Abstract

A better understanding of the molecular and cellular mechanisms involved in retinal hydro-mineral homeostasis imbalance during diabetic macular edema (DME) is needed to gain insights into retinal (patho-)physiology that will help elaborate innovative therapies with lower health care costs. Transient receptor potential cation channel subfamily vanilloid member 4 (TRPV4) plays an intricate role in homeostatic processes that needs to be deciphered in normal and diabetic retina. Based on previous findings showing that TRPV4 antagonists resolve blood-retina barrier (BRB) breakdown in diabetic rats, we evaluated whether TRPV4 channel inhibition prevents and reverts retinal edema in streptozotocin(STZ)-induced diabetic mice. We assessed retinal edema using common metrics, including retinal morphology/thickness (histology) and BRB integrity (albumin-associated tracer), and also by quantifying water mobility through apparent diffusion coefficient (ADC) measures. ADC was measured by diffusion-weighted magnetic resonance imaging (DW-MRI), acquired ex vivo at 4 weeks after STZ injection in diabetes and control groups. DWI images were also used to assess retinal thickness. TRPV4 was genetically ablated or pharmacologically inhibited as follows: left eyes were used as vehicle control and right eyes were intravitreally injected with TRPV4-selective antagonist GSK2193874, 24 h before the end of the 4 weeks of diabetes. Histological data show that retinal thickness was similar in nondiabetic and diabetic wt groups but increased in diabetic Trpv4-/- mice. In contrast, DWI shows retinal thinning in diabetic wt mice that was absent in diabetic Trpv4-/- mice. Disorganized outer nuclear layer was observed in diabetic wt but not in diabetic Trpv4-/- retinas. We further demonstrate increased water diffusion, increased distances between photoreceptor nuclei, reduced nuclear area in all nuclear layers, and BRB hyperpermeability, in diabetic wt mice, effects that were absent in diabetic Trpv4-/- mice. Retinas of diabetic mice treated with PBS showed increased water diffusion that was not normalized by GSK2193874. ADC maps in nondiabetic Trpv4-/- mouse retinas showed restricted diffusion. Our data provide evidence that water diffusion is increased in diabetic mouse retinas and that TRPV4 function contributes to retinal hydro-mineral homeostasis and structure under control conditions, and to the development of BRB breakdown and increased water diffusion in the retina under diabetes conditions. A single intravitreous injection of TRPV4 antagonist is however not sufficient to revert these alterations in diabetic mouse retinas.

Highlights

  • If clinical treatments exist for diabetic macular edema (DME), a complication of diabetes that results from an imbalance between retinal fluid entry and fluid exit, leading to intraretinal and subretinal fluid accumulation in the macula region of the retina [1], offering therapeutic alternatives is still a challenge

  • This study examines whether endogenous TRPV4 regulates retinal hydro-mineral homeostasis under normal and diabetic conditions, using common metrics of retinal edema and diffusion-weighted magnetic resonance imaging (DW-MRI)

  • Retinal morphometry changes that include outer nuclear layer disorganization with fields with larger internuclear distances coincide with blood-retina barrier (BRB) breakdown and increased apparent diffusion coefficient (ADC) in diabetic mouse retinas

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Summary

Introduction

If clinical treatments exist for diabetic macular edema (DME), a complication of diabetes that results from an imbalance between retinal fluid entry and fluid exit, leading to intraretinal and subretinal fluid accumulation in the macula region of the retina [1], offering therapeutic alternatives is still a challenge. During DME, permeability through retinal barriers increases, causing protein leakage within the interstitial retinal tissue that will be accompanied by water accumulation [2] This vasogenic edema may be accompanied by an increase in intracellular fluid volume (cell swelling) [3, 4]. OLM disruption, and deregulation of transporters and ion/water channels contribute to BRB breakdown and reduced drainage in DME. These pathological mechanisms are a consequence of fundamental pathways activated by chronic hyperglycemia, including inflammatory ones [1, 5, 6]. We examined the retinal outcome after a single intravitreal injection of a very potent and selective TRPV4 antagonist, GSK2193874 [39] in diabetic mice

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