Miyazaki Akiko, Kitaichi Nobuyoshi, Ohgami Kazuhiro, Iwata Daiju, Jin Xue-Hai, Iwabuchi Kazuya, Morohashi Taiki, Ohno Shigeaki, Onoé Kazunori
Department of Ophthalmology and Visual Sciences, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Graefes Arch Clin Exp Ophthalmol. 2008 May;246(5):747-57. doi: 10.1007/s00417-007-0730-2. Epub 2007 Dec 18.
Angiotensin II type 1 (AT1) receptor-antagonists are widely used for treatment of hypertension. Recent studies have demonstrated a protective effect of renin angiotensin system (RAS) antagonism against immune-mediated inflammatory diseases such as myocarditis, chronic allograft rejection, antiglomerular basement membrane nephritis, colitis, and arthritis. However, only a few reports have demonstrated the effect of RAS in ocular inflammatory conditions. The purpose of this study was to investigate the anti-inflammatory effect of a selective AT1 receptor antagonist, losartan, on endotoxin-induced uveitis (EIU) and compare the effect on experimental autoimmune uveoretinitis (EAU).
To induce EIU, 7-week-old Lewis rats were injected subcutaneously with 200 microg lipopolysaccharide (LPS). Losartan was administered intravenously at the same time. The aqueous humor was collected from eyes 24 h after LPS injection. The number of infiltrating cells, protein concentration, and levels of tumor necrosis factor (TNF)-alpha and monocyte chemoattractant protein-1 (MCP-1) in the aqueous humor were determined. The collected eyes were immunohistochemically stained with monoclonal antibody for activated nuclear factor (NF)-kappaB. To induce EAU, C57BL/6 mice (6-8 weeks old) were immunized with human interphotoreceptor retinoid binding protein (hIRBP)-derived peptide emulsified in complete Freund's adjuvant (CFA) and concomitantly injected with purified Bordetella pertussis toxin (PTX). Clinical severity of EAU and T cell proliferative response were analyzed.
Losartan significantly suppressed the development of EIU. Numbers of aqueous cells of control EIU rats, those from EIU rats treated with 1 or 10 mg/kg of losartan were 75.3+/-45.6 x 10(5), 27.9+/-8.1 x 10(5), or 41.3+/-30.9 x 10(5) cells/ml respectively (p<0.01 vs control). Aqueous protein, TNF-alpha, and MCP-1 levels were also significantly decreased in a manner dependent on the amount of losartan administered (p<0.01). Treatment of EIU rats with losartan suppressed activation of NF-kappaB at the iris ciliary body. Thus, the suppressive effect of losartan on ocular inflammation in EIU appeared to result from down-regulation of NF-kappaB activation and reduction of inflammatory cytokine production. On the other hand, in the EAU model, neither the clinical score nor the antigen-specific T cell proliferative response was significantly influenced by the treatment with losartan.
The present findings indicate that RAS may be involved in the acute inflammation of the eye, but not in T cell-dependent ocular autoimmunity. Antagonism of the RAS may be a potential prophylactic strategy for treatment of the human acute ocular inflammation.
血管紧张素 II 1 型(AT1)受体拮抗剂被广泛用于治疗高血压。最近的研究表明,肾素血管紧张素系统(RAS)拮抗作用对免疫介导的炎症性疾病如心肌炎、慢性移植物排斥反应、抗肾小球基底膜肾炎、结肠炎和关节炎具有保护作用。然而,仅有少数报告证明了 RAS 在眼部炎症性疾病中的作用。本研究的目的是探讨选择性 AT1 受体拮抗剂氯沙坦对内毒素诱导的葡萄膜炎(EIU)的抗炎作用,并比较其对实验性自身免疫性葡萄膜视网膜炎(EAU)的作用。
为诱导 EIU,给 7 周龄的 Lewis 大鼠皮下注射 200 μg 脂多糖(LPS)。同时静脉注射氯沙坦。LPS 注射后 24 小时从眼中收集房水。测定房水中浸润细胞数量、蛋白质浓度以及肿瘤坏死因子(TNF)-α和单核细胞趋化蛋白-1(MCP-1)的水平。收集的眼睛用活化核因子(NF)-κB 单克隆抗体进行免疫组织化学染色。为诱导 EAU,用乳化于完全弗氏佐剂(CFA)中的人光感受器间维生素 A 结合蛋白(hIRBP)衍生肽免疫 6 - 8 周龄的 C57BL/6 小鼠,并同时注射纯化的百日咳博德特氏菌毒素(PTX)。分析 EAU 的临床严重程度和 T 细胞增殖反应。
氯沙坦显著抑制 EIU 的发展。对照 EIU 大鼠、用 1 或 10 mg/kg 氯沙坦治疗的 EIU 大鼠房水中的细胞数量分别为 75.3±45.6×10⁵、27.9±8.1×10⁵或 41.3±30.9×10⁵个细胞/ml(与对照相比,p<0.01)。房水蛋白质、TNF-α和 MCP-1 水平也以依赖于氯沙坦给药量的方式显著降低(p<0.01)。用氯沙坦治疗 EIU 大鼠可抑制虹膜睫状体处 NF-κB 的活化。因此,氯沙坦对 EIU 眼部炎症的抑制作用似乎是由于 NF-κB 活化的下调和炎性细胞因子产生的减少。另一方面,在 EAU 模型中,氯沙坦治疗对临床评分和抗原特异性 T 细胞增殖反应均无显著影响。
目前的研究结果表明,RAS 可能参与眼部的急性炎症,但不参与 T 细胞依赖性眼部自身免疫。RAS 的拮抗作用可能是治疗人类急性眼部炎症的一种潜在预防策略。