Wallentén Karin Gjörloff, Malmsjö Malin, Andréasson Sten, Wackenfors Angelica, Johansson Kristina, Ghosh Fredrik
Department of Ophthalmology, Lund University Hospital, 22185 Lund, Sweden.
Graefes Arch Clin Exp Ophthalmol. 2007 Dec;245(12):1815-24. doi: 10.1007/s00417-007-0646-x. Epub 2007 Jul 17.
To examine the effects of focal laser photocoagulation on general and local retinal function and to relate electrophysiological findings with changes in protein kinase C (PKC) alpha expression.
Twelve rabbits were treated with 70 spots of laser photocoagulation in the central cone-rich retina. The operated eyes were investigated with electroretinography (full-field ERG and multifocal electroretinography, mfERG) preoperatively and at 1, 3, and 5 weeks after surgery. The expression of PKC alpha was examined at all three time points using immunohistochemistry, and PKC alpha mRNA levels were quantified using real-time polymerase chain reaction (PCR). Immunohistochemistry for glial fibrillary acidic protein (GFAP) and hematoxylin and eosin staining was employed to monitor the extent and dynamics of the morphological response.
The full-field ERG revealed a significant increase in b-wave amplitudes derived from the isolated rod response (blue light) at all three time points after surgery (p < 0.05). Supernormal b-wave amplitudes were also found for the combined rod-cone response at 3 weeks (white light), and for the isolated cone response (light-adapted 30-Hz flicker) at 5 weeks after treatment. In the mfERG, amplitudes derived from the central retina did not change postoperatively, while the implicit time was significantly increased at all time points. Immunohistochemistry for PKC alpha revealed a reduced expression of the enzyme in rod bipolar cells 1 and 3 weeks after laser treatment compared with untreated controls. Five weeks postoperatively, no PKC alpha labeling in rod bipolar cells was found in any part of the retina. Real-time PCR 1 and 3 weeks after treatment displayed a decreased level of PKC alpha mRNA compared to the controls. Immunolabeled tissue sections from laser-treated eyes displayed GFAP expression in Müller cells in the treated as well as untreated retina 1 week postoperatively. At 3 and 5 weeks, GFAP labeling was less pronounced and was concentrated around the laser-treated spots.
Focal laser treatment in the rabbit eye induces local and wide-spread alterations in both rod- and cone-mediated retinal function in the form of supernormal b-wave amplitudes in the full-field ERG and increased latency in the mfERG. The electrophysiological abnormalities are accompanied by a progressive down-regulation of the PKC alpha isoenzyme in rod bipolar cells, reaching far beyond the treated area. PKC alpha is down-regulated directly by impaired protein synthesis, and also possibly indirectly by protein consumption related to GFAP up-regulation. The results indicate that focal laser photocoagulation interferes with PKC-alpha-mediated inhibitory regulation of inner retinal signal transmission.
研究局灶性激光光凝对视网膜整体及局部功能的影响,并将电生理结果与蛋白激酶C(PKC)α表达的变化相关联。
对12只兔子富含视锥细胞的中央视网膜进行70个光斑的激光光凝治疗。术前及术后1、3和5周,对手术眼进行视网膜电图检查(全视野视网膜电图和多焦视网膜电图,mfERG)。在所有三个时间点使用免疫组织化学检查PKCα的表达,并使用实时聚合酶链反应(PCR)对PKCα mRNA水平进行定量。采用胶质纤维酸性蛋白(GFAP)免疫组织化学和苏木精-伊红染色来监测形态学反应的范围和动态变化。
全视野视网膜电图显示,术后所有三个时间点,源自孤立视杆细胞反应(蓝光)的b波振幅均显著增加(p < 0.05)。在术后3周(白光)的视杆-视锥细胞联合反应以及术后5周的孤立视锥细胞反应(明适应30Hz闪烁)中也发现了超常的b波振幅。在mfERG中,中央视网膜的振幅术后未发生变化,而所有时间点的隐含时间均显著增加。PKCα免疫组织化学显示,与未治疗的对照组相比,激光治疗后1周和3周,视杆双极细胞中该酶的表达降低。术后5周,视网膜任何部位的视杆双极细胞中均未发现PKCα标记。与对照组相比,治疗后1周和3周的实时PCR显示PKCα mRNA水平降低。激光治疗眼的免疫标记组织切片显示,术后1周,在治疗及未治疗的视网膜中,Müller细胞均有GFAP表达。在3周和5周时,GFAP标记不那么明显,且集中在激光治疗光斑周围。
兔眼局灶性激光治疗可诱导视网膜视杆和视锥介导功能的局部及广泛改变,表现为全视野视网膜电图中的超常b波振幅以及mfERG中的潜伏期延长。电生理异常伴随着视杆双极细胞中PKCα同工酶的逐渐下调,其范围远远超出治疗区域。PKCα直接因蛋白质合成受损而下调,也可能间接因与GFAP上调相关的蛋白质消耗而下调。结果表明,局灶性激光光凝干扰了PKCα介导的视网膜内层信号传递的抑制性调节。