Animal Model Of Proliferative Vitreoretinopathy Research Articles

A Novel Function of p53: A Gatekeeper of Retinal Detachment

Proliferative vitreoretinopathy (PVR) is a blinding disease associated with rhegmatogenous retinal detachment, for which there is no satisfactory treatment. Surgery helps in many cases, but, to our knowledge, there are no pharmacological approaches to reduce PVR risk. We report that suppressing expression of p53 was a required event in two assays of PVR (namely, platelet-derived growth factor receptor α-mediated contraction of cells in a collagen gel and retinal detachment in an animal model of PVR). Furthermore, preventing the decline in the level of p53 with agents such as Nutlin-3 protected from retinal detachment, which is the most vision-compromising component of PVR. Finally, Nutlin-3 may be effective in the clinical setting because it prevented human PVR vitreous-induced contraction of cells isolated from a patient PVR membrane. These studies identify Nutlin-3 as a potential PVR prophylaxis.

Proliferative Vitreoretinopathy in the Swine–A New Model

To develop a large animal model of proliferative vitreoretinopathy (PVR) in the swine to eventually study disease pathophysiology, as well as novel therapies. PVR was induced in domestic swine by creation of a posterior vitreous detachment, creation of a retinal detachment by the injection of subretinal fluid, and intravitreal injection of green fluorescent protein-positive retinal pigment epithelial (GFP+ RPE) cells. Control eyes had the same surgical procedures without RPE cell injection. PVR was clinically graded on days 3, 7, and 14. Animals were euthanized on day 14, and enucleated eyes were analyzed by light microscopy and immunohistochemistry. Injection of GFP+ RPE cells into the vitreous cavity produced localized, traction retinal detachments by day 14 in all eyes (14 of 14); in contrast, the retina spontaneously reattached by day 3 and remained attached in all control eyes (10 of 10). Contractile epiretinal membranes on the inner retinal surface that caused the traction retinal detachments consisted predominantly of GFP+ RPE cells. These cells stained positive for cytokeratin, confirming their epithelial origin, and also expressed α-SMA and fibronectin, markers for myofibroblasts and fibrosis, respectively. We established a swine PVR model that recapitulates key clinical features found in humans and, thus, can be used to study the pathophysiology of PVR, as well as new novel therapies. GFP+ RPE cells injected into the vitreous cavity formed contractile membranes on the inner retinal surface and caused localized traction retinal detachments.

THE IMPACT OF TACROLIMUS ON GROWTH FACTORS IN EXPERIMENTAL PROLIFERATIVE VITREORETINOPATHY

To investigate the effect of intravitreal tacrolimus on an animal model of proliferative vitreoretinopathy (PVR) and on growth factors implicated in its pathogenesis. Twenty-one guinea pigs were randomly assigned to one of three groups of seven animals each: no-PVR/saline group (no PVR/intravitreal saline-injected group), PVR/saline group (dispase-induced PVR group, treated with control injections of intravitreal saline), and PVR/tacrolimus group (treatment group, dispase-induced PVR group treated with intravitreal tacrolimus injections). At the end of the experiment, eyes were enucleated and the identification of the stages of PVR was carried out. While a halves of the enucleated globes were evaluated histopathologically for PVR formation, the retinas of the other halves of globes were used for the preparation of retinal homogenates. The transforming growth factor-β, platelet-derived growth factor, and fibroblast growth factor levels in homogenized retina tissues were measured by the enzyme-linked immunosorbent assay method. When assessing the average PVR stages in terms of severe PVR rates, the PVR/tacrolimus group had significantly improved when compared with the PVR/saline group. The PVR/tacrolimus group demonstrated significantly decreased levels of transforming growth factor-β, platelet-derived growth factor, and fibroblast growth factor when compared with the PVR/saline group and also demonstrated significant improvement in epiretinal membrane formation and retinal fold in the presence of histopathologic levels. The difference in degradation of photoreceptor cells between the PVR/tacrolimus and the PVR/saline groups was not statistically significant. This study suggests that intravitreal tacrolimus application may suppress PVR development and that tacrolimus may merit investigation for the prophylaxis of PVR.

Expression of CXCL8, CXCR1, and CXCR2 in Neurons and Glial Cells of the Human and Rabbit Retina

Several eye diseases are accompanied by inflammatory processes. The authors examined the expression of the proinflammatory chemokine CXCL8 and the corresponding receptors in healthy human retinas, in cellular membranes from patients with proliferative vitreoretinopathy (PVR) or human glial cell cultures and in an animal model of PVR in rabbit eyes. The authors used immunohistochemical methods, Western blotting, RT-PCR, and real time RT-PCR to characterize the expression of CXCL8, CXCR1, and CXCR2 in human and rabbit retinas. Functionality of the receptors in cultured glial cells was tested by Ca(2+) imaging. Immunohistochemical examinations of normal human and rabbit retinas revealed a distinct expression of CXCR1 and CXCR2 in several neuronal cell types. CXCL8 mRNA was demonstrated only by RT-PCR in normal retinas, and receptor expression was confirmed by Western blotting and RT-PCR. The presence of CXCR1 and CXCR2, but not CXCL8, was detected by immunostaining in glial fibrillary acidic protein-positive glial cells of cellular PVR membranes. Immunoreactivity for CXCL8, CXCR1, and CXCR2 was observed in virtually all cultured glial cells and in the human Müller cell line MIO-M1. Müller cells responded to the application of CXCL8 with increased cytosolic Ca(2+) concentrations. In PVR rabbit retinas, CXCR1 expression is increased in Müller cells, and CXCL8 and CXCR2 are strongly expressed in microglial cells. Expression of CXCL8 and CXCL8 receptors in glial cells of human PVR membranes and rabbit PVR retinas suggests an involvement in glial reactivity. Furthermore, the prominent expression of CXCR1 and CXCR2 in neurons of the healthy human and rabbit retina suggests additional physiological functions.

Enzymatic vitreous disruption

Enzymatic vitreous disruption refers to cleaving the vitreoretinal junction by enzymatic means, thereby inducing posterior vitreous detachment (PVD) and liquefaction of the vitreous gel. Several enzymes have been proposed in this respect, including chondroitinase, hyaluronidase, dispase, and plasmin. In an experimental setting, chondroitinase induced PVD and was helpful in removing epiretinal membranes but no further data have been reported yet. Hyaluronidase liquefies the vitreous as demonstrated in a phase III trial in diabetic patients with vitreous haemorrhage. Dispase induces PVD but also causes inner retinal damage and is now used as an animal model of proliferative vitreoretinopathy. Plasmin has the capability of both PVD induction and liquefaction. However, plasmin is highly unstable and not available for clinical use. Microplasmin (ThromboGenics Ltd, Dublin, Ireland) is a truncated form of human plasmin sharing the same catalytic activity like plasmin. Recombinant microplasmin is under clinical investigation in patients with vitreomacular traction. This review article reports on the current knowledge of enzymatic vitreous disruption and discusses details of the enzyme candidates in basic and clinical research terms.

IL-10 in vivo gene expression in a cell-induced animal model of proliferative vitreoretinopathy

Due to inhibitory activities on cell-mediated immune responses, interleukin-10 (IL-10) has been proposed as a good candidate to treat inflammatory eye disease and proliferative vitreoretinopathy (PVR). In this study we evaluate the effect of human IL-10 (hIL-10) expression in a cell-induced animal model of PVR. Rabbit dermal fibroblasts were genetically modified by infection with retroviral particles carrying the neomycin resistance gene (neoR) alone or in combination with the hIL-10 gene. PVR was induced in rabbits by intravitreal injections of RDF hIL-10 or RDF neo. Some rabbits received instead injections of soluble recombinant hIL-10 (rhIL-10). PVR was graded by fundoscopy. Eyes were enucleated for histology at day 28. ELISA was performed to measure hIL-10 production in RDF supernatants and in vitreous samples, 24 h after injection. Results showed that in vitro hIL-10 production by RDF was 24,500 pg/10(6) cells/ml/24 h. In vivo IL-10 secretion was detected in all rabbits injected with RDF hIL-10 but was undetectable in control rabbits. Similar clinical grades of PVR were found in rabbits injected with RDF hIL-10 or RDF neo. Histology showed that all eyes injected with RDF hIL-10 had significant inflammatory infiltration whereas only one control eye was clearly inflamed. Rabbits injected with soluble rhIL-10 had normal fundoscopy and normal histology. In conclusion, our results show that in vivo, in a cell-induced model of PVR, hIL-10 has no effect in the clinical progression of PVR. Histology, however, shows that pro-inflammatory effects seem to overcome its suppressive properties.

Novel growth factors involved in the pathogenesis of proliferative vitreoretinopathy.

To determine whether hepatocyte growth factor (HGF) and connective tissue growth factor (CTGF) are expressed in human specimens of proliferative vitreoretinopathy (PVR) and to propose a model of PVR pathogenesis based upon the known activities of these growth factors. Methods Immunohistochemical methods (ABC Elite) were used to demonstrate the presence of HGF and CTGF in cryostat sections of five human PVR membranes. In each of the five PVR membranes, stromal cells were immunohistochemically positive for both HGF and CTGF. Based upon this information and the known actions of these growth factors, a model of PVR pathogenesis was developed. In this model, injury of the retina induces an inflammatory response that upregulates HGF expression inducing the formation of multilayered groups of migratory retinal pigment epithelial cells (RPE). These RPE, present in a provisional extracellular matrix, come in contact with vitreous containing TGF-beta. The TGF-beta is activated, upregulating expression of CTGF. Under the influence of TGF-beta and CTGF, RPE become myofibroblastic and fibrosis ensues. Retinal traction induces further detachment continuing the cycle of retinal injury. HGF and CTGF are expressed in PVR membranes and may play important roles in the pathogenesis of PVR. The expression and function of these growth factors should be critically examined in human PVR specimens, in in vitro cultures of RPE, and in animal models of PVR.

The Topoisomerase I Inhibitors, Camptothecin and β-Lapachone, Induce Apoptosis of Human Retinal Pigment Epithelial Cells

The aim of the study was to determine whether the topoisomerase I inhibitors, camptothecin and β-lapachone, are suitable agents for the adjuvant pharmacotherapy of proliferative vitreoretinopathy (PVR). The effects of the drugs on cultured human retinal pigment epithelial (RPE) cells were examined using growth assays, cytotoxicity assays, single cell agarose gel electrophoresis, in situ DNA end labeling and immunoblot analysis for apoptosis-regulatory proteins. Both agents killed RPE cells in a concentration-and time-dependent manner. Cell death was apoptotic as assessed by single cell agarose gel electrophoresis and in situ DNA end labeling. Camptothecin, but not β-lapachone, induced accumulation of p53 and the major growth arrest-associated p53 response protein, p21. Both drugs enhanced expression of the proapoptotic BAX protein. Camptothecin, but not β-lapachone, synergistically enhanced RPE cell apoptosis induced by the cytotoxic cytokine, CD95 ligand (CD95L). This effect was linked to camptothecin-induced inhibition of RNA synthesis. Atypical topoisomerase I inhibitors may be promising agents for the adjuvant pharmacotherapy of PVR. Experimental studies to assess possible ocular toxicity upon local administration and to confirm its therapeutic efficacy in an animal model of PVR are required.

Antiproliferative effect of retinoic acid in 1% sodium hyaluronate in an animal model of PVR

PURPOSE. To determine the antiproliferative activity of intravitreous retinoic acid (RA) dispersed in 1% sodium hyaluronate (HA). METHODS. Six groups of pigmented rabbits underwent gas-compression vitrectomy. Four days later, gas/HA or gas/balanced salt solution (BSS) exchange (1.0 ml) was performed in all rabbits. Groups A (n = 10) and B (n = 5) received intravitreous RA dissolved in 0.01 ml of ethanol and dispersed in 1% HA (10 and 15 µg RA/ml, respectively). Group C (n = 10) received intravitreous RA dissolved in ethanol and dispersed in BSS (10 µg RA/ml). Groups D (n = 5) and F (n = 4) received 1 ml of HA with ethanol; group E (n = 5) received 1 ml of HA without ethanol. All groups except group F also received homologous fibroblasts and autologous, platelet-rich plasma intravitreously. The eyes were examined ophthalmoscopically for 1 month. Proliferative vitreoretinopathy (PVR) findings were graded according to the classification of Fastenberg et al. All group F eyes also were examined by light and electron microscopy. RESULTS. RA in HA lessened PVR progression within 1 month when compared with HA injection controls and within 2 weeks when compared with the RA in BSS treatment group (both, p < 0.05). No specific change attributable to ethanol was observed histopathologically. CONCLUSION. RA dissolved in ethanol and dispersed in HA could be useful to treat PVR when silicone oil is unnecessary.

Prevention of Experimental Proliferative Vitreoretinopathy With a Biodegradable Intravitreal Implant for the Sustained Release of Fluorouracil

To test the efficacy of a biodegradable device for the intravitreal sustained release of fluorouracil in the treatment of tractional retinal detachment due to proliferative vitreoretinopathy. A 6 x 0.9-mm (20-gauge) cylindrical solid implant molded from copolymers of lactide and glycolide admixed with 1 mg of fluorouracil was placed in the vitreous cavity of rabbits in which retinal detachment with proliferative vitreoretinopathy had been initiated. Comparisons of the control (drug-free polymer) and experimental (fluorouracil polymer) groups were made with weekly indirect ophthalmoscopic examinations. In another experiment, the intravitreal concentration of fluorouracil was tested at each time point. Retinas of eight (89%) of nine rabbits that received the polymer with fluorouracil remained attached compared with only one animal (11%) that received the control polymer without the drug. The therapeutic effect of the drug-containing implant was associated with sustained intravitreal concentrations of fluorouracil between 1 and 13 mg/L for at least 14 days, and fluorouracil concentrations remained above 0.3 microgram/mL for almost 21 days. No evidence of the toxic effects of the drug or polymer implant was observed with electroretinographic and histopathologic study. Intravitreal implantation of biodegradable polymers containing fluorouracil can prevent proliferation of epiretinal membranes resulting in complicated retinal detachment in an animal model of proliferative vitreoretinopathy and indicate their possible usefulness for intravitreal delivery of therapeutic agents.

Sustained intraocular delivery of retinoic acid (RA) from microspheres of biodegradable polymers in an animal model of proliferative vitreoretinopathy (PVR)

Sustained intraocular delivery of retinoic acid (RA) from microspheres of biodegradable polymers in an animal model of proliferative vitreoretinopathy (PVR)

Improvement in efficacy of corticosteroid therapy in an animal model of proliferative vitreoretinopathy by pretreatment.

Intraocular injection of the corticosteroid triamcinolone acetonide reduces the incidence of retinal detachment in rabbit eyes injected with tissue-cultured fibroblasts. When the steroid was injected simultaneously with the cells, a reduction of retinal detachment from 93% (control) to 75% (treated) was achieved on day 28. When the steroid was injected 24 h preceding cell injection, the reduction of retinal detachment was from 85% (control) to 43% (treated). The development of retinal detachment is caused by proliferation of injected fibroblasts. Reduction of this proliferation is probably achieved partially through direct inhibition of mitosis, but more important may be the reduction of the reactive inflammatory process.

Cellular migration, proliferation, and contraction. An in vitro approach to a clinical problem--proliferative vitreoretinopathy.

Presently used animal models of proliferative vitreoretinopathy reflect only cell proliferation and contraction. We used an in vitro model that measured cell migration, proliferation, and contraction. The following four drugs were assayed on this system: daunomycin, taxol, colchicine, and cytochalasin B. Daunomycin was the most effective drug against cell proliferation and cell migration but had no effect on cell contraction; taxol and colchicine affected all three parameters. Cytochalasin B was the least effective drug tested.

Mechanisms Involved in Retinal Pigment Epithelial Cell Chemotaxis

Retinal pigment epithelial (RPE) cell chemotaxis may play an important role in proliferative vitreoretinopathy (PVR). Fibronectin and platelet-derived growth factor are chemoattractants for RPE cells. In this study, we used these chemoattractants to examine mechanisms involved in RPE cell chemotaxis. Our results demonstrate that inhibition of RNA and protein synthesis, but not DNA synthesis, are associated with reduced chemotaxis. Microtubules and microfilaments are involved since cytochalasin B and colchicine are potent inhibitors of RPE cell migration. Dexamethasone, to which a beneficial effect has been attributed in an animal model of PVR, had no effect on RPE cell migration. Information concerning mechanisms involved in RPE cell migration may help to explore new avenues of treatment in PVR.

A refined experimental model for proliferative vitreoretinopathy

Animal models of proliferative vitreoretinopathy (PVR) in which the intact vitreous is injected with large numbers of tissue cultured fibroblasts do not accurately represent the disease as it is found in humans. A refined model of PVR is presented, in which the vitreous is compressed and partially detached using intravitreally injected perfluorpropane, followed by injection of 25,000 homologous fibroblasts. Proliferation occurred on the retinal surface, causing retinal detachments with the same frequency as models using greater numbers of cells.

The Effect of Triamcinolone Acetonide on a Refined Experimental Model of Proliferative Vitreoretinopathy

Animal models of proliferative vitreoretinopathy in which the intact vitreous body is injected with large numbers of fibroblasts do not resemble the human situation. Using a refined rabbit model of proliferative vitreoretinopathy in which the vitreous is compressed and partially detached from the retinal surface and small amounts of tissue-cultured homologous fibroblasts (25,000) are scattered over the vascularized part of the retina, we reevaluated the effect of intravitreally injected triamcinolone acetonide. We found that 2 mg of the corticosteroid reduced the incidence of retinal detachments from 90% to 56%. The effect was less than in previous models with intact vitreous. Large doses of the corticosteroid had no additional effect on the reduction of retinal detachments, indicating an optimal dosage of 2 mg. The effect of the corticosteroid on neovascularization was considerable; with 8 mg it could almost be prevented (reduction from 74% to 8%).

Intraocular Injection of Silicone Oil For Experimental Proliferative Vitreoretinopathy

We evaluated the effect of intraocular silicone oil as an internal tamponade on an animal model of proliferative vitreoretinopathy. Lensectomy and vitrectomy were performed on two groups of pigmented rabbits. Twenty-five rabbit eyes then had 1,000 centistokes' viscosity silicone oil injected into the vitreous cavity; 20 control eyes received balanced salt solution. Fourteen days later, each eye was injected with homologous fibroblasts (ten eyes with 100,000 cells, 25 eyes with 250,000 cells, and ten eyes with 750,000 cells). All membranes that developed after the cell injections in both experimental and control eyes produced traction retinal detachment. The character of the membranes formed and the timing of the traction retinal detachment were the same for both groups. In an active phase of experimental proliferation, the internal tamponade of silicone oil is insufficient to keep the retina in place.