Abstract

Sex-based differences in susceptibility have been reported for a number of neovascular ocular diseases. We quantified corneal neovascularization, induced by superficial silver nitrate cautery, in male and female inbred albino Sprague-Dawley, inbred albino Fischer 344, outbred pigmented Hooded Wistar and inbred pigmented Dark Agouti rats of a range of ages. Corneal neovascular area was quantified on haematoxylin-stained corneal flatmounts by image analysis. Pro-and anti-angiogenic gene expression was measured early in the neovascular response by quantitative real-time polymerase chain reaction. Androgen and estrogen receptor expression was assessed by immunohistochemistry. Male rats from all strains, with or without ocular pigmentation, exhibited significantly greater corneal neovascular area than females: Sprague-Dawley males 43±12% (n = 8), females 25±5% (n = 12), p = 0.001; Fischer 344 males 38±10% (n = 12) females 27±8% (n = 8) p = 0.043; Hooded Wistar males 32±6% (n = 8) females 22±5% (n = 12) p = 0.002; Dark Agouti males 37±11% (n = 9) females 26±7% (n = 9) p = 0.015. Corneal vascular endothelial cells expressed neither androgen nor estrogen receptor. The expression in cornea post-cautery of Cox-2, Vegf-a and Vegf-r2 was significantly higher in males compared with females and Vegf-r1 was significantly lower in the cornea of males compared to females, p<0.001 for each comparison. These data suggest that male corneas are primed for angiogenesis through a signalling nexus involving Cox-2, Vegf-a, and Vegf receptors 1 and 2. Our findings re-enforce that pre-clinical animal models of human diseases should account for sex-based differences in their design and highlight the need for well characterized and reproducible pre-clinical studies that include both male and female animals.

Highlights

  • Sex-based differences in incidence and/or prevalence have been observed in a number of ocular diseases [1,2,3,4,5]

  • Since the differences in corneal neovascularization were independent of strain, further experiments were carried out using Sprague Dawley rats, which showed the greatest difference between males and females (72% more vessels in males than females, compared with 42% in Fischer 344, 45% in Hooded Wistar and 42% in Dark Agouti)

  • The sex difference was observed in 4 strains of rats, including inbred and outbred strains, and strains with or without ocular pigmentation, and when animals were stratified by age

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Summary

Introduction

Sex-based differences in incidence and/or prevalence have been observed in a number of ocular diseases [1,2,3,4,5]. Those characterized by the aberrant growth of new blood vessels, such as diabetic retinopathy and age-related macular degeneration, have been shown to display a sex bias [6, 7]. The reasons for this bias remain unclear. The presence of abnormal corneal blood vessels is potentially sight threatening but is an independent risk factor for the failure of a corneal graft [15]

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