography angiography (OCTA) in primary open-angle glaucoma (POAG). Methods We enrolled 30 participants (52 eyes) with POAG and 15 participants (23 eyes) in the healthy control group. All participants were examined for retinal structure using OCTA to assess VD and Spectral domain OCT (SD-OCT) to assess ganglion cell complex (GCC) and peripapillary retinal nerve fiber layer (pRNFL) thickness. Retinal sensitivity was tested with MP and standard automatic perimetry (SAP). Results The VD in moderate/severe POAG was lower than that in mild POAG and healthy control in the macular superficial vascular plexus (SVP) (38.7±6.3% vs. 42.9±5.2%, 49.7±2.6% respectively, P<0.001) and peripapillary radial peripapillary capillaries (pRPC) (36.4±5.7% vs. 43.6±6.6%, 49.1±2.4% respectively, P<0.001). The Pearson’s correlations between function-structure parameters were strongest with MP average sensitivity threshold and SVP VD in the area of whole macula (r = 0.68); followed by SAP mean deviation (MD) and pRNFL thickness (r = 0.63); SAP MD and pRPC VD (r = 0.59) and MP average threshold and GCC thickness (r = 0.54). We found the AUROCs for discriminating between glaucomatous and healthy eyes were highest for structural parameters as follows: pRNFL (0.94), macular SVP whole (0.92), pRPC (0.92) and GCC (0.91). Pairwise comparison of the above parameters showed no difference (P>0.05). Conclusion The relationship between microvascular damage in the macular SVP whole and the decrease of MP average sensitivity threshold is stronger than the pRNFL thickness measurements and SAP parameters. OCTA and MP techniques are valuable methods that allow clinically monitor structural and functional changes in glaucomatous eyes.
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Affiliation(s)
- Katarzyna Zabel
- Department of Sensory Organ Studies, Nicolaus Copernicus University, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
- Oftalmika Eye Hospital, Bydgoszcz, Poland
- Department of Ophthalmology, Nicolaus Copernicus University, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
- * E-mail:
| | - Przemyslaw Zabel
- Department of Sensory Organ Studies, Nicolaus Copernicus University, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
- Oftalmika Eye Hospital, Bydgoszcz, Poland
- Department of Ophthalmology, Nicolaus Copernicus University, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
| | | | | | | | - Magdalena Wietlicka-Piszcz
- Department of Biostatistics and Biomedical Systems Theory, Nicolaus Copernicus University, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
| | - Jakub J. Kaluzny
- Department of Sensory Organ Studies, Nicolaus Copernicus University, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
- Oftalmika Eye Hospital, Bydgoszcz, Poland
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Abu SL, Marín-Franch I, Racette L. A framework for assessing glaucoma progression using structural and functional indices jointly. PLoS One 2020; 15:e0235255. [PMID: 32609734 PMCID: PMC7329074 DOI: 10.1371/journal.pone.0235255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Accepted: 06/11/2020] [Indexed: 11/19/2022] Open
Abstract
Purpose While many tests and indices are available to identify glaucoma progression, using them in combinations may decrease overall specificity. The aim of this study was to develop a framework for assessing glaucoma progression using structural and functional indices jointly for a fixed specificity. Methods The study included 337 eyes of 207 patients with ocular hypertension or primary open-angle glaucoma selected from the Diagnostic Innovations in Glaucoma Study or the African Descent and Glaucoma Evaluation Study. All patients had at least 9 visits. Each visit had retinal nerve fiber layer thickness (RNFLT) and mean sensitivity from static automated perimetry (SAP MS) measured within a one-month window. Simple linear regression was applied to assess deterioration in each index for series of 5 to 9 visits. To identify progression using the two indices jointly, marginal significance levels set at a specificity of 95% were derived for two criteria: ANY (worsening on either RNFLT or SAP MS) and ALL (worsening on both RNFLT and SAP MS). Positive rate (percentage of eyes flagged as progressing) was determined individually for each index, as well as for the ANY and ALL criteria. Results Compared to SAP MS, RNFLT had higher positive rates (15% to 45%) for all series lengths. For the joint analyses, the positive rate was on average 12% higher for the ANY criterion compared to the ALL criterion. While RNFLT-alone had comparable positive rates and time-to-detection as the ANY criterion, each uniquely identified a subset of eyes (Kappa = 0.55 to 0.75). Conclusions This study provides a simple framework for assessing glaucoma progression with data from two tests jointly, without compromising specificity. This framework can be extended to include two or more parameters, can accommodate global or regional indices, and can eventually be used with novel parameters identified as predictive of glaucoma progression.
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Affiliation(s)
- Sampson Listowell Abu
- Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Iván Marín-Franch
- Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
- Computational Optometry, Atarfe, Spain
| | - Lyne Racette
- Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
- * E-mail:
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Cai J, Drewry MD, Perkumas K, Dismuke WM, Hauser MA, Stamer WD, Liu Y. Differential DNA methylation patterns in human Schlemm's canal endothelial cells with glaucoma. Mol Vis 2020; 26:483-493. [PMID: 32606567 PMCID: PMC7316632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 06/24/2020] [Indexed: 11/10/2022] Open
Abstract
Purpose Schlemm's canal (SC) endothelial cells derived from donors with or without glaucoma showed different mechanical properties and gene expression. As an important contributor to the regulation of intraocular pressure (IOP) and pathogenesis of primary open-angle glaucoma (POAG), the heritable key epigenetic changes, methylation may play an important role in the physiologic function of SC cells. This study aims to identify differentially methylated CpG sites (DMSs) in primary cultures of human SC cells with or without glaucoma. Methods We examined the methylation pattern of seven strains of primary human cells (two glaucoma and five normal SC cell samples), which were isolated and characterized using established protocols. DNA methylation was profiled using Illumina Human Methylation 450 BeadChip. Raw data were extracted and exported using Illumina GenomeStudio software. After quantile normalization, DNA methylation data were analyzed using R package RnBeads in Bioconductor. DMSs were filtered with p ≤ 1E-5, methylation change ≥ 0.1, and false discovery rate ≤ 0.05. The closest genes and the location of each CpG site were annotated using R package FDb.InfiniumMethylation.hg19. Gene Ontology and pathway analysis was performed using WebGestalt. Selected DMSs were validated using the Zymo qMethyl kit. Results We used five non-glaucoma and two glaucomatous SC cell samples to profile genome-wide DNA methylation using Illumina Infinium Methylation BeadChips. Principle component analysis showed the separation between the glaucoma and control samples. After quality control and differential analysis, we identified 298 highly significant DMSs (p ≤ 1E-5). Among them, 221 DMSs were within 1 kb of a nearby gene. Gene Ontology analysis demonstrated significant enrichment in positive regulation of cell migration, negative regulation of endothelial cell proliferation, and stress fiber and actin filament bundles. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis showed enrichment in cell adhesion and gap junctions. Several glaucoma-related genes were identified, including TGFBR3, THBS1, PITX2, DAXX, TBX3, TNXB, ANGPT1, and PLEKHA7. We also examined differentially methylated regions (DMRs) near these CpG sites and identified significant DMRs in TBX3, TNXB1, DAXX, and PITX2. Conclusions This study represents the first genome-wide DNA methylation profiling in cultured human primary SC cells. The DMSs were enriched in the pathways related to outflow resistance. Several DMRs were validated in glaucoma-associated genes, further suggesting the role of DNA methylation in glaucoma development. This study could provide comprehensive understanding of DNA methylation in glaucoma and its effect on aqueous humor outflow.
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Affiliation(s)
- Jingwen Cai
- Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, Augusta, GA
| | - Michelle D. Drewry
- Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, Augusta, GA
| | - Kristin Perkumas
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC
| | - W. Michael Dismuke
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC
| | - Michael A. Hauser
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC
- Department of Medicine, Duke University School of Medicine, Durham, NC
| | - W. Daniel Stamer
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC
| | - Yutao Liu
- Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, Augusta, GA
- Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta University, Augusta, GA
- James and Jean Culver Vision Discovery Institute, Medical College of Georgia, Augusta University, Augusta, GA
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Abstract
PURPOSE To compare disease severity between preperimetric primary open-angle glaucoma (POAG) patients with and without deep-layer microvasculature dropout. MATERIALS AND METHODS Ninety-four eyes of 94 preperimetric POAG patients with β-zone parapapillary atrophy (βPPA) were categorized according to the presence of deep-layer microvasculature dropout defined as a complete loss of microvasculature within the choroid or scleral flange on optical coherence tomography angiography. Parameters representing disease severity, that is, visual field (VF) mean deviation (MD), global and sectoral (6-sector) retinal nerve fiber layer (RNFL) thickness, and other factors including age, focal lamina cribrosa (LC) defect, width of βPPA with and without Bruch membrane (BM) (βPPA+BM and βPPA-BM), and optic disc hemorrhage were compared between eyes with and without dropout. RESULTS Deep-layer microvasculature dropout was observed in 33 preperimetric POAG eyes (35.1%). Eyes with dropout had significantly thinner RNFL in all areas except the inferonasal sector, worse VF MD, and higher prevalence of focal LC defect, and larger βPPA-BM (P<0.05), whereas the 2 groups did not differ in age, disc hemorrhage, or βPPA+BM width (P>0.05). In the multivariable logistic regression, worse VF MD [odds ratio (OR), 1.485; P=0.045], thinner RNFL (OR, 1.141; P<0.001), and higher prevalence of focal LC defect (OR, 6.673; P<0.001) were significantly associated with dropout. CONCLUSIONS Deep-layer microvasculature dropout was observed in a considerable number of preperimetric POAG eyes, and worse disease severity was associated with dropout. Future studies elucidating the pathogenic role of deep-layer microvasculature dropout in the development and progression of glaucoma are warranted.
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Affiliation(s)
- Min Hee Suh
- Department of Ophthalmology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Jeoung Ho Na
- Department of Ophthalmology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Linda M. Zangwill
- Hamilton Glaucoma Center, Shiley Eye Institute, and the Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA, United States
| | - Robert N. Weinreb
- Hamilton Glaucoma Center, Shiley Eye Institute, and the Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA, United States
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Waseem NH, Low S, Shah AZ, Avisetti D, Ostergaard P, Simpson M, Niemiec KA, Martin-Martin B, Aldehlawi H, Usman S, Lee PS, Khawaja AP, Ruddle JB, Shah A, Sackey E, Day A, Jiang Y, Swinfield G, Viswanathan A, Alfano G, Chakarova C, Cordell HJ, Garway-Heath DF, Khaw PT, Bhattacharya SS, Waseem A, Foster PJ. Mutations in SPATA13/ASEF2 cause primary angle closure glaucoma. PLoS Genet 2020; 16:e1008721. [PMID: 32339198 PMCID: PMC7233598 DOI: 10.1371/journal.pgen.1008721] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 05/18/2020] [Accepted: 03/17/2020] [Indexed: 11/18/2022] Open
Abstract
Current estimates suggest 50% of glaucoma blindness worldwide is caused by primary angle-closure glaucoma (PACG) but the causative gene is not known. We used genetic linkage and whole genome sequencing to identify Spermatogenesis Associated Protein 13, SPATA13 (NM_001166271; NP_001159743, SPATA13 isoform I), also known as ASEF2 (Adenomatous polyposis coli-stimulated guanine nucleotide exchange factor 2), as the causal gene for PACG in a large seven-generation white British family showing variable expression and incomplete penetrance. The 9 bp deletion, c.1432_1440del; p.478_480del was present in all affected individuals with angle-closure disease. We show ubiquitous expression of this transcript in cell lines derived from human tissues and in iris, retina, retinal pigment and ciliary epithelia, cornea and lens. We also identified eight additional mutations in SPATA13 in a cohort of 189 unrelated PACS/PAC/PACG samples. This gene encodes a 1277 residue protein which localises to the nucleus with partial co-localisation with nuclear speckles. In cells undergoing mitosis SPATA13 isoform I becomes part of the kinetochore complex co-localising with two kinetochore markers, polo like kinase 1 (PLK-1) and centrosome-associated protein E (CENP-E). The 9 bp deletion reported in this study increases the RAC1-dependent guanine nucleotide exchange factors (GEF) activity. The increase in GEF activity was also observed in three other variants identified in this study. Taken together, our data suggest that SPATA13 is involved in the regulation of mitosis and the mutations dysregulate GEF activity affecting homeostasis in tissues where it is highly expressed, influencing PACG pathogenesis.
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Affiliation(s)
- Naushin H. Waseem
- NIHR Biomedical Research Centre at Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, United Kingdom
| | - Sancy Low
- Moorfields Eye Hospital NHS Foundation Trust, City Road, London, United Kingdom
- UCL Institute of Ophthalmology, Bath Street, London, United Kingdom
- Department of Ophthalmology, St. Thomas’ Hospital, Westminster Bridge Road, London, United Kingdom
| | - Amna Z. Shah
- UCL Institute of Ophthalmology, Bath Street, London, United Kingdom
| | - Deepa Avisetti
- Centre for Oral Immunobiology and Regenerative Medicine, Institute of Dentistry, Queen Mary University of London, London, United Kingdom
| | - Pia Ostergaard
- Medical Genetics Unit, St. George’s University of London, Cranmer Terrace, London, United Kingdom
| | - Michael Simpson
- Genetics and Molecular Medicine, King’s College London, Great Maze Pond, London, United Kingdom
| | - Katarzyna A. Niemiec
- Centre for Oral Immunobiology and Regenerative Medicine, Institute of Dentistry, Queen Mary University of London, London, United Kingdom
| | - Belen Martin-Martin
- Blizard Advanced Light Microscopy, Blizard Institute, Queen Mary University of London, London, United Kingdom
| | - Hebah Aldehlawi
- Centre for Oral Immunobiology and Regenerative Medicine, Institute of Dentistry, Queen Mary University of London, London, United Kingdom
| | - Saima Usman
- Centre for Oral Immunobiology and Regenerative Medicine, Institute of Dentistry, Queen Mary University of London, London, United Kingdom
| | - Pak Sang Lee
- NIHR Biomedical Research Centre at Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, United Kingdom
- Moorfields Eye Hospital NHS Foundation Trust, City Road, London, United Kingdom
- UCL Institute of Ophthalmology, Bath Street, London, United Kingdom
| | - Anthony P. Khawaja
- NIHR Biomedical Research Centre at Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, United Kingdom
- Moorfields Eye Hospital NHS Foundation Trust, City Road, London, United Kingdom
- UCL Institute of Ophthalmology, Bath Street, London, United Kingdom
| | - Jonathan B. Ruddle
- Department of Ophthalmology, University of Melbourne, Victoria, Australia
| | - Ameet Shah
- Department of Ophthalmology, Royal Free Hospital NHS Foundation Trust, Pond Street, London, United Kingdom
| | - Ege Sackey
- Medical Genetics Unit, St. George’s University of London, Cranmer Terrace, London, United Kingdom
| | - Alexander Day
- Moorfields Eye Hospital NHS Foundation Trust, City Road, London, United Kingdom
| | - Yuzhen Jiang
- Moorfields Eye Hospital NHS Foundation Trust, City Road, London, United Kingdom
| | - Geoff Swinfield
- Society of Genealogists, Goswell Road, London, United Kingdom
| | - Ananth Viswanathan
- NIHR Biomedical Research Centre at Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, United Kingdom
- Moorfields Eye Hospital NHS Foundation Trust, City Road, London, United Kingdom
- UCL Institute of Ophthalmology, Bath Street, London, United Kingdom
| | - Giovanna Alfano
- UCL Institute of Ophthalmology, Bath Street, London, United Kingdom
| | | | - Heather J. Cordell
- Institute of Genetic Medicine, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - David F. Garway-Heath
- NIHR Biomedical Research Centre at Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, United Kingdom
- Moorfields Eye Hospital NHS Foundation Trust, City Road, London, United Kingdom
- UCL Institute of Ophthalmology, Bath Street, London, United Kingdom
| | - Peng T. Khaw
- NIHR Biomedical Research Centre at Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, United Kingdom
- Moorfields Eye Hospital NHS Foundation Trust, City Road, London, United Kingdom
- UCL Institute of Ophthalmology, Bath Street, London, United Kingdom
| | - Shomi S. Bhattacharya
- NIHR Biomedical Research Centre at Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, United Kingdom
- UCL Institute of Ophthalmology, Bath Street, London, United Kingdom
| | - Ahmad Waseem
- Centre for Oral Immunobiology and Regenerative Medicine, Institute of Dentistry, Queen Mary University of London, London, United Kingdom
| | - Paul J. Foster
- NIHR Biomedical Research Centre at Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, United Kingdom
- Moorfields Eye Hospital NHS Foundation Trust, City Road, London, United Kingdom
- UCL Institute of Ophthalmology, Bath Street, London, United Kingdom
- * E-mail:
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Lee SH, Kim TW, Lee EJ, Girard MJA, Mari JM. Focal lamina cribrosa defects are not associated with steep lamina cribrosa curvature but with choroidal microvascular dropout. Sci Rep 2020; 10:6761. [PMID: 32317767 PMCID: PMC7174329 DOI: 10.1038/s41598-020-63681-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 03/26/2020] [Indexed: 11/08/2022] Open
Abstract
Focal lamina cribrosa (LC) defects have been found to play an important role in the development and progression of glaucomatous optic neuropathy. However, the mechanism of generation of focal LC defects is largely unknown. This cross-sectional study was performed to investigate LC curvature and the frequency of parapapillary choroidal microvascular dropout (MvD) in glaucomatous eyes with focal LC defects. This study was conducted by a retrospective review of patients with primary open-angle glaucoma (POAG) included in an ongoing prospective study being performed at the Seoul National University Bundang Hospital (Investigating Glaucoma Progression Study). A total of 118 eyes of 118 patients with POAG, 59 with and 59 without focal LC defects, with eyes matched by age, axial length, and severity of visual field (VF) damage were included. Posterior LC bowing was assessed by calculating LC curvature index (LCCI), as the inflection of a curve representing a section of the LC, on the optic nerve head images obtained by enhanced-depth-imaging (EDI) spectral-domain optical coherence tomography (OCT). MvD was detected by OCT angiography. LCCI and MvD frequency were compared between eyes with and without focal LC defects. Mean LCCI was significantly smaller than in eyes with than without focal LC defects (9.75 ± 1.29 vs. 11.25 ± 1.39, P < 0.001). MvD was significantly more frequent in eyes with than without focal LC defects (84.7% vs. 49.2%, P < 0.001). MvD in eyes with focal LC defects showed a strong topographic correlation with the focal LC defects. These findings suggest that focal LC defects may primarily result from vascular factors rather than from mechanical strain.
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Affiliation(s)
- Seung Hyen Lee
- Department of Ophthalmology, Bundang Jesaeng General Hospital, Daejin Medical Center, Seongnam, Korea
| | - Tae-Woo Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
| | - Eun Ji Lee
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Michaël J A Girard
- Department of Biomedical Engineering, National University of Singapore, Singapore, Singapore
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
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