Pathogenesis Of Proliferative Vitreoretinopathy Research Articles

Silencing the long noncoding RNA MALAT1 inhibits vitreous-induced epithelial-mesenchymal transition in RPE cells by regulating the PDGFRs/AKT axis.

Epithelial-mesenchymal transition (EMT) is a crucial pathological process that contributes to proliferative vitreoretinopathy (PVR), and research indicates that factors present in the vitreous that target cells play pivotal roles in regulating EMT. Experimental studies have confirmed that rabbit vitreous (RV) promotes EMT in human retinal pigment epithelial (RPE) cells. The long noncoding RNA (lncRNA) MALAT1 has been implicated in EMT in various diseases. Thus, this study aimed to investigate the involvement of lncRNA MALAT1 in vitreous-induced EMT in RPE cells. MALAT1 was knocked down in ARPE-19 cells by short hairpin RNA (shRNA) transfection. Reverse transcription PCR (RT‒PCR) was used to evaluate MALAT1 expression, and Western blotting analysis was used to measure the expression of EMT-related proteins. Wound-healing, Transwell, and cell contraction assays were conducted to assess cell migration, invasion, and contraction, respectively. Additionally, cell proliferation was assessed using the CCK-8 assay, and cytoskeletal changes were examined by immunofluorescence. MALAT1 expression was significantly increased in ARPE-19 cells cultured with RV. Silencing MALAT1 effectively suppressed EMT and downregulated the associated factors snail1 and E-cadherin. Furthermore, silencing MALAT1 inhibited the RV-induced migration, invasion, proliferation, and contraction of ARPE-19 cells. Silencing MALAT1 also decreased RV-induced AKT and P53 phosphorylation. In conclusion, lncRNA MALAT1 participates in regulating vitreous-induced EMT in human RPE cells; these results provide new insight into the pathogenesis of PVR and offer a potential direction for the development of antiproliferative drugs.

Can wall shear-stress topology predict proliferative vitreoretinopathy localization following pars plana vitrectomy?

We numerically study the fluid dynamics of oil tamponade in models of vitrectomized eyes prompted by a subset of daily activities corresponding to movements on the horizontal plane with the patient in a standing position. Bulk flow features are related to near-wall flow topology and transport at the retinal surface through a wall shear-stress-based analysis. Proliferative VitreoRetinopathy (PVR) is the leading cause of retinal re-detachment occurring in about 20% of all cases due to the accumulation of inflammatory cells in discrete retinal regions. Signalling soluble mediators stimulate inflammatory cells’ chemotaxis and studying their distribution across the retinal surface may acquire clinical relevance. In all the investigated cases, persistent and elongated regions along the retina, potentially prone to accumulate chemo-attractants and cells are observed. Gradients of soluble inflammation mediators present in the aqueous are known responsible for the so-called epithelial-mesenchymal transition that initiates PVR and favours recurrent retinal detachment prompting the proliferation of inflammatory cells with collagen matrix deposition and its contraction. The surgical apposition of encircling scleral buckling elements, known for over a century to influence PVR formation and localization, modifies the attracting regions, possibly causing an accumulation of molecules and cells along approximately vertical lines that follow the rising menisci due to the cerclage indentation. The resulting spatial pattern is compatible with clinical observations. This study may open toward rational analyses of near-wall transport to predict PVR pathogenesis by relating biochemical accumulation in certain areas of the retina to clinical conditions.

Epiretinal Amniotic Membrane Influences the Cellular Behavior of Profibrotic Dedifferentiated Cells of Proliferative Vitreoretinopathy In Vitro

Proliferative vitreoretinopathy (PVR) as a rare fibrotic ocular disease is the main reason for failure of retinal detachment surgery and a reduced prognosis following surgery. Amniotic membrane (AM) is a versatile surgical tool for tissue stabilization, antifibrotic properties, and regeneration. Initial clinical case studies now demonstrated intravitreal tolerance as well as good anatomical and functional results for degenerative retinal diseases. Due to its diverse wound healing properties, AM could have promoting, suppressive, or no effects on PVR. To illuminate the potential of epiretinal AM transplantation in complex retinal detachment cases, we investigated its influence on human primary PVR (hPVR) cells in vitro. In our cell culture study, hPVR cells were isolated from surgically removed PVR membranes. Following incubation with AM for 48 h, AM-incubated hPVR showed significantly reduced proliferation (BrdU-ELISA; p < 0.001 ), migration (Boyden chamber, scratch assay; p = 0.003 and p < 0.001 ), and cell adhesion ( p = 0.005). Collagen contraction was nearly unaffected ( p = 0.04), and toxicity (histone-complexed DNA ELISA, WST-1 assay, and life/dead staining) was excluded. Next, immunofluorescence showed a myofibroblastic phenotype with reduced expression of fibrosis markers in AM-incubated cells, which was confirmed by Western blot analysis. In the proteomics assay, AM significantly regulated proteins by a more than 2-fold increase in expression which were related to the cytoskeleton, lipid metabolism, cell-matrix contraction, and protein folding. In conclusion, this in vitro work suggests no induction of fibrosis and other key steps in the pathogenesis of PVR through AM but rather inhibiting properties of profibrotic cell behavior, making it a possible candidate for suppression of PVR. Further clinical studies are necessary to evaluate the therapeutic relevance.

Comparison of vitreous/retinal pigment epithelium relative intensity in proliferative vitreoretinopathy and uveitis

Background: Quantitative measurements of vitreous inflammation using vitreous/retinal pigment epithelium-relative intensity (VIT/RPE-Relative Intensity) have been described recently. In proliferative vitreoretinopathy (PVR), inflammation plays a central role in the pathogenesis, inducing retinal fibrosis and contraction. However, no attempts have yet to be made to analyze the severity of inflammation in PVR progression. Methods: A cross-sectional study was conducted by reviewing OCT image sets obtained from patients divided into four groups: (1) proliferative vitreoretinopathy, (2) intermediate and posterior uveitis, (3) panuveitis, (4) normal healthy eyes in Cipto Mangunkusumo Kirana Eye Hospital between April 2021 – December 2021. OCT images were then analyzed in the ImageJ software for VIT/RPE-relative intensity. Results: A total of 19 PVR eyes, 12 intermediate-posterior uveitis eyes, 16 panuveitis eyes, and 28 normal healthy eyes were recruited for this study. The VIT/RPE-Relative Intensity was significantly higher in PVR eyes (0.415±0.178) than in intermediate-posterior uveitis (0.236±0.043, p=0.002) and panuveitis eyes (0.30±0.07, p=0.023). Compared to the normal eyes, PVR and both uveitis groups have significantly higher VIT/RPE relative intensity (p = <0.001 in each group). Conclusions: VIT/RPE-relative intensity may offer quantitative measurements of vitreous inflammation in the role of the pathogenesis of PVR. Comparison with cellular inflammation in the vitreous is required to validate this finding.

Ligand-independent activation of platelet-derived growth factor receptor β promotes vitreous-induced contraction of retinal pigment epithelial cells

BackgroundEpiretinal membranes in patients with proliferative vitreoretinopathy (PVR) consist of extracellular matrix and a number of cell types including retinal pigment epithelial (RPE) cells and fibroblasts, whose contraction causes retinal detachment. In RPE cells depletion of platelet-derived growth factor (PDGF) receptor (PDGFR)β suppresses vitreous-induced Akt activation, whereas in fibroblasts Akt activation through indirect activation of PDGFRα by growth factors outside the PDGF family (non-PDGFs) plays an essential role in experimental PVR. Whether non-PDGFs in the vitreous, however, were also able to activate PDGFRβ in RPE cells remained elusive.MethodsThe CRISPR/Cas9 technology was utilized to edit a genomic PDGFRB locus in RPE cells derived from an epiretinal membrane (RPEM) from a patient with PVR, and a retroviral vector was used to express a truncated PDGFRβ short of a PDGF-binding domain in the RPEM cells lacking PDGFRβ. Western blot was employed to analyze expression of PDGFRβ and α-smooth muscle actin, and signaling events (p-PDGFRβ and p-Akt). Cellular assays (proliferation, migration and contraction) were also applied in this study.ResultsExpression of a truncated PDGFRβ lacking a PDGF-binding domain in the RPEM cells whose PDGFRB gene has been silent using the CRISPR/Cas9 technology restores vitreous-induced Akt activation as well as cell proliferation, epithelial-mesenchymal transition, migration and contraction. In addition, we show that scavenging reactive oxygen species (ROS) with N-acetyl-cysteine and inhibiting Src family kinases (SFKs) with their specific inhibitor SU6656 blunt the vitreous-induced activation of the truncated PDGFRβ and Akt as well as the cellular events related to the PVR pathogenesis. These discoveries suggest that in RPE cells PDGFRβ can be activated indirectly by non-PDGFs in the vitreous via an intracellular pathway of ROS/SFKs to facilitate the development of PVR, thereby providing novel opportunities for PVR therapeutics.ConclusionThe data shown here will improve our understanding of the mechanism by which PDGFRβ can be activated by non-PDGFs in the vitreous via an intracellular route of ROS/SFKs and provide a conceptual foundation for preventing PVR by inhibiting PDGFRβ transactivation (ligand-independent activation).

Comparison of vitreous/retinal pigment epithelium relative intensity in proliferative vitreoretinopathy and uveitis

Background: Quantitative measurements of vitreous inflammation using vitreous/retinal pigment epithelium-relative intensity (VIT/RPE-Relative Intensity) have been described recently. In proliferative vitreoretinopathy (PVR), inflammation plays a central role in the pathogenesis, inducing retinal fibrosis and contraction. However, no attempts have yet to be made to analyze the severity of inflammation in PVR progression. Methods: A cross-sectional study was conducted by reviewing OCT image sets obtained from patients divided into four groups: (1) proliferative vitreoretinopathy, (2) intermediate and posterior uveitis, (3) panuveitis, (4) normal healthy eyes in Cipto Mangunkusumo Kirana Eye Hospital between April 2021 – December 2021. OCT images were then analyzed in the ImageJ software for VIT/RPE-relative intensity. Results: A total of 19 PVR eyes, 12 intermediate-posterior uveitis eyes, 16 panuveitis eyes, and 28 normal healthy eyes were recruited for this study. The VIT/RPE-Relative Intensity was significantly higher in PVR eyes (0.415±0.178) than in intermediate-posterior uveitis (0.236±0.043, p=0.002) and panuveitis eyes (0.30±0.07, p=0.023). Compared to the normal eyes, PVR and both uveitis groups have significantly higher VIT/RPE relative intensity (p = <0.001 in each group). Conclusions: VIT/RPE-relative intensity may offer quantitative measurements of vitreous inflammation in the role of the pathogenesis of PVR. Comparison with cellular inflammation in the vitreous is required to validate this finding.

Identification and Functional Analysis of Caspase-3 as a Key Hub Gene in Autophagy-Related Pathways in Proliferative Vitreoretinopathy Through Integrated Bioinformatics Analysis

Proliferative vitreoretinopathy (PVR) is a condition where abnormal cell growth in the retina can cause vision loss. Autophagy, a process that removes damaged cellular components, may play a role in PVR. Our research used bioinformatics analysis of gene expression data from PVR patients to identify differentially expressed genes (DEGs) and investigate their potential involvement in autophagy. We found a total of 3947 DEGs in the PVR, with 1296 upregulated and 2651 downregulated. Intersection with autophagy-related genes yielded 37 differential autophagy genes, which were used to construct a protein–protein interaction (PPI) network. Network analysis identified two hub genes, CASP3 and SQSTM1, with CASP3 showing strong correlation with multiple differential autophagy genes. Further analysis using the WGCNA co-expression algorithm revealed a pivotal module of 722 genes with strong correlation to PVR, which were enriched in 516 GO biological processes, 79 GO molecular functions, and 40 GO cellular components. Additionally, GSEA functional enrichment analysis showed that 56 pathways were enriched in CASP3 upregulated and downregulated groups, with the top 4 pathways significantly enriched in both groups. Our results indicated that autophagy and CASP3 may participate in the PVR pathogenesis and could be potential therapeutic targets for the treatment of this disease.

Comparative Analysis of Single-cell and Single-nucleus RNA-sequencing in a Rabbit Model of Retinal Detachment-related Proliferative Vitreoretinopathy

Proliferative vitreoretinopathy (PVR) is the most common cause of failure of retinal reattachment surgery, and the molecular changes leading to this aberrant wound healing process are currently unknown. Our ultimate goal is to study PVR pathogenesis by employing single-cell transcriptomics to dissect cellular heterogeneity. Here we aimed to compare single-cell RNA sequencing (scRNA-seq) and single-nucleus RNA-sequencing (snRNA-seq) of retinal PVR samples in the rabbit model. Unilateral induction of PVR lesions in rabbit eyes with contralateral eyes serving as controls. Proliferative vitreoretinopathy was induced unilaterally in Dutch Belted rabbits. At different timepoints after PVR induction, retinas were dissociated into either cells or nuclei suspension and processed for scRNA-seq or snRNA-seq. Single cell and nuclei transcriptomic profiles of retinas after PVR induction. Single-cell RNA sequencing and snRNA-seq were conducted on retinas at 4 hours and 14 days after disease induction. Although the capture rate of unique molecular identifiers and genes were greater in scRNA-seq samples, overall gene expression profiles of individual cell types were highly correlated between scRNA-seq and snRNA-seq. A major disparity between the 2 sequencing modalities was the cell type capture rate, however, with glial cell types overrepresented in scRNA-seq, and inner retinal neurons were enriched by snRNA-seq. Furthermore, fibrotic Müller glia were overrepresented in snRNA-seq samples, whereas reactive Müller glia were overrepresented in scRNA-seq samples. Trajectory analyses were similar between the 2methods, allowing for the combined analysis of the scRNA-seq and snRNA-seq data sets. These findings highlight limitations of both scRNA-seq and snRNA-seq analysis and imply that use of both techniques together can more accurately identify transcriptional networks critical for aberrant fibrogenesis in PVR than using either in isolation. Proprietary or commercial disclosure may be found after the references.

Using Advanced Bioinformatics Tools to Identify Novel Therapeutic Candidates for Proliferative Vitreoretinopathy.

Proliferative vitreoretinopathy (PVR) is the dreaded cause of failure following retinal detachment repair; however, no cures or preventative therapies exist to date. The purpose of this study was to use bioinformatics tools to identify drugs or compounds that interact with biomarkers and pathways involved in PVR pathogenesis that could be eligible for further testing for the prevention and treatment of PVR. We queried PubMed to compile a comprehensive list of genes described in PVR to date from human studies, animal models, and genomic studies found in the National Center for Biotechnology Information database. Gene enrichment analysis was performed using ToppGene on PVR-related genes against drug-gene interaction databases to construct a pharmacome and estimate the statistical significance of overrepresented compounds. Compounds with no clinical indications were filtered out from the resulting drug lists. Our query identified 34 unique genes associated with PVR. Out of 77,146 candidate drugs or compounds in the drug databases, our analysis revealed multiple drugs and compounds that have significant interactions with genes involved in PVR, including antiproliferatives, corticosteroids, cardiovascular agents, antioxidants, statins, and micronutrients. Top compounds, including curcumin, statins, and cardiovascular agents such as carvedilol and enalapril, have well-established safety profiles and potentially could be readily repurposed for PVR. Other significant compounds such as prednisone and methotrexate have shown promising results in ongoing clinical trials for PVR. This bioinformatics approach of studying drug-gene interactions can identify drugs that may affect genes and pathways implicated in PVR. Predicted bioinformatics studies require further validation by preclinical or clinical studies; however, this unbiased approach could identify potential candidates among existing drugs and compounds that could be repurposed for PVR and guide future investigations. Novel repurposable drug therapies for PVR can be found using advanced bioinformatics models.

Ligand-Independent Activation of Platelet-Derived Growth Factor Receptor β Promotes Contraction of Retinal Pigment Epithelial Cells

Background: Epiretinal membranes in patients with Proliferative Vitreoretinopathy (PVR) consist of extracellular matrix and a number of cell types including Retinal Pigment Epithelial (RPE) cells and fibroblasts, whose contraction causes retinal detachment. In RPE cells depletion of Platelet-Derived Growth Factor (PDGF) receptor (PDGFR) β suppresses vitreous-induced Akt activation, where as in fibroblasts Akt activation through indirect activation of PDGFRa by growth factors outside the PDGF family (non-PDGFs) plays an essential role in experimental PVR. Whether non-PDGFs in the vitreous, however, were also able to activate PDGFRβ in RPE cells remained elusive. Methods: We showed that expression of a truncated PDGFRβ lacking a PDGF-binding domain in the RPE cells whose PDGFRB gene had been silent using the CRISPR/Cas9 technology restored vitreous-induced Akt activation as well as cell proliferation, epithelial-mesenchymal transition, migration and contraction. Results: We found that scavenging Reactive Oxygen Species (ROS) with N-acetyl-cysteine and inhibiting Src Family Kinases (SFKs) with their specific inhibitor SU6656 blunted the vitreous-induced activation of the truncated PDGFRβ and Akt as well as the cellular events related to the PVR pathogenesis. Conclusions: These discoveries suggest that in RPE cells PDGFRβ can be activated indirectly by non-PDGFs in the vitreous via an intracellular pathway of ROS/SFKs to facilitate the development of PVR, thereby providing novel opportunities for PVR therapeutics.

DAPL1 prevents epithelial–mesenchymal transition in the retinal pigment epithelium and experimental proliferative vitreoretinopathy

Epithelial–mesenchymal transition (EMT) of the retinal pigment epithelium (RPE) is a hallmark of the pathogenesis of proliferative vitreoretinopathy (PVR) that can lead to severe vision loss. Nevertheless, the precise regulatory mechanisms underlying the pathogenesis of PVR remain largely unknown. Here, we show that the expression of death-associated protein-like 1 (DAPL1) is downregulated in PVR membranes and that DAPL1 deficiency promotes EMT in RPE cells in mice. In fact, adeno-associated virus (AAV)-mediated DAPL1 overexpression in RPE cells of Dapl1-deficient mice inhibited EMT in physiological and retinal-detachment states. In a rabbit model of PVR, ARPE-19 cells overexpressing DAPL1 showed reduced ability to induce experimental PVR, and AAV-mediated DAPL1 delivery attenuated the severity of experimental PVR. Furthermore, a mechanistic study revealed that DAPL1 promotes P21 phosphorylation and its stabilization partially through NFκB (RelA) in RPE cells, whereas the knockdown of P21 led to neutralizing effects on DAPL1-dependent EMT inhibition and enhanced the severity of experimental PVR. These results suggest that DAPL1 acts as a novel suppressor of RPE-EMT and has an important role in antagonizing the pathogenesis of experimental PVR. Hence, this finding has implications for understanding the mechanism of and potential therapeutic applications for PVR.

Applications of Human Amniotic Membrane Patching Assisted Vitrectomy in the Management of Postoperative PVR in Complex Retinal Detachments.

Human amniotic membranes (hAMs) are extraembryonic tissues currently employed in the treatment of many ocular and systemic diseases. Several reports indicate that hAMs can suppress the signaling pathway of tissue growth factor beta (TGF-β), a cytokine that plays a major role in the pathogenesis of proliferative vitreoretinopathy (PVR) through the induction of epithelial-mesenchymal transition (EMT) in exposed retinal pigmented epithelium (RPE) cells. The present study was conducted to evaluate the efficacy of a modified vitrectomy procedure (hAMP-V) involving the extensive coverage of exposed RPE with hAM patches to prevent postoperative PVR in a series of 15 cases of retinal detachment complicated by severe preoperatory PVR. The primary outcome was to assess the rate of successful retinal reattachment of a single hAMP-V procedure at 6 months from silicone oil removal. Secondary outcomes included the collection of intraoperative data concerning the quantity, size, and scope of hAM patches, and the assessment of postoperative improvements in mean LogMar BCVA at 3 and 6 months. Successful retinal reattachment was obtained in 14 out of 15 eyes (93.3%). Surgical failure due to major recurrence of PVR occurred in 1 out of 15 eyes (6.7%). Postoperative improvements in mean LogMar BCVA were statistically significant (p < 0.05, paired t-test). No intraoperative and postoperative adverse effects were reported. The study helped to refine the surgical technique while also offering cues for future improvements.

Idelalisib inhibits experimental proliferative vitroretinopathy

Proliferative vitreoretinopathy (PVR) is a fibrotic eye disease that develops after rhegmatogenous retinal detachment surgery and open-globe traumatic injury. Idelalisib is a specific inhibitor of phosphoinositide 3-kinase (PI3K) δ. While PI3Kδ is primarily expressed in leukocytes, its expression is also considerably high in retinal pigment epithelial (RPE) cells, which play a crucial part in the PVR pathogenesis. Herein we show that GeoMx Digital Spatial Profiling uncovered strong expression of fibronectin in RPE cells within epiretinal membranes from patients with PVR, and that idelalisib (10 μM) inhibited Akt activation, fibronectin expression and collagen gel contraction induced by transforming growth factor (TGF)-β2 in human RPE cells. Furthermore, we discovered that idelalisib at a vitreal concentration of 10 μM, a non-toxic dose to the retina, prevented experimental PVR induced by intravitreally injected RPE cells in rabbits assessed by experienced ophthalmologists using an indirect ophthalmoscope plus a + 30 D fundus lens, electroretinography, optical coherence tomography and histological analysis. These data suggested idelalisib could be harnessed for preventing patients from PVR.Idelalisib, a specific inhibitor of phosphoinositide 3-kinase (PI3K) δ, inhibits Akt activation, fibronectin expression and collagen gel contraction induced by transforming growth factor (TGF)-β2 in human RPE cells as well as in an animal model of proliferative vitroretinopathy. These results suggest that idelalisib may be useful for preventing proliferative vitroretinopathy in humans.

A Novel Role of IL13Rα2 in the Pathogenesis of Proliferative Vitreoretinopathy.

Proliferative vitreoretinopathy (PVR), an inflammatory and fibrotic blinding disease, is still a therapeutic challenge. Retinal pigment epithelial (RPE) cells dislodged in the vitreous play a central role in the PVR pathogenesis. To identify potential novel contributors to the pathogenesis of PVR, we investigated a profile of vitreous-induced changes in ARPE-19 cells by RNA sequencing. Bioinformatics analysis of the sequencing data showed that there were 258 genes up-regulated and 835 genes down-regulated in the ARPE-19 cells treated with human vitreous. Among these genes, there were three genes related to eye disease with more than threefold changes. In particular, quantitative PCR and western blot results showed that interleukin 13 receptor (IL13R)α2 that is over-expressed in a variety of cancers was up-regulated more than three times in the vitreous-treated ARPE-19 cells. Immunofluorescence analysis indicated that interleukin-13 receptor subunit α2 (IL13Rα2) was highly expressed in ARPE-19 cells within epiretinal membranes from patients with PVR. Importantly, blocking IL13Rα2 with its neutralizing antibody significantly inhibited vitreous-induced contraction of ARPE-19 cells, suggesting a novel role of IL13Rα2 in the PVR pathogenesis. These findings will improve our understanding of the molecular mechanisms by which PVR develops and provides potential targets for PVR therapeutics.

E-cadherin to N-cadherin switching in the TGF-β1 mediated retinal pigment epithelial to mesenchymal transition

A serious form of ocular fibrotic disease is proliferative vitreoretinopathy (PVR) that can ultimately lead to blindness. While the pathogenesis of PVR is known to be closely tied to retinal pigment epithelial (RPE) cell epithelial-mesenchymal transition (EMT) characterized by E-cadherin downregulation and N-cadherin upregulation. Herein, we developed a model of transforming growth factor-β1 (TGF-β1)-induced EMT using human RPE (hRPE) cells as a tool for exploring the mechanistic basis for E-cadherin to N-cadherin switching. This analysis revealed that the loss of E-cadherin led to the separation of β-catenin from the catenin-cadherin complex whereupon it underwent nuclear entry to activate zinc finger E-box binding homeobox 1 (ZEB1), in turn promoting N-cadherin upregulation in this biological context. E-cadherin overexpression was sufficient to inhibit this EMT process and proliferation in RPE cells, further constraining their TGF-β1-induced apoptosis.

Endoplasmic reticulum stress as a novel target to inhibit transdifferentiation of human retinal pigment epithelial cells.

The epithelial to mesenchymal transition (EMT) of retinal pigment epithelial (RPE) cells is a critical event in the pathogenesis of proliferative vitreoretinopathy and neovascular age-related macular degeneration, which are the leading causes of severe vision loss. Endoplasmic reticulum (ER) stress has been implicated in the EMT of many cell types and various ocular diseases. However, the relationship between ER stress and EMT in RPE cells remains unknown. Therefore, in the study, we explored the impact of ER stress on EMT in RPE cells. Different concentrations of tunicamycin (TM) and thapsigargin (TG) were used to induce ER stress in human RPE cells. The expression of epithelial marker, mesenchymal markers and some of genes/proteins involved in TGF-β/Smad signaling were analized by qPCR, western blot or immunostaining at the condition with or without stimulation of TGF-β2 (10 ng/mL). Boyden chamber and scratch assay were used to evaluate the migration of RPE cells, while cell viability and apoptosis of RPE cells were measured by MTT and TUNEL assay, respectively. Treatment of RPE cells with TM and TG (24 h) reduced the expression of α -SMA and FN, and increased the expression of Occludin in a dose dependent manner at protein level, which was highly associated with the expression of GRP78. Treatment with TGF-β2 significantly increased the expression of α-SMA and FN, and decreased the expression of Occludin both in protein and mRNA levels, which was significantly inhibited by a 4h pre-treatment with TM. In addition, the expression of TGF-βRII and Smad2/3, and mRNAs of TGF-βRII and Smad3 were also decreased by the TM treatment. TM-induced ER stress inhibited RPE cell migration, and high concentrations of TM and TG reduced cell viability and induced apoptosis of RPE cells. Chemical induction of ER stress inhibited EMT and migration in RPE cells, possibly by inactivation of TGF-β signaling, suggesting that regulation of ER stress in RPE cells may be a new approach to prevent the development of intraocular fibrosis.

Vitreous M2 Macrophage-Derived Microparticles Promote RPE Cell Proliferation and Migration in Traumatic Proliferative Vitreoretinopathy.

PurposeTo characterize vitreous microparticles (MPs) in patients with traumatic proliferative vitreoretinopathy (PVR) and investigate their role in PVR pathogenesis.MethodsVitreous MPs were characterized in patients with traumatic PVR, patients with rhegmatogenous retinal detachment (RRD) complicated with PVR, and control subjects by flow cytometry. The presence of M2 macrophages in epiretinal membranes was measured by immunostaining. Vitreous cytokines were quantified by ELISA assay. For in vitro studies, MPs isolated from THP-1 cell differentiated M1 and M2 macrophages, termed M1-MPs and M2-MPs, were used. The effects and mechanisms of M1-MPs and M2-MPs on RPE cell proliferation, migration, and epithelial to mesenchymal transition were analyzed.ResultsVitreous MPs derived from photoreceptors, microglia, and macrophages were significantly increased in patients with traumatic PVR in comparison with control and patients with RRD (PVR), whereas no significance was identified between the two control groups. M2 macrophages were present in epiretinal membranes, and their signature cytokines were markedly elevated in the vitreous of patients with traumatic PVR. Moreover, MPs from M2 macrophages were increased in the vitreous of patients with traumatic PVR. In vitro analyses showed that M2-MPs promoted the proliferation and migration of RPE cells via activation of the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT)/mammalian target of rapamycin (mTOR) signaling pathway. However, M2-MPs did not induce the expression of fibrotic proteins, including fibronectin, α-smooth muscle actin, and N-cadherin in RPE cells.ConclusionsThis study demonstrated increased MP shedding in the vitreous of patients with traumatic PVR; specifically, MPs derived from M2 polarized macrophages may contribute to PVR progression by stimulating RPE cell proliferation and migration.

Triamcinolone acetonide modulates TGF‑β2‑induced angiogenic and tissue‑remodeling effects in cultured human retinal pigment epithelial cells

Transforming growth factor-β2 (TGF-β2) has been implicated in the pathogenesis of proliferative vitreoretinopathy (PVR) and proliferative diabetic retinopathy (PDR), due to its ability to stimulate the overproduction of pro-angiogenic factors, such as vascular endothelial growth factor (VEGF), and remodeling of the extracellular matrix (ECM). Although intravitreal triamcinolone acetonide (TA) is clinically useful in the treatment of PVR and PDR, its molecular mechanism has yet to be fully elucidated. The present study investigated whether TA treatment altered TGF-β2-driven biological effects on the behavior of cultured human retinal pigment epithelial (RPE) cells, in order to determine which signaling pathway may be essential for the pharmacological action of TA. The R-50 human RPE cell line was treated with TA in the presence of TGF-β2, followed by analyses of cell viability and contraction using cell viability and collagen gel contraction assays. VEGF mRNA expression and protein production were measured using reverse transcription-quantitative PCR and ELISA, respectively. The phosphorylation status of signaling mediators and the protein expression of type I collagen (COL1A1), α-smooth muscle actin (α-SMA), and ECM-remodeling enzymes, including MMP-2 and MMP-9, were analyzed using western blotting. The gelatinolytic activity of MMPs was detected using gelatin zymography. TA treatment exhibited no prominent cytotoxicity but markedly antagonized TGF-β2-induced cytostatic effects on RPE cell viability and TGF-β2-enhanced contractility in collagen gels. In the context of TGF-β2-related signaling, TA significantly attenuated TGF-β2-elicited Smad2, extracellular-regulated kinase (ERK)1/2 and p38 mitogen-activated protein kinase (MAPK) phosphorylation. Moreover, TA markedly mitigated TGF-β2-induced VEGF upregulation through ablation of p38 signaling activity. TA also partially attenuated TGF-β2-elicted expression of COL1A1, α-SMA, MMP-2, and MMP-9, but only suppressed TGF-β2-induced MMP-9 gelatinolytic activity. Mechanistically, the MEK/ERK signaling pathway may have a critical role in the TGF-β2-induced upregulation of COL1A1, α-SMA and MMP-9. In conclusion, TA may be considered a useful therapeutic agent for treating TGF-β2-associated intraocular angiogenesis and tissue remodeling, the underlying mechanism of which may involve the ERK and p38 MAPK signaling pathways.

Chalcomoracin prevents vitreous-induced activation of AKT and migration of retinal pigment epithelial cells.

Retinal pigment epithelial (RPE) cells are the major cell type in the epi‐ or sub‐retinal membranes in the pathogenesis of proliferative vitreoretinopathy (PVR), which is a blinding fibrotic eye disease and still short of effective medicine. The purpose of this study is to demonstrate whether Chalocomoracin (CMR), a novel purified compound from fungus‐infected mulberry leaves, is able to inhibit vitreous‐induced signalling events and cellular responses intrinsic to PVR. Our studies have revealed that the CMR IC50 for ARPE‐19 cells is 35.5 μmol/L at 72 hours, and that 5 μmol/L CMR inhibits vitreous‐induced Akt activation and p53 suppression; in addition, we have discovered that this chemical effectively blocks vitreous‐stimulated proliferation, migration and contraction of ARPE‐19 cells, suggesting that CMR is a promising PVR prophylactic.

METTL3 attenuates proliferative vitreoretinopathy and epithelial-mesenchymal transition of retinal pigment epithelial cells via wnt/β-catenin pathway.

Proliferative vitreoretinopathy (PVR) is a refractory vitreoretinal fibrosis disease, and epithelial‐mesenchymal transition (EMT) of retinal pigment epithelial (RPE) cells is the key pathological mechanism of PVR. However, few studies focused on the role of METTL3, the dominating methyltransferase for m6A RNA modification in PVR pathogenesis. Immunofluorescence staining and qRT‐PCR were used to determine the expression of METTL3 in human tissues. Lentiviral transfection was used to stably overexpress and knockdown METTL3 in ARPE‐19 cells. MTT assay was employed to study the effects of METTL3 on cell proliferation. The impact of METTL3 on the EMT of ARPE‐19 cells was assessed by migratory assay, morphological observation and expression of EMT markers. Intravitreal injection of cells overexpressing METTL3 was used to assess the impact of METTL3 on the establishment of the PVR model. We found that METTL3 expression was less in human PVR membranes than in the normal RPE layers. In ARPE‐19 cells, total m6A abundance and the METTL3 expression were down‐regulated after EMT. Additionally, METTL3 overexpression inhibited cell proliferation through inducing cell cycle arrest at G0/G1 phase. Furthermore, METTL3 overexpression weakened the capacity of TGFβ1 to trigger EMT by regulating wnt/β ‐catenin pathway. Oppositely, knockdown of METTL3 facilitated proliferation and EMT of ARPE‐19 cells. In vivo, intravitreal injection of METTL3‐overexpressing cells delayed the development of PVR compared with injection of control cells. In summary, this study suggested that METTL3 is involved in the PVR process, and METTL3 overexpression inhibits the EMT of ARPE‐19 cells in vitro and suppresses the PVR process in vivo.