Microglial Galectin3 enhances endothelial metabolism and promotes pathological angiogenesis via Notch inhibition by competitively binding to Jag1.

Microglia were considered as immune cells in inflammation until their angiogenic role was widely understood. Although the pro-inflammatory role of microglia in retinal angiogenesis has been explored, little is known about its role in pro-angiogenesis and the microglia-endothelia interaction. Here, we report that galectin-3 (Gal3) released by activated microglia functions as a communicator between microglia and endothelia and competitively binds to Jag1, thus inhibiting the Notch signaling pathway and enhancing endothelial angiogenic metabolism to promote angiogenesis. These results suggest that Gal3 may be a novel and effective target in the treatment of retinal angiogenesis.

Associations between psycho-behavioral risk factors and diabetic retinopathy: NHANES (2005-2018).

Introduction: Diabetes mellitus (DM) and diabetic retinopathy (DR) increase the global burden. Since their pathogenesis is complex, it is necessary to use the biopsychosocial model to discover the most effective strategies. The study is aimed to investigate the psycho-behavioral factors of DR and confirm the discrepancies from previous studies. Research design and methods: The study comprised seven cycles of cross-sectional data of the National Health and Nutrition Examination Survey (NHANES) from 2005-2006 to 2017-2018. Samples of DM were selected from this complex multi-stage probability sample and divided into the non-DR and DR groups, where 4,426 samples represented 18,990,825 individuals after weighting. This study comprehensively explored the biological, social, and psychological risk factors of DR, among which the biological factors included blood pressure, blood routine, HbA1c%, blood glucose, the duration of DM, family history, comorbidities, and treatment methods. Social aspects include gender, education, income, insurance, smoking, drinking, sleep habits, and recreational activities. The Patient Health Questionnaire-9 (PHQ-9) was used to assess the psychological state. Taylor series regression was used to examine the connection between factors and DR. Results: Men accounted for 55.5% of the DR group (P = 0.0174). Lymphocyte count, insulin treatment, heart failure, stroke, liver condition, and renal failure showed significant differences in DR (P < 0.05). The incidence of depression in DR was 40.5%. Mild to moderate depression [odds ratio was associated with DR [(OR) = 1.37, 95% confidence interval (CI): 1.06-1.79], but there was no statistical difference in severe depression (OR = 1.34, 95% CI: 0.83-2.17). Although ≤ 6 h of sleep was associated with DR (OR = 1.38, 95% CI: 1.01-1.88), we found no statistical differences in alcohol consumption, recreational activities, or sedentary time between the two groups in our current study (P > 0.05). Conclusions: The biological risk factors of DR are significant. It showed that stroke is associated with DR, and retinal exams have the potential value as a screening tool for the brain. Besides, psycho-behavioral risk factors of DR should also be paid attention. Our study highlights that mild and moderate depression and ≤6 h of sleep are distinguishably associated with DM complicated with DR. It indicates that psycho-behavioral risk factors confer a vital influence on diabetic health care and DR.

Effects of bevacizumab on the neovascular membrane of proliferative diabetic retinopathy: reduction of endothelial cells and expressions of VEGF and HIF-1α.

PURPOSE: Anti-vascular endothelial growth factor (VEGF) agents have recently been used intravitreally during the perioperative period for proliferative diabetic retinopathy (PDR). However, the mechanism of theraputic effects of the agents remains unclear. This study aimed to investigate the effects of intravitreal bevacizumab (IVB) on retinal vascular endothelial cells and expressions of VEGF and hypoxia inducible factor-1α (HIF-1α) in PDR. METHODS: Twenty-four patients with PDR were enrolled and randomized to two groups. Twelve eyes of 12 patients of each group received either an intravitreal injection of 1.25 mg bevacizumab or a sham injection 6 days before vitrectomy. Neovascular membranes (NVMs) were collected during pars plana vitrectomy. The numbers of vascular endothelial cells in the NVMs were counted after staining with hematoxylin and eosin and von Willebrand. The expressions of VEGF and HIF-1α in the NVMs were detected through immunohistochemistry. Ten epiretinal membrane specimens from patients with proliferative vitreoretinopathy (PVR) without IVB treatment were set as an additional control. RESULTS: The number of vascular endothelial cells in NVMs of the IVB pretreated group was significantly lower than that of the sham group (21.5±3.94 versus 41.33±7.44, p=0.003). The IVB pretreated group also showed significantly lower levels of VEGF and HIF-1α in NVMs than those of the sham group (P(HIF-1α)=0.02, P(VEGF)<0.001). A stepwise regression analysis showed that IVB was a significant negative predictor for the numbers of vascular endothelial cells (ß=-0.89, p<0.001) and the expressions of VEGF (ß=-0.85, p<0.001) and HIF-1α (ß=-0.64, p=0.001) in PDR patients. Epiretinal membranes of the PVR group showed negative staining of VEGF and HIF-1α. CONCLUSIONS: Pretreatment with IVB in patients with PDR significantly decreased vascular endothelial cells and expressions of VEGF and HIF-1α, which further supports preoperative use of IVB in such patients.

Modulation of migration and Ca2+ signaling in retinal pigment epithelium cells by recombinant human CTGF.

PURPOSE: The migration of retinal pigment epithelium (RPE) cells is an initial step in the development of proliferative vitreoretinopathy (PVR). We investigated the expression of connective tissue growth factor (CTGF) in an in vitro model of wound healing and effects of recombinant human CTGF (rhCTGF) on modulating migration and Ca(2+) signaling in RPE cells. METHODS: Cultured human RPE monolayers were used to establish a wound-healing model. Western blot and in situ hybridization were used to detect the CTGF expression in RPE cells. Migration of RPE cells was measured under the stimulation of rhCTGF alone or in combination with dexamethasone (DEX) or 8-Br-cAMP. To determine the concentration of cytoplasmic-free Ca(2+) ([Ca(2+)]i) responding to CTGF, the fluo-3/AM-loaded RPE cells were observed with a laser scanning confocal microscope. RESULTS: The CTGF expression first increased after being wounded in RPE cells, then reached a peak and maintained at a high level. The positive expression was mainly at the edge of scrape and in motile RPE cells. rhCTGF-stimulated RPE cells migrated in a dose-dependent manner, and both DEX and 8-Br-cAMP could significantly inhibit the CTGF-induced migrations. CTGF induced a (Ca(2+))i elevation in RPE cells in a concentration-dependent manner. Moreover, stimulation of RPE cells with CTGF and DEX or 8-Br-cAMP counteracted the elevation of (Ca(2+))i induced by CTGF. CONCLUSIONS: The CTGF expression could be induced by an in vitro model of scrape wounding. rhCTGF stimulated the migration and Ca(2+) signal pathway in RPE cells in a dose-dependent manner, and DEX and 8-Br-cAMP suppressed this effect. Our results indicate that CTGF is involved in the wound-healing process and plays an important role in the pathogenesis of intraocular proliferative diseases.

Mechanical force enhances MMP-2 activation via p38 signaling pathway in human retinal pigment epithelial cells.

BACKGROUND: Rhegmatogenous retinal detachment and proliferative vitreoretinopathy (PVR) are eye diseases that are characterized by mechanical stress involving stretching of the retinal pigment epithelial (RPE) cells by the vitreous or the hyperplastic membranes. Here, we assessed whether mechanical force could change the expression of matrix metalloproteinases (MMPs) in RPE cells via the mitogen-activated protein kinase (MAPK) pathway. METHODS: Collagen-coated magnetite beads and magnetic fields were used to apply tensile forces to cultured RPE cells at focal adhesions. Activation of the MAPK, including extracellular signal-regulated protein kinase (ERK), c-jun N-terminal kinase (JNK), and p38 were determined over a time course from 5 to 30 min by Western-blot analysis. Activation of p38 was also tested using immunofluorescence staining. The mRNA levels of MMP-2, MMP-9, tissue inhibitor of MMP (TIMP)-2 and fibronectin (FN) were analyzed by RT-PCR. Active MMP-2 and MMP-9 were demonstrated by zymography. MMP-2 secretion was evaluated by enzyme immunoassay. RESULTS: Stimulation of RPE cells with mechanical stress did not change the total protein expression of the MAPK proteins ERK, JNK, and p38. However, of the three kinases, only active p38 showed an increased protein expression which was also shown by a 2.8-fold increase in immunofluorescence staining at 5 min following mechanical stress stimulation. This increase in active p38 expression was blocked by treating the cells with the p38 inhibitor SB203580. FN mRNA increased 2.4-fold at 15 min and MMP-2 mRNA increased 2.1-fold at 4 h. MMP-2 secretion increased 1.5-fold at 4 h and 1.9-fold at 12 h. The expression of MMP-2 and FN, and the activation and secretion of MMP-2, were inhibited in the presence of SB203580. The mRNA expression of MMP-9 and TIMP-2 did not change throughout. CONCLUSIONS: This study shows that mechanical stress upregulates MMP-2 and FN expression through activation of the p38 pathway. The increase in MMP-2 levels evoked by mechanical force may contribute to the remodeling of the extracellular matrix around RPE cells, weakening the interlinkage and membrane attachment between RPE cells, and facilitate cellular migration.

[Clinical characteristics of occult scleral rupture].

OBJECTIVE: To evaluate the clinical characteristics and therapeutic efficacy of occult scleral rupture. METHODS: It was a retrospective case series. Clinical data of 28 patients (28 eyes) with occult scleral rupture in recent 10 years was reviewed. All patients were performed with I-stage debridement and suturing surgery when the scleral ruptures were confirmed by operation search, and fourteen eyes of them were performed II-stage vitrectomy in following up periods. RESULTS: In 28 cases with occult scleral rupture, the major clinical signs included bulbar conjunctival edema and subconjunctival hemorrhage (100%), vitreous hemorrhage (89.3%), hyphema (78.6%), ocular hypotension (75.0%), limitation of ocular movement (75.0%), reduction of visual acuity to light perception or less than light perception (67.9%), impairment or dislocation of the lens (39.3%), pupilla distortion or dilatation (35.7%), choroidal hemorrhage or detachment (35.7%) and retinal detachment (32.1%). In 23 patients their eyes were scanned by A/B-ultrasonography, the image of eyeball wall were found to be interrupted or disorder in 5 eyes and the ocular axis was shorten in 4 eyes. X-ray computed tomography (CT) were performed in 10 patients before operation. It was found interruption or unsharpness of ocular ring in 3 eyes, the unevenness of ocular density in 2 eyes, and both signs were seen in 5 eyes. Total 28 eyes, the visual acuity were improved in 18 eyes after operation, no change 9 eyes and decreased 1 eye. Visual acuity was significantly increased postoperation (X2 = 13.29, P < 0.05). The result showed that the visual acuity increased in 21.4% (6/28) of eyes with I-stage operation and 85.7% (12/14) of eyes with II-stage vitrectomy respectively. CONCLUSIONS: The major sign of diagnosis of occult scleral rupture are visual acuity with light perception or less than light perception, bulbar conjunctival edema and subconjunctival hemorrhage, hyphema, ocular hypotension and limitation of ocular movement, etc after ocular trauma. The intraocular damage such as impairment or dislocation of the lens, vitreous hemorrhage, retinal detachment etc. , is regarded as the important references in the diagnosis, treatment and prognosis. The rates of misdiagnosis can reduce if auxiliary examinations of A or B-ultrasonography and CT are applied. The prompt and appropriate surgery play an important role in the recovery of visual function.

Increased levels of soluble syndecan-1 in the subretinal fluid and the vitreous of eyes with rhegmatogenous retinal detachment.

PURPOSE: To investigate whether rhegmatogenous retinal detachment (RRD) alters intraocular soluble syndecan-1 levels. METHODS: In all, 39 samples of subretinal fluid (SRF) and 10 samples of vitreous fluid from RRD patients were collected. Using ELISA, soluble syndecan-1 levels were detected, and potential correlations between syndecan-1 levels with clinical parameters were analyzed. RESULTS: Soluble syndecan-1 in the vitreous fluid (2.577+/-0.578 ng/ml) and in the SRF (1.499+/-0.184 ng/ml) from eyes with RRD enhanced significantly compared to that of the controls (0.224+/-0.095 ng/ml) (p<0.0001 and p=0.006). An increase in the syndecan-1 concentrations in SRF samples correlated with a longer duration of retinal detachment (r=0.716, p<0.0001) and a younger age (r= -0.341, p=0.017). CONCLUSIONS: RRD was found to be associated with a significant increase of soluble syndecan-1 in the vitreous fluid and SRF. In SRF, an enhanced soluble syndecan-1 concentration correlated positively with the duration of retinal detachment and inversely with the age of patients.

Epidermal growth factor receptor in cultured human retinal pigment epithelial cells.

BACKGROUND: Migration and proliferation of retinal pigment epithelial (RPE) cells play an important role in proliferative vitreoretinopathy. Epidermal growth factor receptor (EGFR) is a cell surface receptor with intrinsic tyrosine kinase activity. The engagement of the receptor by its ligand can induce intracellular mitogenic signal transduction pathways and stimulate proliferation, migration and differentiation of cells. This experiment aimed to investigate the activation and role of EGFR signal transduction pathway in proliferation of human RPE cells. METHODS: Cultured human RPE cells of the 3rd to 6th passages were studied by colorimetric assay for cellular growth and survival (MTT assay) to test the effects of EGF (0.1, 1, 10, 50, and 100 ng/ml) and fetal bovine serum (FBS) on proliferation of human RPE cells. An in vitro wound healing model was also set up, and the number of cells that had entered the denuded area was counted. The human RPE cells were cultured for 3 days with 0.1% FBS, 10% FBS, 10 ng/ml EGF + 0.1% FBS and a combination of EGF and 10% FBS, respectively. Immunohistochemical staining and in situ hybridization were used to observe the expressions of EGFR protein and mRNA, respectively. Activation of mitogen-activated protein kinase (MAPK) was detected by immunohistochemical method with specific antiphosphorylated extracellular signal-regulated kinase (ERK)1/2 antibody. RESULTS: EGF stimulated proliferation and migration of cultured human RPE cells in a concentration-dependent manner. The maximum of the proliferation rate of RPE cells was 81.8% with EGF at a concentration of 10-100 ng/ml of EGF in serum-free Dulbecco's modified essential medium (DMEM) and 122.7% at a concentration of 1-10 ng/ml of EGF in 5% FBS DMEM (p < 0.001); there was a significant difference between serum-free DMEM groups and 5% FBS DMEM groups. The maximum of the migration rate of the cells was 438.9% at a concentration of 10-100 ng/ml of EGF in 10% FBS DMEM, 147% with 10% FBS, and only 36% with EGF in 0.1% FBS at the concentration of 10 ng/ml (p < 0.001). EGF promoted the expression of EGFR protein and mRNA in RPE cells. FBS cooperated with EGF in the stimulation of EGFR expression, and it had a stronger effect in the process than EGF alone. After 3 days of incubation with EGF, phosphorylated ERK1/2 was detectable in the nucleus of RPE cells, whereas cells presented immunostaining positive for phosphorylated ERK1/2 in the cytoplasm before stimulation, indicating that EGF could induce MAPK nuclear translocation. CONCLUSION: EGF could induce EGF-EGFR-MAPK signal transduction pathway in human RPE cells in a concentration-dependent manner in vitro, which may play a key role in the activation of human RPE cell proliferation and migration.

[Effects of magnetic field on MAPK signaling pathways of human retinal pigment epithelial cells bound with beads in vitro].

OBJECTIVE: To observe the changes of mitogen activated protein kinase (MAPK) signaling pathways of human retinal pigment epithelial cells( RPEs) bound with beads under stretch caused by the force from magnetic field in vitro. METHODS: Ferric oxide microparticles, coAted with collagen, were added to dishes containing substrate-attached RPEs. After incubation, the cell layer bound with beads was laid in a magnetic field, the cells were stretched by the magnetic force. The activation status of the extracellular signal-regulated protein kinase (ERK), c-jun N-terminal kinase (JNK), and p38 in RPEs was determined over a time course from 3 to 30 minutes with western-blot analysis. To examine the role of p38 kinase in the response to stretching, cells were grown for 30 minutes in the presence or absence of inhibitor of p38 (SB203580). The changes of the expression of active p38 kinase were observed with fluorescence staining. RESULTS: Total ERK, JNK, and p38 were detected in RPEs. Active ERK and p38 were detected but active JNK was not detected. Activation of ERK was unchanged during the time course. In contrast, p38 activation was barely detected in the normal cells, but this stress-activated protein kinase exhibited a robust activation after 5 minutes in the magnetic field. SB203580 blocked the p38 activation during stretch stimulation. The stretch stimulation also increased the fluorescence staining of active p38. CONCLUSION: A magnetic field can affect RPEs bound with beads. The effect may be partially through p38 signaling pathway.