Abstract

BackgroundRetinal detachment (RD) can lead to proliferative vitreoretinopathy (PVR), a leading cause of intractable vision loss. PVR is associated with a cytokine storm involving common proinflammatory molecules like IL6, but little is known about the source and downstream signaling of IL6 and the consequences for the retina. Here, we investigated the early immune response and resultant cytokine signaling following RD in mice.MethodsRD was induced in C57BL/6 J and IL6 knockout mice, and the resulting inflammatory response was examined using immunohistochemistry and flow cytometry. Cytokines and signaling proteins of vitreous and retinas were quantified by multiple cytokine arrays and Western blotting. To attempt to block IL6 signaling, a neutralizing antibody of IL6 receptor α (IL6Rα) or IL6 receptor β (gp-130) was injected intravitreally immediately after RD.ResultsWithin one day of RD, bone marrow-derived Cd11b + monocytes had extravasated from the vasculature and lined the vitreal surface of the retina, while the microglia, the resident macrophages of the retina, were relatively unperturbed. Cytokine arrays and Western blot analysis revealed that this sterile inflammation did not cause activation of IL6 signaling in the neurosensory retina, but rather only in the vitreous and aqueous humor. Monocyte infiltration was inhibited by blocking gp130, but not by IL6 knockout or IL6Rα blockade.ConclusionsTogether, our results demonstrate that monocytes are the primary immune cell mediating the cytokine storm following RD, and that any resulting retinal damage is unlikely to be a direct result of retinal IL6 signaling, but rather gp130-mediated signaling in the monocytes themselves. These results suggest that RD should be treated immediately, and that gp130-directed therapies may prevent PVR and promote retinal healing.

Highlights

  • Retinal detachment (RD) can lead to proliferative vitreoretinopathy (PVR), a leading cause of intractable vision loss

  • Because interleukin 6 (IL6) increases in the ocular fluids of RD human patients [9], we examined the extent of monocyte infiltration following RD in the absence of IL6 signaling

  • Since neither IL6 nor IL6 receptor α (IL6Rα) are expressed at detectable levels in the retina, our results suggest that gp130 mechanistically lies between monocyte-secreted IL6 in the vitreous and the induction of CCL2 expression in the Müller glia

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Summary

Introduction

Retinal detachment (RD) can lead to proliferative vitreoretinopathy (PVR), a leading cause of intractable vision loss. Prompt surgical procedures are required to save vision, but are often delayed for the convenience of both patient and practitioner. In many countries, this delay exceeds several weeks [6]. Delayed treatment often leads to serious secondary complications, including proliferative vitreoretinopathy (PVR). PVR is caused by proliferation of glial or RPE cells to form a fibrous, multicellular scar termed epiretinal membrane at the retinal surface. The epiretinal membrane can produce physical traction and deformation of the retina, leading to more widespread detachment, tears, and retinal puckers. Because PVR often leads to poor visual outcomes, understanding how

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