Background: One of the main causes of blindness in persons over 60 is glaucoma, yet there are presently no viable therapies available. The differentiation to retinal ganglion cell (RGC) is a key step in the stem cell-based ocular regeneration therapy that have become a new hotspot in this field. This study aimed to investigate the differentiation pathway of Retinal stem cells (RSCs) and their potential for future application in glaucoma treatment. Methods: Gas pressurization was employed to simulate intraocular pressure (IOP) conditions in vitro, utilizing polyimide membranes as the culture chamber. RSCs were derived from mice and underwent a series of transfection and detection procedures. The expression levels of mRNA and protein were quantified using quantitative real-time polymerase chain reaction (qRT-PCR) and western blotting, respectively. Cell apoptosis and proportion were assessed through flow cytometry analysis. Immunofluorescence staining was performed to identify cell morphology, growth status, and relative markers. In vivo validation was conducted on glaucoma mouse models, highlighting the regulatory system involving Atoh7/Notch for RSC differentiation. Results: At 40 mmHg, Atoh7 facilitates RGC differentiation through the regulation of Notch expression. Activation of Atoh7/Notch signaling in glaucomatous retina enhances RSC viability and differentiation. Subsequent transplantation of RSCs significantly improves visual acuity in glaucoma animal models, accompanied by increased expression and number of positive cells for RGC markers, as well as activation of Atho7/Notch signaling. Conclusion: The present study elucidates the alterations and impacts of IOP in glaucoma, while also highlighting the potential utility of Atoh7/Notch as a promising avenue for comprehending the underlying mechanisms governing retinal ganglion cell differentiation.
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